About a year ago, we wrote that the Consolidated Appropriations Act of 2021 (CAA) would soon begin holding employers accountable for upholding their fiduciary responsibility of evaluating and managing employee health benefits to optimize costs. There was talk then that the CAA would even allow employees to sue employers if they didn't effectively manage their health benefits.
That inevitable class action lawsuit was filed earlier this year, alleging that Johnson & Johnson mismanaged drug benefits for employees. The lawsuit states that no prudent fiduciary—by law, someone who manages another person's money for the customer's benefit—"would agree to make its plan and beneficiaries pay a price that is 250 times higher than the price available to any individual who just walks into a pharmacy and pays out-of-pocket."
Some experts believe that this is just the first of many lawsuits that will be the catalyst for revamping the approach to employer-sponsored benefits, and that it will ultimately have a positive effect on the healthcare industry. Change is certainly needed, as the average family premium has increased at a 14 percent clip year-over-year for the past two decades.
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