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The Wagner Law Group Asks DOL for Cybersecurity Guidance

"A number of legal questions remain unanswered and there is an acute need for comprehensive guidance from the DOL. These questions include: [1] what is the specific personal and/or confidential participant information that must be safeguarded by plan fiduciaries; [2] what standard of care applies to the protection of participant personal information; [3] what is the plan administrator's responsibility with respect to disclosing to participants the unauthorized appropriation of participant information; and [4] whether state cybersecurity, privacy, consumer protection or other laws are pre-empted by ERISA."

Proposed Changes to DOL Regs on ESG and Other Investments by Fiduciaries: What You Should Know and How The Wagner Law Group Responded

"The proposed rule ... goes beyond its stated objectives to affect how fiduciaries make all investment decisions.... In addition, the Proposed Rule would require fiduciaries to consider 'available alternative investments' in making investment decisions, without guidance as to what this would mean, and without recognizing that the best practice of comparing investment alternatives is not universally applicable to all circumstances.... The Proposed Rule does not define ESG Factors."

Rep. Wagner Introduces Bill to Kill the DOL Fiduciary Rule

"Rep. Ann Wagner, R-Mo., has introduced legislation that would create a new advisory standard somewhere between fiduciary and suitability.... Wagner's bill also would eliminate the fiduciary rule's prohibited transaction exemptions. It would amend the Securities Exchange Act of 1934 to include a best interest standard of care for brokers advising investors in the retail market."

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)]

Pharmacy Groups Defend Iowa PBM Law Amid Legal Challenge

"The National Community Pharmacists Association, Iowa Pharmacy Association, American Pharmacists Association and Independent Pharmacy Cooperative filed a friend-of-the-court brief ... arguing that the law is legal and urging the 8th Circuit Court of Appeals to allow it to stand. The groups, which represent independent community pharmacies, say that PBM actions targeted by Iowa's law are driving unaffiliated pharmacies out of business and harming patient access to drugs." [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)]

SECURE 2.0 Modifies Controlled Group and Affiliated Service Group Rules

"SECURE Act 2.0 changes the family attribution rules to allow disaggregation of the entities if the only common ownership is the indirect ownership of the entities by a child under the age of 21 due to the attribution of the parents' ownership interests to the child.... [A second change disregards] community property laws when determining ownership for purposes of controlled groups and affiliated service groups."

Experimental and Investigational Treatments and Procedures Under ERISA Group Health Plans (PDF)

17 pages. "While most group health plans contain an exclusion for medical and investigational procedures, the scope and the pace at which medical procedures and treatments are tested in the 21st century makes this an extremely difficult standard to apply. There is no bright-line test, experts frequently disagree as to when the line has been crossed, and in some instances the stakes are literally life and death. This article discusses some potential pitfalls for plan administrators and offers suggestions on how to address this difficult aspect of group health care administration."

Groom Law Group Recommendation for IRS Priority Guidance Plan: Expand 'Dependent' Definition for VEBA Purposes

"The Treasury regulations governing VEBAs were published nearly 45 years ago. Since that time, the provisions regarding who qualifies as a 'dependent' for VEBA purposes have become outdated.... This letter briefly summarizes [the] rationale for requesting this change and recommends an approach to modify the VEBA regulations to include expanded family relationships, similar to other areas of the law."

Fifth Circuit Weighs in on a Recurrent Problem: When Operational Errors Eliminate Group Life Insurance Benefits

"Group life is the redheaded stepchild of employee benefits, often added on by insurers on top of the primary products being sold to plan sponsors and employers, such as disability insurance.... [P]roblems tend to crop up in the administration of group life plans and in the payment of claims due to nothing more than the lack of attention that comes with being a relative afterthought." [Edwards v. Guardian Life Ins. of Am., No. 24-60381 (5th Cir. June 20, 2025)]

Group Health Plan Considerations in the Face of Potential Changes to Abortion Laws

"If an employer provides a travel benefit outside of its group health plan, the employer could unwittingly create another group health plan that would raise numerous compliance issues ... Amending a group health plan to provide travel benefits for participants to receive abortions out of state where abortions are not legal could subject an employer and its employees to potential risk under state law.... Employers who wish to take action to address the changes in the law should proceed with caution and remain flexible[.]"

New Illinois State Law Imposes Disclosure Requirements on Group Health Plans

"The CCDA requires employers that sponsor group health plans with employees in Illinois to disclose a comparison of the plan's coverage to certain 'Essential Health Benefits' required by Illinois state law.... The CCDA broadly applies, regardless of the employer's size or its location, to fully insured and self-funded group health plans. Additionally, the Illinois [DOL] has taken the position that the CCDA also applies to ERISA-covered self-funded group health plans."

