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Third Party Mangers Can Be a Fiduciary Under ERISA
Posted by: Melville Johnson, P.C.
June 04, 2008
Topic: Erisa Retirement Benefits
The Attorneys at Melville Johnson, P.C. can provide this type of representation for you regarding your ERISA claims:
U.S. District Court Judge Harold Ackerman ruled in Wayne Surgical Center v. Concentra, that the Plaintiff, Wayne Surgical Center, can pursue a claim, under ERISA that the Defendant failed to pay required reimbursement for patient treatments. The Defendant had argued that third-party administrators are not the proper defendants, since the insurance companies control the health plans and pay the reimbursements. Judge Ackerman essentially ruled that a third-party plan administrator employed by an insurance carrier can be a proper defendant in an ERISA claim.
Concentra is a company that assist insurers in setting reimbursement levels, paying the claims and negotiating with providers fees for their services. Defense attorneys argued in the ERISA action that the suggestion that Concentra acted as a fiduciary for ERISA purposes distracts attention from the real issue at hand, namely that insurance companies control the health plans and pay the reimbursements. Judge Ackerman accepted plaintiff's attorney's argument that the decision to pay providers originates from Concentra and that discretion makes them a fiduciary under ERISA. Melville Johnson, P.C. is an experienced law firm, and its attorneys handle all types of ERISA claims.
This article is largely based on a Law.com Article written by Henry Gottlieb on May 14, 2008.
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