## Your Fiduciary Responsibilities

As a self-funded plan fiduciary, you are legally bound to act solely in the best interest of plan participants -prudently, loyally, and with full accountability.

## Loyalty

Act solely in the 'best interest of plan participants and beneficiaries, prioritizing their rights above all else.

## Prudence

Make decisions with care, skill, prudence, and diligence, ensuring expenditures reflect reasonable value.

## Follow Plan Document

Adhere to the plan's terms; ensure all operations and payments comply with its provisions.

## Protect Plan Assets & Data

Implement safeguards for payments and sensitive data; ensure privacy and security compliance.

## Monitor Providers

Independently monitor Networks, TPAs, PBMs, and other vendors for errors, violations, and compliance.

## Ensure Fee Reasonableness

Confirm that all plan fees are fair and reasonable; uncover hidden charges.

## Avoid Conflicts of Interest

Ensure conflict-free decision-making across all parties by engaging independent oversight.

## Diversified Investments

ClaimInformatics doesn’t manage investments, but fiduciaries must mitigate losses through diversification.

## Why You Need Claims Data to Fulfill Your Fiduciary Duties

- Monitor vendors for payment errors, hidden fees, and compliance failures  
- Identify financial leakage and waste  
- Enforce plan terms and contracted rates  
- Create a defensible audit trail

The Consolidated Appropriations Act (CAA) and ERISA require fiduciaries to demand and use data to protect plan assets.

## The Cost of Not Demanding Your Claims Data

- Personal fiduciary liability  
- Regulatory penalties  
- Undetected overpayment add hidden costs

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