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Dell Facing $318M ERISA Lawsuit Over Alleged 401(k) Mismanagement

"The company's 401(k) plan covers about 63,000 participants and holds nearly $15 billion in assets, according to the complaint. Roughly one-third of these funds were in what plaintiffs termed 'underperforming' products ... The former employees argued that the company was involved in self-dealing and prohibited transactions under ERISA because it designed its own funds, picked the managers, decided how assets were allocated and then collected related fees." [Lowbruck v. Dell, No. 26-0209 (W.D. Tex. complaint filed Jan. 28, 2026)]

Are Biosimilars and Generics Living Up to Their Promise?

"According to the Association for Accessible Medicines (AAM), last year, generic and biosimilar drugs saved patients in the U.S. health care system approximately $467 billion, and their impact is only growing as more biologic patents expire. Still, realizing their full potential requires more than market availability. Plans require a well-defined strategy, supported by clear metrics, smart formulary design, and strong provider engagement, to convert potential into measurable ROI and improved health outcomes."

PBM Fiduciary Bill Arrives with Bipartisan Support

"[The] PBM Fiduciary, Accountability, Integrity and Reform Act, or PBM FAIR Act [S 3549], would add a PBM fiduciary section to ERISA section 3(21) ... The bill would also add a section to ERISA that would require PBMs and health plans' 'third party administrators' to give an employer plan sponsor or other 'responsible plan fiduciary' detailed compensation disclosures."

FDA Approves Wegovy Tablet, Creating a New Challenge for Employers

"The addition of new, effective weight-loss drugs could help hold down spending on the drugs, by increasing the level of competition and putting pressure on the manufacturers and distributors to hold down prices."

Employer Groups File Brief Against Iowa PBM Law to Protect Self-Funded Plan Flexibility

"The plaintiff is challenging the Iowa law requiring that, among other provisions, 'any willing pharmacy' be included in a prescription drug plan's provider network, including self-insured prescription drug plans governed by ERISA. In October, a federal judge blocked enforcement of several portions of the law, citing potential conflict with ERISA. In its brief, ERIC argued that ERISA preempts Iowa's law because that law directly interferes with prescription-drug benefit plan design and administration [.]" [Iowa Assoc. of Bus. and Ind. v. Ommen, No. 25-0211 (S.D. Iowa Jul. 21, 2025; on appeal to 8th Cir. No. 25-2494)]

District Court Dismisses Johnson & Johnson ERISA Suit Over Drug Costs

"A federal judge [has] dismissed the primary claims in a lawsuit alleging that Johnson & Johnson had mismanaged prescription drug benefits for employees. Judge Zahid N. Quraishi ... ruled that plaintiffs Ann Lewandowski and Robert Gregory failed to show they had standing to allege that the company had breached its fiduciary duty under [ERISA]." [Lewandowski v. Johnson & Johnson, No. 24-0671 (D.N.J. Nov. 26, 2025)]

Is Your 401(k) Keeping Up with Change?

"[Recent] developments create appealing opportunities for plan sponsors and participants; however, they require careful consideration from many dimensions.... [1] How will participants evaluate contribution options? [2] If automatic enrollment or escalation features are added, what is the forecasted impact on company costs? [3] Will new matching provisions, such as matching student loan payments, affect nondiscrimination testing? [4] Can payroll systems handle the Roth catch-up requirement? [5] Is an emergency savings account appropriate within your 401(k) plan? [6] Can your recordkeeper effectively administer and communicate new features?"

GLP-1 Coverage: A Roadmap for Balancing Cost and Care

"Simply slashing coverage isn't always a viable solution, as GLP-1s have become a competitive differentiator ... As a result, many employers are turning to utilization controls to curb unsustainable growth while continuing to offer access to GLP-1s. As employers grapple with balancing cost and access, some are pioneering innovative strategies to manage this tension."

Unfunded Retiree Health Care Debt Surpasses Pension Liabilities

"Unfunded retiree health care debt is becoming an unsustainable financial burden for state and local governments, as the price tag for Other Post-Employment Benefits (OPEB) grows larger with medical inflation, while assets set aside to pre-fund these obligations remain low.... [A recent analysis] found that states and large municipalities collectively reported $789 billion in unfunded OPEB liabilities, exceeding the $753 billion in unfunded pension liabilities, as of 2022."

Employers' Legal Minefield: Balancing COBRA, the ACA, ERISA, and Immigration Enforcement

"This article addresses the tensions employers face when an employee loses valid work authorization or is discovered to have used false identity documents.... [A] termination of employment with a loss of health plan coverage usually triggers a legal obligation to offer continuation coverage. This can leave employers questioning whether offering COBRA to someone now unlawfully present could violate immigration law.... Employees who lose TPS or other temporary work authorization present a particular challenge."

