"SCOTUS seems to have opened the door to direct state-level regulation of PBMs and other vendors that provide services to self-funded plans, like third-party claims administrators.... The earlier standard allowed provider regulation that has an indirect impact on an employer plan costs. Now, SCOTUS is saying that state laws that regulate the amount PBMs pay for prescriptions directly but do not reference ERISA plans specifically are not preempted. The Rutledge opinion also weakens the longstanding holding that regulatory uniformity is a core ERISA principle." [Rutledge v. Pharmaceutical Care Mgmt. Assoc., No. 18-540 (S. Ct. Dec. 10, 2020)]