Podcasts about erisa

In Episode 491, Stacey Richter interviews Elizabeth Mitchell, CEO of the Purchaser's Business Group on Health (PBGH), about the PBGH Transparency Demonstration Project. They discuss the project's aim to provide jumbo self-insured employers with transparency in healthcare costs, quality, and safety data. Collaborating with Milliman and Embold and funded by the Peterson Center on Healthcare, PBGH's project reveals no correlation between higher prices and quality in healthcare services. The episode highlights the impacts on TPAs, consultants, and clinical organizations, and underscores the importance of employers using this new transparency data for strategic advantage and compliance with the Consolidated Appropriations Act. Richter and Mitchell delve into the broader implications for creating high-value networks and fostering market competition based on quality and affordability. === LINKS ===

On this Ropes & Gray podcast, benefits consulting principal David Kirchner is joined by Sharon Remmer, an ERISA and benefits partner, and Elliot Saavedra, a senior benefits consultant, to discuss the implications of President Trump's recent Executive Order encouraging expanded access to alternative assets for retirement plans and the potential impact on plan sponsors. Our speakers discuss the evolving regulatory landscape and provide actionable guidance for plan sponsors and fiduciary committees preparing for potential changes in defined contribution plan investment options. As they discuss in the episode, emphasis should be place on the importance of prudent governance and ongoing education as the market and regulatory frameworks develop.Ropes & Gray provides a comprehensive suite of legal services for retail alternatives, including fund formation, registration and compliance, structuring of public-private investment solutions, tax planning, and ongoing regulatory and transactional support. For additional information, please visit our Alternative Retail Funds page, which includes a library of our thought leadership resources with insights on the latest market developments.

SummaryIn this episode of the Compliance Guy podcast, Sean M Weiss welcomes Don Self, a veteran in the medical billing industry, to discuss his extensive experience and insights. They explore Don's two recent books, touching on topics such as medical office management, evaluation and management services, and the importance of understanding ERISA. The conversation highlights the challenges faced by healthcare providers in documentation and billing, as well as the need for better practices in the industry. Personal anecdotes and reflections on mentorship add depth to the discussion, making it both informative and engaging.TakeawaysDon Self has over 40 years of experience in the medical billing industry.The importance of mentorship in professional growth is emphasized.Don's books are accessible and filled with practical advice.Evaluation and management services continue to challenge providers.Documentation practices have become more complex and subjective.Healthcare systems in other countries can offer valuable lessons.Local coverage determinations are crucial for understanding payment policies.ERISA provides significant protections for employees and providers.Many providers are unaware of their rights under ERISA.The conversation encourages proactive engagement with insurance carriers.

Join Traci and attorney Bryan Driscoll for this month's Policy Pulse episode covering the latest workplace regulations that demand your attention. Together they break down the DOL's new emergency pay ruling, a shocking discrimination lawsuit, California's pay transparency expansion, and Supreme Court cases that could reshape federal workplace regulation.Spoiler alert: Emergency pay just became part of your overtime calculation headache, and California is done with fake pay ranges.This episode unpacks how the Department of Labor now requires emergency and hazard pay to be included when calculating overtime rates, making your payroll significantly more complex. You'll also hear about the EEOC's lawsuit against a staffing firm that honored male-only hiring requests and why this puts all recruiters on notice. Discover how California's strengthened pay transparency law demands "good faith" ranges that include total comp, not theoretical maximums, plus why the Supreme Court's upcoming term could create wild policy swings for the NLRB and EEOC.What We Cover:– DOL's new emergency pay overtime requirement– The staffing firm's male-only hiring lawsuit– California's "good faith" pay range mandate– Why vendor compliance doesn't absolve employer liability– Supreme Court cases threatening independent agencies– The ERISA fiduciary risks HR overlooksKey Quote: "California now says you can't put in a job description what you could pay an employee. You have to put in the job posting what you will pay the employee." – Bryan DriscollConnect with Bryan Driscoll: https://www.linkedin.com/in/bryanjohndriscoll/ Connect with Traci here: https://linktr.ee/HRTraci Disclaimer: Thoughts, opinions, and statements made on this podcast are not a reflection of the thoughts, opinions, and statements of the Company by whom Traci Chernoff is actively employed.Please note that this episode may contain paid endorsements and advertisements for products or services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.

What if you could score and rank hundreds of investment funds in mere moments, based on your unique preferences?   In this episode of the Registered Investment Advisor Podcast, Seth Greene interviews Eric Smith, J.D., Chairman & CEO of Decision Technologies Corporation, who discusses their patented decision assistant technology, designed to help investment professionals score and rank mutual funds and ETFs. This powerful tool allows advisors to customize 48 performance factors, enabling them to select the best funds for their clients and providing deeper insights than traditional rating systems like Morningstar. Tune in to learn how this innovative software can transform how you evaluate investments, optimize portfolios, and strengthen client relationships.   Key Takeaways: → Why investment professionals often struggle to understand how their choices compare across the market. → How Decision Technologies' patented tool helps users score and rank investment funds objectively. → How this tool allows you to create personalized ranking systems tailored to your client's goals. → How real-time ranking allows users to monitor funds and adjust as market conditions change. → Decision Technologies provides a game-changing tool for attracting new clients and managing existing investments more effectively.   Eric S. Smith, J.D., is the Chairman, CEO, and Co-Founder of Decision Technologies Corporation (DTC), where he co-invented the company's patented decision-assistance technology. This technology powers DTC's Professional RapidReview Tool (ProRRT) for investment advisors and its Retail Investment Tracking Application (RITA) for individual investors. DTC's transformative technology enables both groups to make informed investment decisions in an increasingly complex financial landscape. Additionally, Mr. Smith serves as President of Trustee Empowerment & Protection, Inc. (TEPI), an SEC-registered investment adviser that helps retirement plan sponsors mitigate risks associated with class-action lawsuits. A licensed institutional investment consultant and attorney with over 22 years of experience in corporate and ERISA law, Eric brings a client-centric perspective to financial services, focusing on empowering individual investors and their advisors. He has spoken at various conferences on fiduciary responsibility, investment decision-making, and the flaws in the financial services marketplace. Connect With Eric: Websitse  https://decisionengines.tech/ https://prorrt.com/LinkedIn https://www.linkedin.com/in/eric-smith-82558710/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Justin, a seasoned U.S. Air Force veteran with extensive experience in Operation Iraqi Freedom and Enduring Freedom, is the Co-Founder and CEO of Catapult HQ, Inc. Catapult provides a flexible Request for Proposal (RFP) platform designed to serve multiple industries and project types, including RFPs, RFIs, RFQs, DDQs, Cybersecurity, Government, Healthcare, and more. Catapult enhances the RFx workflow for organizations worldwide, improving efficiency by over 90% and standardizing internal processes. To date, Catapult has managed over $400 billion in RFPs. Justin is also highly regarded for his technological innovations, serving on the Forbes Technology Council, the advisory board for 20+ companies, and as an Atlassian Leader in North Carolina. He was a part of a team that built the online community with over 13 million monthly viewers and has made a significant impact in the Financial Services - Retirement industry. He has developed three Target Date Solutions for significant institutions such as AllianzGI, Merrill Lynch, and Principal Financial Group's successful Target Date Analyzer. In this episode, Eric and Justin Witz discuss:Using innovation to reclaim time and focusDesigning tools that adapt to real needsBalancing efficiency with human connectionLeading with clarity and transparencyKey Takeaways:Automation and AI can transform exhausting tasks into quick, efficient systems. When technology handles repetition, people gain space to think, connect, and lead with purpose.Flexibility and usability ensure that innovation serves more people. Platforms that adjust to varied industries and workflows stay relevant and valuable over time.Even with automation, genuine service builds trust. A responsive, people-first culture turns technology into a partnership rather than a replacement.Simple, open systems foster accountability and confidence. When processes are fair and information is shared, teams make better decisions and relationships thrive.“What kills companies is the amount of time it takes to respond. So what if we could take the industry average of 39 hours and drop it to, say, 20 minutes? How much more effective can you be in handling more opportunities?” - Justin WitzConnect with Justin Witz:Website: https://catapulthq.com/ LinkedIn: https://www.linkedin.com/in/justin-witz/ Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ Important clarification from the podcast show dialogue: “If an ERISA plan exceeds 100 participants with an account balance but remains under 120 in perpetuity, then the plan would not require an audit for each subsequent year that it remains under 120 participants with a balance. Please verify current rules and check with your plan record-keeper, advisor, or CPA to ensure compliance with this requirement.”The information and content of this podcast are general in nature and are provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date, but may be subject to change.It is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design, or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 35 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "The Hidden Role of Job Skills in Winning (or Losing) Your ERISA Disability Claim."Most people think that winning a Long-Term Disability claim is all about proving you're sick or injured, with medical records, doctor's notes, or diagnostic tests. But in ERISA claims, that's only half the story. What often makes or breaks your case isn't just your health - it's your job skills. Insurance companies know that every job leaves you with transferable abilities: skills, knowledge, and experience that could, in theory, be used in another line of work. And they use that to their advantage. By arguing that you can apply your past skills to a new occupation, carriers can deny or terminate benefits even when you clearly can't return to your old job. In this episode of Winning Isn't Easy, disability law expert Nancy L. Cavey explains how your work history and skill classification can shape the outcome of your claim. You'll learn what “own occupation” really means, how insurers decide whether your work is skilled, semi-skilled, or unskilled, and how those labels can be twisted to fit their narrative. Nancy also discusses how vocational experts and work history forms are used, and sometimes misused, during the claims process, along with practical strategies to document your true job duties and protect your benefits. If your disability carrier says you can “do other work,” this episode shows you how to fight back with facts, clarity, and confidence. In disability law, understanding your skills isn't just helpful - it's essential. Winning Isn't Easy, but with the right approach, you can make your story and your skills work for you.In this episode, we'll cover the following topics:One - The Own and Any Occupation Stages and Why Skills MatterTwo - How Carriers Classify Job SkillsThree - Work History, Vocational Experts, and Fighting BackWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

In this episode of Friday Fiduciary Five, Eric Dyson talks about the differences between ERISA 3(21) investment advisor and 3(38) investment manager arrangements in retirement plans. A 3(21) advisor provides investment advice but lacks discretion, while a 3(38) investment manager has discretion over fund selection. Eric emphasizes the importance of plan committees monitoring both types of advisors and maintaining an investment policy statement. He also highlights the need for clear communication and understanding of the advisor's roles, including whether they manage QDIA selections and perform record keeper searches, and which role [3(21), 3(38), or other] they are acting under.Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information contained herein is general in nature and is provided solely for educational and informational purposes.It is not intended to provide a specific recommendation of any type of product or service discussed in this presentation or to provide any warranties, financial advice, or legal advice.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan specific circumstances.

