Achieve Compliance + Cost Savings In 2025
A new year brings fresh opportunities. For health plan fiduciaries, 2025 is the year to ensure compliance and drive meaningful cost savings.
This year, make your fiduciary duties a beacon of best practices—because nothing says “new year, new you” like protecting your plan participants and cutting unnecessary costs.
Here’s a list of 10 resolutions to help you achieve The Health Plan Compliance Advantage in 2025. Resolve to:
- Know Your Fiduciary Role Inside Out: Review and refresh your understanding of fiduciary duties. Train all committee members to ensure clarity on roles and responsibilities.
- Implement a Fiduciary Calendar: Map compliance deadlines, reviews, and updates to prevent surprises. A well-organized calendar demonstrates your diligence.
- Demand Transparency from Service Providers: Request detailed, itemized compensation disclosures from brokers, consultants, TPAs, PBMs, etc. Scrutinize fee structures for conflicts of interest and market competitiveness.
- Audit Your Agreements: Include audit rights, claims data access, and termination clauses in service provider agreements.
- Create a Participant-Focused Benefits Roadmap: Evaluate how your plan’s benefits align with participant needs. Lower copays, improve access to generic drugs, and prioritize solutions to enhance health outcomes while controlling costs.
- Double Down on Plan Monitoring: Use dashboards or management software to track plan performance, high-cost claims, and claims denials. Conduct quarterly reviews to stay proactive, not reactive.
- Empower High-Cost Claimants: Appoint an independent advocate to assist participants with high-cost claims and care options. This step builds trust and reduces litigation risk.
- Strengthen Your Documentation Game: Keep meticulous records of all fiduciary actions, decisions, and meeting minutes. Well-documented processes demonstrate diligence and protect against liability.
- Adopt Continuous Education: Schedule annual training on new regulations and emerging fiduciary trends. An informed committee is a compliant committee.
- Conduct a Mock DOL Audit: Proactively identify vulnerabilities by simulating a Department of Labor audit. Fix weaknesses before they become liabilities.
By tackling these resolutions, you’ll ensure 2025 is a year of compliance-confidence and cost-saving success.
Raise a glass—or a compliance checklist—to a year of doing the right thing for your plan, participants, and peace of mind.
Key Takeaways
- Fiduciary Excellence Drives Success: Adopting and adhering to best practices in health plan management isn’t just about avoiding penalties—it’s about delivering better outcomes for your employees while reducing unnecessary costs. Staying informed, organized, and proactive is the foundation of compliance and cost savings.
- Prioritize Participant Interests to Protect Your Plan: By focusing on the needs of plan participants and embracing transparency, education, and effective oversight, fiduciaries can strengthen trust, mitigate risks, and build a plan that benefits everyone involved. Doing the right thing isn’t just ethical—it’s good business too.
Special Announcement
A New Year, A New Collaboration!
“Two perspectives. One mission. Redefining how employers approach health benefits compliance and cost savings.”
We’re thrilled to announce a new collaboration with Ann Lewandowski, founder of PatientValue Insights. Together, we combine professional expertise and personal experience to guide employers through the complexities of health benefits and fiduciary duties.
Our mission? To drive compliance, reduce costs, and ensure employees receive the benefits they deserve—all while protecting organizations from costly legal risks.
To get us kicked off in 2025 we’re hosting a webinar.
Don’t Miss Our Webinar
Join us on January 15th at 11 am CT for “Why Employees Are Suing Employers Over Health Benefits.“ Hear from Ann as she provides valuable perspectives on employees’ legal challenges and the broader implications for employers navigating these complex issues.
Space is limited so register today.
