"New IRS guidance expands the permitted preventive care offerings to include over-the-counter oral contraceptives (including the birth control 'minipill' and the emergency contraception 'morning after pill') and male condoms. The guidance also clarifies the scope of preventive care for breast cancer screening, continuous glucose monitors, and selected insulin products."  MORE >>

"The law will apply to all employers, though different standards will apply to those with 19 or fewer employees in 20 or more calendar weeks in the current or preceding year ('small employer'). It appears that the 'small employer' definition is based on the number of employees anywhere, not just in Nebraska."  MORE >>

"[E]ffective May 1, 2025, Missouri will join the growing list of states that require employers to provide paid sick leave to their employees.... The new law applies to all private Missouri employers, regardless of the size of the employer's workforce ... Eligible employees will accrue one hour of paid sick leave for every thirty hours worked."  MORE >>

"Effective November 21, 2024, Massachusetts employees working for covered employers will receive expanded benefits under the Massachusetts Earned Sick Time Law ... [to] allow an employee to 'address the employee's own physical and mental health needs, and those of their spouse, if the employee or the employee's spouse experiences pregnancy loss or a failed assisted reproduction, adoption or surrogacy.' "  MORE >>

"[1] Expanded definition of employers ... [2] Coverage for (almost) all employees ... [3] Accrual of sick leave ... [4] Carryover provisions ... [5] Conditions for leave use ... [6] No replacement requirement ... By expanding the pool of covered employees and providing more flexible sick leave options, the law will touch nearly every employee and employer throughout the state."  MORE >>

"The court's decision ... offers relief from the need to recalculate the QPAs applicable to services or disclose additional information to providers about the methodology used in determining QPAs.... However, under the ruling, many claims administrators and insurers will need to vary their practice of pending claims for a period while seeking needed information. When the NSA rules apply, they will need to process a claim within 30 days of receiving a bill.... The decision may also signal how courts will apply the Supreme Court's standard that limits the discretion of regulating agencies." [Texas Medical Association (TMA) v. HHS, No. 23-40605 (5th Cir. Oct. 30, 2024)]  MORE >>

"Guy argued that despite Tennessee's state slayer statute, he should nevertheless be permitted to collect the proceeds because the plans were governed by ERISA, and ERISA preempts state laws where employee benefit plans are involved. The Sixth Circuit declined to rule on the preemption issue, determining that whether the state slayer statute is preempted or not, Guy would still be barred from collecting the insurance proceeds." [Standard Ins. Co. v. Guy, No. 21-5562 (6th Cir. Aug. 19, 2024)]  MORE >>

"[T]he complaint's primary allegations are that Optum and ESI both promoted opioid distribution for their own profit and failed to use the tools at their disposal to combat opioid overuse after the crisis became apparent. The complaint identifies utilization-management programs and drug formularies available to PBMs to monitor drug distribution."  MORE >>

"[T]he Health Infrastructure Security and Accountability Act (HISAA) would create significant new security requirements ... designed to address cybersecurity risks, require ongoing risk assessments and audits related cybersecurity practices, establish new penalties for noncompliance with these requirements ... and create funding incentives ... for entities subject to these requirements." [Legislative text and one-page summary]  MORE >>

"Although employers generally outsource administration of ERISA plans to service providers, employers retain a fiduciary duty to manage the plan for the benefit of the participants. The DOL appears to interpret this to mean that employers have a duty to safeguard plan data and assets from cybersecurity risks. In 2021, the DOL kicked off a cybersecurity initiative for ERISA plans ... The DOL has since conducted numerous investigations into the cybersecurity programs of ERISA plans."  MORE >>

"American employers and employees are facing a conundrum: heightened levels of workplace stress and burnout. This concern is exacerbated by ongoing rising costs of health care, financial vulnerability and looming worry about the future of their families ... [B]urnout is affecting nearly 3 in 5 American workers -- with a notable generational gap.... [E]mployees experiencing high levels of stress is now up to 38% in 2024 -- from 33% in 2023.... [A] growing number of employees would consider leaving their jobs for better benefits, even if it meant taking a pay cut (62%, compared to 53% in 2023)."  MORE >>