"Revenue Procedure 2025-26 specifies the new indexing adjustments for employer shared responsibility payments (ESRPs) for the 2026 plan year. The 'A Penalty' for not offering minimum essential coverage rises to $3,340 per full-time employee and the 'B Penalty' for offering unaffordable minimum value coverage increases to $5,010.... The higher penalty amounts for 2026 are the result of changes to the income and premium factors that are used in calculating the penalty amounts."  MORE >>

"IRS uses Letter 226-J to inform ALEs of their potential liability under Code Section 4980H. A response form (Form 14764) is included with Letter 226-J so that an ALE can inform the IRS whether it agrees with the proposed penalty. For proposed assessments issued on or after January 1, 2025, the employer has at least 90 days from the date of Letter 226-J to respond."  MORE >>

"[B]eginning July 31, 2025, New York's COVID-19 Paid Emergency Leave will expire, and employers will no longer be required to provide separate leave for COVID-19 quarantines and isolations.... [E]mployees who need time off to manage care for COVID-19 can continue to use other paid leave options, including New York State's Paid Sick Leave, New York City's Earned Sick and Safe Time, or New York Paid Family Leave."  MORE >>

"The repeal is final: No further accrual or usage requirements under Proposition A after August 28. Employers who had introduced compliance-focused paid sick leave may [after August 28] [2] Integrate it into existing paid leave; [2] Eliminate it entirely, or [3] Re-position in a policy aligned with your goals. Unused paid sick time hours accrued before August 28 can typically be used through that date. Beyond that, usage is discretionary -- you may want to clarify this in a written policy."  MORE >>

"[E]mployers should ... [1] Confirm that the plan (especially if self-funded) is being administered on a state-by-state basis to comply with applicable law. [2] Analyze how various state bans might impact access to such care for the covered participants. [3] Review the plan's travel benefit (if any and if desired) to ensure sufficiency for participant travel to obtain necessary care while also ensuring that such benefits do not run afoul of any applicable state criminal laws." [U.S. v. Skrmetti, No. 23-477 (S.Ct. Jun. 18, 2025)]  MORE >>

"The court found that a 'structural conflict may exist' regarding the relevant underlying plan documents and other documents and ordered limited discovery. The court also ordered limited discovery regarding the existence of reinsurance for the plan and the identity and authority of any such reinsurer." [THC-Orange County, LLC v. Regence BlueShield of Idaho, Inc., No. 24-0154 (D. Idaho Jun. 2, 2025)]  MORE >>

"This decision only impacts the changes to the Privacy Rule related to Reproductive Health Care Privacy Protections included in the Final Rule. It does not impact Covered Entities' or Business Associates' other obligations under the HIPAA privacy and security rules, nor does it impact any state law protections that may limit the disclosure of this information, which vary from state to state."  [Purl v. HHS, No. 24-0228 (N.D. Tex. Jun. 18, 2025)]  MORE >>

"39% of millennials and 35% of Gen Z say access to weight loss drugs would improve their job satisfaction or productivity.... Only 14% of Americans believe insurance should cover weight loss drugs for everyone ... A larger group supports more limited coverage, only for those with medical conditions like obesity. And many remain undecided, reflecting broader uncertainty around fairness, affordability and long-term outcomes."  MORE >>

46 pages; rev. Jul. 23, 2025. "[CMS] is releasing an updated Summary Report on Individual and Small Group Market Risk Adjustment Transfers for the 2024 Benefit Year, which incorporates a 2024 benefit year discrepancy received by CMS on June 5, 2025 impacting 69 state market risk pools across 43 states and the District of Columbia." [Also available: Appendix A: HHS Risk Adjustment Program State-Specific Data (Rev. July 23, 2025) (XLSX); Appendix C: Issuer-Specific Information for Non-Merged Market Issuers (Rev. July 23, 2025) (XLSX); Appendix D: Issuer-Specific Information for Merged Market Issuers (Rev. July 23, 2025) (XLSX)]  MORE >>

"While 39% of workers said they've taken a mental health day, only 10% felt comfortable being honest with their employer about it -- and received a positive response. Another 19% have disguised their mental health days as physical illness days, and 11% told their employer the truth but felt dismissed or unsupported."  MORE >>

"Many of our agencies offer self-audit programs, which are voluntary tools to help the regulated community proactively assess and improve compliance with the labor laws we enforce.... Self-audits enable you to identify and fix potential violations, reduce the likelihood of litigation, and demonstrate a good-faith commitment to following the law. They also help ensure that workers get the protections and benefits they are entitled to -- like timely wages, fair and safe working conditions, and benefits security."  MORE >>

"[T]he ever-expanding range of risks that plan sponsors and fiduciaries are facing, and the rapidly evolving decisions they have to make, call for a litigator’s advice, and preferably not any litigator, but one with both significant courtroom experience and deep substantive knowledge of ERISA."  MORE >>