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Health & Welfare Plans Newsletter

June 27, 2025

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[Guidance Overview]

Fitbits at Work: Navigating the Legal Risks of Wearables in Corporate Wellness Programs

"Employers should consider whether they, or third-party wellness vendors, are collecting and storing biometric data in a way that triggers state law obligations. Even if an employer doesn’t touch the data directly, liability may attach if the program is employer-sponsored."  MORE >>

Akerman

Supreme Court Upholds Appointment of Preventive Services Task Force Members by HHS Secretary (PDF)

"Task Force members are inferior officers whose appointment by the Secretary of HHS is consistent with the Appointments Clause.... [T]he Secretary has power to appoint Task Force members, and no statute restricts their removal. Therefore, the Secretary may remove Task Force members at will, enabling him to supervise and direct them.... Beyond at-will removal, the Secretary has statutory authority to directly review and block Task Force recommendations before they take effect." [Kennedy v. Braidwood Management, Inc., No. 24-316 (S. Ct. Jun. 27, 2025)]  MORE >>

Supreme Court of the United States

Sixth Circuit Rules Third-Party Administrator May Be Liable as ERISA Fiduciary

"The Sixth Circuit disagreed and held that a dispute arising from contractual terms may still give rise to claims for breach of fiduciary duties under ERISA, and BCBSM is not shielded from liability merely because its overall business practices affect many plans." [Tiara Yachts, Inc. v. Blue Cross Blue Shield of Mich., No. 24-1223 (6th Cir. May 21, 2025)]  MORE >>

Slevin & Hart, P.C.

PBM Hit with $95 Million False Claims Act Judgment

"This ruling is particularly significant as it sheds light on the all-too-opaque process of drug pricing.... When PBMs are accused of having violated the False Claims Act by overbilling Medicare -- when Caremark is supposed to be reporting the actual prices remitted in reimbursement to pharmacies for Medicare Part D drugs -- it follows that the reimbursement paid to pharmacies is significantly less than what it otherwise should be." [U.S. ex rel Behnke v. CVS Caremark Corp., No. 14-0824 (E.D. Penn. Jun. 25, 2025)]  MORE >>

Duane Morris LLP

The FMLA Trap You May Be Walking Into, Even When Fraud Seems Obvious

"This case isn't about whether the employee lied. It's about whether the employer followed the rules. And under the FMLA, suspicion isn't a substitute for process. So if something about the certification seems wrong, slow down, document everything, and follow the steps. That's how you protect your company and stay out of court." [Mook v. City of Martinsville, VA, No. 23-0028 (W.D. Va. Jun. 14, 2024)]  MORE >>

Pierson Ferdinand LLP

ERISA Preemption Debate Heats Up in 2025

"We can reasonably expect to see increasing turbulence between the states and multi-state plan sponsors (and the vendors who work for them).... [S]teps employers can take to prepare for the storm: [1] Keep senior management aware of ... ongoing developments and the potential impact on health benefits.... [2] Keep up to date on legislative and regulatory developments in the states where you operate.... [3] Assess the impact of enacted legislation on plan design."  MORE >>

Mercer

May Health Plan Business Associates Disclose PHI Directly to Other Business Associates of the Same Plan? (PDF)

"PHI generally can be disclosed directly by one business associate to another business associate of the same covered entity without having to use the covered entity as a conduit or intermediary, so long as certain conditions are met."  MORE >>

Thomson Reuters / EBIA

An Employer's Legal Compliance Guide to Handling Employee Medical Information

"There are myriad federal, state, and local laws that govern what employee medical information may be collected by employers, when an employer can request employee medical information, how such information may be requested, how it must be stored, and how long the records must be retained.... Once medical information is obtained, employers must also be sure to comply with laws governing how such information must be maintained, protected, and retained."  MORE >>

Venable LLP

Benefits in General

[Guidance Overview]

DOL Relaunches Opinion Letter Program Amid Shifting Enforcement Priorities

"[T]he program is designed to 'promote clarity, consistency, and transparency in the application of federal labor standards.' Any interested party, including employers, employees, and unions, may submit requests, particularly in cases where existing laws are unclear or do not fully address specific workplace scenarios."  MORE >>

FordHarrison

EBSA Nominee Aronowitz Advances in the Senate

"Aronowitz was approved on a 14-9 vote, with Sens. Tim Kaine (D-Va.) and John Hickenlooper (D-Colo.) crossing party lines to support the nominee. He still needs to be confirmed by the full Senate, however, before he can officially take office."  MORE >>

American Retirement Association [ARA]

Webcasts and Conferences
(Health & Welfare Plans)

Creating a Competitive Advantage Through Employee Benefits

RECORDED

Maynard Nexsen

Last Issue's Most Popular Items

Time to Revisit Your HIPAA Documents

Seyfarth

Final Regs Address ACA Exchange Integrity, Revise 2026 Annual Limitation on Cost-Sharing

Thomson Reuters / EBIA

District Court Decision in Life Insurance Case Underscores ERISA Prudence

HUB International

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

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