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Health & Welfare Plans Newsletter
June 12, 2025
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💼 5 New Job Opportunities
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[Guidance Overview]
Enforcement Pause Provides Only Limited Mental Health Parity Relief for Plan Sponsors
"This may come as welcome news for employers throughout the country who have struggled to understand, and ultimately comply with, the highly technical mental health parity laws, particularly the requirement to provide a detailed non-quantitative treatment limitation (NQTL)
comparative analysis. However, until the Departments re-examine their MHPAEA enforcement program more broadly, the non-enforcement policy provides limited relief[.]" MORE >>
Snell & Wilmer L.L.P.
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[Guidance Overview]
PCORI Filings and Fees, 2025 Edition
"Generally, health care Flexible Spending Accounts (FSAs) are not required to file a Form 720 unless the employer (and not just the employee) makes contributions to it that exceed the lesser of $500 annually or a dollar-for-dollar match of the employee's
contribution.... For Health Reimbursement Arrangements (HRA) ... [if] the integrated group health plan ... is fully insured, then the employer must file the 720 for the HRA and pay the [PCORI fee per employee].... If however, the underlying group health plan is self-funded then no separate 720 need be filed [for the HRA]." MORE >>
Kushner & Company
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[Guidance Overview]
CMS Doubles Down on Medicare Advantage Recoupment, Announces Aggressive RADV Strategy to Reclaim Billions
"By engaging with enhanced technology and significantly expanding its workforce, CMS states that it intends to audit every eligible MA contract for Payment Years (PY) 2018 through 2024 and recover on all prior audits conducted by CMS and the Office of Inspector General.
Historically, CMS has only selected a small subset of contracts (approximately sixty) for each PY audited." MORE >>
Epstein Becker Green
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Ninth Circuit: Releases of ERISA Claims Require Special Scrutiny as Fiduciary Actions
"Following the merger, the surviving corporation, Microchip, announced that it would no longer honor a severance plan, that Atmel had adopted prior to the merger, for employees who were fired without cause. Two such former employees ... filed an ERISA class action
lawsuit ... asserting that that Microchip further violated its fiduciary duties under ERISA by encouraging employees to sign the release of claims in exchange for significantly lower benefits than they were allegedly entitled to under the severance plan." [Schuman v.
Microchip Technology Inc., Nos. 24-2624, 24-2978 (9th Cir. Jun. 5, 2025)] MORE >>
Trucker Huss
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Second Circuit: Power of Attorney Does Not Give Medical Provider Standing to Sue Under ERISA
"The court determined that Dr. Karkare lacked Article III standing. Despite holding a power of attorney, he was suing in his own name rather than on behalf of Patient JN. The court emphasized that a power of attorney does not equate to an ownership interest in the claim, which is
crucial for establishing standing." [Karkare v. Int'l Ass'n of Bridge 580, No. 22-2874 (2d Cir. June 9, 2025)] MORE >>
Roberts Disability Law
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A Half-Hour Absence; Seven Years of FMLA Fallout
"The Seventh Circuit revived an FMLA interference claim brought by a former state employee who was fired after using the wrong type of paid leave to cover 30 minutes of pregnancy-related severe morning sickness. The court found genuine factual disputes and sent the case back for
trial." [Davis v. Illinois Dept. of Human Serv., No. 22-2118 (7th Cir. May 14, 2025)] MORE >>
Pierson Ferdinand LLP
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Individual Patient's Genes May Affect Which GLP-1 Obesity Drugs Work Best
"Knowing which works better is critical for employers' health plans, because anti-obesity drugs now account for about 17% of U.S. employer health plan prescription spending ... The full retail price of the drugs is about $1,400 per month for Victoza; $1,500 per month for
Wegovy, a better-known drug that's similar to Victoza; and just $200 per month for Qsymia." MORE >>
BenefitsPro; login may be required
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The New Look of Virtual Care: What's Right for Employers and Plan Sponsors?
