Recover What Your TPA Won't Return

AVYM identifies and recovers self-funded health plan assets hidden within complex TPA recoupment cycles and structural conflicts — as required under ERISA and fiduciary law.

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Zero Conflict of Interest No Upfront Costs 13+ Years

Your TPA Has a Structural Conflict

Third Party Administrators operate in a landscape where their interests often diverge from plan sponsors. Aetna, UnitedHealthcare, and Cigna administer 42–76% of all self-funded lives — creating inherent incentive misalignments that cost plan sponsors millions.

42-76%

Self-funded lives

Of the total US insured population covered by ERISA self-funded plans.

67%

Covered workers

Are enrolled in plans that are self-funded rather than fully insured.

$593B

TPA market size

Projected global market revenue for claims administration services.

$26.9K

Avg family cost

Annual health coverage cost for an average family of four.

How We Recover Your Plan Assets

Comprehensive Recovery
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Demystify TPA Recoupments

Uncover overpayment recoupments between TPAs and providers that quietly drain your plan assets instead of returning them to sponsors.

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Identify Hidden Fees

Analyze Administrative Service Agreements to pinpoint undisclosed shared savings or transactional fees disguised as claim payments.

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Pinpoint ASA/ASO Issues

Fiduciary-first auditing of legal contracts to ensure compliance with ERISA section 404/406 standards and protect plan interests.

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Turnkey Operation

Full lifecycle management of claims recovery with zero disruption to your existing HR or financial workflows. No upfront costs.

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Ongoing Claims Monitoring

Continuous oversight of current claims cycles to prevent future leakage and maintain permanent plan asset integrity.

The Only Independent Auditor With Zero Conflicts

AVYM Corporation is not an insurance company, a broker, or a TPA. Our independence is our greatest asset, allowing us to pursue recoveries that others are structurally incentivized to ignore.

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Zero Insurance Affiliations

We are purely client-focused. We never receive kickbacks or commissions from the carriers we audit.

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13+ Years in Market

Over a decade of specialized experience in ERISA law and healthcare billing cycle forensics.

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No Upfront Costs

Our performance-based model means we only succeed when you recover your assets.

Millions Recovered. Precedent Set.

Millions Total Recovered
100+ ERISA Articles
Since 2011 Operating History

Horizon BCBS Exposed

AVYM consultants exposed Horizon's alleged scheme to overcharge New Jersey's public employee health programs, leading to regulatory scrutiny.

6th Circuit Recovery Pathway

Federal appeals court created a new legal pathway for self-insured health plans to recover plan assets from TPAs under ERISA fiduciary standards.

Peters v. Aetna Fiduciary Lessons

Landmark fiduciary case establishing precedent for TPA accountability — every plan sponsor needs to understand these implications.

UHC Cross-Plan Offsetting Ruling

Court ruled UnitedHealthcare's cross-plan offsetting constitutes a grave conflict of interest, vindicating years of AVYM advocacy.

Frequently Asked Questions

What is ERISA healthcare claims recovery? expand_more
ERISA recovery involves auditing healthcare plans to ensure all paid claims align with plan documents and federal law, and recovering assets that were overpaid or improperly handled by TPAs.
Does our TPA already do this for us? expand_more
Most TPAs have internal recoupment cycles, but they often lack the incentive to return these funds to the plan sponsor, frequently keeping the recovered assets as "fees" or "shared savings."
Can a self-insured plan sue its TPA? expand_more
Yes. Under ERISA, plan sponsors have the right to bring action against TPAs for fiduciary breaches, including unauthorized recoupments, cross-plan offsetting, and failure to disclose fees. Federal courts have consistently upheld these rights.
What does the CAA 2021 gag-clause ban mean? expand_more
The Consolidated Appropriations Act of 2021 prohibits gag clauses that prevent plan sponsors from accessing their own claims data. This gives employers a statutory right to audit their TPA's performance and identify overpayments or hidden fees.

Find Out What Your Plan Is Owed