Donovan Ryckis is the award-winning founder and CEO of Ethos Benefits, leading the charge in fiduciary-driven healthcare strategies for employers. A former Securities Advisor, he shifted from investment advising after uncovering inefficiencies in employer healthcare plans—achieving 40% savings for a client without reducing benefits. Alongside his wife and business partner, Chelsea, Donovan applies a fiduciary financial process to help organizations cut costs and improve outcomes.Brenda Kruse, CFO of Axiom Healthcare Services, brings over 26 years of financial leadership in healthcare and senior living. A licensed CPA, she excels in strategic planning, compliance, and cost management, driving both financial strength and quality care across her organization.In this episode, Eric, Donovan, and Brenda discuss:How employers can apply a fiduciary mindset to healthcare plans under ERISA.The importance of data transparency in managing plan costs and pharmacy benefit managers (PBMs).Aligning advisor compensation with employer and employee interests.Real-world examples of reducing costs while improving employee benefits.Key Takeaways:Many employers don't realize their healthcare plans carry ERISA fiduciary liability just like retirement plans. Creating a formal benefits committee ensures decisions are documented, consistent, and defensible.Data ownership and transparency are critical. Without detailed claims and pharmacy data, employers can't pinpoint where costs are being driven or negotiate effectively.Pharmacy Benefit Managers (PBMs) are often overlooked sources of cost savings. Changing PBMs can reduce plan expenses by up to 50–70% with minimal disruption to employees.Aligning broker and consultant incentives with the employer's goals prevents conflicts of interest and ensures decisions are made in the plan participants' best interests.“If we don't have data, we don't know where our costs are being spent… 60% of our costs were in pharmacy, and yet our previous broker really wasn't even trying to change our pharmacy plan at all.”— Brenda Kruse“Even disclosing fees is only since the CAA of 2021, even still today, companies are doing it very poorly… They say it's part of their entire book of business, so they can't calculate it per client—that's certainly a bad starting point.” — Donovan RyckisConnect with Donovan Ryckis & Brenda Kruse:Website: https://ethosbenefits.com/ & https://www.axmservices.com/LinkedIn: https://www.linkedin.com/in/donovanryckis/ / https://www.linkedin.com/in/brenda-kruse-1a90592b/Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ Important clarification from the podcast show dialogue: "If an ERISA plan exceeds 100 participants with an account balance but remains under 120 in perpetuity, then the plan would not require an audit for each subsequent year that it remains under 120 participants with a balance. Please verify current rules and check with your plan record-keeper, advisor, or CPA to ensure compliance with this requirement." The information and content of this podcast are general in nature and are provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date, but may be subject to change.It is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design, or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 34 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Breast Cancer and Disability - Understanding the Condition, Its Impact, and Your Claim."Most people assume that a breast cancer diagnosis automatically guarantees Long-Term Disability benefits, but in ERISA claims, it's rarely that simple. Insurance companies often downplay symptoms, ignore treatment side effects, or misclassify your job duties to deny or terminate benefits. The truth is, even early-stage breast cancer can cause lasting physical and cognitive challenges that make full-time work impossible, and your paperwork must tell that story clearly. In this episode of Winning Isn't Easy, disability law expert Nancy L. Cavey explains what it really takes to win a breast cancer Long-Term Disability claim. You'll learn how insurers evaluate cancer-related claims, what evidence they find persuasive, and how to document limitations such as fatigue, pain, cognitive changes, and immune issues so your claim stands strong. We'll also cover how your cancer stage, treatment plan, and occupation affect an insurer's decision, and share a real-world case where benefits were cut off too soon and what it took to fight back. If you or someone you love is facing breast cancer while protecting your financial future, this episode offers the knowledge, strategy, and confidence to take control of your claim. Because in disability law, telling your story the right way isn't just important - it's essential. Winning Isn't Easy, but with the right guidance, it can be done.In this episode, we'll cover the following topics:One - Breast Cancer and Its SymptomsTwo - How Breast Cancer Can Be DisablingThree - Case Example – Lessons From the Kiersman CaseWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

On this episode of Fully Invested, asset management partners, Eric Requenez and Jessica Reece, along with Josh Lichtenstein, a benefits partner and head of the ERISA fiduciary practice, discuss collective investment trusts (CITs) as a compelling strategy for raising and investing money for asset managers. Due to their potential to tap into large sums of retirement assets, we expect CITs to continue growing in importance and sophistication in the coming years, especially in light of President Trump's support for expanding 401(k) and defined contribution plan access to alternative investments. Ropes & Gray provides a comprehensive suite of legal services for retail alternatives, including fund formation, registration and compliance, structuring of public-private investment solutions, tax planning, and ongoing regulatory and transactional support. For additional information, please visit our Alternative Retail Funds page, which includes a library of our thought leadership resources with insights on the latest market developments.  

On this episode of Fully Invested, asset management partners, Eric Requenez and Jessica Reece, along with Josh Lichtenstein, a benefits partner and head of the ERISA fiduciary practice, discuss collective investment trusts (CITs) as a compelling strategy for raising and investing money for asset managers. Due to their potential to tap into large sums of retirement assets, we expect CITs to continue growing in importance and sophistication in the coming years, especially in light of President Trump's support for expanding 401(k) and defined contribution plan access to alternative investments. Ropes & Gray provides a comprehensive suite of legal services for retail alternatives, including fund formation, registration and compliance, structuring of public-private investment solutions, tax planning, and ongoing regulatory and transactional support. For additional information, please visit our Alternative Retail Funds page, which includes a library of our thought leadership resources with insights on the latest market developments.  

In this episode of Friday Fiduciary Five, Eric Dyson discusses the importance of ERISA fiduciary training for plan committee members and industry professionals. He announces the launch of a new training platform, which will offer SHRM professional development credits, CE for advisors with the fi 360 designation, and CFP certification. Eric emphasizes the need for regular, foundational fiduciary training, noting that those with the most responsibility and liability often have the least amount of training. He highlights the prevalence of ERISA training questions in litigation and encourages committee members and advisors to prioritize this education.Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information and content of this podcast is general in nature and is provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date but may be subject to changeIt is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.

In this special RxBenefits-sponsored episode of The ASHHRA Podcast, hosts Bo Brabo and Luke Carignan explore the dynamic pharmacy benefits landscape with experts Sarah Hearn and Wes Hill (Director of Compliance & Legal Operations). Amid the busiest legislative season yet—over 1,500 bills—they discuss PBM reforms, ERISA challenges, compounding alternatives for GLP-1 drugs like Ozempic, 340B pricing, and emerging lawsuits. Gain insights on transparency, cost savings, and compliance for healthcare HR pros navigating employee benefits.Key takeaways for healthcare HR leaders:Legislative Surge: 1,500+ state bills target PBMs, carriers, and more; expect increased reporting burdens but better data for informed decisions.ERISA Erosion Risks: States challenge federal uniformity—multi-state plans face conflicting laws; monitor for compliance headaches.Positive Reforms: New mandates empower plan sponsors with PBM data; leverage 340B and coupons to cut costs (e.g., Wegovy from $1,000 to $100/month).Compounding & Innovation: Affordable GLP-1 alternatives via telehealth, but ensure safety and avoid controlled substance pitfalls.Lawsuits to Watch: Oklahoma ERISA win; Arkansas PBM permit ban challenges interstate commerce—outcomes could reshape operations.Action Steps: Demand vendor transparency; align with ERISA; educate teams on benefits to prevent misuse and optimize savings.Essential listening for HR managing rising pharmacy costs and regulations. Spark curiosity—reach out to RxBenefits for guidance!From Our Sponsors...Optimize Pharmacy Benefits with RxBenefitsElevate your employee benefits while managing costs. Did you know hospital employees fill 25% more prescriptions annually than other industries? Ensure cost-effective, high-quality pharmacy plans by leveraging your hospital's own pharmacies. Discover smarter strategies with RxBenefits.Learn More here - https://rxbene.fit/3ZaurZNStreamline HR Compliance with oneBADGEhealthcareSimplify screening, credentialing, and compliance for healthcare HR. oneBADGEhealthcare from ISB Global offers a tailored solution to keep your workforce compliant and efficient. Built for healthcare leaders, it's your all-in-one compliance tool.Get Started here - https://isbglobalservices.com/onebadgeunitedstates/ashhra/ Support the show

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 33 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "From Canes to Tech: Proving Disability with Assistive Devices."Most people assume that using a cane, walker, or wheelchair automatically proves disability - but in ERISA claims, it's rarely that simple. Insurance carriers don't approve benefits just because you use an assistive device; they want to see why you need it, how it limits your daily function, and whether your medical records tell a consistent story. In this episode of Winning Isn't Easy, disability law expert Nancy L. Cavey breaks down how assistive devices (like canes, braces, wheelchairs, and electric carts) can strengthen your Long-Term Disability claim when documented correctly. We'll explore how to connect your device use to your medical conditions, what kind of documentation insurers actually find persuasive, and the common mistakes that can make even legitimate claims fall apart. What if your doctor prescribed a wheelchair, but the insurer still denies your claim? Does using a cane automatically mean you can't perform sedentary work? How can you prove that your device isn't just optional, but essential to your functioning? Nancy explains how to build the evidence trail insurers can't ignore - linking your diagnosis, limitations, and assistive device into a clear, credible narrative. If you rely on an assistive device or wonder how it affects your eligibility for Long-Term Disability benefits, this episode will give you the clarity, strategy, and confidence to make your records work for you. Because in disability law, the story your paperwork tells can make all the difference - and Winning Isn't Easy.In this episode, we'll cover the following topics:One - How Carriers View Assistive DevicesTwo - Proving Medical NecessityThree - How Specific Devices Affect Disability ClaimsWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 32 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Disability Claims: Your Questions About the Medical Side, Answered."Most people assume proving disability is as simple as saying, “I can't work.” But in ERISA claims, the medical side is where cases are often won - or lost. A diagnosis or doctor's note isn't enough. Carriers want detailed, consistent proof showing exactly how your conditions limit your ability to function. In this episode of Winning Isn't Easy, we're answering your medical questions about disability claims - and breaking down the traps insurers use to deny benefits. What happens when multiple conditions - like back pain, fatigue, and migraines - keep you from working, but insurers minimize their combined effect? How do mental health caps and exclusions for “subjective” conditions like fibromyalgia change your claim? And what are insurers really looking for in your medical records? Disability law expert Nancy L. Cavey explains how to use residual functional capacity forms to your advantage, avoid policy pitfalls, and make sure your records tell the full story. We'll also tackle listener-submitted medical questions with practical steps you can use right now. If you've worried about whether your documentation is strong enough or struggled to show how your conditions prevent you from working, this episode will give you the tools - and confidence - to protect your benefits. Winning isn't easy, but understanding the medical side puts you in control.In this episode, we'll cover the following topics:One - Multiple Disabilities and Residual Functional CapacityTwo - Policy Limitations – Mental Health, Subjective Conditions, and Benefit AmountsThree - What Insurers Look for in Your Medical Records and Functional CapacityWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 31 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Disability Law, Explained: Tackling Your Most Pressing Questions."Most people assume disability insurance and ERISA benefits will protect them when they can't work. But the reality is often far more complicated. In this episode of Winning Isn't Easy, we're tackling the tough questions claimants face with insurers, employers, and the fine print buried in benefit plans. What happens if an insurance company accuses you of “coaching” your doctor? Can a separation agreement's promise to “irrevocably release” your benefits actually stop you from making a claim? And why do insurers dismiss disabling conditions as “not severe enough” even when you can't work? These aren't hypotheticals, they're real roadblocks people face every day. Disability law expert Nancy L. Cavey explains how to respond when your credibility is challenged, avoid traps in severance agreements, and push back when your medical condition is unfairly minimized. We'll also answer listener-submitted questions, giving you practical guidance you can use right now. If you've worried about your rights after a claim denial, felt pressured to sign releases, or struggled to prove your condition is disabling, this episode will give you the tools - and confidence - to fight back. Winning isn't easy, but knowing the rules puts you in control.In this episode, we'll cover the following topics:One - Can an Insurance Company Deny Your Claim by Accusing You of Coaching Your Doctor?Two - Is a “Voluntary, Irrevocable, and Unconditional Release” of ERISA Benefits in a Separation Agreement Legally Binding?Three - Answering Listener-Submitted QuestionsWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

