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Word
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Definition
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Administrative Services Only (ASO)
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Administrative Services Only (ASO): An arrangement in which an insurance company provides claims paying assistance to a self-funded plan, such as claims adjudication, forms and enrollment, and perhaps arranging for stop loss insurance, but does not assume any insurance risk to plan participants or beneficiaries.
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Arbitrary and Capricious
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Arbitrary and Capricious: When applied in terms of a review of a claims denial, the phrase is tantamount to the least demanding form of judicial review. In effect, the Court must only determine whether, in light of the plan's provisions, the plan administrator's decision was rational. "[W]hen it is possible to offer a reasoned explanation, based on the evidence, for a particular outcome, the outcome is not arbitrary or capricious." Id. Though extremely deferential, the standard does not permit the reviewing court to merely "rubber stamp the administrator's decision." See, Jones v. Metropolitan Life Ins. Co., 385 F.3d 654 (6th Cir.2004).
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