Employee Benefit News September 29, 2025
It’s tempting to breeze through contract execution during another busy renewal season, but pausing to truly review the contractual language could save group health plan sponsors and participants significant financial and legal headaches.
A recent case, Tiara Yachts, Inc. v. Blue Cross Blue Shield of Michigan, serves as a powerful reminder: what’s in your client’s contract matters. Seemingly harmless terms like “shared savings” may sound like smart cost-containment strategies, but in practice, they often mask hidden conflicts of interest that can drain plan assets and expose fiduciaries to risk.
At first glance, the shared-savings model appears to align employer and vendor goals. Networks or third-party administrators renegotiate provider claims and take a cut of what they “save” the plan. But...
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