ERISA and Your Duty to Monitor TPA’s Working on Your Health Plan

February 01, 2020
  • Your fiduciary duty begins when you hire the TPA – best hiring practices include, but are not limited to, obtaining competitive bids and ensuring the TPA has all the proper credentials.
  • Make sure the TPA you hire charges reasonable fees and provides only the services necessary to operate the plan. Verify that there are no hidden fees in the contract.
  • Make sure any TPA hired for claims handling follows the ERISA claims regulations 
  • Have you ever tried to audit your TPA to see how your Plan assets are being spent?
  • Make sure your contract with the TPA allows you access to your own plan data!
  • How can you show you care about complying with ERISA? 

    • Check the actual fees your plan is being charged

    • Always follow up on all participant complaints,

    • Read any reports, letters, and other information from the TPA, and

    • Ensure you understand the claims handling procedures.

Employee Benefits / ERISA