12 pages. "The first quarter of 2025 witnessed a surge in benefit-related bills, but only a relative few have reached the finish line so far.... Regulatory and judicial activity took center stage. Developments occurred in all four states with pending paid family and medical leave (PFML) mandates -- Delaware, Maine, Maryland, and Minnesota -- including a likely third delay of Maryland's start date."  MORE >>

"This year paid sick leave laws in three new states are expected go into effect: Missouri, Alaska, and Nebraska. These three state laws have some similarities, but the laws also have differences that present a challenge or don't address an aspect of sick and safe leave at all."  MORE >>

"Employers can provide tax-advantaged mass transit, vanpool, and qualified parking benefits to employees. The monthly limit for mass transit and vanpooling is aggregated, but the monthly limit for qualified parking is separate. Employees can therefore take advantage of the full limit for both transit pass/vanpooling and qualified parking."  MORE >>

"[Executive Order 14273] requires the [DOL] to propose regulations under ERISA Section 408(b)(2) to improve transparency into the direct and indirect compensation received by pharmacy benefit managers (PBMs). An accompanying fact sheet states that the order intends to improve disclosure of fees that PBMs pay to brokers for steering employers to use their services."  MORE >>

"[Executive Order 14273] does not carry the force of law and does not provide details explaining how the administration will seek to accomplish its policy objectives. Many of the Executive Order's proposals appear to require congressional action and/or formal rulemaking, each of which could take many months, if not years, to accomplish and could be subject to legal challenge. ... [This article addresses] the components of the Executive Order and what they mean for the regulated industries[.]"  MORE >>

"The Justices posed questions about core issues related to whether the Secretary of [HHS] has sufficient control over the U.S. Preventive Services Task Force members and its recommendations.... Notably absent was any discussion of the real-life consequences of an adverse ruling." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024; cert. pet. granted Jan. 10, 2025; oral arg. Apr. 21, 2025)]  MORE >>

"If the Supreme Court upholds the lower court ruling, it will effectively remove the requirement ... for group health plans and insurers to provide coverage without cost sharing for the preventive items and services USPSTF recommended after March 23, 2010. Regardless of the outcome of this litigation, nongrandfathered group health plans will still be required to cover at no cost vaccines recommended by ACIP, pediatric and women's preventive care recommended by HRSA, and USPSTF preventive items and services recommended before March 23, 2010, since those are effectively part of the ACA." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024; cert. pet. granted Jan. 10, 2025; oral arg. Apr. 21, 2025)]  MORE >>

"In litigation challenging a categorical policy exclusion for coverage of mastectomies for transgender youth, a Washington State district court held that the policy discriminated on the basis of sex in violation of Section 1557 of the [ACA]. The court also held that the plaintiffs failed to exhaust administrative remedies for a related age discrimination claim under Section 1557." [L.B. & M.B. v. Premera Blue Cross, No. 23-0953 (W.D. Wash. Apr. 18, 2025))]  MORE >>

"It's essential for self-insured health plans to conduct thorough vendor due diligence.... Establishing clear and protective contracts ... Regular monitoring of vendor performance ... Maintaining regular communication with vendors ... [C]omprehensive documentation of all oversight activities is critical to demonstrating due diligence and protecting plan sponsors from potential liability."  MORE >>

"Recent government announcements highlight several key areas to watch in 2025, both for their potential impacts on the pharmaceutical industry and to potentially provide insights into how the current administration may plan to effectuate policy change in related areas. These, in turn, may illuminate strategies for industry and stakeholder response and engagement in this rapidly evolving regulatory environment."  MORE >>

"Securing favorable terms and dissecting the various pricing models requires specialized expertise.... A [certified pharmacy benefit specialist (CPBS)] can help you mitigate rising specialty drug costs in a number of ways: ... [1] Negotiating contracts ... [2] Monitoring the contract and performance ... [3] Assessing the formulary and prior authorizations."  MORE >>

"Cassidy's proposals include: [1] Expanding access to and the use of retirement accounts for independent workers via pooled employment plans and single employee pension individual retirement accounts ... [2] Establishing a 'safe harbor' for companies so they can provide independent workers with benefits without litigation fears; and [3] Increasing independent workers' health care options, such as allowing access to association health plans and health reimbursement arrangements."  MORE >>

"The broad implications of this case are concerning, potentially leading to more lawsuits with fewer dismissals at early stages and requiring plans and fiduciaries to expend considerable time and money responding to lawsuits that assert the mere existence of a prohibited transaction." [Cunningham v. Cornell Univ., No. 23-1007 (S.Ct. Apr. 17, 2025)]  MORE >>

"This decision highlights the importance to plan sponsors and fiduciaries of having a process in place to review service provider agreements. The Supreme Court's decision may result in cases getting into discovery on these issues with more frequency, which will put a focus on compliance with the exemptions." [Cunningham v. Cornell Univ., No. 23-1007 (S.Ct. Apr. 17, 2025)]  MORE >>