Lawmakers ask DOL about 'self-dealing' health plan service providers

The letter indicates that ERISA pressure could heat up in the health and welfare sector.

The U.S. Capitol rotunda in Washington. Credit: Diego M. Radzinschi/ALM

The same kinds of fiduciary obligation fights hitting retirement plans may now be coming to health and welfare plan administrators and other service providers.

Two House Democrats are asking U.S. Labor Department officials to focus on that issue in a letter sent to Lisa Gomez, the assistant Labor secretary in charge of the department’s Employee Benefits Security Administration.

The lawmakers asked Gomez to talk about health and welfare plan service providers’ fiduciary obligations under the Employee Retirement Income Security Act and how EBSA is enforcing plan service providers’ compliance with their ERISA fiduciary obligations.

The lawmakers also ask how EBSA plans to enforce the new benefit plan service provider compensation disclosure requirements included in the health cost transparency provisions in the Consolidated Appropriations Act, 2021 package.

Related: Consolidated Appropriations Act brings long overdue transparency: panelists

The lawmakers asked Gomez what kinds of resources Congress needs to provide so that EBSA can ensure that service providers comply with the CAA, 2021 requirements.

The lawmakers who sent the letter are Rep. Robert Scott, D-Va., the highest-ranking Democrat on the House Education and the Workforce Committee, and Rep. Mark DeSaulnier, the highest-ranking Democrat on the committee’s Health, Employment, Labor and Pensions Subcommittee.

Discussions of the CAA, 2021 disclosure requirements have often focused on agents’, brokers and consultants’ disclosure requirements, but Scott and DeSaulnier refer directly only to pharmacy benefit managers and third-party administrators, or outside companies that help run benefit plans.

Republicans now have a 220-212 majority in the House, but Rep. Nancy Pelosi, D-Calif., a former House speaker, said on PBS Tuesday that she believes Democrats have a shot at regaining a majority in the November general elections.

Lawmakers, labor groups, employees of specific companies, and other players have made ERISA fiduciary responsibility a key focus in the past year in suits against retirement plan sponsors, efforts to regulate pharmacy benefits managers and other benefits battles.