Groom Law Group Comments on Possible Changes to Administrative Procedures and Rules for IRAs (PDF)

10 pages. Excerpt: On behalf of a group of financial institutions which offer products and services to individual retirement accounts and annuities, Groom Law Group submitted the [target] letter to the IRS requesting that the Service consider several areas in which the administrative procedures and rules for IRAs for tax purposes, which have not significantly changed in many years, could be improved or supplemented.

Groom Law Group Urges IRS to Expand Determination Letter Program

"[Groom Law Group submitted letters] recommending consideration of the following plans as applicants for updated determination letters: [1] Plans with a cash balance or similar benefit formula whose last determination letter was before the effective date of the final IRS hybrid plan regulations. [2] Plans that address income replacement and inflationary pressures through adoption of a variable annuity feature. [3] Traditional pension plans that convert to a cash balance-type formula. [4] Plans that undergo major changes that otherwise make certain compliance testing unnecessary -- such as safe harbor 401(k) plans. [5] Plan changes accompanying significant workforce adjustments, such as downsizings or corporate separations. [6] Corrective plan amendments submitted as part of an EPCRS submission. [7] Governmental plans where there has been a significant change in the governing state or local law."

Effect of New Federal Laws on Group Health Plans (PDF)

5 pages. Excerpt: This bulletin provides a summary of two federal laws that will impact group health plans: The American Recovery and Reinvestment Act of 2009, which was signed into law on February 17, 2009, and the Children's Health Insurance Program Reauthorization Act of 2009, which was signed into law on February 4, 2009.

Several New Laws Affect ACA and Employer-Sponsored Health Plans in 2020

"The [Further Consolidated Appropriations Act] repeals the ACA-imposed annual fee on health insurance providers ... which applied to insurance policies in the individual and small group markets ... [T]he Act finally repeals the highly unpopular excise tax on high-cost employer group health plans (the 'Cadillac' tax).... The Act extends the ACA's PCORI fee for 10 years, meaning that insurers and employers will have to continue to pay this fee until 2029 or 2030, depending on their plan year."

Is My Group Health Plan Covered by State PBM Reporting Laws?

"[A]ll 50 states have laws that regulate PBMs in some way, but all are unique.... [Most] have the same primary goals of reducing governmental waste and addressing the rising cost of drugs.... [M]any states have started implementing laws that have either a direct reference to self-insured plans or, even when silent on whether they apply to self-insured plans, still have a direct effect on the actions of the plan administrators."

Business Groups Sue Over Iowa's New Law Regulating PBMs

"The lawsuit ... contends that the law, Senate File 383, would upend prescription drug coverage in the state and violate the First Amendment by preventing employers from directing workers to some pharmacies over others. The lawsuit also says the Iowa law is in conflict with [ERISA]." [Iowa Association of Business and Industry v. Ommen, No. 25-0211 (S.D. Iowa complaint filed Jun. 23, 2025)]

District Court Rules Colorado Law Turns Group Life Insurance Policy's Two-Year Suicide Exclusion into a One-Year Exclusion

"Colorado Revised Statute Section 10-7-109 nullifies suicide exclusions longer than one year in life insurance policies. MetLife argued the statute applied to individual policies, but not group policies. The court rejected this argument because the Supreme Court of Colorado had recognized the longstanding public policy in Colorado that disfavored suicide exclusions and had applied the statute to group credit life insurance -- a different, but similar type of group insurance." [Auwae v. Metropolitan Life Ins. Co., No. 19-2504 (D. Colo. Mar. 2, 2020)]

Groom Law Group Letter to IRS: 2024-25 Priority Guidance Plan Recommendation (PDF)

"We again write to recommend that Treasury and IRS publish official guidance confirming that the 100% excise tax on reversions under Section 4976 of the Internal Revenue Code ... does not apply when an employer 'repurposes' surplus retiree benefit assets in a welfare benefit fund to provide other health and welfare benefits, including to active employees.... [T]here are compelling policy reasons to issue guidance to allow the repurposing of such assets -- and no apparent policy or legal reasons to continue to place billions of dollars of tax-deferred welfare benefit fund assets in 'tax limbo.' "

What Federal Laws Apply to Wellness Programs Under ERISA Group Health Plans? (PDF)

"Employers are faced with the tremendous challenge of understanding and complying with the many overlapping laws and continually changing rules that govern the various types of programs. Here is a high-level overview of some of the federal laws that employers with ERISA group health plans should consider before adding a wellness program."