Self-funded employers are subject to fiduciary duty under the Department of Labor’s ERISA law. This is a critical responsibility as employers must assure that health claims are paid in a non-discriminatory fashion and that plan assets (the money in the plan) are used appropriately at all times. What if violation of this fiduciary duty occurs? Civil and criminal penalties can be issued.
To protect clients from these costly ramifications, Cypress offers the Plan Appointed Claim Evaluator (PACE) program through its long-time partner, The Phia Group. This innovative, one-of-a-kind solution assumes the fiduciary burden on behalf of self-funded employers and utilizes the firm’s legal expertise when benefit claims are denied and appeals are initiated. It offers critical guidance on complex claims decisions and legal counsel in the event of a lawsuit.
More on fiduciary duty protection through PACE:
Read Article: TPA Teams Up with Long-Time Partner to Offer Fiduciary Protection Program to Self-Funded Client