#ThisMorning | A #Special #ERISA #Court to #Reduce #Legal #Uncertainties | Kevin Walsh, Groom Law Group | #Tunein: broadcastretirementnetwork.com #Aging, #Finance, #Lifestyle, #Privacy, #Retirement, #Wellness

S3E10: What's Trending NOW is Reinventing Supplemental Health Benefits: How Group Captive Insurance Creates Transparency and Returns Value to Employees. On this episode host Shahid Shah is joined by Lamont Thurston, founder and CEO of BENERē, a company that is changing the way people think about supplemental coverage, one claim at a time. Lamont shares insights on how group captive insurance models are reshaping supplemental health benefits. From tackling runaway commissions to returning unused premiums as ERISA plan assets, BENERē is disrupting a $12B industry built on inefficiencies. Thurston explains why employers must act as fiduciaries, how transparency drives employee trust, and why the future of voluntary benefits may depend on scalable, low-risk captive models. A must-listen for HR leaders, CFOs, and benefits professionals navigating today's high-deductible healthcare landscape. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

In this episode of Friday Fiduciary Five, Eric Dyson talks about the differences between ERISA bonds and fiduciary liability insurance. ERISA bonds protect against fraud and theft, while fiduciary liability insurance covers fiduciary breaches. Eric emphasizes the importance of having both types of insurance, noting that ERISA bonds are required by the Department of Labor, while fiduciary liability insurance is not required, but is highly recommended. He advises that committees should ensure their policies cover past, present, and future committee members and highlights the need for clear communication between risk management and the 401(k) plan committee to determine adequate coverage.Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information contained herein is general in nature and is provided solely for educational and informational purposes.It is not intended to provide a specific recommendation of any type of product or service discussed in this presentation or to provide any warranties, financial advice, or legal advice.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan specific circumstances.

If you take health insurance as payment, payers are a big part of your practice. What happens when they mess up? How do you hold them accountable? Can you hold them accountable? My guest today says the answer is “yes”. He runs a business that spends a lot of time holding payers accountable for their clients, and he'll help us break this down.David Zetter is the founder and President of Zetter HealthCare, LLC in Mechanicsburg, PA and has over 24 years of operational and healthcare experience. David is nationally recognized for his speaking, presentations and healthcare business expertise. He is well versed in regulatory requirements, revenue cycle management, credentialing and contracting, compliance, coding and documentation. He is considered an expert on Medicare, not only by his clients, but also through consultant colleagues and healthcare attorneys across the country. David is an expert on ERISA regulations, which protect over 80% of the claims in the US, and he knows how to stop payor recoupments dead in their tracks and what is legal and illegal in many payor contracts. David's firm works with healthcare professional clients and facilities coast to coast, in all areas of practice and facility management.In this episode Carl White and David Zetter discuss:In what areas are you able to hold payors accountable?Are there laws, guidance or regulations that support you in holding payors accountable?How does it work or can you tell me how ZHC holds payors accountable and how can practices and providers do so?Want to be a guest on PracticeCare®?Have an experience with a business issue you think others will benefit from? Come on PracticeCare® and tell the world! Here's the link where you can get the process started.Connect with David Zetterhttps://zetter.com/https://www.linkedin.com/company/zetter-healthcare/https://www.facebook.com/zetterhchttps://www.instagram.com/zetterhealthcare/Connect with Carl WhiteWebsite: http://www.marketvisorygroup.comEmail:  whitec@marketvisorygroup.comFacebook:  https://www.facebook.com/marketvisorygroupYouTube: https://www.youtube.com/channel/UCD9BLCu_i2ezBj1ktUHVmigLinkedIn: http://www.linkedin.com/in/healthcaremktg

If you've seen the 401k headlines recently, you know that the 401k industry is noisy right now. It feels like new legislation comes out daily, along with a million new tools and options that 401k plan sponsors have to choose from. Plan sponsors are overwhelmed with all of the "information." They don't know what they need to be addressing or when they need to be addressing. They also don't know who should be walking them through these scenarios to help them make informed decisions for their plan and their participants. In this episode of the 401k playbook, I talk about the state of the industry (hint: noisy) as well as how we handle this type of environment for our clients.  Whether you are an advisor in the 401k space or a 401k plan sponsor, I hope the information is helpful.  If you have any questions or simply want to connect, the easiest place to find me is on LinkedIn.

Ellen Alphonso, CPA, is a Senior Manager at Boyum Barenscheer PLLP and a recognized expert in employee benefit plan audits, with extensive experience guiding plan sponsors through the complexities of employee benefit plan compliance. Licensed as a Certified Public Accountant in Minnesota, Ellen has led audits for retirement plans ranging from under $500,000 to over $5 billion in assets, offering a rare depth of insight across a wide spectrum of plan sizes and structures.Known for her collaborative approach and clear communication style, Ellen excels at translating technical audit findings into actionable strategies for fiduciaries and plan management. Her work emphasizes not only regulatory compliance but also the importance of accountability, transparency, and a participant-first mindset.Ellen leads Boyum Barenscheer's training initiatives for employee benefit plan audits, a vital component of the firm's ongoing compliance with its EBPAQC (Employee Benefit Plan Audit Quality Center) credentials. She also contributes her expertise as a member of the Minnesota Society of CPAs' Audits of Employee Benefit Plans Conference Task Force, helping shape educational programming for practitioners across the state. Beyond her professional work, Ellen serves as the board treasurer for In the Heart of the Beast Puppet and Mask Theater, supporting the organization's mission to foster creativity and community through the arts.In this episode, Eric and Ellen Alphonso discuss:Prioritizing specialized expertiseStrengthening audit scope and practicesAddressing common pitfallsLeveraging auditors as partnersKey Takeaways:Auditors with deep experience in employee benefit plan audits reduce errors and ensure compliance. Choosing specialists, especially for first-time audits, safeguards accuracy.Effective audits go beyond financials to include compliance checks, reconciliations, and verification of new employee contributions, building stronger systems.Errors often stem from overextended HR/payroll departments, manual processes, or system changes. Proactive integration and training minimize risks.Strong audit firms provide more than compliance—they communicate with service providers, share best practices, assist with onboarding, and support fraud prevention through security measures.“Absolute best practice I see in my superstar clients is they do reconciliations regularly and on an annual basis.” - Ellen AlphonsoConnect with Ellen Alphonso:Website: https://myboyum.com/leadership/ellen-alphonso/ Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ Important clarification from the podcast show dialogue: "If an ERISA plan exceeds 100 participants with an account balance but remains under 120 in perpetuity, then the plan would not require an audit for each subsequent year that it remains under 120 participants with a balance. Please verify current rules and check with your plan record-keeper, advisor, or CPA to ensure compliance with this requirement." The information and content of this podcast are general in nature and are provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date, but may be subject to change.It is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design, or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.

On this Ropes & Gray podcast, ERISA and benefits partner Sharon Remmer is joined by litigation & enforcement partners, Amy Roy and Dan Ward, to discuss President Trump's recent Executive Order that directs the U.S. Department of Labor and other federal agencies to expand access to alternative assets for 401(k) investors and what the potential ramifications could be for retirement plan sponsors and asset managers from a litigation risk perspective. We have been closely monitoring the significant increase in lawsuits targeting 401(k) and 403(b) retirement plans over the last several years, where plaintiffs have alleged fiduciary defects in the prudence of investment menu design as well as with respect to the monitoring of plan service providers and fees. Using this as a backdrop, our team examines the evolving landscape and how recent case law clarifies key points for plan sponsors to consider should they decide to offer private equity and other alternative assets in their menus. Our speakers discuss practical steps for mitigating risk when offering alternative investments, such as conducting thorough due diligence, providing clear participant disclosures, and maintaining robust documentation of investment decisions.

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 30 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Getting Long-Term Disability Benefits for Stevens-Johnson Syndrome."Most people expect Long-Term Disability insurance to step in when illness or injury prevents them from working. But for those living with the aftermath of Stevens-Johnson Syndrome (SJS), the reality is often far more difficult. Triggered by common medications, SJS is a devastating condition that can cause blistering rashes, organ damage, and lasting complications like vision loss, chronic pain, and breathing problems. Recovery may take months, but the effects can last a lifetime, making work not just difficult, but impossible. That's when disability benefits should help. Instead, insurers often downplay the severity of SJS, deny claims by insisting patients have “recovered,” or ignore complications that make steady employment unsafe. In this episode of Winning Isn't Easy, disability law expert Nancy L. Cavey explains what it takes to file - and win - a Long-Term Disability claim with SJS. You'll learn what evidence matters most, how to document your limitations, which complications are commonly overlooked, and when to bring in legal help. If you or someone you love is battling the effects of SJS and struggling with a disability claim, this episode will give you the tools and strategies to fight back. Winning isn't easy, but with the right approach, it's possible.In this episode, we'll cover the following topics:One - Understanding Stevens-Johnson Syndrome (SJS) and Its ImpactTwo - How Disability Carriers View SJS ClaimsThree - Appealing Denials and Maximizing Your ClaimWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

In this episode of Friday Fiduciary Five, Eric Dyson talks about the McDonald v LabCorp lawsuit, focusing on part three and float compensation. He recaps previous episodes on record-keeping fees and investment share classes. The court found the plan's fee monitoring process sufficient. Float income, earned on stale checks, is a plan asset under ERISA, and fiduciaries must ensure it's managed in participants' best interests. Eric advises plan fiduciaries to inquire about float income from record keepers and to review old service agreements. In the LabCorp case, the court concluded that float income was disclosed and monitored appropriately. Eric emphasizes regular benchmarks and RFPs for service providers.Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information contained herein is general in nature and is provided solely for educational and informational purposes.It is not intended to provide a specific recommendation of any type of product or service discussed in this presentation or to provide any warranties, financial advice, or legal advice.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan's specific circumstances.

Rancho Mesa's Alyssa Burley and Vice President of the Human Services Group Sam Brown talk about mitigating risk for ERISA retirement plans, which Rancho Mesa offers to clients to attract and retain talented employees, reduce turnover, and build employee trust.Show Notes: ⁠⁠⁠⁠⁠Subscribe to Rancho Mesa's Newsletter⁠⁠⁠⁠⁠Director/Host: ⁠⁠⁠⁠⁠Alyssa Burley⁠⁠⁠⁠⁠Guest: ⁠⁠⁠⁠⁠Sam Brown⁠⁠⁠⁠⁠Producer/Editor: Megan LockhartMusic: "Home" by JHS Pedals, “Breaking News Intro” by nem0production© Copyright 2025. Rancho Mesa Insurance Services, Inc. All rights reserved.

