"[T]here will continue to be enforcement of the NQTL requirements in effect prior to the Final Rule, [and] much of the lack of regulatory clarity that plagued CAA enforcement will remain in place until the broader review of enforcement signaled by the Departments is complete.... [P]articipants in ERISA plans have the right to request the NQTL comparative analyses under ERISA 104(b) and receive the analyses within 30 days of the request. These requests can serve as a form of pre-litigation discovery for the plaintiffs' bar, and should be treated as such by plans and issuers."  MORE >>

"The May 15, 2025 announcement ... does not clearly indicate, however, which provisions are considered 'new' relative to the 2013 Final Rule and the MHPAEA amendments in the CAA 2021.... [A] chart provides an assessment of key MHPAEA compliance obligations that are likely paused and those that are likely still in effect."  MORE >>

"Group health plans are [still] required to conduct parity testing under the MHPAEA and CAA for both quantitative and nonquantitative limitations ... The NQTL analysis must demonstrate that the processes, strategies, evidentiary standards and other factors the plan uses in applying an NQTL to MH/SUD benefits are comparable to and applied no more stringently than those used with respect to M/S benefits."  MORE >>

"DOL must propose regulations requiring PBMs to disclose both direct and indirect compensation within 180 days of the EO (by October 12, 2025).... The regulations could increase clarity of prescription drug prices and allow employers to better understand PBM terminology, rebate arrangements and hidden fees in order to renegotiate contracts."  MORE >>

"The [Maryland Parental Leave Act (MPLA)] was intended to apply to smaller employers not covered by the FMLA ... [T]here have been occasions of overlap, where both laws apply to companies that change in size.... SB 785 ... amends the definition of 'employer' under the MPLA to exclude those covered by the FMLA in the current year, effectively exempting FMLA-covered employers from Maryland's parental leave requirements."  MORE >>

"[T]he federal appellate court ... [ruled] that an 'employee's entitlement to FMLA leave is not strictly bound by the precise parameters laid out in the medical certification.' ... [This] case reminds employers that they should follow up with the doc if the employee's reported or observed need for leave is not expressly covered by the physician's statements in the certification.... The [easier?] route here is simply to request recertification for absences based on the same condition but that come different in form (e.g., continuous vs. intermittent leave)." [Davis v. Illinois Dept. of Human Serv., No. 22-2118 (7th Cir. May 14, 2025)]  MORE >>

"As you evaluate potential partners for obesity care, here are a few critical questions to ask: [1] How are you making prescribing decisions? ... [2] Do you make money on the prescriptions you write? ... [3] When you say you provide physician-led care, what does that really mean? ... [4] If the program is focused on deprescribing, is it because there is mass prescribing upfront? ... By asking these questions, benefit leaders can begin to separate evidence-based solutions from those driven by desire to make a quick profit on GLP-1s. "  MORE >>

"You may also be able to successfully appeal denials from employer health insurance plans or traditional Medicare -- whether for prior authorization or for a service you already received -- although few people know their appeal rights.... Here's what you need to know to appeal a health insurance denial, whether it involves a prior authorization request or a big bill following a procedure or treatment that you believe your insurance should cover."  MORE >>

"53% of companies are taking direct action to reduce healthcare costs, while cost-sharing adjustments (23%) and sunsetting low-value programs (30%) signal a shift toward tightening plan designs.... The number of companies matching employee [retirement plan] contributions continues to grow -- up 17% since 2023. More employers are enhancing existing matches -- 6% increased their existing matches in the past 12 months[.]"  MORE >>

"[T]he bill does not change the tax incentives for retirement savings or cap the exclusion for employer-sponsored health insurance. However, it does include other benefit-related provisions, including changes to [HSAs], [ICHRAs], fringe benefits, and executive compensation. It also creates new tax-preferred 'Trump Accounts' for children and provides the Office of Management and Budget with $100 million for deregulatory activities."  MORE >>