The Impact of Tiara Yachts v. BCBSM on Self-Funded Plans and Their TPAs

David Ostrowsky analyzes the Sixth Circuit’s decision in Tiara Yachts v. BCBSM and its far-reaching implications for self-funded plan sponsors and their TPAs. He highlights how the ruling underscores the critical need for sponsors to scrutinize claims administration practices, provider network arrangements, and out-of-network pricing, while reminding TPAs of their expansive ERISA fiduciary duties.