ERISA governs most employer health plans, and most of those plans include a reimbursement provision. Section 502(a)(3) lets a plan pursue equitable relief to enforce it, usually through an equitable lien. After McCutchen, the plan’s written terms control that analysis, which means the reduction on your file was largely decided the day the plan was drafted. Recovery vendors negotiate on the assumption that nobody will ask to read it. The strategies below start from the opposite assumption.
Every one of these turns on plan documents most firms never deeply analyze.
The steps in order, from confirming funding status through the document request, the plan language review, and the equitable arguments that remain open. Built for paralegals and attorneys handling ERISA plan reimbursement.
Teresa Kenyon and the Synergy subrogation team on key ERISA considerations and common pitfalls, reviewing plan language and demand documentation, understanding reimbursement rights and enforcement, navigating negotiation challenges, and strategies to help maximize the client’s recovery.
Seven checkpoints covering retainer language, client consent, fee transparency, and partner vetting, plus the supervisory steps that keep your firm accountable once the work is outsourced. Grounded in ABA Model Rules 1.1 and 1.15, built for firms sending ERISA, Medicare, and Medicaid liens to a third party.
Funding status, the 1024(b)(4) request, plan language ambiguity, the equitable doctrines that survive where the plan is silent, and defenses including unjust enrichment and undue hardship.
Synergy is the nation's largest provider of single-event healthcare lien resolution and Medicare Secondary Payer compliance for personal injury law firms. We act as an extension of the firm, removing the lien resolution administrative burden and ensuring compliance so our clients can focus on what they do best. Our team pairs deep subrogation expertise with advanced technology and industry leading customer service to deliver exceptional outcomes. With more than 300 years of combined experience across all 50 states, we have saved injury victims over $1 billion through strategic lien resolution.
Send it over. A Synergy attorney or lien specialist will review the plan posture and tell you where the reduction opportunities are. Request your Free ERISA Lien Analysis.
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