"It is that time of year again when about half of the state paid family and medical leave (PFML) programs have announced changes to their contribution rates and benefits. A few programs have also announced a new state average weekly wage, upon which the maximum weekly PFML benefit calculation is based. Some of the changes are effective now, while others were recently announced with an effective date of January 1, 2026."  MORE >>

"Unless the employee's consent specifically identifies Form 1095-C, it will not serve as valid consent to receive Form 1095-C electronically.... Beginning with calendar years after 2023, Form 1095-C is not required to be sent to individuals unless it is requested. An electronic copy of Form 1095-C can be provided to employees who request a copy if the individual has affirmatively consented to electronic receipt of Form 1095-C at any prior time unless the consent is revoked in writing. "  MORE >>

"[A]ll employers sponsoring group health plans with prescription drug coverage, regardless of size, must ensure the Medicare Part D Creditable Coverage Disclosure notice is provided before October 15.... Given that plan sponsors may not know all who are Medicare eligible, the simplest way to approach providing notices is to disclose them to everyone who is enrolled or seeking to enroll in the plan."  MORE >>

"Employers that currently sponsor an HDHP that provides telehealth benefits or a stand-alone telehealth plan should review their plans to incorporate any benefits changes given the passage of this Act, and may make those changes retroactively to January 1, 2025.... Employers that choose to increase the limit applicable under their DCAP/DCFSA for taxable years beginning on or after January 1, 2026 should amend any communications and plan materials to reflect the updated limit."  MORE >>

"Based on the Mulready decision, it appears attempts to force plans to eliminate incentives for mail-order programs, accept any pharmacies into their networks and abide by state regulations to determine network adequacy would not survive an ERISA preemption challenge. This would likely apply to any state regulations that interfere with plan operations or administration. However, other state laws affecting PBMs could survive preemption." [PCMA v. Mulready, No. 22-6074 (10th Cir. Aug. 15, 2023; cert pet. denied Jun. 30, 2025, No. 23-1213]  MORE >>

"The court agreed with the majority of circuits holding that ERISA Section 1132(g)(1), which governs fee-shifting, does not authorize recovery of attorney's fees incurred during administrative proceedings.... [The case] serves as a cautionary tale for ERISA claimants: successful reinstatement of benefits may not open the door to broader monetary remedies, particularly when a claimant did not fully pursue administrative remedies. " [Stark v. Reliance Standard Life Ins. Co., No. 24-6137 (10th Cir. Jul. 8, 2025)]  MORE >>

"The District Court reasoned that although Cal-COBRA is a state law, the continuation coverage was an extension of an ERSA-governed plan. As a result, once Owens elected continuation coverage, she remained a participant in the original Frederickson plan, and any claims related to that plan -- even during the continuation period -- fall under ERISA's exclusive regulatory regime." [Owens v. Blue Shield of California, No. 24-0400 (N.D. Calif. Mar. 20, 2025)]  MORE >>

"[W]ith this new Advanced Primary Care model, employees enjoy easy, on-site access to care, at times that work with their schedules, and a location that is convenient for them. No complicated scheduling systems or insurance red tape -- just care when they need it."  MORE >>

"[I]ndividuals and businesses in parts of Texas affected by severe storms, straight-line winds. and flooding that began on July 2, 2025 ... now have until Feb. 2, 2026, to file various federal individual and business tax returns and make tax payments.... [I]ndividuals and households residing or having a business in Kerr County qualify for tax relief."  MORE >>

"[1] Public employee compensation: Expansion of deduction limit applicable to executive compensation ... [2] Continuation of employer credit for paid family and medical leave ... [3] Health Savings Account provisions ... [4] Increased limits for Dependent Care Assistance Programs ... [5] Continuation of employer-provided educational assistance ... [6] [T]he House [had] proposed eliminating the deduction for bicycle commuting reimbursements ... However, the final BBB retains the deduction for bicycle commuting reimbursements.... [7] Tax-exempt organizations: Expanded excise tax on excess compensation."  MORE >>

"[T]he OBBB expands access to and eligible expenses payable from Health Savings Accounts (HSAs), solidifies first dollar coverage for telehealth under high-deductible health plans (HDHPs), and permanently increases the annual contribution limit for dependent care flexible spending accounts (FSAs) for the first time since 1986.... This legal update provides an overview of the OBBB's employee benefits provisions and any actions that employers need to take for their employee benefit plans now or in the future."  MORE >>

"Morgan Stanley argued that the district court's commentary on the merits of the underlying ERISA claims rendered its order effectively a 'denial' of arbitration, and therefore appealable. The Second Circuit rejected this novel theory, citing the statute's plain language and declining to interpret a granted motion as a constructive denial.... Morgan Stanley separately sought a writ of mandamus ... to erase the district court's conclusion that the compensation plans were governed by ERISA. But the Second Circuit made clear that such relief is only available in extreme circumstances." [Shafer v. Morgan Stanley, No. 24-3141 (2d Cir. July 9, 2025; unpub.)]  MORE >>

"[T]he ERISA-required fidelity bond protects the plan and its participants, not the employer. If the bonding company does pay a claim, it may have subrogation rights to recover its payment from the employer and/or its officers and employees responsible for plan administration.  ... [C]onsider fiduciary liability insurance that is not just an add on to other policies. But there is no standard form for such insurance, so every proposal needs to be carefully reviewed and compared to other policies on the market."  MORE >>

"With more and more change and risk coming to plans and to those running them, particularly with regard to what the investment menu is going to begin to look like in many plans, plan sponsors and fiduciaries ... have to end the blind eye they often used to take with regard to the details of their vendor contracts or the terms in those contracts.... As the current evolution of plans, and particularly of the financial exposures of fiduciaries, continues ... the cost for not proactively taking this action will become much too high."  MORE >>