For CEOs, CFOs & Boards
If you approve, oversee, or defend an employer health plan, start here. These issues focus on fiduciary responsibility, governance, documentation, compensation, and the questions leadership should be asking before the next PBM deal is signed.
Three issues to read first.
Trust Is Not a Fiduciary Strategy
The duty stays with the plan sponsor. Trusting a broker, PBM, or adviser is not a substitute for documented oversight and evidence of prudent process.
READ THE ISSUE →13 Years as a Defendant
One recommendation led to thirteen years of litigation and a $105 million lesson in governance, documentation, committee process, and defensibility.
READ THE ISSUE →The Question You Didn’t Ask
Fiduciaries need to understand who is being paid, how much, and whether compensation is reasonable. The questions you fail to ask can become part of the record later.
READ THE ISSUE →Go deeper on leadership and fiduciary oversight.
The 2029 Myth
Why a future effective date does not justify waiting to address the contracts and fiduciary decisions being made today.
The Law Changed. The Game Hasn’t.
PBM reform changes the rules, but employers still have to understand where the money moves and how the business model adapts.
DOL Just Wrote The Safe Harbor Argument
A proactive fiduciary process begins before the problem appears, with disciplined selection and better contract terms.
Employers Say They Put People First
Fiduciary leadership ultimately comes back to the people the plan exists to serve: employees and their families.
The Middleman’s Cut Is Here
A leadership-level view of where pharmacy dollars go, why the contract matters, and why executives own the outcome.
What I Learned from 25 Newsletters
A retrospective on fiduciary responsibility, vendor oversight, documentation, and the consequences of passive compliance.
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