Self-funded employers must analyze medical claims data to provide optimal benefits. Many are frustrated with third-party administrators (TPAs) over data access, leading to lawsuits, including a notable class action against JPMorgan. Sherri Samuels-Fuerst emphasizes forming a benefits committee with key stakeholders to ensure fiduciary duty compliance and effective management. Employers should also regularly review contracts with TPAs for issues like auditing rights and fees. By actively questioning contract details, employers can better leverage their data and avoid overpaying for benefits.
"Having a cross-functional team, including your CFO, CHRO, legal team, benefit team members and your consultants, who all meet regularly to review the plan's financial metrics...is really best practice."
"While it's not very exciting, details matter, and they matter in our contracts a lot. ... Question everything that doesn't sound right."
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