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 29 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "When Your Disability Insurance Carrier Isn't a Disability Specialist - What You Need to Know."Most people buy disability insurance trusting the name on the policy. If a major insurer sells it, surely they know how to handle disability claims - right? Not always. For many big-name carriers, disability insurance is just a sideline to their main business of life, auto, property, or investment products. That lack of focus can cost you. Without specialized staff or resources, these companies often outsource reviews to third-party administrators or “independent” doctors who never meet you. The result? A system built to protect the insurer's bottom line, not your future. In this episode of Winning Isn't Easy, disability law expert Nancy L. Cavey exposes how three carriers - Ameritas, Chubb, and Voya - handle disability claims. You'll hear how their processes differ from disability-focused insurers, the games they play to delay or deny benefits, and what you can do to protect yourself. If you have a policy from one of these companies - or any insurer where disability isn't a priority - this episode will give you the tools to fight back. Winning isn't easy, but with the right strategy, it's possible.In this episode, we'll cover the following topics:One - Ameritas: Lack of Internal Resources and the Peer Review TrapTwo - Chubb: Big-Name Insurer, Small Disability FootprintThree - Voya, ReliaStar, and the DRMS / Fullscope RMS ProblemWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 28 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Disability and Disputed Illnesses: Navigating Claims Without Full Medical Recognition."Some medical conditions cause symptoms so real and severe that they disrupt daily life, yet remain disputed or only partly recognized by mainstream medicine. For patients, it is not just a fight to be believed, it is also a fight to secure the disability benefits they need. With ERISA-governed Long-Term Disability insurance, the challenges are even greater. In this episode of Winning Isn't Easy, disability law expert Nancy L. Cavey examines one of the most difficult areas of disability claims: conditions the medical community has not fully accepted. From chronic Lyme disease, fibromyalgia, and chronic fatigue syndrome to mental health diagnoses such as dissociative identity disorder, adult ADHD, and PTSD outside of combat, Nancy explains why these claims are often denied and what you can do about it. You will learn how insurers view subjective symptoms like pain, fatigue, and cognitive fog, why strong documentation and physician support matter, and the strategies that can help prove the impact of these conditions on your ability to work. Nancy also shares a real case example that shows how persistence and preparation can turn the tide. If you are living with a condition the medical world questions but your symptoms are real, this episode will give you the tools to fight for the benefits you deserve. Winning is not easy, but with the right strategy, it is possible.In this episode, we'll cover the following topics:One - Disputed Physical ConditionsTwo - Disputed Mental ConditionsThree - Multiple Chemical Sensitivity (MCS)Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

With growing interest in alternative investments—from private equity and digital assets to ESG—defined contribution plan sponsors face both fresh opportunities and heightened scrutiny. In this episode of Williams Mullen's Benefits Companion, Brydon DeWitt is joined by Beryl Ball, Principal Financial Advisor at CAPTRUST, to explore how plan sponsors can assess these emerging asset classes, weigh participant demand, and use tools such as self-directed brokerage windows. They also examine the implications of President Trump's August 7, 2025, executive order, which directs the Department of Labor, SEC, and Treasury to revisit ERISA guidance, develop potential safe harbors, and lower litigation risks for offering alternatives in 401(k) plans.

President Trump's new executive order could reshape retirement savings. For the first time, 401(k) plans may allow real estate investing, along with other alternative assets like private equity and crypto. In this episode of Real Estate News for Investors, Kathy Fettke breaks down what the rule change means for retirement savers, why real estate has been off-limits in 401(k)s until now, and what risks and opportunities could lie ahead. We'll also cover how ERISA rules, fiduciary responsibilities, and SEC guidance play into the decision, and what investors should watch for as retirement plans evolve. If you've ever wondered whether you can use a 401(k) to invest directly in real estate, this episode explains the potential changes—and why they matter for your financial future. LINKS: JOIN RealWealth® FOR FREE https://realwealth.com/join-step-1  FOLLOW OUR PODCASTS Real Wealth Show: Real Estate Investing Podcast https://link.chtbl.com/RWS SOURCE:  https://www.whitehouse.gov/fact-sheets/2025/08/fact-sheet-president-donald-j-trump-democratizes-access-to-alternative-assets-for-401k-investors/

Today I am speaking with Dave Chase from Health Rosetta, and I'm asking Dave Chase three inferno-level burning questions—questions that, across the country, many self-insured employers are trying to find the answers to. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. Now, an important underlying point that comes across loud and clear but remains unsaid, actually, in the conversation that follows is this: There are amazing brokers and EBCs (employee benefit consultants) and benefits advisors or TPAs (third-party administrators) who put their clients first and have the receipts (ie, they have data and they're willing to share it to prove this). And then there are those with the exact same titles, often enough, who are very much the opposite of this but super charming, I'm sure. I mean, it'd be a stretch to assume that the same roles don't apply to brokers or EBCs that apply for titles like hospital administrators where there's great ones and really not great ones; but everybody often gets lumped into the same category or even the term hospitals. Each of these terms is a broad stroke and contains multitudes. And do listen to the bonus clip from two weeks ago with Jonathan Baran for just more on this point. We dig into it for like 10 minutes or something. I also talk about this same concept in an upcoming episode with Mick Connors, MD. So, keep that underlying and unsaid theme in mind because a lot of these questions do boil down to, How do you figure out who's on the up-and-up and who's not? And if you need an example of the latter category, listen to the show with Ann Lewandowski (EP476) about the whistleblower lawsuit or the show with AJ Loiacono (EP379) about the myriad of brokers taking $7 or $14 per script written payable by the PBM (pharmacy benefit manager) and not reported on, as far as I know. This is very much still going on today, by the way, despite the CAA (Consolidated Appropriations Act) and the 5500 forms. Alright, so, first burning question, Question 1: After seeing J&J (Johnson & Johnson) and Wells Fargo sued for fiduciary breaches, what specific questions do I need to ask my benefits advisor to prove that my benefits advisor actually protects my interests? Okay, paraphrased, this question is employers trying to figure out what they can ask or how they can figure out if their benefits advisor or broker or employee benefit consultant is really as trustworthy as they'd like you to believe they are. There's been a whole bunch of shows that circle up on this. The thing is, though, the stakes are very, very high right now. So, yeah, I can see why this is turning into a burning question for anyone worried they might get sued personally unless they can figure out how to vet, for real in writing, who their broker, EBC, or advisor serves actually at the end of the day. Question 2 that I ask Dave Chase, and I'm not giving you the answers to these questions. You gotta listen to the show. But here's the second question I ask: How do I avoid personal liability when my TPA contract has hidden conflicts that could trigger an ERISA (Employee Retirement Income Security Act) lawsuit? Kind of a continuation of Question 1, but yeah, you can tell that self-insured employer teams are really digging in here and many, many are very aware of, first of all, the extent and depth of middle people doing things like, again, allegedly taking $20 million of employer clients' money and funding their executive bonus pool. So, yeah, definitely this is another doozy of a burning question. Also on these same topics, listen to the show with Justin Leader (EP433) and also the one with Cynthia Fisher (EP457) about spread pricing. Question 3 that I ask Dave Chase: My pharmacy costs keep climbing despite PBM guarantees. How do I tell if I am being systematically overcharged? Well, if your consultants are taking your rebates to fund their executive bonus pools, as I just mentioned there's a whole show about with Ann Lewandowski, or if they're taking $7 a script for every script that gets written for your members, which, yeah, that's afoot. I've seen the contracts and the cease and desists currently flying around our industry about that one. Or read that Osceola County lawsuit against their longtime brokers. Bottom line and end of this intro, informed employer teams are, for sure, wondering these questions. But even more than just wondering, what these questions signify to me, kind of at the macro level, they're realizing the danger of kind of sitting on that knowledge or just assuming that because everybody else is doing whatever, it's somehow safe—though status quo is getting kind of more and more dicey every single day. As some additional foreshadowing, this show finishes up with Dave Chase talking about the open-source resources that are available so that you too can create a high-performance health plan where members get higher-quality healthcare and, as Dave Chase says, the cost savings for free. There are links to many things that you can get from Health Rosetta and their sister company, Nautilus. Again, all the stuff is for free. Go to nautilushealth.org. That's their main Web site. Dave Chase, who has been on this podcast—I think this is his third time, although it has been a while—Dave Chase is co-founder and CEO of Health Rosetta. Also mentioned in this episode are Health Rosetta; Jonathan Baran; Mick Connors, MD; Ann Lewandowski; AJ Loiacono; Chris Deacon; VerSan Consulting; Justin Leader; Cynthia Fisher; Nautilus; Andreas Mang; Blackstone; Jon Camire; Claire Brockbank; Elizabeth Mitchell; Scott Haas; Paul Holmes; Chris Crawford; Luke Slindee, PharmD; Mark Cuban; Marilyn Bartlett, CPA, CGMA, CMA, CFM; Leah Binder; and Dawn Cornelis.   You can learn more at Health Rosetta and follow Dave on LinkedIn.   Dave Chase is on a mission to restore hope, health, and economic well-being to communities through healthcare transformation. As creator of the community-owned health plan (COHP) model, he is building a nationwide movement that turns health plans from drivers of wage stagnation into vessels for well-being and wealth creation. As founder of Health Rosetta, Dave has helped transform healthcare for thousands of employers covering more than five million Americans. What began with identifying just five successful health plans nationwide has grown into a movement with thousands of sustainable successes that deliver superior care at 20% to 50% lower costs. In 2024, his team launched Nautilus Health Institute, catalyzed with $4 million in Health Rosetta intellectual property and investment. Nautilus provides open-source standards, contracting templates, and technology infrastructure (including METL, an open-source healthcare data platform) that establish new market norms benefiting employers, clinicians, and communities. Dave's work in healthcare transformation has reached over 10 million people through best-selling books (The CEO's Guide to Restoring the American Dream, The Opioid Crisis Wake-up Call, Relocalizing Health), media, TED Talks, and TV/film appearances. He has received the World Health Care Congress's Lifetime Achievement Award for Health Benefits Innovation. Dave is dedicated to transforming healthcare through transparency, community ownership, and proven solutions that restore the American Dream.   06:36 What questions does a plan sponsor need to ask their consultant, EBC, or broker to ensure they are protecting the interest of the plan sponsor? 07:59 EP478 with Andreas Mang and Jon Camire. 08:49 EP453 with Claire Brockbank. 09:51 EP433 with Justin Leader. 09:53 EP436 with Elizabeth Mitchell. 11:03 How can plan sponsors avoid personal liability when their TPA has hidden conflicts of interest? 11:40 Tiara Yachts v. Blue Cross Blue Shield of Michigan lawsuit. 13:48 EP483 (Part 1) with Jonathan Baran. 14:18 EP457 with Cynthia Fisher. 16:18 The Marshall-Hickenlooper bill called the Price Tags Act. 16:50 Summer Short with Elizabeth Mitchell. 17:36 How do plan sponsors figure out if they are being overcharged for pharmacy benefits? 18:09 EP365 with Scott Haas. 20:18 EP397 with Paul Holmes. 20:22 EP465 with Chris Crawford. 20:37 EP429 with Luke Slindee, PharmD. 22:56 EP476 with Ann Lewandowski. 28:38 Where to find open-source resources to help guide plan sponsors with making better health plan decisions. 29:47 How the open-source trend is growing for health transparency. 30:48 What to look forward to at RosettaFest.   You can learn more at Health Rosetta and follow Dave on LinkedIn.   @chasedave discusses questions #plansponsors need to ask on our #healthcarepodcast. #healthcare #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Jonathan Baran (Part 2), Jonathan Baran (Part 1), Jonathan Baran (Bonus Episode), Dr Stan Schwartz (Summer Shorts), Preston Alexander, Dr Tom X Lee (Take Two: EP445), Dr Tom X Lee (Bonus Episode), Dr Benjamin Schwartz, Dr John Lee (Take Two: EP438), Kimberly Carleson, Ann Lewandowski (Summer Shorts), Andreas Mang and Jon Camire (EP479)

