"The [Inflation Reduction Act (IRA)] amended Part D, in part, to limit the annual out-of-pocket maximum amount to $2,000 in 2025 (a $6,000 reduction from the $8,000 limit in 2024) for people with Medicare Part D. This reduction coupled with other changes in the IRA may make it less likely that certain employer-sponsored plans will provide creditable coverage in 2025. High deductible health plans are particularly exposed to this risk."  MORE >>

"Covered employers (those with 10+ Delaware-based employees) must register for LaborFirst, the state's system for managing Delaware Paid Leave. Registration is open now and must completed by January 1, 2025.... Delaware has also released the model Notice of Employee Rights... [and] helpful FAQs and guides for employers[.]"  MORE >>

"The FTC's administrative complaint alleges ... that the three PBMs created a perverse drug rebate system that prioritizes high rebates from drug manufacturers, leading to artificially inflated insulin list prices. The complaint charges that even when lower list price insulins became available that could have been more affordable for vulnerable patients, the PBMs systemically excluded them in favor of high list price, highly rebated insulin products. These strategies have allowed the PBMs and GPOs to line their pockets while certain patients are forced to pay higher out-of-pocket costs for insulin medication, the FTC's complaint alleges."  MORE >>

"In claims litigation under [ERISA] arising from a health insurer's termination of benefits for inpatient care to treat a minor dependent's anorexia nervosa, the Fifth Circuit held that the benefits denial was substantively and procedurally deficient. The Fifth Circuit also ruled in the participant's favor regarding the appropriate network reimbursement rate for certain services provided under the plan." [Dwyer v. United Healthcare Ins. Co., No. 23-50439 (5th Cir. Sept. 19, 2024)]  MORE >>

"[Plaintiffs] asserted two claims: [1] that Caterpillar violated GIPA Section 25(c)(1), which prohibits employers from requesting genetic information from applicants or their family members during the pre-employment process, and [2] that Caterpillar violated GIPA Section 25(e), which prohibits the use of genetic information in connection with workplace wellness programs. Caterpillar moved to dismiss both claims." [Branson v. Caterpillar, Inc., No. 23-14329 (N.D. Ill. Aug. 14, 2024)]  MORE >>

"Following the passage of the Consolidated Appropriations Act, 2021 (CAA), and the associated implementation of the Transparency in Coverage Rule requiring public posting of machine-readable files listing prescription drug prices, plan participants and their law firms can now compare and review fiduciary decisions via data that was not previously available. This increased scrutiny means health plan fiduciaries are now subject to increased litigation risk."  MORE >>

"Benefits portals are the entryway to a connected benefits experience and serve as the 'hub' of all employee benefits-related activity.... When used properly, benefits portals can ... [1] Increase efficiency and focus on benefits strategy.... [2] Deliver an optimal employee experience.... [3] Help employees thrive.... The elements of a next-generation benefits portal ... The impact of a benefits portal on the employee experience ... Choosing a benefits portal partner."  MORE >>

"This annual notice provides the 2024-2025 special per diem rates for taxpayers to use in substantiating the amount of ordinary and necessary business expenses incurred while traveling away from home, specifically [1] the special transportation industry meal and incidental expenses (M&IE) rates, [2] the rate for the incidental expenses only deduction, and [3] the rates and list of high-cost localities for purposes of the high-low substantiation method."  MORE >>

"[T]he basic fiduciary requirements of ERISA apply to health and welfare plans too. Unfortunately, health and welfare plans are often left to insurers, and employers are unaware of the other requirements that can't be delegated to a vendor.... While much of cybersecurity best practices will involve the plan sponsor's IT personnel and third-party vendors ... [f]iduciaries must ensure that these policies and procedures are in place and being followed[.]"  MORE >>