Signed, Sealed… Sued?
Signed, Sealed… Sued? If You Didn’t Write the Contract, You’d Better Rewrite the Rules. Most health plan contracts come pre-written—by brokers, vendors, or consultants. But when…
Category: Contracts & Terms
Healthcare contract provisions, transparency, accountability, negotiating terms, and protections for employers and plan participants.
The PBM Reform Playbook
The PBM Reform Playbook State Legislatures Are Doing What Congress Hasn’t Executive Brief State legislatures are cracking down on PBM profit games—banning spread pricing, requiring rebate…
PBM Illusions, Exposed
PBMs thrive on confusion. Bold employers are demanding receipts—and revealing just how costly that confusion really is.
What Health Plans Haven’t Yet Learned from 401(k)s
What Health Plans Haven’t Yet Learned from 401(k)s Same law. Same risks. Bigger blind spots. Executive Brief The fiduciary failures we fixed in retirement plans are…
What I Learned from 25 Newsletters
What I Learned from 25 Newsletters And a Lot of Lawsuits Executive Brief Welcome to Issue #26 of The Health Plan Compliance Advantage. Most newsletters don’t…
Is Your Health Plan Killing the Corner Pharmacy?
Is Your Health Plan Killing the Corner Pharmacy? How employer decisions fuel pharmacy closures—and what you can do about it Executive Brief Independent pharmacies are disappearing—hurting…
Why Companies Stick With Bad Vendors
Why Companies Stick With Bad Vendors The Psychology of Loyalty and the Legal Risk of Doing Nothing You’ve seen the headlines: lawsuits, subpoenas, FTC crackdowns. PBMs,…
What Health Plan Lawsuits Reveal
What Health Plan Lawsuits Reveal And How to Stay Out of Them You may never find yourself in court over your company’s health plan. But that…
Compensation Disclosure
Compensation Disclosure Time for Brokers to Come Clean The world of employee benefits is changing—and so is the expectation around who works for whom. For decades,…
Making Prudent Vendor Decisions
Making Prudent Vendor Decisions A Fiduciary and Strategic Imperative Here’s the uncomfortable truth: Many of the problems plaguing employer health plans are compliance failures rooted in…