We dig into who truly makes claim decisions in self-funded plans and why that matters when ethics and compliance collide. Adam Russo shares how fiduciary prudence, transparent compensation, and NSA arbitration are reshaping risk, trust, and costs.

• plan sponsors as final decision makers on claims
• plan documents lagging laws and mandates
• compliance versus ethics as distinct obligations
• transparent compensation, performance fees, and caps
• fiduciary prudence in subrogation and settlements
• NSA and IDR process failures driving higher spend
• negotiation strategy, data, and calibrated offers
• governance, documentation, and audit-ready processes

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