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…
Category: Litigation
Court decisions, legal challenges, and litigation developments affecting employer health plans, fiduciaries, and healthcare intermediaries.
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…
The Fiduciary Lawsuit That Could Change Everything
The Fiduciary Lawsuit That Could Change Everything No More “We’re Just Administrators” TPA Defense Executive Brief Can a TPA avoid ERISA liability by calling itself an…
Employers Say They Put People First
Employers Say They Put People First Until Someone Gets Sick When that spreadsheet-driven plan design causes delays, denials, or dropped coverage, it’s not just a bad…
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…
Boardroom Risk Alert
Boardroom Risk Alert Fiduciary Failure Leads to Personal Liability Inflation, wage pressure, rising drug costs, and tariffs on products and supplies are squeezing health plan budgets.…
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,…
Smarter Approach to PBM Management
Smarter Approach to PBM Management The PBM Landscape The Big 6 PBMs—CVS Health, Express Scripts, OptumRx, Humana Pharmacy Solutions, MedImpact, and Prime Therapeutics—control 94% of the…
Rising Risk of Pharmacy Benefits
Rising Risk of Pharmacy Benefits Board Directors Are Now Named Defendants Recent lawsuits against major corporations highlight a growing risk: PBM mismanagement is leading to overspending,…