Earlier this month, a U.S. executive order was signed to broaden the availability of alternative asset investments for individuals with 401(k) plans. In this Sidecar episode of our Committed Capital podcast, Dechert partners Bill Bielefeld and Steve Rabitz dive into the challenges fiduciaries face under ERISA and the regulatory shifts poised to redefine retirement investment strategies moving forward. From liquidity concerns to fee structures and legal uncertainties, this comprehensive conversation sheds light on how plan sponsors and asset managers can navigate the evolving landscape of alternative asset inclusion in participant-directed retirement plans.Show Notes:New Order ‘Targets' 401(k) Plan ‘Alternatives': President Takes Aim at Legal Barriers and Litigation Risks, Dechert OnPoint (August 11, 2025)

Jenny Kiesewetter has more than 24 years of experience advising businesses in ERISA, employee benefits, compensation, fiduciary responsibility, and compliance matters.As a member of the firm's Employee Benefits and Tax Practice in Nashville, she advises clients on all aspects of employee benefits and executive compensation, including qualified and nonqualified retirement plans, health and welfare benefit plans, cafeteria plans, severance plans, and equity-based compensation plans.Jenny has also worked with businesses and investors during mergers and acquisitions, focusing on due diligence and compliance related to employee benefit plans, including retirement, health and welfare, and executive compensation plans. Additionally, she has worked on many post-acquisition employee benefit matters, specifically related to plan compliance and correction.Jenny earned her law degree from the University of Tennessee College of Law, Knoxville, as well as a master's in communications. She earned her undergraduate degree from the University of Florida. She has been consistently recognized by U.S. News - Best Lawyers for ERISA Litigation and Employee Benefits (ERISA) Law.Jenny is a frequent speaker and author on topics including ERISA, employee benefits, retirement plans, health plans, and statutory and regulatory compliance. To subscribe to her LinkedIn newsletter “ERISA Explained,” please visit - https://www.linkedin.com/newsletters/erisa-explained-7083416224222601216/ In this episode, Eric and Jenny Kiesewetter discuss:Fiduciary responsibility in ERISA health plan oversightConducting proper due diligence for health plan service providersSecuring and ensuring access to health plan dataReviewing provider fee disclosuresKey Takeaways:Selecting and monitoring health plan providers is an ongoing fiduciary function. Sponsors must document their decision-making and maintain oversight even after hiring a provider.When choosing a broker or advisor, conduct thorough due diligence. Interview multiple candidates, review their experience, services, and fees, and ensure they fit your organization's needs.Plan sponsors should secure access to all necessary health plan data. Owning and understanding this data is critical for informed fiduciary decisions and compliance with federal laws.Review 408(b)(2) fee disclosures from health plan service providers. Missing or incomplete disclosures can create compliance risks and may be seen as an unreasonable relationship by the Department of Labor.“You can't make fiduciary decisions if you don't know what the data says. That's my opinion. You have to understand what the data says to be able to make the right fiduciary decisions.” - Jenny KiesewetterConnect with Jenny Kiesewetter:LinkedIn: https://www.linkedin.com/in/jennykiesewetter/ Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information and content of this podcast are general in nature and are provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date, but may be subject to changeIt is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design, or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 27 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Vascular Malformations of the Brain."Vascular malformations of the brain may be rare - but when they strike, the effects can be devastating. These defects in the brain's blood vessels can trigger seizures, strokes, cognitive decline, and even life-threatening hemorrhages. For patients, it's not just a medical battle - it's also a fight to protect their livelihood. And with ERISA-governed disability insurance, the odds often feel stacked against you. In this episode of Winning Isn't Easy, disability law expert Nancy L. Cavey unpacks one of the toughest areas of neurological disability claims: vascular malformations and Long-Term Disability benefits. You'll learn what these conditions are, how their unpredictable symptoms make steady employment difficult, and the common tactics insurers use to deny claims. Nancy shares proven strategies to strengthen your case - like building a detailed medical record, documenting symptom fluctuations, and avoiding traps such as “subjective condition” or mental health limitations. Whether you're newly diagnosed, appealing a denial, or just trying to understand your coverage, this episode will give you the tools to protect your rights and fight for the benefits you deserve. Because when your brain - and your future - are at stake, winning isn't easy, but it is possible with the right strategy.In this episode, we'll cover the following topics:One - What Are Vascular Malformations of the Brain?Two - Navigating ERISA Disability Claims for Vascular MalformationsThree - Strategies to Build a Strong Claim and Avoid DenialWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

