Healthcare logistics company Owens & Minor has filed a lawsuit against Anthem Blue Cross and Blue Shield of Virginia, accusing the insurer of failing to uphold its fiduciary duties under ERISA through mismanagement of its employee health plan.
The lawsuit, filed Nov. 18 in a Virginia federal court, marks another chapter in a growing trend of legal disputes between employers and their health plan administrators over transparency and cost management.
Owens & Minor sponsors a self-funded healthcare plan for its employees and their families, relying on Anthem, a subsidiary of Elevance Health, to manage the plan's administration and assets since 2017. According to the lawsuit, Owens & Minor requested plan data in 2021 to ensure proper oversight. Anthem allegedly delayed and resisted providing the requested information, eventually forcing Owens & Minor to file suit to access its own data.
Now in possession of partial data, Owens & Minor claims it has uncovered significant financial mismanagement. The company alleges that Anthem used plan assets to enrich itself, failed to control healthcare costs, and sought to increase administrative expenses for its benefit. These actions have allegedly resulted in tens of millions of dollars in losses for the plan, with damages likely to grow as further withheld data is revealed.
The company seeks to recover losses and recoup what it describes as Anthem receiving "ill-gotten gains" as a "fox in the henhouse." Anthem told Becker's it does not comment on active litigation.
This lawsuit reflects a wider legal trend for employers and health plan administrators navigating ERISA requirements. Under the law, plan fiduciaries must act in the best interests of beneficiaries by seeking the lowest reasonable costs for services. Recent amendments, such as the Consolidated Appropriations Act of 2021, have heightened transparency requirements, leaving employers with new tools — and new pressures — to ensure compliance.
In June 2023, Kraft Heinz sued Aetna, alleging it exploited its role to charge undisclosed fees and process claims without adequate oversight. The food manufacturer voluntarily dismissed the lawsuit in December and moved it to private arbitration.
Additionally, lawsuits targeting PBMs have added to the momentum. Wells Fargo and Johnson & Johnson are facing claims that they allowed inflated drug prices to harm employee health plans. J&J's lawsuit revealed stark pricing discrepancies, with a multiple sclerosis drug costing $10,000 through its health plan versus $40 at retail pharmacies without insurance.
Prominent voices such as Mark Cuban have also cautioned employers about potential risks in their benefit management practices, warning that class-action lawsuits over pharmacy rebates are inevitable and could rival tobacco settlements in scale.