"How do plan employers and plan sponsors factor into this evolving and developing landscape? To maximize investment in virtual care solutions and to guide choices, they may want to establish and/or refresh their virtual care strategy annually. From there, vendor partners can be
identified that best support the strategy. The last piece of the puzzle is a solid measurement program that tracks results and evaluates outcomes." MORE >>
International Foundation of Employee Benefit Plans [IFEBP]
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Implementing Voluntary Benefits to Reduce Employee Stress
"[E]mployers should measure the success of the programs every 12 to 24 months. Employers can conduct surveys to test employee awareness of, understanding of, and satisfaction with the programs. Companies can also benchmark their benefit portfolios against those offered by
industry peers. Finally, employers can examine participation rates among employees to determine if they are at, above, or below industry norms with regard to re-enrollment and persistency." MORE >>
AssuredPartners
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Workplace Well-Being in 2025: Insights from the Workplace and Employee Survey (PDF)
13 pages. "The average mental health rating [by employees] was 3.29, one of the lowest ratings across five distinct dimensions of well-being: physical, work, social, mental health and financial well-being.... From 2024 to 2025 there was a 14% decrease in the number of employees
who reported Excellent mental health.... [O]nly one in four employees strongly agree that their organization cares about their well-being. " MORE >>
WebMD HealthServices
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[Opinion]
When the Fully Insured Plan No Longer Works, What's Next for Employers?
"For employers navigating rising costs and evolving employee expectations, the answer is rarely another level of benefits complexity. It's a focus on the fundamentals: budget predictability, plan flexibility, and the ability to align investment with impact. In that context,
reclaiming control isn't about resisting change; it's about reasserting ownership in a space where that's been far too difficult to achieve for far too long. And it's for this reason that the defined contribution model -- often implemented through an ICHRA -- is gaining traction." MORE >>
MedCity News
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Benefits in General |
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[Official Guidance]
IRS Disaster Relief Announcement MS-2025-01, for Taxpayers Impacted by Severe Storms, Straight-Line Winds, Tornadoes, and Flooding in Mississippi
"[I]ndividuals and businesses in parts of Mississippi affected by severe storms, straight-line winds, tornadoes, and flooding that began on March 14, 2025 ... now have until Nov. 3, 2025, to file various federal individual and business tax returns and make tax
payments.... [I]ndividuals and households that reside or have a business in Calhoun, Carroll, Covington, Davis, Grenada, Humphreys, Issaquena, Itawamba, Jefferson Davis, Lee, Leflore, Marion, Montgomery, Pike, Prentiss, Sharkey, Smith, Walthall, and Washington counties qualify for tax relief." MORE >>
Internal Revenue Service [IRS]
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While HSA Account Balances Rise, One-Third of Accountholders Withdrew More Than They Contributed in 2023
"Out-of-pocket patient spending on health care increased in 2023, rising 7.5% over 2022. Still, average end-of-year HSA balances were higher than average beginning-of-year balances.... 43% of accountholders received an employer contribution.... More than half of the HSAs in
EBRI's database had a distribution in 2023, and the average distribution was $1,801." MORE >>
Employee Benefit Research Institute [EBRI]
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Employee Benefits Jobs
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Webcasts and Conferences (Health & Welfare Plans) |
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Making Sense of Compliance in the Fertility and Family-Building Space.
June 17, 2025 WEBINAR
Nava Benefits
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Guidance on State and Local Paid Sick Leave and Paid Time Off Laws: 2025 Mid-Year Checkup
June 25, 2025 WEBINAR
Seyfarth Shaw LLP
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Labor, Employment and Employee Benefits Considerations in Layoffs and Reductions in Force
July 8, 2025 WEBINAR
Stinson
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Last Issue's Most Popular Items |
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HHS Settles Potential HIPAA Violations for $600,000 After Phishing Attack
Hall Benefits Law
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Wellness Benefits Are Not Improving Employee Health
ebn
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Taking Stock of the Health Coverage Impacts of the House Reconciliation Bill
Health Affairs Forefront
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Copyright 2025 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.
BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
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