"FMLA and state or local paid leave program compliance can be complex, and how an employer's policies interact with such leave laws may vary.... In response to the opinion letter, employers should review and/or revise their applicable handbook policy language to ensure proper application of the substitution rule during overlapping periods of FMLA and state or local paid family and medical leave. Employers may also coordinate with any third-party leave administrators to ensure proper implementation."  MORE >>

"CMS proposes to revise the simplified methodology to consider prescription drug coverage to equal or exceed the actuarial value of the defined standard Part D benefit -- and, therefore, to be creditable -- if it meets all of the following: [1] Provides reasonable coverage for brand name and generic prescription drugs and biological products; [2] Provides reasonable access to retail pharmacies; and [3] Is designed to pay on average at least 72% of participants' prescription drug expenses."  MORE >>

"The 2026 Payment Notice represents a final set of Marketplace and health insurance policies from the Biden administration. The administration describes its goals with these policies as providing 'quality, affordable coverage' to consumers while minimizing administrative burden and advancing health equity. [This article is focused] on policies related to Marketplaces, insurance reforms, and Advance Premium Tax Credits (APTC)."  MORE >>

"[T]he evolution of employee experience, workplace flexibility, and benefits expectations is now inextricably linked to rising healthcare costs, mental health expansion, and AI-driven health management. Employers must adapt to these changes to remain competitive and position themselves as an employer of choice in one of the tightest labor markets in decades."  MORE >>

"If executed properly, a strong emphasis on a healthy workplace environment can accelerate the organization's RTO objectives while giving employees the support they need. The goal is that employees returning to the office feel cared for and appreciated as they make the transition -- and realize the intended benefits of their return."  MORE >>

"Legislative and regulatory changes, along with changes in utilization patterns, have significantly altered the Medicare Part D landscape in recent years, driving an increase in focus on Part D costs across all stakeholders. This article provides an overview of top-line gross cost trends in Medicare Part D, focusing on factors that Part D stakeholders should consider as they review 2024 prescription drug data. The Q1-Q3 2024 data reveals gross average allowed costs per member per month (PMPM) decreased 1.7%, due to offsetting key downward and upward trends relative to 2023."  MORE >>

"Health plan fiduciaries should strongly consider these steps to reduce their litigation exposure: [1] Establish a fiduciary committee for health and welfare benefits, adopt a committee charter, and delegate fiduciary responsibility to the committee. [2] Engage qualified prescription drug plan consultants to assist in comparing PBMs and prescription drug arrangements.... [3] Request and review PBM agreements, fee and rebate arrangements, and formularies, and negotiate reasonable terms.... [4] Collect and review benchmark information from other plans and pharmacies and compare to current and prospective vendor agreements or proposals." [Lewandowski v. Johnson & Johnson, No. 24-0671 (D.N.J. Jan. 24, 2025)]   MORE >>

"The Order directs that any agency endeavoring to promulgate a new rule, regulation or guidance must simultaneously identify at least 10 existing rules, regulations, or guidance documents to be repealed. The Order further requires that the total incremental cost of all new regulations for fiscal year 2025, taking into account any repealed regulations, be significantly lower than zero ... [In] 2024 alone the [DOL] issued or proposed three significant new ERISA-related regulations ... The cost to the [DOL] for just three new regulations under the Trump Administration will be the elimination of 30 existing regulations."  MORE >>

"Providing a baseline level of core benefits coverage, combined with flexibility for personalization, can help meet the diverse needs of employees.... Benefits packages also significantly impact workplace culture.... Companies should prioritize offerings that foster a deep-rooted relationship with employees, such as retirement plans."  MORE >>

"ERISA litigation has rapidly expanded over the past few years, and 2024 was no exception. Defined contribution plan litigation picked up even more steam, defined benefit plan litigation took off, and health plan fiduciary breach claims were also on the rise. And the 2025 outlook is even busier."  MORE >>