Plan Sponsors, Insurers Spar Over Fiduciary Data Despite Lawsuits

  • May 31, 2024

    Plan sponsor groups say that health insurers have blocked or ignored employers’ requests to obtain information relating to both parties’ role as plan fiduciaries under the Employee Retirement Income Security Act of 1974 (ERISA). That’s despite the fact that insurers are required under a recent law to provide that information to employers on request — and that plan sponsors and plan members have begun to sue insurers to gain access to it. 

    Plan sponsors have growing legal risk in their role as ERISA fiduciaries due to ongoing litigation and provisions included in the Consolidated Appropriations Act, 2021 (CAA). The lawsuits, many of which spring from requirements in the CAA, all relate to requirements that say health plans must prove they obtained the lowest prices possible for health care services and prescription drugs.  

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  • Peter Johnson

    Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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