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rocknrolls2

Can Fund Be Bound by CBA to Provide Claims Information to Contributing Employer?

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Under a multiemployer health and welfare plan, an employer and a local union enter into a collective bargaining agreement which includes a provision that permits the employer to request detailed claims information (which has been santized of HIPAA protected health information) from the fund. The fund is not a signatory to the collective bargaining agreement but later an individual who is both a local union officer and a union trustee for the fund signs in both capacities assenting to the preceding terms, including the portion of the CBA allowing the employer to request detailed claims information. Does the signature  on a letter by an individual who is both a local union officer and a union trustee for the fund in both capacities bind the fund to comply with the employer's request for detailed claims information?

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I have to first ask Why was this  included in the CBA discussions? I do not think that the signing of any agreement between 1 employer and any union can prevail over the multiemployer plan which is between a group of employers and does not include the union or the CBA. A  participating employer does not have the power to bind the Plan and the  Plan is not a party to the CBA.

In any case, it is usual and customary for participating employers to readily be provided with detailed claims information on request. I have never heard of any Plan, TPA or Insurer, refusing to readily supply this detailed claims info. The providing of detailed claims information is required under State Insurance laws and Unfair Business Practices laws.

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