Where we’re going

The recent decision in Tiara Yachts v. Blue Cross Blue Shield of Michigan highlights a growing legal threat facing employers that sponsor self-insured health plans. It sends a clear message to plan sponsors that they cannot assume their administrator is always acting in the best interest of the plan. More importantly, they cannot afford not … Continued

In California, an ACL surgery can cost $4,400 at one hospital or $63,800 at another—both using the same insurer and located just 75 miles apart. The only real difference is which contract applies and which facility performs the service. The care is the same. The billing is not. This is not a rare outlier. It’s … Continued

Insights from Christine Cooper, CEO aequum and Jack Towarnicky, member, aequum   As healthcare costs continue their upward climb, plan sponsors face intensifying pressure to manage expenses while maintaining quality benefits. Traditional PPO models, long relied upon for broad provider access, now contribute to unchecked cost growth. In the July/August 2025 issue of Benefits Magazine, … Continued

Why This Case Signals a Shift in Risk and Responsibility for Plan Sponsors A recent ruling by the Fifth Circuit in Guardian Flight v. Health Care Service Corporation sends a strong message to healthcare providers and plan sponsors alike: the courts will not step in to enforce payment of Independent Dispute Resolution (IDR) awards under … Continued

Author: Jack Towarnicky, Member, aequum I was recently asked for advice by someone who was adding HSA-capable coverage for the first time. Here is some of my response: I have a number of plan design and communication suggestions based on my 20+ years of experience with HSA capable coverage. Each situation is different. So, you … Continued