"HSAs are viewed as personal accounts that are not ERISA-covered welfare benefit plans, so long as employee participation is completely voluntary and the employer's involvement is limited. However, there are ways in which an HSA contribution program could become subject to ERISA. Those ERISA triggers should be avoided because ERISA's compliance obligations were not crafted with HSAs in mind, and it is not clear how and whether all of ERISA's requirements could be satisfied by an HSA program."  MORE >>

"The 2024 guide offers drill-down information on complying with the Security Rule's administrative, physical, and technical safeguards for protected health information (PHI) in electronic form."  MORE >>

"Massachusetts employers have been reporting an uptick in audit requests from the Massachusetts Department of Family and Medical Leave (DFML) in late 2023 and early 2024. This article outlines ongoing requirements for Massachusetts employers under the MA PFML program and an overview of the audit process."  MORE >>

"[T]he first complaint was filed in what is expected to be a wave of litigation alleging breach of fiduciary duty in selecting and monitoring welfare plan vendors. While the facts of this particular case may make it somewhat distinguishable from the circumstances involved in most employer-sponsored plans, it does provide early insight into how future litigation may proceed." [Lewandowski v. Johnson & Johnson, No. 23-0671 (D.N.J. complaint filed Feb. 5, 2024)]  MORE >>

"HHS and [DOL] and Treasury released public-use files showing the outcome of every dispute decided in the independent dispute resolution (IDR) portal from January through June. In a summary report, the departments wrote that providers (including air ambulance providers) prevailed in 77% of the nearly 84,000 disputes in which a decision was rendered.... A previous report examined data over a 50-week stretch ending March 31, 2023, and found providers had won 71% of cases."  MORE >>

"Employer-sponsored plans are beginning to use data from hospitals and health plans to compare the prices they pay and design more efficient plans that meet quality goals ... But many plan sponsors say insurers often refuse to turn over their claims data, leading to government investigations."  MORE >>

26 pages. "OCR received 626 notifications of breaches affecting 500 or more individuals, representing an increase of 3% from the number of reports received in calendar year 2021. These reported breaches affected a total of approximately 41,747,613 individuals.... OCR completed 799 breach investigations ... OCR resolved three breach investigations with resolution agreements, corrective action plans, and monetary payments totaling $2,425,640."  MORE >>

"About two-thirds of individuals reported that they have a choice of health plan.... Enrollment in HSA-eligible health plans and health reimbursement arrangements appears to have leveled off, bouncing around between 18-19% between 2020 and 2023. Enrollment in health plans with high deductibles that were not eligible to be paired with an HSA fell from 12% to 9% between 2022 and 2023, after having reached 15% in 2020.... HDHP enrollees are less likely to be extremely or very satisfied than traditional plan enrollees. "  MORE >>

"A small number of PBMs hold significant market power and are reaping abundant profits at the expense of the patients, employers, and government payors the PBMs are supposed to help.... While state law can provide the basis for oversight of and lawsuits against PBMs, States often face arguments by PBMs that federal jurisdiction and preemption limit states' authority to regulate PBMs.... Thus, the FTC and Congress must act to ensure fulsome regulation of PBMs nationwide."  MORE >>

"If Chevron is overturned or significantly weakened, new DOL and US Department of the Treasury regulations featuring aggressive statutory interpretations (like the fiduciary rule) are likely to become rarer and more vulnerable to challenge.... [B]ecause employee benefits cases challenging agency actions have only rarely reached the Supreme Court, employee benefit cases may be especially affected by how lower courts apply the result of Loper Bright and Relentless, which in turn may vary by federal circuit and district court." [Loper Bright Enterprises, Inc. v. Raimondo, Sec. of Comm., No. 22-451 (S.Ct. transcript of oral argument Jan. 17, 2024); Relentless, Inc. v. Dept. of Commerce, No. 22-1219 (S. Ct. transcript of oral argument Jan. 17, 2024)]  MORE >>

"The monetary results reflect the breadth of the DOL's civil enforcement actions, with just over half of recoveries relating to terminated vested defined benefit plan participants and the rest (over $415 million) from other plan investigations. The specific mention of results relating to mental health reflects that this topic is currently a high priority for the DOL."  MORE >>