313 pages. "This memorandum provides interested parties with the final Medicare Drug Price Negotiation Program guidance for initial price applicability year 2027 and manufacturer effectuation of the maximum fair price (MFP) in 2026 and 2027."  MORE >>

"Plans should update existing NQTL comparative analyses documentation on or before the effective date. ... Self-funded non-federal governmental plans must begin to comply with all MHPAEA provisions. An ERISA plan fiduciary must certify that the fiduciary has engaged in a prudent process to select at least one qualified service provider to complete the plan’s comparative analysis and has satisfied the duty to monitor the service provider."  MORE >>

"A key focus of the Final Rules is to ensure that NQTLs related to provider network composition and reimbursement rates do not impose greater restrictions on access to MH/SUD benefits than they do for M/S benefits."  MORE >>

"Individuals generally must authorize any use or disclosure of their PHI that is not for treatment, payment, or health care operations. HIPAA authorizations must contain specific 'core elements' and required statements to be valid."  MORE >>

"The Family School Partnership Act provides employees the option of taking leave to participate in their children's education.... [E]ligible employees have the right to take up to five days of bereavement leave upon the death of a covered family member.... [An] employee who is a victim of certain forms of crime or abuse is entitled to take time off from work under certain circumstances.... [E]mployees are entitled to time off for jury duty 'in any court of the United States' which includes service on a grand jury and trial jury."  MORE >>

"The Department did not change the benefit contribution rate for 2025. The benefit contribution rate will remain .88% of eligible wages ... The Department increased the maximum weekly benefit amount available to individuals to $1,170.64."  MORE >>

"Effective November 21, 2024, Massachusetts employers must allow employees to use Massachusetts Earned Sick Time to address the employee’s or the employee’s spouse’s physical or mental health needs related to pregnancy loss or a failed assisted reproduction, adoption, or surrogacy."  MORE >>

"[H]ere is a timely reminder for employers in Minnesota, Iowa, South Dakota, and North Dakota regarding their obligations under these states' laws to excuse employees from work to go to the polls. With many voters opting to vote early or by mail, the number of voters going to the polls in person on Election Day may be smaller than in the past, but here are the points employers need to know regarding the rules for voting in person on Election Day."  MORE >>

"[T]wo plaintiffs sued Walmart, Inc. ...  claiming that the world's largest private employer is "unfairly targeting employees based on their health status" as smokers.  ...  [A second] suit claims that GardaWorld's smoking cessation and vaccine wellness programs both violate ERISA's requirement that plan members who do not meet initial standards have a reasonable alternative to earn the full reward. ... Another ERISA challenge to a smoker surcharge was before the Ninth Circuit in September[.]"  MORE >>

"While this case is a win for MetLife, the court's refusal to dismiss the case for lack of standing under the reasoning of Thole and Perelman may prove significant for health plan ERISA litigation filed in the Third Circuit." [Knudsen v. MetLife Grp., Inc., No. 23-2420 (3d Cir. Sep. 25, 2024)]  MORE >>

"Recent class actions have highlighted the complexities and potential liabilities associated with third-party vendor fees. It is essential fiduciaries be well-informed about current third-party vendor contracts or agreements, including their termination or renewal periods. These periods can offer opportunities to reassess and renegotiate fees."  MORE >>

"In a memo to agency heads Wednesday, Acting OPM Director Rob Shriver announced that his agency and the Office of Management and Budget will establish an emergency leave transfer program for federal employees across seven states. Such programs enable agencies to set up banks so that federal workers may donate unused paid leave to their colleagues impacted by natural disasters can take time off without needing to use their own paid -- or unpaid -- leave."  MORE >>

"[I]ndividuals and businesses in the Confederated Tribes and Bands of the Yakama Nation in Washington state affected by wildfires that began on June 22, 2024 ... now have until Feb. 3, 2025, to file various federal individual and business tax returns and make tax payments.... Currently, this includes the Confederated Tribes and Bands of the Yakama Nation in Washington state."  MORE >>

"[P]lan sponsors and fiduciaries [should]: [1] Establish strong procedures, protocols, policies, and other safeguards to protect participants' data and their retirement accounts, [2] Develop a process for prudent selection and monitoring of their plan service providers to ensure that they also maintain and follow strong cybersecurity and breach response procedures, and [3] Establish and practice an incident response plan, before a cybersecurity incident occurs, and follow the plan if an incident occurs[.]"  MORE >>