CAA Fiduciary Compliance: Why Employers Need a Health Plan Fiduciary Charter & Checklist
What Is the CAA and Why Does It Matter to Employers?
The Consolidated Appropriations Act of 2021 (CAA) significantly expanded fiduciary responsibilities for employers sponsoring ERISA‑covered group health plans. While employers have always been fiduciaries under ERISA, the CAA clarified, and intensified, expectations around transparency, documentation, and prudent decision‑making for health plans.
In simple terms, regulators and courts now expect employers to manage their medical plans with the same level of fiduciary care as retirement plans. This means documenting decisions, reviewing vendor compensation, and actively monitoring plan performance. Failure to comply doesn’t just create regulatory risk, it also increases exposure to fiduciary breach claims and potential class-action litigation.
The Shift: From “Passive Oversight” to Active Fiduciary Governance
One of the most important changes under the CAA is the expectation that employers establish a formal fiduciary process, not just rely on carriers, TPAs, or brokers.
Under the CAA, plan sponsors must be able to demonstrate that they:
- Act solely in the best interest of plan participants
- Make decisions using a documented, prudent process
- Monitor service providers and fees for reasonableness
- Maintain records showing how and why decisions were made
This is why regulators and advisors increasingly recommend forming a Fiduciary Committee governed by a written charter.
Why a Fiduciary Committee Charter Is the Foundation of CAA Compliance
A fiduciary committee charter establishes the structure, authority, and responsibilities of the individuals overseeing the health plan. It helps answer critical questions such as:
- Who is acting as a fiduciary?
- What decisions fall under fiduciary authority?
- How are conflicts of interest addressed?
- How often are decisions reviewed and documented?
Innovative Benefit Planning created a Fiduciary Committee Charter Sample to help employers take this first, critical step. The sample outlines governance best practices, fiduciary duties, and operating procedures designed specifically for health and welfare plans, not just retirement plans.
👉 Download: Fiduciary Committee Charter Sample
The CAA Fiduciary Checklist: Turning Requirements Into Action
While a charter defines governance, employers also need a practical roadmap for meeting CAA obligations. That’s where a fiduciary checklist becomes essential.
The CAA Fiduciary Checklist developed by Innovative Benefit Planning organizes compliance into a clear, repeatable process focused on three phases:
1. Establish
Adopt a fiduciary committee
Delegate fiduciary responsibilities
Establish governance practices aligned with ERISA standards
2. Analyze
Review PBM, TPA, and vendor agreements
Assess broker and consultant compensation
Conduct RxDC reporting and gag clause attestation
Perform Mental Health Parity (NQTL) analysis
3. Execute & Monitor
Document fiduciary decisions
Periodically benchmark vendors and fees
Monitor outcomes and adjust strategy as needed
This checklist is designed to help employers prove procedural prudence, which is often the most critical defense in fiduciary audits or litigation.
👉 Download: CAA Fiduciary Checklist
Documentation Is Your Strongest Fiduciary Defense
A key theme across CAA guidance and litigation trends is clear:
It’s not just what decisions you make—it’s how well you document them.
Courts and regulators focus heavily on whether employers followed a reasonable, consistent process supported by written records. A fiduciary charter combined with a structured CAA checklist helps create that defensible record.
How Innovative Benefit Planning Helps Employers Navigate CAA Compliance
Innovative Benefit Planning works with employers to:
- Establish fiduciary committees and charters
- Implement CAA‑aligned governance practices
- Support RxDC reporting, gag clause attestations, and NQTL analysis
- Create ongoing fiduciary documentation processes
Our goal is to help employers reduce risk, control costs, and confidently fulfill their fiduciary responsibilities under the CAA.
Start Building Your Fiduciary Framework Today
CAA compliance doesn’t have to be overwhelming, but it does require action.
✅ Start with governance
✅ Follow a documented process
✅ Keep records that demonstrate prudence
Free Resources:
📄 Fiduciary Committee Charter Sample
Both tools are designed to help employers move from awareness to action.
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