"Group health plan sponsors should immediately consider several items from the Final Rule to demonstrate compliance: [1] Short timeline for government document requests.... [2] Stand-alone notice of noncompliance and public naming in report to Congress.... [3] Stop order for noncompliant NQTLs.... [4] Disclosures.... [5] Fiduciary certification.... [M]any plan sponsors.... will need to have a comparative analysis for each NQTL that complies with the Final Rule by January 1, 2025."  MORE >>

"The Rule amends and ... significantly adds to existing MHPAEA regulatory requirements and standards promulgated in 2013.... [T]he Final Rule, like the Proposed Rule, places heightened importance on covered plans and issuers providing access to mental health and substance use disorder (MH/SUD) benefits in order to demonstrate compliance, above and beyond whether plans are designed and administered in accordance with plan terms and processes that are in parity."  MORE >>

"[T]he Final Rule will continue to pose significant compliance challenges for plans and issuers with new requirements related to the documentation and justification of NQTLs. Plans and issuers must continue to perform and document NQTL comparative analyses, and these new rules will require plans and issuers to update existing NQTL comparative analyses documentation to comply with these new requirements."  MORE >>

"​This change in the affordability threshold for next year affords employers only a modest increase from 2024 in terms of setting affordability."  MORE >>

"Additional details regarding scenarios in which attestations are required are now available. For example, the instructions now clearly outline that attestations are required for self-funded and fully insured group health plans (including those sponsored by unions). In contrast, attestations are not required for retiree-only group health plans."  MORE >>

"[T]he DOL continues to see cybersecurity as a top priority ... [F]iduciaries and service providers to ERISA plans may want to consider evaluating the plan's cybersecurity regime, such as through a cybersecurity self-audit, adoption of a cybersecurity policy, or through other improvements to the cybersecurity and/or monitoring processes. For group health plans, this can be done in conjunction with the self-audits that must be conducted to develop those policies and procedures required under the HIPAA Privacy and Security Rules"  MORE >>

"[To] the extent that Plaintiff alleges that EBPC, as a Plan fiduciary, and Boeing, as a functional fiduciary, were performing fiduciary functions when they continued to charge and collect premiums after receiving Plaintiff's [QDRO] notice stating that he was divorced, Plaintiff plausibly alleged that they were acting as fiduciaries when they continued to collect premiums. The court also found that he plausibly alleged that Boeing and EBPC breached their fiduciary duties by failing to investigate Plaintiff's ex-wife's continued eligibility after they received the QDRO stating that they were divorced. The court reversed the dismissal of these claims." [McIver v. Metropolitan Life Ins. Co., No. 23-55306 (9th Cir. Sept. 11, 2024; unpub.)]  MORE >>

"A three-judge panel of the Eleventh Circuit Court of Appeals ... recently held that employers who sponsor group health insurance plans must cover gender-affirming medical care for their transgender employees or face liability under Title VII.... [T]he Eleventh Circuit vacated the panel's opinion and voted to re-hear the case as an entire Court.... [A] new opinion ... will likely come out some time next year. In the meantime, employers in Alabama, Georgia, and Florida who sponsor health plans need not change any of their current coverages." [Lange v. Houston County, Georgia., No. 22-13626 (11th Cir. May 13, 2024; vacated and rehearing granted, Aug. 15, 2024)]  MORE >>

"Because the health plans at issue in these excessive fee cases are self-funded and the employer -- not the participant -- pays the cost of benefits after the participant's deductible is met, [the authors] expect defendants to argue that the plaintiffs have not suffered injury in fact because the participant's costs are not impacted.... Similar arguments have been made as to claims in the retirement plan and MEWA contexts, and those cases may offer useful insight into the viability of a constitutional standing argument in the excessive health plan fee cases."  MORE >>

"[T]otal health benefit cost per employee is expected to rise 5.8% on average in 2025, even after accounting for planned cost-reduction measures. Employers estimated that their cost would rise by about 7%, on average, if they took no action to lower cost. Smaller employers (those with 50-499 employees) ... reported that cost would rise by about 9% on average if they took no action to lower cost."  MORE >>

"[The House Committee on Education and the Workforce passed] a resolution disapproving of a Biden administration rule limiting access to association health plans.... Critics say these plans allow small businesses to sidestep the [ACA] in an effort to offer less extensive benefits, while proponents argue the flexibility in plans results in more coverage."  MORE >>

"At issue is whether people are over- or understating their incomes to qualify for the subsidies. In addition, some lawmakers are concerned about reports that consumers are being enrolled in ACA plans or their coverage is being switched -- without their consent -- by a subset of unscrupulous brokers eager to gain commissions."  MORE >>

"Employers view the consistent benefits made possible by ERISA preemption as a tool for increasing work force mobility ... ERISA preemption reduces administrative costs and burdens, thus enabling employers to deliver richer benefits and lower-cost coverage to their workers.... ERISA preemption fosters innovation that would otherwise be stifled by different states requiring different coverages or administrative rules.... Despite predictions of a decline, the employment-based health coverage system has demonstrated continued resilience."  MORE >>

"With the noncompete rule set aside for all employers, the company that lost its injunction bid in Pennsylvania asked the federal judge to stay its lawsuit rather than decide it on summary judgment ... [T]he FTC believes it would harm the public interest to delay proceedings because staying the case may 'deprive other courts and the judicial system of the benefits that would flow from [the Pennsylvania court's] consider views' on whether the FTC rule is lawful." [ATS Tree Services, LLC v. Federal Trade Commission, No. 24-1743 (E.D. Penn. Jul. 23, 2024; defendant's brief opposing motion to stay Sep. 11, 2024)]  MORE >>

"[1] Relying on antivirus software alone ... [2] 3rd party risk assessments ... [3] Over-reliance on IT departments ... [4] Not seeing cybersecurity as an investment ... [5] Falling for cyber scams ... [6] Not updating networks and software ... [7] Inadequate employee training ... [8] Lack of multi-factor authentication ... [9] Reusing passwords ... 10. Underestimating AI-deep fakes."  MORE >>

10 pages. "[This paper explores] what service excellence means today in the world of benefits administration and engagement. [It also walks] you through the features and services you should expect from a benefits administration partner, what the current market landscape looks like and how to select the right partner for your company's -- and your employees' -- needs."  MORE >>