Dark Data:
Unknown or untapped data across an organization;
Data that companies lack the expertise to extract value from.
Dark Data:
Unknown or untapped data across an organization;
Data that companies lack the expertise to extract value from.
Self-funded plan sponsors and their executives are ERISA Fiduciaries required to act solely in the interest of plan participants, carry out duties prudently, follow plan documents, hold plan assets in trust, and pay only reasonable plan expenses.
Employee class-action lawsuits for health plan fiduciary breach were filed against Johnson & Johnson
and Wells Fargo in 2024.
To deploy fiduciary oversight, employers must obtain paid claims data and financial information held by their Plan Administrator (ASO Carrier/TPA) to be analyzed by retained healthcare experts.
The Consolidated Appropriations Act of 2021 (Section 201) made clear that Plan Administrators can no longer withhold this data from employers, and that employers may share this data with Business Associates.
Plan Administrators do not want to share this data and therefore offer "standard" layouts that are missing several key pieces of information.
To obtain all necessary data, employers must make targeted requests for specific data extracts that each contain specific data fields. This is not possible without knowledge of what extracts are available and what fields are contained within them.
Dark Data Health Insights has spent the last 18 years analyzing the paid claims data of 37 of the most prominent medical carriers in the U.S. (the "BUCAs").
We know exactly what is available and how to ask for it. Let us help you obtain all information needed to understand your spend, protect your plan, and control your costs.