"If an employer posts a clear, conspicuous and accessible notice informing employees that any individual to whom Form 1095-C/1095-B would otherwise be required to be provided may request a copy of the applicable forms, a broad mailing to all employees is not required. There has not been subsequent guidance on what will qualify as 'clear, conspicuous and accessible,' so for purposes of complying with the notice condition this year, employers are left to make a good-faith and reasonable interpretation of the standards."  MORE >>

"With the flexibility to use the FPL in place six months prior to the start of the plan year, the FPL safe harbor amount will depend on plan year start, as described above. As such, ALE employers who rely on the FPL safe harbor to meet the ACA affordability requirements should keep this in mind when developing their plan contribution strategy."  MORE >>

"[T]op 'just do it' items to ensure compliance: [1] Read the FMLA regulations all the way through.... [2] Download the general notice (FMLA poster) from the [DOL] Wage and Hour Division website, and post it where workers will see it. [3] Follow guidelines provided by the DOL Wage and Hour Division and create the required FMLA forms (eligibility notice, rights and responsibilities notice, and designation notice) as well as the medical and military certification forms.... [4] Create a company FMLA policy, if there isn't one."  MORE >>

"OPM has issued its annual carrier call letter outlining policy goals and initiatives for the 2026 plan year. It emphasizes two main themes: streamlining how FEHB plans work to reduce friction experienced by federal employees and annuitants, and maintaining focus on ongoing healthcare priorities highlighted in previous years."  MORE >>

"The decision in the J&J Case is a win for plan sponsors.... [T]he plaintiffs' bar will continue to bring 'excessive' fee cases against the fiduciaries of employer-sponsored health plans. If they are able to establish standing and survive a motion to dismiss -- such as on the claim of a prohibited transaction in the Wells Fargo Case -- the flood gates could open." [Lewandowski v. Johnson & Johnson, No. 24-0671 (D.N.J. Jan. 24, 2025)]  MORE >>

"Following a wave of ERISA fiduciary breach class action lawsuits, the district court's ruling is welcome news for group health plan sponsors ... The decision ... reinforces that participants must demonstrate a personal and concrete injury due to a fiduciary's alleged breach that is redressable by court action; broad speculative claims will not suffice. However, the district court left open the question of whether a participant who did not reach their plan's OOP maximum could potentially establish an injury-in-fact based on excessive prescription drug costs." [Lewandowski v. Johnson & Johnson, No. 24-0671 (D.N.J. Jan. 24, 2025)]  MORE >>

"[T]he executive orders do provide a general road map on where the Trump administration may go with its health policy, including potential impacts on employer group health plans. Generally, the orders include directives aimed at chipping away and rescinding prior Biden administration policies, including ones that promoted expanding coverage under the ACA and Medicaid, lowering drug costs, and discrimination protections on the basis of gender identity and for LGBTQ+ individuals (including gender transition coverage under health insurance policies and plans)."  MORE >>

"We urge Congress to find ways to strengthen employer-sponsored coverage rather than to search for alternatives to it.... [T]he following principles [are] important to ensuring that employment-based coverage thrives into the future: [1] Uphold the current tax treatment of employer-sponsored coverage. [2] Preserve ERISA preemption -- the vital backbone of employer-sponsored coverage. [3] Address rising medical costs and market dysfunctions to help keep care and coverage more affordable."  MORE >>