"Since taking office, President Donald Trump has issued several executive orders (EOs) and actions that may have an impact on group health plans. These EOs provide insight into [the] administration's policies and outline potential actions that regulatory agencies and Congress may take to implement these policies."  MORE >>

"[The No Severance Ultimatums Act (S 372) would require] employers to provide employees with at least 21 business days to review a separation agreement, and seven calendar days to revoke the separation agreement (meaning an agreement cannot become effective or enforceable until the revocation period has expired). While employees can voluntarily sign a separation agreement before the required consideration period expires, the revocation period is not waivable."  MORE >>

"Section 1557 protects against discrimination on grounds prohibited under specified federal laws, including (as relevant here) the Rehabilitation Act of 1973. That law prohibits discrimination on the basis of disability, which is defined as a physical or mental impairment that substantially limits one or more major life activities as evidenced by a permanent or substantial impairment. Although this participant did not present sufficient evidence of impairment, the plan did provide coverage for individuals with 'clinically severe obesity,' which likely provided coverage for individuals with disabilities under the Rehabilitation Act and Section 1557." [Whittemore v. Cigna Health and Life Ins. Co., No. 24-0206 (D. Me. Feb. 12, 2025)]  MORE >>

"[Perez] argued the company violated the FMLA because, when an employer doubts the validity of an FMLA certification, it must always first seek the opinion of a second or third healthcare provider or seek recertification on a reasonable basis.... The FMLA regulations provide that an employer 'may' require those actions when it doubts the original or continuing validity of the original certification. So, the employer was well within its rights to hire a P.I. and act upon the information provided. " [Perez v. Barrick Goldstrike Mines, Inc., No. 23-15043 (9th Cir., Jun. 28, 2024)]  MORE >>

"Employers may have embraced mental health benefits during the height and aftermath of COVID, but they need to do more to adapt and address the stress associated with the employee experience today ... While employers have typically folded their mental health care offerings into an EAP, those programs see a 4% utilization rate on average."  MORE >>

"The state insurance plan is projected to have a $500 million shortfall in 2026 which will increase to $800 million in 2027 ... The State Health Plan has about 750,000 people who are retired or employed by the state, including teachers, and their dependents."  MORE >>

"Dozens of providers have filed new lawsuits against Blues insurers, arguing that the plans colluded to block competition and reimburse them at lower rates. The payers reached a tentative $2.8 billion settlement agreement in Alabama court in October, but the new lawsuits opt out of it and instead press for a jury trial."  MORE >>

"The average plan could pay for approximately one year and two-and-a-half months of benefits and expenses with its net assets, a decrease of approximately half a month of total expenses from last year. Total expenses exceeded total income by 1.0%. This is the first time since 2008 that expenses exceeded income, driven by investment losses.  ... On a per member basis, expenses decreased by 2.4% and total contribution income increased by 1.7% year over year."  MORE >>

"While most TPAs keep copies of documents they prepared, they do not always ... keep copies of signed versions, or older documents, or documents prepared by a prior TPA.... If the IRS or DOL comes in and initiates an audit/examination, [they] can ask to see documents all the way back to the beginning of the plan.... Benefit claims, including law suits, can come up years later, and the terms of the plan as provided in the plan document in effect at the time of the claim will govern[]"  MORE >>

"Is your SPD written clearly enough to help your workforce understand the plan? Did you remove technical jargon that might be difficult to understand? Did you break long, complex sentences into shorter, more manageable ones? Did you provide plenty of examples to explain difficult topics?"  MORE >>

"[W]omen are more likely to worry about having enough money to save for retirement, being able to save for an emergency fund, paying for long-term care expenses, and being able to support themselves if they become unable to work due to a disabling illness or injury.... Sixty-three percent of women agree that workplace benefits are integral to their overall financial wellness, and nearly 7 in 10 women say their employer should provide benefits that address their financial stress."  MORE >>