Who is an ERISA fiduciary for a health and welfare plan?

Who is an ERISA fiduciary for health and welfare plans?

Under ERISA, anyone who exercises discretionary authority over a health and welfare plan—or its assets—must act solely in the best interest of plan participants and beneficiaries.

ERISA fiduciaries in health and welfare plans include:

• Plan sponsors or committees that make decisions about plan coverage or benefit design

• Claims administrators or third-party administrators (TPAs) with discretionary authority to approve or deny benefits

• Trustees or plan administrators responsible for managing plan operations and ensuring compliance

But, not everyone involved in administering health and welfare benefits is a fiduciary.

Non-fiduciaries could include:

• TPAs that perform purely administrative tasks without discretionary decision-making

• Service providers (e.g., recordkeepers or brokers) offering basic data or transactional support

• Consultants providing general education or recommendations without authority to implement their decisions.

The bottom line: ERISA fiduciaries must uphold a high standard of care and loyalty—always putting participants’ interests first.

If you manage or oversee a health and welfare plan, it’s essential to understand whether you’re acting as a fiduciary.

What’s your biggest challenge in navigating ERISA compliance for health and welfare plans?