Which Controls – Plan Document or PPO Contract?

Free Webinar 
Negotiating PPO agreements and stop loss contracts consistent with the Summary Plan Description is a significant undertaking in today’s current marketplace.  TPA’s are typically obligated to honor the PPO agreement and reimburse providers for unreasonable charges, posing reoccurring issues of wasting valuable assets for TPA’s and their plans.
Please join us on October 28th at 1 PM EST as we discuss PPO Conflict Resolution Techniques including:
Proactive Strategies,  Implementing Authority, Defending Plan Rights, Drafting Tips
Register now at www.phiagroup.com  

 Editor’s Note: ERISA mandates that a Plan Fiduciary pay only fair and reasonable rates. A Plan Fiduciary must practice due dilligence in assessing what is fair and reasonable to protect the assests of the Plan. Since Plan Sponsors are only third party beneficiaries of PPO contracts, and have little or no knowledge as to the terms and rates agreed between the PPO network and their participating providers, is the Plan Sponsor/Fiduciary acting in a prudent business fashion as required by Federal Law? Probably not.