"Generally, for-profit health insurers operate in their local jurisdiction with a lower capital and surplus level, reporting lower RBC ratios, while their increased leverage leads to higher returns on equity. This management approach usually entails larger and more frequent contributions of capital to the insurer by its ultimate owners, as well as more frequent dividends being paid out by the insurer. In contrast, nonprofit or not-for-profit insurers have less access to outside capital and therefore must effectively manage business requirements and risk by holding more capital and surplus on their own balance sheet." MORE >>
"Earlier this year, the nation's highest court asked for the [DOL] to weigh in on a case involving the burden of proof in ERISA cases -- and the response is a complete reversal of its previous position. In an amicus filing ... the [DOL] explained that the 'relevant authorities' provided no trust-law consensus on shifting the burden of proving causation to defendants. And that, they wrote, means that the 'ordinary default rule' governs -- and that was correctly applied by the court of appeals here that required the plaintiffs to prove causation." [Pizarro v. Home Depot, No. 22-13643 (11th Cir. Aug. 2, 2024; cert. pet. filed Dec. 3, 2024; DOL brief filed Dec. 9, 2025)] MORE >>
"The US solicitor general advised the US Supreme Court to hear two pending ERISA disputes and rule in favor of the defendant employers ... In urging the justices to hear the case against Home Depot, the government acknowledged that it's taken the opposite position in prior briefs, including a 2023 brief supporting the plaintiff Home Depot employees in the US Court of Appeals for the Eleventh Circuit." [Johnson v. Parker-Hannifin Corp., No. 24-3014 (6th Cir. Nov. 20, 2024; cert. pet filed Mar. 26, 2025, No. 24-1030; DOL amicus brief filed Dec. 9, 2025); Pizarro v. Home Depot, No. 22-13643 (11th Cir. Aug. 2, 2024; cert. pet. filed Dec. 3, 2024; DOL amicus brief filed Dec. 9, 2025) ]MORE >>
"IRS guidance permits employers to post a website notice of availability of Forms 1095-B and 1095-C with respect to those ACA forms rather than distribute the forms to every individual. But some states now have their own reporting requirements that may still require the ACA forms or similar state-issued forms to be automatically provided to individuals." MORE >>
"Because exhaustion is not required for a true fiduciary-duty claim, the court concluded that Bechtel was not obligated to pursue a second plan appeal. It therefore denied Wexford's motion as to the Section 1132(a)(3) claim. The court granted summary judgment to Wexford on the Section 1132(a)(1)(B) denial-of-benefits claim and denied summary judgment on the Section 1132(a)(3) fiduciary-breach claim." [Bechtel v. Wexford Health Sources Inc., No. 25-8006 (D. Ariz. Dec. 10, 2025)] MORE >>
"PSCA's 2025 403(b) Plan survey shows that automatic enrollment is beginning to take hold in 403(b) plans, boosting participation rates to all-time highs. The survey also shows big jumps in the adoption of Roth, investment advice, and SECURE Act provisions." MORE >>
"A variety of nonprofit organizations have called on top leaders from both chambers of Congress in support of legislation that would allow plan sponsors of 403(b)s to include collective investment trusts (CITs) in their investment lineups." MORE >>
"The Connecticut Supreme Court reversed a lower court and held that the Town of Groton is not required to extend employer health savings account (HSA) contributions to retired police officers.... [R]etirees argued that a 2008 pension agreement promising the 'nature and scope of coverages, including but not limited to deductibles' in effect for active officers entitled them to the same HSA contributions the town provides to active officers under a later collective bargaining agreement." [Duso v. Groton, No. SC 21082 (Conn. Dec. 9, 2025)] MORE >>
"Preventive care is one of the most valuable yet misunderstood benefits employees have access to. This guide breaks down what preventive care really includes, what's free under most health plans, and why early detection matters for both employee well-being and employer costs. HR leaders play a critical role in helping employees use these benefits confidently, reducing confusion, strengthening trust, and improving overall health outcomes." MORE >>
"[T]he lower tax rates were extended permanently by OBBBA -- but this is no time to let your guard down -- a future Congress could still increase tax rates. Take advantage now before year end especially with Roth conversions, and maximizing the lower tax rates for 2025. Also, avoid focusing on reducing taxes for this year at the expense of lifetime tax savings. Plan for life and beyond, not just for this year." MORE >>
"Although third quarter 2025 PRT sales fell 32% year over year, results were 137% higher than second quarter 2025 results. In the third quarter, total PRT new premium was $10.6 billion. YTD, total PRT sales were $21.6 billion, down 48% year over year.... More than 80% of the contracts sold this year were less than $50 million, signaling broader market interest in these pension liability mitigation solutions[.]" MORE >>
"Health plan prescription drug formularies continue to increase in complexity, and changes to those formularies are especially challenging for consumers to navigate.... Formularies are divided into anywhere from four to six tiers to manage costs and encourage the use of clinically effective, lower-cost medications. Each tier corresponds to a different level of cost-sharing for the patient. The lower the tier, the less the patient pays out of pocket." MORE >>
