Jump to content

Recommended Posts

Posted

At least once a month we receive notices of class-action settlements and an option-in form, or bankruptcy settlements for health care companies I have never even heard of. Does anyone out there respond to these? Does a TPA have the duty to pursue these settlement amounts on behalf of a client, notify the client that they exist, or what? The latest one would require that we search through hundreds of thousands of pharmacy records to see if we paid for certain drugs that are the subject of the settlement. No idea whether the settlement is pennies on the dollar. Help!

Guest 33fan
Posted

As an attorney, I advise plan clients that they should have their TPAs let them know when these kinds of notices are received, and the plan fiduciary(ies) should decide what to do. As a TPA, your responsibilities concerning these notices are governed by your contract with the plan (e.g., there may be a general provision requiring you to advise the plan of correspondence received). Unless your contract provides for you to do more, I think advising the plan of the notice is sufficient. Once you've notified the plan, the plan's attorney will probably advise the fiduciary(ies) about what action (if any) to take.

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Terms of Use