Loyalty
Act solely in the 'best interest of plan participants and beneficiaries, prioritizing their rights above all else
Prudence
Make decisions with care, skill, prudence, and diligence, ensuring expenditures reflect reasonable value
Follow Plan Document
Adhere to the plan's terms; ensure all operations and payments comply with its provisions
Protect Plan Assets & Data
Implement safeguards for payments and sensitive data; ensure privacy and security compliance
Monitor Providers
Independently monitor Networks, TPAs, PBMs, and other vendors for errors, violations, and compliance
Ensure Fee Reasonableness
Confirm that all plan fees are fair and reasonable; uncover hidden charges
Avoid Conflicts of Interest
Ensure conflict-free decision-making across all parties by engaging independent oversight
Diversified Investments
ClaimInformatics doesn’t manage investments, but fiduciaries must mitigate losses through diversification.
Why You Need Claims Data to Fulfill
Your Fiduciary Duties
Monitor vendors for payment errors,
hidden fees, and compliance failures
Identify financial leakage and waste
Enforce plan terms and contracted rates
Create a defensible audit trail
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