Indians Are Restless – “We’re Not Paying This!”

We’ve heard of shareholders’ lawsuits – it’s high time Plan members hold decision-making entities responsible through Plan member lawsuits……………….

The following is a Linkedin post in a string of comments regarding plan sponsors who fail in their fiduciary duties. Its only a matter of time before we find more lawsuits filed against plan sponsors for wanton disregard of their duties to prudently manage plan assets………………………

By Randy Gardner

I’m familiar with a $960K hospital claim, which has $165K erroneous charges. The ASO affiliated PPO network and the hospital are pushing for complete payment, but the client, a tribal group, is not paying.

They had been sold 70%+ discounts, not the whopping 20% discount they received due to contractual stop-loss provisions. To add insult to injury, the tribe also discovered that Medicare would only pay $165K.

The fiduciaries are ballistic because they feel they were duped by the company rep and their broker.

Since the Plan is contributory for all Plan members, every erroneous payment has been paid with Plan participants’ money. All employees and eligible dependents have grievances against the Plan fiduciaries, the Plan administrators, the Plan network, and the Plan brokers / consultants, for misappropriation of Plan funds. We’ve heard of shareholders’ lawsuits – it’s high time Plan members hold decision-making entities responsible through Plan member lawsuits.