Welcome to RIMScast. Your host is Justin Smulison, Business Content Manager at RIMS, the Risk and Insurance Management Society.   In this episode, Justin interviews David Neikrug, CEO at Optimatum Solutions, about managing vendors of employer-sponsored healthcare and a recent Optimatum Solutions report, “A Path Not Taken: Vendor Management in Employer-Sponsored Healthcare”. David explores with Justin the topic of applying risk management tools to HR programs and plans, an area that risk managers rarely visit. They touch on ways for risk managers to contribute at the table using the risk management skills and tools that they have applied to recognized risk areas for years.   Listen to learn about the benefits of managing benefit plan vendors.   Key Takeaways: [:01] About RIMS and RIMScast. [:17] About this episode of RIMScast. Our topic is vendor management. We will dive deeply with Optimatum Solutions CEO, David Neikrug. [:40] RIMS-CRMP Workshops! The next Virtual RIMS-CRMP exam prep, co-hosted by Parima, will be held on September 2nd and 3rd. [:50] The next RIMS-CRMP-FED virtual workshop will be held on November 11th and 12th, and led by Joseph Mayo. Links to these courses can be found on the Certification Page of RIMS.org and through this episode's show notes. [1:07] RIMS Virtual Workshops! RIMS has launched a new course, “Intro to ERM for Senior Leaders.” It will be held again on November 4th and 5th and will be led by Elise Farnham. RIMS members enjoy deep discounts! [1:24] The full schedule of virtual workshops can be found on the RIMS.org/education and RIMS.org/education/online-learning pages. A link is also in this episode's notes. [1:35] The next RIMS Webinar will be held on September 4th and will be led by AXA XL. It is titled “Lockdown & Level Up: Turn Up Your Cyber Security Game Against Creative Cyber Criminals”. [1:48] On September 18th, Origami Risk will present “Driving Better Incident and Claims Management with Data, Technology & Strategic Collaboration”. [1:56] On October 30th, Swiss Re will present “Parametric Insurance: Providing Financial Certainty in Uncertain Times”. [2:05] On November 6th, Hub will present “Geopolitical Whiplash — Building Resilient Global Risk Programs in an Unstable World”. Register at RIMS.org/Webinars. [2:17] Mark your calendars for November 17th and 18th for the RIMS ERM Conference 2025 in Seattle, Washington. The agenda is jam-packed with educational sessions that will resonate with risk practitioners in all stages of their careers. [2:38] See the full agenda at RIMS.org/ERM2025. [2:44] RISKWORLD 2026 will be in Philadelphia, Pennsylvania, from May 3rd through May 6th. RIMS members can now lock in the 2025 rate for a full conference pass to RISKWORLD 2026 when registering by September 30th. [2:58] This also lets you enjoy earlier access to the RISKWORLD hotel block. Register by September 30th, and you will also be entered to win a $500 raffle. Don't miss out on this chance to plan and score some extra perks. [3:11] The members-only registration link is in this episode's show notes. If you are not yet a member, this is the time to join us. Visit RIMS.org/membership and build your risk network with us here at RIMS. [3:26] On with the show! You wanted to hear about vendor management, and that's why I reached out to Optimatum Solutions CEO, David Neikrug, to discuss the findings in Optimatum's new report, “A Path Not Taken: Vendor Management in Employer-Sponsored Healthcare”. [3:50] It's got some fascinating insights, and I wanted to extend the dialogue beyond the PDF, so let's get started! [3:56] Interview! David Neikrug, welcome to RIMScast! [4:07] Justin hasn't covered vendor management much on RIMScast. Justin invited David on the show to talk about Optimatum's publicly available paper, “A Path Not Taken: Vendor Management in Employer-Sponsored Healthcare.” This speaks to a risk management audience. [4:28] There is a link in this episode's show notes. The average cost of healthcare in 2025 is pushing north of $25K total cost, per employee per year, and it's an outsourced function. It's a large amount of money. [5:08] HR generally doesn't have the traditional service level agreements (SLAs) or performance guarantees that are present in an IT services agreement. That's a major disconnect that leads to financial, operational, and risk issues that go unchecked. [5:44] Traditionally, we don't see risk managers getting involved in HR things like employer-sponsored healthcare. David encourages risk managers to take the tools and skills they know and apply them to HR and employer-sponsored healthcare and retirement plans. [6:23] David suggests risk managers should demand vendor transparency when it comes to fees, debits, and credits. David talks about pharmacy rebates, segregation, and how credits are captured and applied. [7:09] David says vendor harmonization can be applied vertically or horizontally. The vertical side is when a company has acquired several HR benefits and programs, and then merges them into one program. The value creation by doing that is immense. [7:56] David says horizontal harmonization applies to anybody who aggregates companies of various kinds, including family offices. Each company may have a disparate benefits plan. Bringing plans together can save hundreds to thousands of dollars per employee per year. [8:46] Those are the types of numbers Optimatum Solutions is seeing as the opportunity for a risk manager to focus on as a quantifiable value proposition of bringing 10 vendor programs into one aggregated program. [9:14] From a risk standpoint, you have a single source to manage across enterprises. [9:31] David often speaks using numbers to convey the point. He says risk managers have a wealth of information and know what they are doing. When it comes to opportunities to create value, HR is an area they're not thinking about. [10:25] David suggests surveying risk managers and asking what percentage of risk managers are focused on the HR side, employer-sponsored healthcare, and retirement plans. You'll see the opportunity is almost endless. [10:44] Quick Break for RIMS Events!  On September 18th, the 10th Annual Chicagoland Risk Forum will be held at The Old Post Office in Chicago. Register at ChicagoRIMS.org. [10:59] On October 1st through the 3rd, the RIMS Western Regional Conference will be held in North San Jose at the Santa Clara Marriott. The agenda is live. It looks fantastic! Visit RIMSWesternRegional.com and register today! [11:15] On November 17th and 18th, elevate your ERM Program and career at the RIMS ERM Conference 2025 in Seattle, Washington. The agenda is live, and early rates are available until September 5th. Register now to save $110 and secure your spot at the ERM event of the year. [11:37] Canadian listeners, take note, that's just a little bit South of the border in British Columbia. That's a great way to extend your knowledge after the RIMS Canada Conference. Visit RIMS.org/ERM2025 to register. [11:52] At the top, Justin mentioned RISKWORLD 2026. Through September 4th, the RISKWORLD education content submission process is still open. [12:02] RIMS invites you to share your experiences, best practices, and innovative strategies that represent the global outlook of risk management. Send us your submission, and who knows? We might select you to speak at RISKWORLD 2026 in Philadelphia! The link is in the show notes. [12:20] Let's Return to My Interview with David Neikrug!  [12:42] David says the first thing to do is make sure risk managers have a seat at the table of employer-sponsored healthcare. They need to look at and understand all the terms and conditions of the contracts, looking for the low-hanging fruit. [12:55] Look for Service Level Agreements, Performance Guarantees, and Built-in Reconciliation Clauses for the vendor to provide a self-reconciliation of all the debits and credits from the plan year. Understand the contracts. [13:17] Second, make sure that you're a part of the team. Look at what you can do, bringing all the tools that you've acquired, dealing with the risk side over the years, and applying them to the HR benefits side. [13:54] For organizations of between 500 to 5,000 employees, there is ample opportunity. Those are going more unwatched than the larger organizations. The vendors aren't used to being held as accountable as they are for a Fortune 100. [14:21] David would say there isn't an organization that doesn't have an opportunity. It's a matter of focusing on it and bringing your expertise to the table to help your organization hold those vendors accountable, drive savings and performance, and create value. [14:59] David said Optimatum Solutions had a client that was a rapidly growing organization. They had acquired a company and decided to change the acquired company's vendor because they had been using a different vendor. [15:22] David mentions that Optimatum Solutions has a focus on improving or fixing relationships with vendors, versus running an RFP and finding a new vendor. It's better to fix a problem than to replace it. [15:40] Someone at the client company decided to move the pension plan business of the acquired company to a new provider. The plan was started in 1972, before the ERISA regulations on how pension plans are managed. The new vendor did no due diligence and took it over. [16:37] Within the first year, there was a claim by a retiree that the lump sum payment should have been 10 times what it was, stemming from one example in a plan document of how a benefit will be calculated. The company had to defend an $18 million potential claim. [17:11] It took three years to resolve. This taught the new vendor what the old vendor had been doing seamlessly for all those years. The former vendor knew how to deal with various situations, including payments to international employees. [17:49] The new vendor hadn't understood what they were acquiring. That led to a colossal mess. [18:10] It was an HR issue. They had a risk manager, but hadn't thought of having the risk manager at the table for this event. [18:20] A Final Break! The Spencer Educational Foundation's goal to help build a talent pipeline of risk management and insurance professionals is achieved, in part, by its collaboration with risk management and insurance educators across the U.S. and Canada. [18:40] Since 1999, Spencer has awarded over $2.9 million to create more than 570 Risk Management Internships. The Internship Grants application process is now open through October 15th, 2025. [18:56] To be eligible, risk managers must be based in the U.S., Canada, or Bermuda. A link to the Internship Grants page is in this episode's show notes. You can always visit SpencerEd.org, as well. [19:10] The Spencer 2025 Funding their Future Gala will be held on Thursday, September 18th, at the Cipriani 42nd Street in Manhattan, New York. This year's honoree is Tim Ryan, the U.S. President of Lockton, and we look forward to having Tim join us here on RIMScast very soon. [19:29] A link to the Gala is also in this episode's show notes. Buy a ticket, enjoy a great night in the city, and support the future of risk management. [19:38] Let's Return to the Conclusion of My Interview with Optimatum Solutions CEO, David Neikrug! [19:47] Behavioral and mental health are workforce concerns and reputational risks. David says the real number is productivity. If a factory has employees out for behavioral health issues, it has to replace those employees with temporary workers while still paying them. [20:43] The total cost of unmanaged behavioral health in a workforce is not just the behavioral health medical claims, pharmacy claims, or inpatient claims; it's also the lost working hours of those employees and the replacement costs of those employees. [21:15] That's a much larger number than just the surface of behavioral and mental health. Today, all health plans have strong behavioral programs. Organizations have Employee Assistance Programs (EAPs). [21:38] There are also point solutions adding a layer of a microbenefit on top of the program to ensure that employees are receiving the right care at the right time, in the right place.  [22:01] Organizations have the right tools. An employer will have all these programs, but they're disconnected. No one is bringing everyone to the table. [22:24] For a certain cost per employee per month, an EAP vendor will provide a given number of behavioral health visits. They will support the process within the traditional healthcare delivery system. Organizations can have point solutions for behavioral health. [23:00] Organizations can have these vendors at the table to understand what's going on at the organization. Are there RIFs? Are there acquisitions? Does the organization have seasonal issues driving stress? Is there an issue with the community where the organization is located? [23:20] Look at it holistically. Bring all these vendors to the table and discuss what's going on.  [23:30] In an unfortunate situation where employees are very stressed and have some sort of episode while at work, that's a material reputational risk, internally, and it may become an external issue. Most employers today have the vendors in place who can support them. [24:05] The steps are bringing the vendors to the table and managing them to ensure that they're aligned with the intended outcomes, and everyone's goal is aligned accordingly. [24:20] When you're discussing the organization with vendors, what about trade secrets, such as expansion and strategy? David says if you have the right vendor, they're about confidentiality. [24:46] If you're about to announce a Reduction in Force (RIF) or an acquisition, you will want your EAP in place to train managers to deal with employees who may be stressed. [26:01] David talks about AI risks. Ensure that when your employees are using any AI platform, you have thoroughly vetted the platforms you are allowing them to use to make sure that none of your proprietary or confidential information lands in public. [26:36] When using AI with confidential information, unless it's a closed system, you have a material risk of it being exposed. [27:02] AI is here for the future. It will change the face of every single profession. Justin assures that there will be no bots hosting or guesting on RIMScast! [27:35] David asks organizations, in the face of AI, What are you doing about it? How are you training and supporting your employees so that they can be part of the future, versus being a former employee who has been replaced due to AI? [27:54] In analytics, AI is simplifying delivery and crunching numbers like we've never seen before. These are incredible benefits for organizations in the future. [28:27] David thinks that you need internal tools to ensure that your employees are not divulging confidential information within public tools and that your vendors and their vendors are all aligned to apply the same rules for confidentiality. [29:12] David, you have been such a wonderful guest! I'm so glad that you were here to provide a little extra insight into the recent Optimatum Solutions paper, “A Path Not Taken: Vendor Management in Employer-Sponsored Healthcare”. A link is in this episode's show notes. [29:35] At the end of the paper is David's contact information. [29:53] Special thanks again to Optimatum Solutions CEO, David Neikrug, for joining us here on RIMScast. You can find the link to A Path Not Taken, the professional report, at OptimatumSolutions.com and in this episode's show notes. [30:11] I've also got links to RIMS coverage of vendor management in this episode's show notes. [30:17] Plug Time! You can sponsor a RIMScast episode for this, our weekly show, or a dedicated episode. Links to sponsored episodes are in the show notes. [30:45] RIMScast has a global audience of risk and insurance professionals, legal professionals, students, business leaders, C-Suite executives, and more. Let's collaborate and help you reach them! Contact pd@rims.org for more information. [31:03] Become a RIMS member and get access to the tools, thought leadership, and network you need to succeed. Visit RIMS.org/membership or email membershipdept@RIMS.org for more information. [31:21] Risk Knowledge is the RIMS searchable content library that provides relevant information for today's risk professionals. Materials include RIMS executive reports, survey findings, contributed articles, industry research, benchmarking data, and more. [31:37] For the best reporting on the profession of risk management, read Risk Management Magazine at RMMagazine.com. It is written and published by the best minds in risk management. [31:52] Justin Smulison is the Business Content Manager at RIMS. Please remember to subscribe to RIMScast on your favorite podcasting app. You can email us at Content@RIMS.org. [32:04] Practice good risk management, stay safe, and thank you again for your continuous support!   Links: RIMS ERM Conference 2025 — Nov. 17‒18 The call for RISKWORLD 2026 submissions is now open! RIMS Canada 2025 — Sept. 14‒17 | Registration open! 10th Annual Chicagoland Risk Forum — Sept. 18 | Registration open! RIMS Western Regional — Oct 1‒3 | Bay Area, California | Registration open! RISKWORLD 2026 — Members-only early registration! Register through Sept 30! RIMS-Certified Risk Management Professional (RIMS-CRMP) The Strategic and Enterprise Risk Center Spencer Educational Foundation 2025 Funding Their Future Gala — Sept. 18, 2025, in NYC! Spencer Internship Program — Registration Open Through Oct. 15. RIMS-CRO Certificate in Advanced Enterprise Risk Management — Featuring Instructor James Lam! Next bi-weekly course begins Oct 9. RIMS Diversity Equity Inclusion Council RISK PAC | RIMS Advocacy | RIMS Legislative Summit SAVE THE DATE — March 18‒19, 2026 RIMS Risk Management magazine | Contribute RIMS Now Optimatum Professional Report: “A Path Not Taken: Vendor Management in Employer-Sponsored Healthcare” OptimatumSolutions.com RIMS Webinars: RIMS.org/Webinars “Lockdown & Level Up: Turn Up Your Cyber Security Game Against Creative Cyber Criminals” | Sept. 4, 2025 | Sponsored by AXA XL “Driving Better Incident and Claims Management with Data, Technology & Strategic Collaboration” | Sept. 18 | Sponsored by Origami Risk “Parametric Insurance: Providing Financial Certainty in Uncertain Times” | Oct. 30, 2025 | Sponsored by Swiss Re “Geopolitical Whiplash — Building Resilient Global Risk Programs in an Unstable World” | Nov. 6 | Sponsored by Hub   Upcoming RIMS-CRMP Prep Virtual Workshops: RIMS-CRMP Exam Prep Virtual Workshop — Sept 2‒3, 2025 | Presented by RIMS and PARIMA RIMS-CRMP-FED Exam Prep Virtual Workshop — November 11‒12 Full RIMS-CRMP Prep Course Schedule “Intro to ERM for Senior Leaders” | Nov. 4‒5 | Instructor: Elise Farnham See the full calendar of RIMS Virtual Workshops RIMS-CRMP Prep Workshops   Related RIMScast Episodes: “ERM, Retail, and Risk with Jeff Strege” “Supply and Bike Chains with Emily Buckley”   Sponsored RIMScast Episodes: “The New Reality of Risk Engineering: From Code Compliance to Resilience” | Sponsored by AXA XL (New!) “Change Management: AI's Role in Loss Control and Property Insurance” | Sponsored by Global Risk Consultants, a TÜV SÜD Company “Demystifying Multinational Fronting Insurance Programs” | Sponsored by Zurich “Understanding Third-Party Litigation Funding” | Sponsored by Zurich “What Risk Managers Can Learn From School Shootings” | Sponsored by Merrill Herzog “Simplifying the Challenges of OSHA Recordkeeping” | Sponsored by Medcor “Risk Management in a Changing World: A Deep Dive into AXA's 2024 Future Risks Report” | Sponsored by AXA XL “How Insurance Builds Resilience Against An Active Assailant Attack” | Sponsored by Merrill Herzog “Third-Party and Cyber Risk Management Tips” | Sponsored by Alliant “RMIS Innovation with Archer” | Sponsored by Archer “Navigating Commercial Property Risks with Captives” | Sponsored by Zurich “Breaking Down Silos: AXA XL's New Approach to Casualty Insurance” | Sponsored by AXA XL “Weathering Today's Property Claims Management Challenges” | Sponsored by AXA XL “Storm Prep 2024: The Growing Impact of Convective Storms and Hail” | Sponsored by Global Risk Consultants, a TÜV SÜD Company “Partnering Against Cyberrisk” | Sponsored by AXA XL “Harnessing the Power of Data and Analytics for Effective Risk Management” | Sponsored by Marsh “Accident Prevention — The Winning Formula For Construction and Insurance” | Sponsored by Otoos “Platinum Protection: Underwriting and Risk Engineering's Role in Protecting Commercial Properties” | Sponsored by AXA XL “Elevating RMIS — The Archer Way” | Sponsored by Archer   RIMS Publications, Content, and Links: RIMS Membership — Whether you are a new member or need to transition, be a part of the global risk management community! RIMS Virtual Workshops On-Demand Webinars RIMS-Certified Risk Management Professional (RIMS-CRMP) RISK PAC | RIMS Advocacy RIMS Strategic & Enterprise Risk Center RIMS-CRMP Stories — Featuring RIMS President Kristen Peed!   RIMS Events, Education, and Services: RIMS Risk Maturity Model®   Sponsor RIMScast: Contact sales@rims.org or pd@rims.org for more information.   Want to Learn More? Keep up with the podcast on RIMS.org, and listen on Spotify and Apple Podcasts.   Have a question or suggestion? Email: Content@rims.org.   Join the Conversation! Follow @RIMSorg on Facebook, Twitter, and LinkedIn.   About our guest: David Neikrug, CEO at Optimatum Solutions LLC   Production and engineering provided by Podfly.  

