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In Episode 428 titled 'Do It Now Advice From the J&J and the DOL versus BCBS lawsuits,' host Stacey Richter discusses the implications of two major legal cases on plan sponsors with guest Julie Selesnick, an attorney specializing in fiduciary responsibilities. The episode covers essential actions for plan sponsors, brokers, and employee benefit consultants to avoid conflicts of interest and ensure fiduciary compliance.
Selesnick, a senior counsel at Berger Montague's Employee Benefits and ERISA Group, emphasizes the importance of obtaining and effectively using claims data, renegotiating administrative services agreements, and conducting independent claims reviews. The discussion also highlights practical strategies like carving out certain high-cost services and establishing a health and welfare fiduciary committee.
=== LINKS === đź”— Show Notes with all mentioned links: https://cc-lnk.com/EP428
✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe
đź«™ Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe
🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1
🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b
📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue
=== CONNECT WITH THE RHV TEAM === âś LinkedIn https://www.linkedin.com/company/relentless-health-value/ âś Threads https://www.threads.net/@relentlesshealthvalue/ âś Bluesky https://bsky.app/profile/relentleshealth.bsky.social âś X https://twitter.com/relentleshealth/
05:48 What's happening with the J&J lawsuit?
07:38 What's going on with the DOL v BCBS case?
08:49 What do these cases mean for plan sponsors?
09:21 Why is engaging with claims data critical?
12:30 EP408 with Chris Deacon.
14:20 EP379 with AJ Loiacono.
16:58 What's one solution to avoiding a conflict of interest?
18:02 Why there's still not a total understanding about what to do with claims data once acquired.
20:58 NADAC (National Average Drug Acquisition Cost) to check pharmacy prices.
21:31 What advice do plan sponsors need to know that never gets recommended to them when dealing with conflicting interests?
27:02 EP337 with Olivia Webb.
28:41 EP285 with Dawn Cornelis.
30:24 "As a fiduciary, your money should only go to pay your plan's benefits, not to other plan benefits."
30:59 What's Julie's advice to advisors?
33:17 "Giving nonconflicted advice … is something you really can only do if you have no conflicts."
35:57 What's Julie's advice for administering whole plans?
By Stacey Richter4.9
231231 ratings
In Episode 428 titled 'Do It Now Advice From the J&J and the DOL versus BCBS lawsuits,' host Stacey Richter discusses the implications of two major legal cases on plan sponsors with guest Julie Selesnick, an attorney specializing in fiduciary responsibilities. The episode covers essential actions for plan sponsors, brokers, and employee benefit consultants to avoid conflicts of interest and ensure fiduciary compliance.
Selesnick, a senior counsel at Berger Montague's Employee Benefits and ERISA Group, emphasizes the importance of obtaining and effectively using claims data, renegotiating administrative services agreements, and conducting independent claims reviews. The discussion also highlights practical strategies like carving out certain high-cost services and establishing a health and welfare fiduciary committee.
=== LINKS === đź”— Show Notes with all mentioned links: https://cc-lnk.com/EP428
✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe
đź«™ Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe
🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1
🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b
📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue
=== CONNECT WITH THE RHV TEAM === âś LinkedIn https://www.linkedin.com/company/relentless-health-value/ âś Threads https://www.threads.net/@relentlesshealthvalue/ âś Bluesky https://bsky.app/profile/relentleshealth.bsky.social âś X https://twitter.com/relentleshealth/
05:48 What's happening with the J&J lawsuit?
07:38 What's going on with the DOL v BCBS case?
08:49 What do these cases mean for plan sponsors?
09:21 Why is engaging with claims data critical?
12:30 EP408 with Chris Deacon.
14:20 EP379 with AJ Loiacono.
16:58 What's one solution to avoiding a conflict of interest?
18:02 Why there's still not a total understanding about what to do with claims data once acquired.
20:58 NADAC (National Average Drug Acquisition Cost) to check pharmacy prices.
21:31 What advice do plan sponsors need to know that never gets recommended to them when dealing with conflicting interests?
27:02 EP337 with Olivia Webb.
28:41 EP285 with Dawn Cornelis.
30:24 "As a fiduciary, your money should only go to pay your plan's benefits, not to other plan benefits."
30:59 What's Julie's advice to advisors?
33:17 "Giving nonconflicted advice … is something you really can only do if you have no conflicts."
35:57 What's Julie's advice for administering whole plans?

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