Health Plan Fiduciary Services
Helping Employers Minimize Fiduciary Liability
In the complex and rapidly evolving world of U.S. healthcare, navigating the regulatory landscape can be daunting for organizations of all sizes. Aon’s Health Plan Fiduciary Services help ease the compliance burden for employers and ensure they adhere to health and welfare plan requirements.
Our comprehensive suite of solutions and services is designed to review governance and fiduciary best practices, identify gaps, and assist employers in proactively implementing procedures to mitigate risks. Backed by the expertise of Aon’s Health Solutions team, plan sponsors are better informed on best practices and better positioned against the risks of fiduciary conduct litigation.
Why Are Health Plan Fiduciary Services Important?
The Employee Retirement Income Security Act of 1974 (ERISA) mandates that plan sponsors act as fiduciaries, managing their health plans with the highest standard of care and in the best interests of plan participants. With the introduction of new health plan price transparency laws and the availability of more publicly accessible cost information, employer-sponsored health plans are facing heightened scrutiny.
As a result, employers are increasingly at risk of legal actions, facing accusations of failing to meet their fiduciary obligations. Common claims include:
- Lacking a robust process for selecting vendor partner(s)
- Neglecting to monitor selected vendor partner(s)
- Not negotiating lower costs for the plan and its participants
- Failing to administer the health plan according to its terms due to missing or inadequate documentation
26%
One in four employers haven’t reviewed their plan governance structure in the last year.
Source: 2025 Aon Health Survey
To reduce litigation risk, plan sponsors should review their governance and vendor selection processes.
-
Plan Governance
Establish and document the governance structure and processes for health and welfare plans.
-
Vendor Selection
Manage the vendor selection process, including network and pricing evaluations, and contract reviews.
-
Documentation Review
Review and update key provisions in Summary Plan Description documents (i.e. incorporate legal developments, best practices, pharmacy rebates, etc.)
-
Plan Compliance
Regularly review the plan to ensure compliance with applicable law (ACA, HIPAA, Mental Health Parity, etc.).
How Aon Can Help
-
Fiduciary Liability Support
Aon provides employers a range of support for reviewing and improving their health plan’s governance, including, but not limited to:
- Plan Governance Advisory Services: Our team helps employers review their current governance structure, advise on future governance structure, draft committee charters, and establish clear delegations of authority for relevant stakeholders.
- Plan Document Review: We review plan documents, Summary Plan Descriptions, and other governing documents of the health plan for fiduciary best practices.
- Plan Design Compliance: Aon provides ongoing support to ensure plan design compliance, including COBRA premium development, minimum value testing, imputed income calculations, and more.
- Fiduciary Training: We train plan fiduciaries on their role, responsibilities, and best practices to provide fiduciaries with confidence in appropriate administration of the health plan.
- Employer Tools: Employers are offered self-serve tools and checklists for the services listed above.
-
Health Price Transparency Analysis
Aon’s Health Price Transparency Analysis offers plan fiduciaries new insights into healthcare pricing by distilling the massive raw data from publicly-posted machine-readable files (MRFs) into a consumable and actionable format. With this powerful new source of information, fiduciaries can demonstrate prudent service provider selection and monitoring.
- Proprietary Data Collection and Processing: Aon collects both hospital and payer MRFs and then utilizes a proprietary data cleaning and validation process to improve the accuracy of pricing information. Our team combines deep subject matter expertise with commercial data from over 50 million lives to convert this information into meaningful plan insights.
- Informed Network and Provider Decisions: Our analysis empowers organizations to utilize this data to comparatively benchmark across markets, procedures and hospitals. This allows them to make the most informed decision when selecting a network that best meets the needs of their population.
- Process Support and Documentation: We provide detailed documentation, enabling employers to demonstrate prudent consideration of service providers by utilizing all relevant data available to make spending decisions.
-
Health Plan Testing and Audits
Aon provides comprehensive support for health plan testing and audits to ensure plan sponsors meet their obligations.
- Annual Testing Support: Our team assists plan sponsors with annual mandated tests, including Medicare Part D creditable coverage testing, non-discrimination testing, and more.
- Due Diligence and Pre-Implementation Audits: We conduct due diligence audits to ensure the accuracy and integrity of employer health plans, and recommend they be performed every 2-3 years. Pre-implementation audits are also essential to proactively identify programming errors whenever changes are made to the carrier, plan benefits, or claim processing system.
- Dependent Eligibility Verification: Aon assists employers with dependent eligibility verification audits and ongoing services, allowing employers to reduce unnecessary healthcare spend, maintain plan integrity and mitigate risk.
-
Broader Compliance Support
Aon offers additional compliance services, including:
- Mental Health Parity: We perform Financial Requirements and Quantitative Treatment Limitation (QTL) testing on your medical/Rx plan design, and we review Nonquantitative Treatment Limitation (NQTL) comparative analyses for completeness and alignment with the latest regulations.
- Government Filings: Our team streamlines the filing process for a range of federal requirements, ensuring timely submission to the appropriate reporting entities. This includes Medicare Part D Retiree Drug Subsidy Attestation, Form 5500 filing, PCORI fee calculations, Prescription Drug Data Collection (RxDC) reporting and submission, and more.
- HIPAA Privacy: We offer HIPAA Privacy training, assessment, and document drafting support.
- State and Local Health Plan Compliance: Aon assists employers with Massachusetts Health Care Reform, Hawaii’s Prepaid Health Care Act, and San Francisco’s Health Care Security Ordinance analyses.
Product / Service
Fiduciary Liability Insurance