160 pages; Dec. 2025. "This document covers details on composing and submitting Forms 1094/1095-B and Forms 1094/1095-C by transmitters to IRS. The scope of the document addresses the A2A-application based via SOAP messages exchanged between client and exposed Web Service endpoints and the Web UI-browser-based requiring human initiation." MORE >>
"The class action lawsuit, dismissed in 2010, did not deter the NEA, but raised awareness of potential conflicts of interest when unions endorse costly financial/retirement products for their members." MORE >>
"Earlier this year, the district court allowed the case to move forward saying the plaintiffs had established standing but immediately froze further proceedings after a nearly identical case was dismissed in a separate circuit. In August, Lockheed Martin filed an immediate appeal on the standing issue, which was supported by ERIC and other employer groups who filed an amicus brief urging the appeals court to review and reverse the district court's decision." [Konya v. Lockheed Martin Corp., No. 24-0750 (D. Md. Mar. 28, 2025; on appeal to 4th Cir. No. 25-180)] MORE >>
"A study led by Brown University researchers found that Oregon's cap on hospital prices for its public employees, established by 2017 legislation that limits payments to 200% of Medicare rates for in-network services and 185% for out-of-network, has so far produced little disruption in hospital finances or the quality of patient care." MORE >>
"77% of Americans who have reviewed their 2026 plan choices felt good about their coverage options, with the highest satisfaction among Medicare beneficiaries (86%) and people with employer-sponsored plans (81%). 57% of Americans enrolled in ACA plans remain hopeful that enhanced subsidies will be extended by Congress. 51% of Americans who have reviewed their coverage options were surprised by the high cost of monthly premiums, including 79% of ACA enrollees." MORE >>
"Employers interested in offering a [Trump Account Contribution Program (TACP)] benefit now have scaffolding upon which to start building out their programs. For example, employers will want to consider whether to allow funding through cafeteria plan salary reductions, as well as the processes for tracking contributions and communicating the new benefit to employees. Meanwhile, the federal government has established a new website with information about TAs and has issued drafts of IRS Form 4547 (Trump Account Election(s)) and related instructions." MORE >>
25 pages. "This GRIST details the 2026 COLAs for retirement, health and fringe benefit plans, as well as Medicare and Social Security. Although IRS has not issued 2026 covered compensation tables for retirement plans, Mercer has projected those amounts." MORE >>
18 pages; Rev. Nov. 2025. "The purpose of this publication is to set forth the tax year 2025 requirements for: [1] Using official [IRS] forms to file information returns with the IRS, [2] Preparing acceptable substitutes of the official IRS forms to file information returns with the IRS, and [3] Using official or acceptable substitute forms to furnish information to recipients." MORE >>
101 pages; rev. Dec. 2025. "[This publication] outlines the communication procedures, transmission formats, business rules and validation procedures for information returns transmitted electronically through the AIR System.... The procedures in this publication should be used when the following information returns are transmitted electronically for [Tax Years 2015 through 2025] in PY2026: [1] Form 1094-B ...[2] Form 1095-B ...[3] Form 1094-C ...[4] Form 1095-C[.]"MORE >>
"[Attorney Jamie Fleckner] recommends that fiduciaries make sure the plan document is 'consistent with what company and fiduciaries are looking for.' Fiduciaries should look holistically at the document, and 'if you want to offset, either mandate that or allow that.' ... [Attorney David Levine] makes a similar recommendation. Sponsors should look at their documents and evaluate their process to see if the two align." MORE >>
"Many middle- and upper-income savers assume they will face a higher tax rate in retirement, but that might be less likely than they think. A taxpayer's effective tax rate is lower than their top marginal rate. Careful tax analysis -- not speculation -- should inform the choice between making traditional and Roth contributions at work." MORE >>
"The [CMS] understands that funds in many QHP issuers' Section 1303 segregated accounts holding payments received for coverage of non-Hyde abortion services have accumulated year over year ... These segregated accounts may also generate interest, further increasing the total amount accumulated. These FAQs ... and provide guidance on how QHP issuers in the individual market can use the accumulated funds in their Section 1303 segregated accounts, and the non-Hyde abortion segregated accounts in particular." MORE >>
"Taking no more than your RMD generally is advantageous because of tax-deferred compounding. But a larger distribution in a year your tax bracket is low may save tax. Be sure, however, to consider the lost future tax-deferred growth and, if applicable, whether the distribution could: [1] cause Social Security payments to become taxable, [2] increase income-based Medicare premiums and prescription drug charges, or [3] reduce or eliminate the benefits of other tax breaks with income-based limits, such as the new $6,000 deduction for seniors." MORE >>
