6th Circuit Revives ERISA Fiduciary Claims Against Health Plan TPA

( May 22, 2025, 2:37 PM EDT) -- CINCINNATI — Disagreeing with the trial court on every challenged issue it reached, the Sixth Circuit U.S. Court of Appeals on May 21 reversed dismissal of a company’s suit against the third-party administrator (TPA) of its self-funded health benefits plan, concluding that relief is available under the Employee Retirement Income Security Act and that the company sufficiently alleged that the TPA was a functional fiduciary when allegedly “exercising discretion over its compensation” under a shared savings program (SSP) and “overpaying providers based on flip logic and other claims-processing errors.”...