"[1] Improving upon the Inflation Reduction Act ... [2] Reducing the prices of high-cost drugs for seniors.... [3] Appropriately accounting for acquisition costs of drugs in Medicare.... [4] Promoting innovation, value, and enhanced oversight in Medicaid drug payment.... [5] Access to affordable life-saving medications.... [6] Reevaluating the role of middlemen.... [7] Accelerating competition for high-cost prescription drugs.... [8] Increasing prescription drug importation to lower prices.... [9] Reducing costly care for seniors.... [10] Improving transparency into pharmacy benefit manager fee disclosure.... [11] Combating anti-competitive behavior by prescription drug manufacturers." [Also available: Fact Sheet]  MORE >>

"[If] an ERISA plan covers at least the number of participants indicated by regulations who are literate only in the same non-English language, the plan is required to provide assistance to participants in that language and to prominently display the availability of the assistance in the SPD/SMM/SAR. Alternatively, the plan may choose to provide the SPD/SMM/SAR translated to the non-English language(s), even though it's not required."  MORE >>

"[1] ERISA reporting and disclosure requirements; [2] COBRA coverage continuation requirements; [3] HIPAA privacy and security rules; [4] [ACA] information reporting by health coverage providers."  MORE >>

"[F]ederal workers have access to Temporary Continuation of Coverage (TCC), which has many similarities to COBRA but is specific to the Federal Employees Health Benefits (FEHB) Program. If a federal employee with FEHB coverage loses their job for reasons other than gross misconduct, they can use TCC to continue their coverage for up to 18 months."  MORE >>

"When finalized, healthcare benefit payments of $8.35 per hour will be required for airport and hotel workers in Los Angeles. It is anticipated this will be effective beginning July 1, 2025; however, the updates have not yet been written into law."  MORE >>

"In litigation challenging the process for imposing employer mandate penalties under the [ACA], a Texas district court held that HHS, not the IRS, must provide certifications that result in employer mandate assessments. Because the IRS provided the certification to the employer in this case, the district court concluded that the refund imposed on the employer by the IRS had to be refunded. The court also set aside an HHS regulation delegating certification authority to the IRS." [Faulk Company, Inc. v. HHS, No. 24-0609 (N.D. Tex. Apr. 10, 2025)]  MORE >>

"Although the lawsuit is in its early stages ... the claims mentioned throughout the complaint offer important insights for employers to consider. [1] Evaluate conflicts of interest with third-party service providers, consultants, and experts ... [2] Conduct a thorough PBM selection process ... [3] Evaluate PBM recommendations regularly." [Stern v. JPMorgan Chase & Co., No. 25-2097 (S.D.N.Y. complaint filed Mar. 13, 2025)]  MORE >>

"Although it is unlikely that AI will entirely replace human oversight, its role in health and welfare plans is expected to expand. Employers must strike a balance between embracing innovation and upholding compliance obligations. Employers who correctly utilize AI systems will benefit significantly so long as they are capable of safeguarding the interests of their workforce."  MORE >>

"Exposures such as IT supply chain dependencies, website tracking litigation, ransomware attacks, new security regulations and data breach class actions put healthcare organizations of all sizes at high risk for cyber insurance claims. Understanding trends in cyber attacks as well as the evolving regulatory and litigation environment is critical to building resilience and maximizing insurance indemnification."  MORE >>

"[E]mployers have the opportunity to better engage their employees through the successful use of employee benefit accounts, such as: [1] Health savings accounts (HSA); [2] Flexible spending accounts (FSA); [3] Health reimbursement arrangements (HRA); [4] Commuter benefit accounts.... Alongside these tax-advantaged accounts are lifestyle accounts -- like those that cover fitness or therapy expenses -- which help round out the employer-offered benefits package."  MORE >>

"The utilization patterns observed in the last quarter of 2024 confirmed expectations of beneficiary utilization changes in response to legislative changes enriching the Part D benefit. Reviewing these trends by income status reveals that NLI beneficiary utilization trends are significantly outpacing those of the LI beneficiary population."  MORE >>