Healthcare providers that act as fiduciaries for employee benefit plans must be diligent in navigating ERISA’s rules on prohibited transactions. Recent court cases, like Mator v. Wesco Distribution Inc., have underscored the critical need for ensuring that dealings with service providers, including third-party plan administrators and pharmacy benefit managers, are reasonable and not in violation of ERISA standards unless explicitly exempted. With increased scrutiny on fee disclosures and the management of plan assets, particularly under the new fee disclosure rules from the Consolidated Appropriations Act of 2021, healthcare providers should meticulously document all fiduciary actions to safeguard against potential legal issues.