Individual Patient's Genes May Affect Which GLP-1 Obesity Drugs Work Best

"Knowing which works better is critical for employers' health plans, because anti-obesity drugs now account for about 17% of U.S. employer health plan prescription spending ... The full retail price of the drugs is about $1,400 per month for Victoza; $1,500 per month for Wegovy, a better-known drug that's similar to Victoza; and just $200 per month for Qsymia."

House Bill Could Eliminate ACA Employer Health Coverage Mandate

"[HR 3080] could eliminate the [ACA] employer health coverage mandate ... Other provisions would support state efforts to create association health plans and endorse state use of high-risk pools to provide health coverage for high-risk individuals ... [The] bill would replace today's HSAs with 'Roth HSAs' ... [E]arlier version of [this] bill had six Republican cosponsors and died in committee. The new version may have a chance to go farther[.]"

ACA Changes Could Impact Employer Plans, Individual Coverage Reimbursements

"[T]he new draft regulations could affect efforts to use small-group exchange plan coverage or help workers with individual coverage health reimbursement arrangements use the ICHRAs to sign up for individual health coverage. The draft regulations could also have indirect effects on employer plan coverage, by reducing people's access to individual ACA exchange plan coverage and increasing pressure on workers to get health coverage through their employers."

Change Healthcare Sued by CareFirst BlueCross BlueShield Over 2024 Data Breach

"The lawsuit ... alleges that the UnitedHealth Group subsidiary's cybersecurity standards were insufficient to prevent the attack.... CareFirst said it lost a large amount of data related to employer accounts and its Medicare Advantage business ... CareFirst BlueCross BlueShield serves 3.5 million groups and individuals in Maryland and the Washington, D.C., metropolitan area. It has a 75 percent market share in the state and also serves more than 626,000 members in the Federal Employees Health Benefits Program." [CareFirst Inc. vs. Change Healthcare Technologies, LLC, No. C-03-CV-25-000701 (Balt. Cty. Circ. Ct. complaint filed Feb. 21, 2025)]

PBM Rebate Law Leads to Dramatic Premium Reductions in West Virginia

"West Virginia insurance regulators have evidence that requiring pharmacy benefit managers to pass all prescription drug rebates through to employers could lead to huge premium savings in the small-group health insurance market. A new report posted by the state's Office of the Insurance Commissioner shows that a state PBM rebate pass-through law cut the average 2025 small-group rate increase by 52%.'  

Texas Could Keep Health Insurers from Making Patients Use Insurer-Owned PBMs

"Texas state Rep. Cody Harris ... introduced a bill that could prohibit a health insurer, a health maintenance organization or any other health benefit plan issuer with a financial interest in a PBM from requiring a plan participant to use the PBM.... [The bill would prohibit] health benefit plan issuers and PBMs from using cost-sharing rules or other benefit design rules to encourage patients to use pharmacies affiliated with the issuers or PBMs."

Supreme Court Hears Cornell's 403(b) Excessive Fees Case: Did It Open the Floodgates for More Suits?

"The Supreme Court was divided on the issue, with Associate Justice Brett Kavanaugh expressing concern about the burden of providing evidence for employers if plaintiffs can sue without evidence upfront, which 'risks opening the floodgates to burdensome [lawsuits],' he said. On the opposite end, Justice Ketanji Brown Jackson questioned whether the current legal standard makes it too difficult for workers to hold fiduciaries accountable because it 'would be really, really hard for us to determine that the plaintiff has to plead them because they don't have the information,' she said." [Cunningham v. Cornell Univ., No. 21-0088 (2d Cir. Nov. 14, 2023; cert. pet. granted Oct. 3, 2024; oral arg. Jan. 22, 2025 transcript and audio)] 

Trump Rescinds Biden-Era Supplemental Health Benefits Notice Requirement

"The executive order that was canceled helped serve as the justification for a warning notice requirement that affected all forms of fixed-indemnity health insurance benefits, including critical illness insurance, cancer insurance, hospital indemnity insurance and accident indemnity insurance."

Vermont Saves: New Auto-IRA Program Requires Employers Without a 401(k) to Enroll Employees

"Vermont is joining the growing list of states -- now 17 -- requiring employers to either enroll tens of thousands of employees in the state plan or offer their own 401(k) plan. The program is a state-run automated savings program (or Roth IRA-style program) in which participants can contribute up to $7,000 a year that is automatically deducted out of an employee's paycheck."

Drivers of Pharmacy Benefits Costs (and How to Control Them)

"[K]ey trends driving drugflation: [1] The uneven employer-PBM negotiating field ... [2] The rapidly increasing number of specialty medicines ... [3] The explosive rise in GLP-1 use (and uses) ... [S]trategies for benefits advisors looking to help their clients optimize their pharmacy benefits: [1] Check the fine print ... [2] Focus on the right details ... [3] Ensure your pharmacy benefits partner is working for you."