The Hidden Legal Risk in Your Health Plan

If you are a CEO, CFO, head of HR, or financial decision-maker for your company—don’t skip this quick read.Missing it could mean overlooking a growing legal threat—and walking straight into the kind of fiduciary litigation that’s already hitting some of the largest companies in the country.

In a recent article, healthcare policy expert and attorney Chris Deacon unpacks a wave of lawsuits filed by employees against their employers—companies like Johnson & Johnson and JPMorgan Chase—alleging mismanagement of health plan funds. These lawsuits are based on ERISA, which requires employers to act as fiduciaries when managing employee benefit plans, ensuring that every dollar spent is in the best interest of the employee.

The focus? Massive overpayments on prescription drugs and healthcare services, largely due to poor oversight and opaque relationships with third-party vendors like pharmacy benefit managers (PBMs). These vendors are often recommended by benefit consultants or brokers—many of whom receive commissions, rebates, or bonuses from the carriers and PBMs themselves.

This is what we mean by conflicts of interest: the people tasked with guiding your company's healthcare strategy may be financially incentivized to recommend plans that benefit them more than you or your team.

Here’s something that’s important to acknowledge: most traditional brokers aren’t bad actors. They’ve simply been trained in a system where “helping” a business means selling them a health insurance policy from one of the big BUCA networks—Blue Cross, UnitedHealthcare, Cigna, Aetna—and then earning a commission on that sale. But those commissions aren’t coming from you, the employer—they’re paid by the insurance companies.

And this may be a harsh reality, but it’s an important one: if your broker is getting paid by the insurance company, then who are they really working for?

Even if they genuinely want to help you, they’re limited by a model that prioritizes volume and loyalty to carriers—not cost savings, innovation, or individualized solutions for your business.

And that’s why these lawsuits should be a wake-up call—not just for large corporations, but for small and mid-sized businesses too. Especially those with under 50 employees, who often assume high-quality benefits are out of reach.

Here’s where it gets personal.

I’m Dr. Dana Mincer, a board-certified family physician, founder of Love Health DPC, and someone who grew up in a small family-run business. I watched my parents pour everything they had into caring for their employees—including paying 100% of their healthcare premiums. But over time, those 7–10% annual premium hikes made it impossible to keep up. The coverage got worse, the costs got higher, and it put them at a disadvantage against larger competitors.

It wasn’t because they didn’t care—it was because they didn’t know better options existed. And most small business owners still don’t.

That’s why I do what I do now.

At Love Health DPC, we help businesses build benefits strategies that:

• Cut healthcare spending by 25–50%

• Offer unlimited, direct access to high-quality primary care

• Eliminate waste and broker conflicts of interest

• Empower employers with control, compliance, and clarity

We combine Direct Primary Care, transparent third-party administrators (TPAs), and ethical pharmacy partners to deliver better care at lower costs—without sacrificing employee experience. In fact, your employees love this kind of care.

The truth? The real risk is doing nothing. Continuing with “the way it’s always been” isn’t just expensive—it’s legally risky, financially unsustainable, and increasingly out of step with what’s possible.

Let’s change the game. Let’s stop playing by rules that were never made for us. Let’s give your business—and your people—a better way.