Are employers being forced to break the law by insurance carriers?! The Fiduciary Fight is ON!

Insurance carriers have long said it is their job to negotiate with doctors, hospitals, and pharmacy providers to get the best, lowest price for plan sponsors. To assist in that promise, Congress amended ERISA laws adding new price transparency requirements in 2020. This means employers should, in theory, be able to compare what they pay for medical care to publicly reported prices. But when companies have attempted to use these new rules to acquire the data, they’ve run into resistance and in some instances have been forced into court.

There are still reliable ways to provide healthcare to employees that do not necessitate working with a carrier actively engaged in a legal battle to obfuscate plan sponsors at best and force illegal activity at worst.

The key now is to ensure your benefits consultant is performing regular audits of your healthcare spend. You have heard the classic phrase "C.Y.A." - Until further notice, the employer is responsible for every dollar sent to a medical provider or administrator, whether you are self-insured or in a contract with one of the large carriers named in these lawsuits. Don’t be forced into breaking the law with a take-it-or-leave-it contract.