On August 7, President Trump issued a much-anticipatedexecutive order, directing the Labor Department to (re)consider barriers to defined contribution plans accessing alternative investments.  Nevin & Fred check it out – and theimplications.More specifically, an executive order directed the Secretary of Labor to, among other things, “reexamine the Department of Labor's guidance on a fiduciary's duties regardingalternative asset investments in ERISA-governed 401(k) and other defined-contribution plans” – a stance widely seen as encouraging the consideration of alternative assets in defined contribution plans, including 401(k)s and 403(b)s.The EO states as “the policy of the United States that everyAmerican preparing for retirement should have access to funds that include investments in alternative assets…”That policy is, however, conditioned to situations “when therelevant plan fiduciary determines that such access provides an appropriate opportunity for plan participants and beneficiaries to enhance the net risk-adjusted returns on their retirement assets.” While the Executive Order doesn't immediately changeanything, it sets in motion the possibility of a less restrictive regulatory view on so-called, “alternative” assets, including private markets, real estate, digital assets, and lifetime income.The Executive Order calls out “burdensome lawsuits that seek to challenge reasonable decisions by loyal, regulated fiduciaries,” as well as “stifling Department of Labor guidance” that is says has “denied millions of Americans opportunities to benefit from investment in alternative assets.”Episode ResourcesBreakingNews: Trump Signs EO to Advance Private Market Investments in 401(k)sLifetimeIncome Also Cited in Private Markets Executive OrderTalkingPoints: Pandora's BoxThingsI Worry About (12): Private Funds and 401(k) Plans - Fred ReishDOLPulls Guidance Cautioning Fiduciaries About Private Equity in 401(k)s

In this episode, Suzanne Spradley and Carol Wood discuss the role of pharmacy benefit managers (PBMs) and the recent proliferation of state laws that regulate PBMs. Next, Suzanne explains how these state PBM laws interact with federal laws, which are supreme. Suzanne reviews ERISA preemption and the U.S. Supreme Court Rutledge case, and how state lawmakers continue to test the boundaries of their authority with PBM legislation. The conversation then turns to a controversial Arkansas PBM law and the related litigation that has gained national attention. Suzanne and Carol end by providing employer takeaways and explaining why it's important for employers to continue to monitor developments in this complex benefits area.

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 26 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Understanding "Own Occupation" Benefits Under ERISA Disability Insurance."“Own Occupation” and “Any Occupation” might sound like simple terms - but in the world of Long-Term Disability insurance, they can make or break your claim. In today's episode, disability law expert Nancy L. Cavey unpacks one of the most misunderstood but critical distinctions in disability policies: how your occupation is defined. If you've ever had to read a disability policy - or worse, file a claim - you know these definitions aren't just legal jargon. They determine whether you'll receive benefits when you can't work in your specialized field, or whether an insurer can cut you off by arguing you could work in any other job, even one far outside your training, experience, or pay grade. Nancy breaks it all down: what “own occupation” and “any occupation” really mean, how these definitions can shift over time in an ERISA plan, and why understanding them early can be the key to protecting your income. You'll learn the secrets to securing your own occupation disability benefits, common pitfalls that lead to denials, and specific strategies for those facing psychiatric disability claims - where insurers often push hardest to reclassify your case. Whether you're just reviewing your coverage, preparing to file, or already battling a denial, this episode offers clear, actionable guidance to help you navigate the fine print and fight for the benefits you deserve. Let's get started.In this episode, we'll cover the following topics:One - Own Occupation vs. Any Occupation – What's the Difference?Two - The Secret to Getting Your Own Occupation ERISA Disability BenefitsThree - Tips for Preventing a Denial of Own Occupation Psychiatric Disability Insurance ClaimsWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

Now “retired” (whatever that means), Nevin is the former Chief Content Officer and Head of Retirement Research for the American Retirement Association. One of the retirement industry's most prolific writers, these days he's “retired”, which means he writes less, but continues to keep his eye on developments in, and threats to, the nation's private retirement system. He's the Chief Advisor Strategist at Endeavor Retirement, and he's also the “Nevin” in the Nevin & Fred podcast (along with renowned ERISA attorney Fred Reish), offering irreverent, but relevant perspectives on the critical issues confronting plan sponsors, advisors, and retirement industry professionals. Prior to his time at the ARA, he was the Employee Benefits Research Institute's Director of Education and External Relations, Co-Director of EBRI's Center for Research on Retirement Income, and Director of the American Savings Education Council, and prior to that, spent a dozen years as Global Editor-in-Chief of PLANSPONSOR magazine and PLANSPONSOR.com, as well as PLANADVISER and PLANSPONSOR Europe magazines. He was the originator, creator, writer, and publisher of PLANSPONSOR.com's NewsDash. He began his retirement services career at Northern Trust in Chicago, where he later served in a variety of management roles, culminating in the development of a proprietary recordkeeping platform, and at Wachovia Bank, leading their defined contribution/recordkeeping businesses.In this episode, Eric and Nevin Adams discuss:Retirement income requires tailored solutions.Fiduciary roles shift after adoption.Default options remain a challenge.Adoption will be gradual and cautious.Key Takeaways:There's a wide range of income options beyond annuities, but each plan should carefully assess its participants' needs before implementing anything.Choosing to offer a retirement income option begins as a settlor decision, but once implemented, it becomes a fiduciary duty to select the specific solution, to monitor, and manage.Auto-enrolling participants into lifetime income products is complex—many don't fully grasp the trade-offs, and surveys show mixed interest.Due to regulatory uncertainty and logistical hurdles, most plan sponsors are expected to move conservatively, guided by education and expert consultation.“How are we making default lifetime income assumptions about people on a generic basis without some of that nuance? Aren't you, almost by definition, creating a product that's not really going to fit people anyway?” - Nevin AdamsConnect with Nevin Adams:Website: https://nevinandfred.com/ LinkedIn: https://www.linkedin.com/in/nevinadams/ Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information and content of this podcast are general in nature and are provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date, but may be subject to changeIt is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design, or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 5, Episode 25 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Short-Term Disability and Pregnancy: Understanding Your Rights and Benefits."Pregnancy and Short-Term Disability don't always go hand in hand - at least not the way they should. In today's episode, disability law expert Nancy L. Cavey sheds light on a critical issue affecting millions of working women: the challenges of securing Short-Term Disability benefits during pregnancy. While pregnancy is often a time of excitement and change, it can also involve serious medical complications, extended leave, or postpartum recovery that makes returning to work impossible. That's when Short-Term Disability insurance is meant to provide support - but the claims process is often anything but supportive. From unclear policy terms to denied claims and employer resistance, many women find themselves overwhelmed and underprotected at one of the most vulnerable times in their lives. Nancy breaks it all down - what pregnancy-related conditions qualify, how Short-Term Disability differs from long-term coverage, when to seek legal help, and how to fight back if your claim is denied. Whether you're pregnant now, planning to be, or helping someone through the process, this episode offers clear, actionable guidance for navigating the system and securing the benefits you deserve. Let's get started.In this episode, we'll cover the following topics:One - Understanding Short-Term Disability and PregnancyTwo - Filing and Protecting Your Pregnancy-Related Disability ClaimThree - Knowing Your Rights and Seeking SupportWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

In this episode of "The Free Lawyer," host Gary interviews Ben Glass, co-founder of Ben Glass Law and Great Legal Marketing. Ben shares his journey from traditional legal practice to building a fulfilling, innovative law firm. He discusses the importance of curiosity, collaboration, and values-driven leadership, encouraging lawyers to delegate, focus on client experience, and foster positive firm cultures. Ben also addresses lawyer wellness, advocating for proactive business strategies and personal growth. The episode offers practical advice for lawyers seeking greater satisfaction and success in their careers.Ben Glass is a prominent long-term disability attorney, business leader, and legal marketing expert with over 40 years of experience in representing disabled and injured clients against insurance companies. He is widely recognized for his innovative approach to law and business, making significant contributions to both fields.Ben is a nationally recognized and sought after speaker in the legal industry and has taught and lectured on a variety of legal subjects including direct and cross examination, the use of expert witnesses, conducing effective voir dire and jury selection, maximizing recovery in personal injury cases and effective representation of disabled workers in ERISA long-term disability cases. Ben has been featured prominently in numerous publications and media outlets such as Lawyers Weekly Virginia, The Washington Post, Newsweek, USA Today, and The Wall Street Journal. Ben Glass is not only a successful attorney but also a leading figure in legal marketing. He founded Great Legal Marketing (GLM), an organization dedicated to helping solo and small-firm lawyers refine their marketing strategies and business practices. His expertise has been sought after nationwide, and he is a frequent speaker and author on legal marketing, delivering talks at in-person and virtual conferences for entrepreneurs worldwide.Collaboration vs. Competition in Law (00:06:27Starting Ben Glass Law: Early Challenges (00:07:43)s.Magnetic Marketing and Information-Based Approach (00:09:37) Client Experience and Referral Cultivation (00:12:05) Renegade Lawyer Philosophy (00:14:07) Entrepreneurial Mindset vs. Legal Mindset (00:15:19)Lawyer Wellness and Business Foundations (00:16:16) The Hard Work of Entrepreneurship (00:18:32) .Biggest Misconceptions About Law Practice Success (00:20:17) .Analyzing and Improving Law Firm Systems (00:22:17) Breaking Free from the Prison of Success (00:24:17) Mindset Differences: Stuck vs. Thriving Lawyers (00:26:18) Building a Values-Driven Practice (00:28:34) Lessons from Mistakes: Hiring and Coaching (00:31:12) The Importance of Ongoing Coaching (00:32:39) Controlling Your Environment and Inputs (00:34:23)Advice to Young Ben: Vulnerability and Coaching (00:36:13) .Encouragement for Stuck and Overwhelmed Lawyers (00:38:07) Would you like to learn more about Breaking Free or order your copy? https://www.garymiles.net/break-free Would you like to schedule a complimentary discovery call? You can do so here: https://calendly.com/garymiles-successcoach/one-one-discovery-call

