Recently, Insurance Business has announced on several massive health insurance hoaxes. These pose a menace to the economic and clinical well-being of workers and place corporate officials in legal jeopardy. Under ERISA, plan sponsors are to exercise the same standard of fiduciary oversight of health plans as they do for retirement plans.
Self-insured plans fail to realize the risk they have assumed includes the risk of fraud. They may have a false sense of security assuming their administrator will fight fraud – a dangerous and costly assumption. Administrators say they are not paid to reduce fraud, particularly since the funds belong to the plan. Sponsors also assume they have no affordable tools to address it. This is another inaccurate and costly belief.
Fraud is authorized by many factors, including:
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