PPO fiduciary responsibility.

F D Hunt

PubMed · 10149637

PPO fiduciary responsibility.

Abstract

This article will be frustrating for you. It warns you of comprehensive legal liability--but does not give you step-by-step guidance or checklists. Why? Because there are practically no examples or specifics or checklists in the Employee Retirement Income Security Act of 1974 (ERISA), especially for fiduciary duty and the new "knowing participant" fiduciary duty which applies to PPOs. Other than a relative handful of official Prohibited Transaction Exemptions (PTEs), everything is judged on a case-by-case basis. Even Department of Labor Opinion articles are merely that--opinions written with lots of caveats and not considered legal precedents. In defense of the Department of Labor, the slightest difference in circumstance can trigger a totally opposite ruling, so their hesitancy to give simple checklists is understandable. This article also takes a conservative approach. Enforcement of ERISA fiduciary duty has been sporadic. However, this article is important to you and timely. In recent years, the Department of Labor has devoted at least 50 percent of its employee review with criminal penalties of benefits cases deemed to be fraud, waste, or abuse. It is important to remember that the Department of Labor will judge your actions with 20/20 hindsight. Thus, it is important not only to have good intentions, but also to be sure that it looks like you have taken the most prudent action when all is said and done--even if the action defies common sense or normal business practices.(ABSTRACT TRUNCATED AT 250 WORDS)

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F D Hunt. PPO fiduciary responsibility.. https://pubmed.ncbi.nlm.nih.gov/10149637/

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