In this episode of the Astonishing Healthcare podcast, host Justin Venneri speaks with Lindsey Butler, PharmD, Vice President & Clinical Pharmacy Consultant at Lockton, and Chris England, Vice President of National Business Development at Capital Rx. They discuss what health systems need from a pharmacy benefit management (PBM) partner, the challenges in today's market, and the opportunities for innovation and collaboration to advance care for the patients in the communities health systems serve. State-level regulatory changes are top of mind, and Lindsey explains what she's tracking and how she's approaching meeting her clients' unique requirements: How can the benefits program aid with talent acquisition and retention? Can a pharmacy program meet everyone's needs (from the C-suite to the pharmacy team)? Both guests share insights from their extensive experience, offering ideas for health systems to enhance their pharmacy programs and improve the health benefits and healthcare experience for employees and communities.HighlightsArkansas and Louisiana are among the states leading PBM reform efforts, and fiduciary responsibility is in focus - Lindsey discusses ERISA lawsuits and the Arkansas bill, while Chris talks about the push to use NADAC for drug pricing.Health systems are grappling with the high costs of GLP-1 drugs and exploring ways to integrate wraparound support, such as nutrition counseling, to improve outcomes - it's interesting that most health systems do cover them for weight loss!Many health systems are leveraging - or considering opening - in-house pharmacies to reduce costs, improve medication access, and enhance continuity of care.Having a PBM partner with flexible technology allows for custom network and reimbursement structures that align pharmacy benefits with health systems' goals.Collaboration among providers, pharmacies, and health plans is essential to ensure that decisions benefit both a health system and the patients it serves.Related ContentPharmacy Benefit Procurement: How to Ensure That Savings Materialize (eBook)AH021 - Managing Pharmacy Costs in a GLP-1 World, with Bridget Mulvenna & How to Manage Pharmacy Benefit Spend in a GLP-1 World (Blog)AH029 - Selling Pharmacy Benefits: Building Relationships & Meeting Clients' Needs, with Nick Van HookPharmacy Benefits 101: The Importance of the NetworkTo get in touch with Lindsey: Lindsey Butler, PharmD, CSPPlease visit Capital Rx Insights for more information, including this episode's transcript!

In recent days, federal courts have dismissed two notablesuits regarding forfeiture reallocation, but most notably the Labor Department has now weighed in on behalf of plan fiduciaries in another case.  Could this be a turning point?  Nevin & Fred weigh in.The suits – against JP Morgan and Wells Fargo – weredismissed in different courts on different grounds.  Still, they came at a time, and in a way, that suggests at least some federal courts are now inclined to see practices long sanctioned by practice (and the IRS) as meritless.The real game changer, of course, might be the LaborDepartment's “friend of the court” filing on yet another suit – one that the fiduciary defendants have already had success in challenging the suit, and yet find themselves (still) in court litigating the issue(s).Speaking of the Labor Department, a federal judge in Texasrecently ruled on a suit filed challenging the application of the so-called fiduciary regulation, most specifically with regard to its implications on rollovers.So what does all that portend for ERISA plan fiduciaries?  And what might the anticipated executive order from the Trump Administration expanding/opening the door for private assets in defined contribution mean?All this and more in the latest episode of Nevin (Adams)& Fred (Reish)…Episode ResourcesForfeituresDOL Backs HP in Forfeiture Reallocation Suit AppealWells Fargo Fends Off Forfeiture Fiduciary Suit JP Morgan Gets Clear Win in 401(k) Forfeiture Reallocation SuitFiduciary SuitFederal Court Vacates Part of Rollover RulePrivate MarketsRetirement Plan Participants Want Access to Private Market InvestmentsPrivate Market Investments: Promises and Potential Pitfalls  https://issuu.com/usaretirement/docs/napa_net_the_magazine_summer_2025Empower'sMurphy Responds to Warren's Private Market Criticism

In this episode of the Friday Fiduciary Five, Eric Dyson discusses the current “Hot Topics” for ERISA plans. Leading the list is the Cunningham v. Cornell decision, which shifts the burden of proving exemptions in prohibited transactions to fiduciaries. Fee and forfeiture litigation remains active, with dozens of new cases this year. Health plan fiduciary risks—such as mental health parity rules and PBM transparency—are under increased scrutiny. SECURE 2.0 compliance, especially auto-enrollment and catch-up contributions, is still a key focus. Emerging risks around AI, cryptocurrency, ESG, and private equity in 401(k) plans are also highlighted. Dyson emphasizes strong fiduciary governance and stewardship.Included in this episode are references to previous podcast episodes that address many of these issues.Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information contained herein is general in nature and is provided solely for educational and informational purposes.It is not intended to provide a specific recommendation of any type of product or service discussed in this presentation or to provide any warranties, financial advice, or legal advice.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan specific circumstances.

ERISA expert and Industry Vet Jack Towarnicky joins Retireholics today. Topics to include: Josh Itzoe's New Product Launch, J.P. Morgan and Vestwell's SoloK, Is the Coverage Gap really narrowing?, Senator Warren vs Empower drama now includes Voya Financial, Blue Owl Capital and Trump, My QDIA is better than your QDIA, and what is a Ben Franklin Child Roth IRA?

Are you looking to seize control of your retirement funds and explore alternative investment avenues beyond traditional stocks? In this episode, Adam Bergman, a nine-time author, former tax and ERISA attorney, and founder of IRA Financial, shares how self-directed IRAs can empower you to invest in assets like real estate, crypto, gold, private businesses, and more. Learn the essential tax rules and strategies to cultivate your retirement growth. In this episode, we chat about… Introduction to Self-Directed IRAs: Explained what a self-directed IRA is and how it differs from traditional IRAs managed by custodians like Fidelity or Vanguard. Three Things You Can't Do with an IRA: Clear breakdown of IRS restrictions: no life insurance, no collectibles, and no self-dealing (IRC Section 4975(c)). What Triggers UBIT (Unrelated Business Income Tax): Covered the three scenarios that may trigger UBIT and outlined strategies to avoid or minimize it. Solo 401(k) vs. Self-Directed IRA: Compared the advantages of solo 401(k)s for the self-employed, including UBIT exemptions and higher contribution limits. Using an IRA LLC or "Checkbook IRA": Describe the structure, benefits of control, limited liability, and privacy offered by IRA LLCs. Real Estate and Crypto with a Self-Directed IRA: Detailed how self-directed IRAs can be used for real estate and crypto investments, including the role of non-recourse loans. Key Takeaways: Self-directed IRAs allow you to invest in a wide range of alternative assets, with only a few IRS restrictions. A qualified custodian is required to handle IRA funds and facilitate compliant investments. UBIT may apply to leveraged real estate or active business investments, but it can often be reduced or avoided with the right strategy. IRA LLCs with checkbook control offer more flexibility, privacy, and direct access to manage investments. Solo 401(k)s are ideal for self-employed individuals, offering higher contribution limits and exemptions from UBIT on leveraged real estate. Learning from credible sources and consulting professionals is essential to avoid costly mistakes in self-directed retirement planning   Resources from Adam      LinkedIn | IRA Financial  Resources from Mike and Nichole      Gateway Private Equity Group |  Nic's guide

In this episode of the Power Producers Shop Talk, David Carothers shares an insightful conversation with Ciara Gravier from The Bunker Insurance & Risk Management and Zach Matter from ZipBonds. This episode is a must-listen for anyone involved with contractors, particularly those navigating the world of surety bonds. Ciara and Zach discuss how contractors can face challenges with messy financials and how these issues can impact their ability to qualify for larger projects. They dive into the importance of having tidy books, understanding bond requirements, and using bonds as a way to build strong client relationships. Zach also highlights the essential three C's for bond approval—character, capacity, and capital—and explains how producers can add value by properly presenting these factors to underwriters. This episode is packed with practical strategies for agents to help contractors and clients navigate the complexities of surety bonds while building stronger, more profitable relationships. Key Highlights: Understanding Bonds for Contractors Ciara explains how she used bonds as an educational tool to connect with contractors and help them understand the importance of having clean financials. She also shares how SEO and email marketing strategies can help agents engage contractors on bond topics. The Three C's of Bond Approval Zach breaks down the three key factors for bond approval: character, capacity, and capital, and how agents can provide valuable insights to help contractors qualify for bonds. Expanding the Bond Conversation Beyond Construction Zach emphasizes that bonds aren't just for construction. From liquor licenses to ERISA bonds for 401(k) plans, many industries require bonds, making it an essential conversation for all agents to have with their clients. Using Bonds as a Client Relationship Builder Ciara shares how she leveraged bonds to build relationships with CPAs, contractors, and even business attorneys, turning bonds into a valuable revenue stream and referral source. Subcontractor Default Insurance vs. Surety Bonds Zach talks about the growing use of subcontractor default insurance (SDI) and how it can impact the bond process. He explains the additional work involved when a subcontractor cannot qualify for SDI and how to handle it as a producer. Connect with: David Carothers LinkedIn Zach Matter LinkedIn Ciara Gravier LinkedIn Kyle Houck LinkedIn Visit Websites: Power Producer Base Camp ZipBonds The Bunker Insurance & Risk Management Killing Commercial Crushing Content Power Producers Podcast Policytee The Dirty 130 The Extra 2 Minutes

Enhancing Payment Integrity in Health Systems: An In-depth Discussion with Kimberly Carleson. In Episode 481 of Relentless Health Value, host Stacey Richter speaks with Kimberly Carleson, CEO of US Beacon, about payment integrity within health systems. They delve into strategies some hospitals use to maximize revenue without raising rates and discuss the importance of accurate billing.  Key takeaways include the high prevalence of billing errors, which can lead to significant overcharges for plan sponsors, often due to documentation gaps and complex coding systems. Kimberly provides actionable advice for both healthcare providers and plan sponsors on how to mitigate billing inaccuracies and enhance transparency.  Emphasized points include the necessity of third-party claim audits, understanding legal rights under various acts, and the importance of maintaining clear communication and compliance with legal billing standards. === LINKS ===