"The standard rule is that employees who are HSA-eligible for only a portion of the calendar year have a reduced HSA contribution limit ... [which] is a proportional amount based on the number of months of HSA eligibility for the employee in the calendar year.... [T]he 'last-month rule' (alternatively referred to as the 'full contribution rule') may apply to permit the mid-year enrollee to contribute up to the full statutory limit -- even though the employee was not HSA-eligible for the full calendar year."  MORE >>

"Because some aspects of the EO are not consistent with the laws of certain states, full compliance with the EO's restrictions on the provision of gender-affirming care creates a compliance risk for health providers and insurers."  MORE >>

"The Sixth Circuit noted that 'the statutory text does not tell us whether the FMLA recognizes in loco parentis relationships under these circumstances.' ... [The court] looked to the common law definition of in loco parentis ... [and] outlined several factors to evaluate 'whether a person intended to assume parental status over another adult.' " [Chapman v. Brentlinger Enterprises, No. 23-3582/3613 (6th Cir. Dec. 13, 2024)]  MORE >>

"In January, the Agencies' annual report to Congress identified common NQTLs and how to address them, focusing primarily on certain key priority areas such as mental health and substance use disorder benefit exclusions, prior authorization requirements, and network composition issues.... Almost simultaneously, the ERISA Industry Committee initiated a legal challenge against the MHPAEA Final Rule issued in September 2024. The complaint seeks to invalidate certain provisions in the Final Rule, arguing that the requirements create a benefit mandate, pose unreasonable and unnecessary burdens on plans and fiduciaries, exceed regulatory authority (relying on Loper Bright), and are generally vague and arbitrary." [ERIC v. HHS, No. 25-0136 (D.D.C. complaint filed Jan. 17, 2025)  MORE >>

"A disgruntled former employee sued her employer and a private equity firm that had hiring and firing authority over the employer's employees for ... failing to provide a COBRA election notice.... The employee argued that the two businesses should be treated as a single employer because the equity firm 'exerted some control' over her employer.... The court agreed with the employer, stating that the employee made 'no meaningful arguments' for why the relationship between the employer and the equity firm would allow their employee numbers to be aggregated." [Smith v. Pile, No. 23-0815 (D. Ariz. Jan. 7, 2025)]  MORE >>

"In the first month of the second Trump presidency, the administration has focused on several executive orders and policy changes that may have significant implications for employer health and welfare plans. In a sweeping overhaul of federal policies, these changes target healthcare coverage, diversity initiatives, and federal funding which have the potential of sparking legal challenges[.]"  MORE >>

"There are over 700 independently owned pharmacies in Alabama ... As aggressive cost cutting by PBMs -- often paying pharmacies less than Medicaid -- combined with increasing costs of doing business ... 252 independent pharmacies have closed down since 2019. Affixing this per-prescription fee to all PBM throughput is intended to combat what is seen by many as unfair or insufficient compensation."  MORE >>

"[F]or all combined organ and tissue transplants, per member costs based on billed charges saw an average annual increase of 5.2% for those under age 65, and 9.1% for those age 65 and over when compared to the 2020 report.... [D]ouble-lung transplants have the highest billed charges in the U.S., at an estimated $2.3 million dollars, followed by heart transplant ($1.9 million), single lung ($1.8 million) and intestine ($1.7 million).... [T]he study estimates over 28,000 kidney transplants will be performed in 2025 -- by far the most of any organ -- followed by nearly 11,000 liver transplants."  MORE >>