News Archive

"For calendar year 2027, the annual limitation on deductions under section 223(b)(2)(A) for an individual with self-only coverage under a high deductible health plan is $4,500. For calendar year 2027, the annual limitation on deductions under Section 223(b)(2)(B) for an individual with family coverage under a high deductible health plan is $9,000.

"For calendar year 2027, a DPCSA is not treated as a health plan with respect to an otherwise eligible individual if the aggregate monthly fees for all DPCSAs with respect to the individual do not exceed $150 or, if the individual is covered by a DPCSA that covers more than one individual, $300.

"For calendar year 2027, a 'high deductible health plan' is defined under section 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,750 for self-only coverage or $3,500 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $8,700 for self-only coverage or $17,400 for family coverage.

"For plan years beginning in 2027, the maximum amount that may be made newly available for the plan year for an excepted benefit HRA under Section 54.9831-1(c)(3)(viii) is $2,250."  MORE >>

"The [DOL's] proposed regulation on selecting designated investment alternatives ... reflects an effort by the DOL to bring greater structure and clarity to how fiduciary decisions are evaluated under ERISA. For plan committees and advisors, that shift creates a number of practical opportunities.... [1] A clearer playbook for fiduciary decisions ... [2] Stronger documentation and defensibility ... [3] More confidence to evaluate broader investments ... [4] Reduced pressure to default to lowest cost ... [5] Better alignment with participant outcomes."  MORE >>

"Qualified long-term care distributions, established by the SECURE 2.0 Act, are plan distributions made after December 29, 2025, that satisfy specified criteria ... [IRS Notice 2026-33] explains that qualified long-term care distributions are considered to [1] satisfy the Code Section 401(k)(2)(B) distribution rules (and similar rules under Code Sections 403 and 457), [2] are not subject to the additional 10% tax on early distributions under Code Section 72(t), and [3] are not eligible rollover distributions."  MORE >>

"For employers that already provide fertility benefits through their major medical plans and/or through fertility HRAs, it is unclear whether an employer would terminate their existing fertility arrangement in favor of an excepted fertility benefit program that has set dollar limits, or adopt an excepted fertility benefit to supplement their existing fertility coverage.... Excepted benefit status may assist employers who sponsor a fertility HRA to avoid the ACA-HRA integration rules[.]"  MORE >>

"Employers that have allowed insurers to market these types of voluntary programs to their employee populations, and who are currently taking the position that the DOL's voluntary plan safe harbor applies, should take a fresh and careful look at whether all of the elements of the safe harbor have been met with respect to their voluntary benefit programs."  MORE >>

"[U]nlike certain other SECURE 2.0 permitted distribution, QLTCDs are not eligible for the extended three-year repayment period and are subject to several reporting and disclosure requirements, including a long-term care premium statement that must be filed with the plan by the insurance issuer. For plan sponsors that do choose to offer QLTCDs, [Notice 2026-33] provides relief by extending the amendment deadline."  MORE >>

"Although the Proposed Rule is framed as a relatively narrow set of amendments implementing SECURE 2.0, it could require meaningful operational adjustments for plan sponsors and service providers ... The Proposed Rule also may create incentives for some employers to reconsider which safe harbor they use. In particular, the DOL requested comments on whether plans may shift from the 2020 notice-and-access framework back to the 2002 wired-at-work Safe Harbor for active employees in light of the new paper statement requirements."  MORE >>

"One change that could increase traffic in the IDR portal is a reduction in the administrative fee for IDR participants from $115 to $15 per case.... Although slashing the fee could further increase the number of IDR cases, the federal departments say other finalized provisions should counter that trend.... Payers face new claim communication requirements ... Open negotiation becomes a more structured step ... Batching rules and eligibility reviews will shape dispute volume ... IDR eligibility scrutiny is set to increase ... Payer identification should become easier"  MORE >>

"Beginning with the 2027 plan year, insurers will no longer be required to offer standardized plans ... HHS now believes that these plans are 'an ineffective strategy' to simplify the plan selection process, improve the consumer experience, and increase consumer understanding.... The final rule permanently removes the option for insurers to use fixed-dollar and gross-premium threshold flexibilities beginning with the 2027 plan year.... [T]he final rule will largely continue current risk adjustment policies, with narrow exceptions.... The final rule adopts a [risk adjustment] user fee rate of $0.18 per member per month for the 2027 benefit year, a slight decline from the $0.20 per member per month fee that applied for the 2026 benefit year."  MORE >>

"The Proposed Rule does not by itself resolve all of the structural questions that private funds and other nonregistered products face in DC plans. It does, however, offer a clearer framework for fiduciaries' prudent process and highlights where the operational features of these products (particularly liquidity, valuation, benchmarking, fees, and complexity) may have to evolve. For managers and sponsors, the near-term focus is likely to be both on vehicles such as target date funds, balanced funds, and CITs and other delivery structures that can satisfy the Safe Harbor's expectations, and on targeted comments aimed at ensuring that the final rule can be applied to nonregistered structures on workable terms."  MORE >>

