Health & Welfare Plans Newsletter
May 30, 2025
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💼 5 New Job Opportunities
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[Official Guidance]
Draft of Instructions for 2025 IRS Form 7206: Self-Employed Health Insurance Deduction (PDF)
May 30, 2025. "Use Form 7206 to determine any amount of the self-employed health insurance deduction you may be able to report on Schedule 1 (Form 1040), line 17. You may be able to deduct the amount you paid for health insurance, which includes medical, dental,
and vision insurance and qualified long-term care insurance for yourself, your spouse, and your dependents. The health insurance can cover your child who was under age 27 at the end of 2025, even if the child wasn't your dependent." MORE >>
Internal Revenue Service [IRS]
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[Guidance Overview]
A Detailed Review of the Family and Medical Leave Act
"The FMLA and the employment rights and circumstances it seeks to protect are many times complicated and delicate to address in real-time. Employees and employers alike can find themselves frustrated with understanding the availability and statutory limits of FMLA protections,
permissions, and requirements." MORE >>
Freeman Law
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[Guidance Overview]
Would Failure to Offer Coverage to an Employee's Spouse Potentially Result in Employer Shared Responsibility Penalties? (PDF)
"For purposes of employer shared responsibility penalties, the term 'dependents' does not include any individuals other than an employee's children ... Thus, an ALE is not required to offer coverage to an employee's spouse to avoid employer shared
responsibility penalties. " MORE >>
Thomson Reuters / EBIA
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[Guidance Overview]
Agencies Press Pause on the 2024 Final MHPAEA Rule
"MHPAEA is still very much in force -- only the new provisions of the 2024 Final Rule are on hold. Plan sponsors must: [1] Continue complying with the MHPAEA requirements in the 2013 Final Rule. [2] Perform and document the NQTL comparative analysis.
[3] Monitor further developments as the Departments reconsider the 2024 Final Rule." MORE >>
Trucker Huss
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[Guidance Overview]
What Relief Does the MHPAEA Nonenforcement Policy Actually Provide to Employers?
"The Departments' nonenforcement policy does not mean an employer (even one under a current MHPAEA examination) is relieved of compliance with MPHAEA. However, ... such compliance can be less burdensome (and, in particular, the NQTL comparative analysis can be less
detailed without fear of reprisal) during the nonenforcement period, which is likely to last until at least 2027 and likely 2028 or beyond." MORE >>
Davis Wright Tremaine LLP
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District Court Finds Employer's Incomplete Email Response Creates Liability for Entire Life Insurance Benefit
"The court found that the former employee was asking about his benefits as a whole and the company had a fiduciary duty to respond to his inquiry with complete and accurate information regarding all benefits, including the information that his life insurance policy would need to
be converted or else it would lapse, given that he was still within the eligibility window for conversion." [Watson v. EMC Corp., No. 19-2667 (D. Colo. May 7, 2025)] MORE >>
Haynes and Boone, LLP
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Express Scripts, CVS Sue Arkansas Pharmacy Board Over PBM Law
"Express Scripts argues that the bill ... would have the effect of shutting down many pharmacies across [the state].... Express Scripts is bringing the suit to prevent this harm and because it believes 'the law violates multiple provisions of federal law,' the PBM
said in the complaint." [Express Scripts, Inc. v. Arkansas State Board of Pharmacy, No. 25-0520 (E.D. Ark. complaint filed May 29, 2025); CVS Pharmacy, Inc. v. Arkansas State Board of Pharmacy, No. 25-0524 (E.D. Ark. complaint filed May 29, 2025)] MORE >>
FierceHealthcare
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Florida Regulatory Action Highlights Need for Insurers to Use Licensed TPAs
"A Florida-based [HMO] was fined for contracting with a [TPA] that was not licensed in Florida, violating its statutory obligation to ensure competent administration under Florida law. The HMO ... was fined $10,000 and agreed that any future violations would be considered
willful and could lead to more severe regulatory action. This case underscores the importance of insurers and HMOs verifying the licensure status of all TPAs before entering into business arrangements." MORE >>
Polsinelli PC
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House OKs HSA Enhancements, Paid Leave Employer Tax Credits, Student Loan Provisions in Budget Bill
"[A] host of employer-friendly provisions [would] expand eligibility and uses for Health Savings Accounts and Health Reimbursement Arrangements, extend and enhance the employer tax credit for paid family and medical leave, and extend employers' ability to provide tax-free
educational assistance. An extension of pandemic-related telehealth flexibility for High-Deductible Health Plans is not in the measure." MORE >>
Mercer
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Healthcare Costs for an American Family Reach $35,119 in 2025 (PDF)
"Healthcare costs for the average person increased 6.7% in 2025, with pharmacy costs increasing by 9.7% and outpatient facility care costs rising 8.5%. Healthcare costs for a hypothetical family of four rose to $35,119.... [O]utpatient facility services and pharmacy costs
together accounted for nearly 70% of the total cost increase. Much of the outpatient growth is linked to high-cost drugs administered in outpatient settings." MORE >>
Milliman
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PSYPACT Gets an A (for Access, Among Other Things)
"[T]he Psychology Interjurisdictional Compact (PSYPACT®) became operational in April 2019 ... to facilitate telepsychology and temporary in-person psychology across state lines.... PSYPACT can help health plan participants in several ways: [1] Continuity of
care in the event of travel or relocation; [2] Access to specialized services in rural, remote or otherwise underserved areas; [3] Ability to meet with psychologists fluent in their primary language; [4] High degree of consumer protection across state lines; [5] Greater scheduling flexibility." MORE >>
Mercer
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[Opinion]
ICHRA: The 401(k) Moment for Health Care
"ICHRAs shift responsibility while expanding choice. Employers define a tax-free, fixed monthly contribution for each employee. Employees then use those funds to shop for coverage ... This is a fundamental shift in the way health care benefits are delivered -- and a restructuring
that mirrors the pension-to-401(k) evolution almost exactly. Risk is decentralized. Choice is elevated. Employees are given true control over their health care decisions, and employers can offer benefits that are both sustainable and inclusive. It recasts the employer-employee dynamic: less 'controlled for you,' more 'collaborative with you.' " MORE >>
InsuranceNewsNet.com
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Benefits in General |
Senate Committee Schedules June 5 Hearing on Nomination of EBSA Head
"In February, President Donald Trump nominated Daniel Aronowitz to serve in the position ... Aronowitz is the president of Encore Fiduciary, which insures employers against liability for alleged violations of their fiduciary duty as sponsors of defined benefit plans. His
firm has tracked ERISA-related litigation for about a decade, and he has served as president of Encore Fiduciary for more than 13 years." MORE >>
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Employee Benefits Jobs
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Executive Director
Employees’ Retirement System of Rhode Island (ERSRI)
Warwick RI / Hybrid
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Webcasts and Conferences (Health & Welfare Plans) |
Conducting the Insurance Business in an Ethical Manner
June 5, 2025 WEBINAR
Savoy
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Smarter HR: How AI is Transforming Benefits, Engagement, and Workforce Strategy
June 17, 2025 WEBINAR
New England Employee Benefits Council [NEEBC]
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Health & Welfare Fiduciary Duties in Focus: What Employers Need to Know Now
June 17, 2025 in KY
Bricker Graydon
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Last Issue's Most Popular Items |
One Big Beautiful Bill: The Health and Retirement Provisions
Groom Law Group
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Departments Pause Enforcement of MHPAEA Final Rule and Reconsider MHPAEA Enforcement Program
Groom Law Group
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The Parity Paradox: MHPAEA Compliance for Employers and Insurers During the 2024 Enforcement Pause
Littler
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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
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