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Health & Welfare Plans Newsletter

May 2, 2025

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[Guidance Overview]

IRS Announces 2026 Limits for HSAs, HDHPs, HRAs

"All of the dollar limits currently in effect for 2025 will change for 2026, with [one] exception ... The HSA catch-up contribution for individuals ages 55 and older will not change as it is not subject to cost-of-living adjustments.... [A table] compares the applicable dollar limits for HSAs, HDHPs, and excepted benefit HRAs for 2025 and 2026."  MORE >>

McDermott Will & Emery

[Guidance Overview]

Executive Order Targets Prescription Drug Price Reduction

"[Executive Order 14273] sets forth the administration's statement of objectives to reduce prescription medication costs by promoting competition and eliminating practices that lead to high drug prices.... [T]he executive order sets forth a broad agenda to impact Medicare prescription drug costs, including in the Medicare Part D program."  MORE >>

Winston & Strawn LLP

District Court Hands Employers a Win Against ACA Penalties

"A court in Texas has given employers a new weapon in the fight against [ACA] penalties.... The court held that under the ACA, the certification process must be administered by HHS and could not be delegated to the IRS. Because HHS currently has no certification process in place, the IRS is arguably unable to impose penalties." [Faulk Company, Inc. v. HHS, No. 24-0609 (N.D. Tex. Apr. 10, 2025)]  MORE >>

Venable LLP

ERISA Litigation Highlights: The Concept of 'Reasonableness'

"One court rejected the parties' proffered definitions of the term 'working' and instead determined that a dictionary definition was reasonable. Two cases reflect courts considering whether it is reasonable for an insurer to award or deny LTD benefits based largely on subjective evidence, and due to differing facts come to different conclusions. Another court considered the reasonableness of a class action settlement related to dependent child life insurance policies. And another court considered whether an insurer acted reasonably in terminating LTD benefits in the face of a structural conflict of interest."  MORE >>

Saul Ewing LLP

House Bill Could Eliminate ACA Employer Health Coverage Mandate

"[HR 3080] could eliminate the [ACA] employer health coverage mandate ... Other provisions would support state efforts to create association health plans and endorse state use of high-risk pools to provide health coverage for high-risk individuals ... [The] bill would replace today's HSAs with 'Roth HSAs' ... [E]arlier version of [this] bill had six Republican cosponsors and died in committee. The new version may have a chance to go farther[.]"  MORE >>

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Employee Perspectives on Long-Term Care

"Four in 10 workers reported a belief that they will likely need long-term care as they age, but a substantial portion remained unsure (32 percent) ... Thirty-seven percent of employees reported low or no knowledge of how to access LTC services in their community.... Only 24 percent of benefits-eligible employees said their employer offers long-term care insurance, and just 9 percent of those employees were enrolled."  MORE >>

Employee Benefit Research Institute [EBRI]

[Opinion]

The Pointless Proliferation of Tax-Preferred Health Spending Arrangements, Part 2: Ideas for Reform

"A comprehensive solution would be to consolidate all the variants into a much smaller number, merging current multiple variants that generally accomplish the same purposes.... [P]olicy makers could reduce complexity by eliminating particular variants.... [S]everal options are redundant, strictly dominated by others, or used by too few people to justify their administrative cost.... [S]ubstantiation rules could be aligned among HSAs, FSAs, and individual coverage HRAs.... Better data are crucial to understanding the impact of the variants[.]"  MORE >>

Health Affairs Forefront

Benefits in General

[Official Guidance]

Text of WHD Field Assistance Bulletin 2025-1: FLSA Independent Contractor Misclassification Enforcement Guidance (PDF)

"WHD will no longer apply the 2024 Rule's analysis when determining employee versus independent contractor status in FLSA investigations. WHD will enforce the FLSA in accordance with Fact Sheet #13 (July 2008), and as further informed by Opinion Letter FLSA2019-6[.]"  MORE >>

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

[Guidance Overview]

New DOL Guidance Hits Pause and Rewind on Independent Contractor Crackdown

"While still in effect for private lawsuits, the 2024 Rule won't be used by WHD in active investigations unless or until further guidance is issued. WHD is back to using the 2008 'economic realities' test. That test, drawn from longstanding Supreme Court precedent, considers multiple factors to determine whether a worker is economically dependent on a business."  MORE >>

Pierson Ferdinand LLP

Employee Benefits Jobs

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VP, Institutional Business Development (Retirement Industry)

Ascensus

Remote / Hybrid

View job as VP, Institutional Business Development (Retirement Industry) for Ascensus

Selected New Discussions

How Does IRS Track Ineligibility for HSA Because of Contributions to Health FSA?

"Let's say an employee enrolls in an HDHP with family coverage and contributes to an HSA. Their spouse contributes to a general purpose health FSA, which we know is disqualifying coverage for purposes of the HSA. But how would the IRS know this? It doesn't seem that health FSAs are reported to the IRS (whereas dependent care benefits, like dependent care FSA contributions, are reported on W-2). What am I missing?"

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Press Releases

PSCA Honors Nevin Adams with 2025 Lifetime Achievement Award

PSCA [Plan Sponsor Council of America]

PSCA Signature Awards: Excellence in Retirement Plan Education

PSCA [Plan Sponsor Council of America]

KLB Benefits Law Group Welcomes Kathleen Salas Bass as a Partner of the Firm

KLB Benefits Law Group

Webcasts and Conferences
(Health & Welfare Plans)

How Continuation Interacts with other Policies

May 21, 2025 WEBINAR

Savoy

ERISA Litigation 2025: Key Trends and Mid-Year Insights

June 4, 2025 WEBINAR

Thompson Hine LLP

Last Issue's Most Popular Items

Text of IRS Rev Proc 2025-19: 2026 Inflation-Adjusted Amounts for HSAs, HDHPs and Excepted Benefit HRAs (PDF)

Internal Revenue Service [IRS]

Critical Compliance Issues for Employee Benefits in 2025

Woodruff Sawyer

Pharmacy Benefit Managers (PBMs): Drug Pricing and Fiduciary Issues

Trucker Huss, via Reuters Practical Law; registration required

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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.

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