"The [DOL] continued its active defense of employers against claims they violated fiduciary duties in their use of forfeited funds when department lawyers made brief oral arguments in three separate appeals, having already filed amicus briefs siding with the employers in each."  MORE >>

"This decision adds to a growing split on whether providers may enforce IDR awards through private litigation. While the Fifth Circuit has held that no such right exists, this court and certain other federal trial courts have concluded otherwise, meaning that plans and insurers operating outside the Fifth Circuit may face greater exposure to enforcement lawsuits when they fail to pay IDR awards within the required 30-day window." [PHI Health, LLC v. Optimum Choice, Inc., No. 25-2320 (D. Md. Mar. 27, 2026)]  MORE >>

"Forty percent of respondents indicated [litigation] occasionally influences decisions, while nearly a quarter of respondents stated it frequently shapes their approach. While it's clear that litigation risk has an impact of decisions, many in the comments indicated that they feel pretty good about their documented processes for making plan design and administrative decisions."  MORE >>

"While about 84% of respondents to a recently released ACA Group survey reported using AI, they also reported that 'active AI use' occurred, on average, in only two of 20 compliance and operations sub-functions. Only 18% of firms that responded said they used AI in compliance tasks, compared with 5% in operations."  MORE >>

"The decision turns on two issues of interest to ERISA practitioners: whether the policy qualified as an ERISA-governed employee welfare benefit plan, and, after concluding that it did not, how Texas state law resolves a beneficiary dispute where the decedent signed a binding informal settlement agreement in pending divorce proceedings but died before the divorce decree was entered." [Principal Life Ins. Co. v. Jones, No. 25-0221 (S.D. Tex. May 27, 2026)]  MORE >>

39 pages. "Aon conducted a study of the investment policy statements of the 50 largest U.S. public pensions.... There is no single 'right' way to write an IPS, but it should be structured and worded with intention to provide clear guidance for implementation Especially with an evolving investment environment -- it is important that IPS documents evolve with the markets while maintaining appropriate risk management."  MORE >>

"[This] article examines how multi-layer asset allocation ranges can help institutional investors close unintended risk gaps in their investment policy statements. Aon's review of public pension investment policy statements found an even split between single-layer and multi-layer asset allocation ranges, despite the fact that single-layer approaches can allow significant risk drift without violating policy."  MORE >>

"The PBM industry continues to evolve through legislative action, litigation, and voluntary industry changes. [This article provides] a brief round-up of recent developments including new federal and state legislation targeting vertical integration, an ERISA preemption challenge to California's PBM reform law, and a new pharmacy care model announced by Optum Rx."  MORE >>

24 pages. "This report addresses the OIG's accomplishments for the semiannual reporting period from October 1, 2025, through March 31, 2026.... Investigative activities [in this time period included]: 737 Complaints received; 4 Criminal investigations referred for prosecution; 1/0 Indictments/Convictions; 23 Subpoenas issued."  MORE >>

"[T]his Essay argues that administrative and financial disclosure are not necessarily equivalent to fiduciary intelligibility. ... [It] identifies a participant-facing practice of fiduciary justification potentially latent within ERISA’s disclosure architecture itself. In a post-Loper Bright environment emphasizing statutory interpretation over accumulated administrative convention, the Essay argues that ERISA’s SPD framework may reveal a continuing commitment to participant-facing fiduciary stewardship rather than technical disclosure alone."  MORE >>

"A DCFSA is one of the few benefits that costs relatively little to offer but delivers real, recurring value to employees. Working parents notice when their employer helps them solve an actual problem, and a DCFSA does exactly that during the most expensive childcare months of the year."  MORE >>

"Although rooted in an executive order on alternative assets, the proposal addresses more than just alternative assets and outlines a new process-based safe harbor for fiduciary decision-making. This LawFlash outlines key themes and implications from the proposal."  MORE >>

"The SECURE 2.0 Act added this penalty exception, which is effective for distributions after December 29, 2025. Participants must provide a long-term care premium statement to the plan sponsor in order for the distribution to be qualified. The distribution will be qualified as long as the premium paid does not exceed the lesser of $2,600 (for 2026) or 10% of the participant's vested account balance."  MORE >>

607 pages. "This document sets forth these final rules related to certain provisions of the No Surprises Act regarding the Federal independent dispute resolution (IDR) process, which was established as part of the Consolidated Appropriations Act, 2021 (CAA). These rules finalize new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act. These final rules also require plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice (ERA) to an entity that does not have a contractual relationship with the plan or issuer. This document also finalizes amendments to certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review process, and the payment and collection of administrative fees and certified IDR entity fees. This document also finalizes the definition of bundled payment arrangements, amends requirements related to batched items and services and amends the rules for extensions of timeframes due to extenuating circumstances. Additionally, this document finalizes provisions that require plans and issuers to register in the Federal IDR portal."  MORE >>

38 pages. "This 2027 Final Letter provides updates on operational and technical guidance for the 2027 plan year for issuers seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Exchanges (FFEs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs). It also describes how parts of this 2027 Final Letter apply to issuers in State-based Exchanges on the Federal Platform (SBE-FPs).... The 2027 Final Letter focuses on guidance that has been updated for the 2027 plan year[.]"  MORE >>