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Group Health Plan Governance

Meaning

Group Health Plan Governance refers to the comprehensive system of rules, processes, and oversight structures that ensure an employer-sponsored health plan operates legally, ethically, and in the best financial interest of its participants. This encompasses the formal designation of fiduciaries, the establishment of internal controls, and adherence to all federal and state regulatory requirements, including the mandates of the Employee Retirement Income Security Act or ERISA. Effective governance provides a framework for managing risk and maximizing the value of the health benefit investment. It is an essential component of corporate responsibility and compliance.