|
Health & Welfare Plans Newsletter
July 30, 2025
|
|
|
|
💼 2 New Job Opportunities
|
| |
|
[Guidance Overview]
A Balancing Act: State PBM Laws and ERISA Preemption (PDF)
"For now, we know that Rutledge does not preempt PBM regulations that merely increase the cost of doing business in the state. Mulready preempts plan design requirements, including network adequacy, in PBM laws in the 10th Circuit, but network
considerations are likely not preempted pursuant to Wehbi in the 8th Circuit. Finally, Gobeille provides an argument that ongoing reporting and attestations are preempted.... [T]he only thing that is clear is that PBM laws that merely increase plan costs, without more, are not preempted. Most other types of provisions ... are still up for debate." MORE >>
Arthur J. Gallagher & Co.
|
|
[Guidance Overview]
The 2026 Required Annual Benefit Notices to Employees
"Employers must provide the Medicare Part D, CHIP, and WHCRA notices annually. All three can be satisfied together by timing their distribution to meet the October 15 Notice of Creditable Coverage deadline.... The new mid-year update of the DOL Children's Health Insurance Program (CHIP) Model Notice ... marks the unofficial start to the protracted health and welfare plan annual notice season for the upcoming year. [This article] outlines the required and recommended
notices to include in the distribution to employees." MORE >>
Newfront
|
|
[Guidance Overview]
DOL Self-Audit Paid Program Returns, Now Allowing Employers to Identify and Resolve FMLA Violations
"Under the PAID program framework, an employer first reviews the program's compliance assistance materials and conducts a
self-audit of compensation and/or leave practices. Next, the employer contacts WHD to discuss any noncompliance issues the employer wishes to resolve and ... submits required information to WHD.... The PAID program ... addresses certain FMLA leave violations, including miscalculating leave, incorrect eligibility assessments, improper attendance penalization, or improperly categorizing leave as an unexcused
absence." MORE >>
Ballard Spahr, via JDSupra
|
|
[Guidance Overview]
PAID Back: DOL Revives Voluntary Self-Audit Program, Extends it to FMLA Issues
"The [DOL] has officially revived its Payroll Audit Independent Determination (PAID) program ...[which] aims to encourage employers to self-identify and correct compliance issues under the FLSA and FMLA.... For employers, the program provides a potential avenue to correct
mistakes without inviting the threat of fines, litigation, or plaintiffs' attorney fees (though ... not all exposure necessarily disappears).... The revived PAID program includes several enhancements and limitations[.]" MORE >>
Seyfarth Shaw, via JDSupra
|
|
[Guidance Overview]
OBBBA Permanently Enhances Dependent Care Benefits
"The One Big Beautiful Bill Act introduces lasting changes to dependent care benefits, including permanent increases to the annual income exclusion for employer-provided dependent care assistance programs, as well as enhancements to the child and dependent care tax credit and the
employer-provided childcare tax credit, beginning in 2026." MORE >>
Mercer
|
|
[Guidance Overview]
Indiana Mandates Employee Leave for School Meetings
"Effective July 1, 2025, Indiana generally requires all employers [to] provide unpaid leave for employees to attend school conferences and meetings for their children. Employers are prohibited from taking adverse action against an employee who is absent from work to attend
an attendance conference or a case conference committee meeting regarding their child." MORE >>
Vorys
|
|
[Guidance Overview]
Maryland Again Delays Paid Family and Medical Leave Program
"The new law delays the start of contributions from July 1, 2025 until January 1, 2027, and delays the availability of benefits from July 1, 2026 to between January 1, 2027 at the earliest and January 3, 2028 at the latest. HB 102 also repeals certain requirements for participating self-employed individuals, and defines an 'anchor date' for the calculation of a covered employee's average weekly wage and eligibility for
increases in weekly benefits." MORE >>
Littler
|
|
Sixth Circuit Reverses Dismissal of ERISA Healthcare Fee Suit Against Third-Party Administrator (PDF)
"The court reasoned that 'contractual duties and ERISA fiduciary status are not mutually exclusive.' Rather, 'an administrator's performance (or nonperformance) of its contractual obligations can illuminate whether it was acting as an ERISA fiduciary.' On this
point, the court agreed with the [DOL's] argument in its amicus brief -- 'to hold that an administrator like BCBSM insulates itself from ERISA liability because a contract governs its relationship with its customer would "gut ERISA's fiduciary provisions." ' " [Tiara Yachts, Inc. v. Blue Cross Blue Shield of Mich., No. 24-1223 (6th Cir. May 21, 2025)] MORE >>
Holland & Knight
|
|
District Court Upholds Unum’s Termination of Disability Benefits Based on International Residency Clause
"The court found that the plan's language was unambiguous: a beneficiary is deemed to reside outside the U.S. or Canada if they spend six or more months abroad during any 12-month benefit period.... Despite her arguments about pandemic travel barriers, the court held that
U.S. citizens like Archer were exempt from border restrictions and that her failure to return to the U.S. was not legally excused under an 'impossibility' theory." [Archer v. Unum Life Ins. Co. of Am., No. 23-1128 (W.D. Wash. Jul. 28,
2025)] MORE >>
Roberts Disability Law
|
|
HDHP-HSA Plan Trends
"Gen Z workers had the highest HSA-eligible HDHP participation relative to Millennials, Gen Xers, and Baby Boomers, and while overall participation in HDHP plans dipped slightly across all generations in 2025, ... HSA-eligible HDHP participation increased among Gen Zers at a
greater clip compared to Millennials, Gen Xers, and Baby Boomers from 2024 to 2025.... Gen Z workers had the lowest health care utilization." MORE >>
Benefitfocus
|
Benefits in General |
|
Harnessing AI Under ERISA: A Compliance and Oversight Guide for Retirement and Health Plan Fiduciaries
"AI technologies are already being integrated into various aspects of Plan management and operations. Fiduciaries should understand how these technologies can benefit participants and beneficiaries -- and how to mitigate associated risks.... Recommended action items include:
[2] Integrate AI risk management into the Plan's overall governance strategy. [2] Evaluate and document how AI tools impact investment selection, recordkeeping, and participant advice. [3] Review and revise service provider contracts to include AI-specific clauses. [4] Conduct initial and periodic due diligence on vendors, involving technical experts as needed." MORE >>
Jackson Lewis P.C.
|
|
2025 Retiree Health Care Cost Estimate
"a 65-year-old retiring in 2025 can expect to spend an average of $172,500 in health care and medical expenses throughout retirement. This represents a more than 4% increase over 2024 and continues the general upward trajectory of projected health-related expenses since
Fidelity’s inaugural $80,000 estimate in 2002." MORE >>
Fidelity
|
|
Employee Benefits Jobs
|
|
|
|
|
|
|
Press Releases |
|
Strongpoint Partners Announces Partnership with United Benefit Pensions, LLC
Strongpoint Partners
|
|
|
Webinars, Podcasts and Conferences (Health & Welfare Plans) |
|
Mid-Year Update on Family Leave Insurance
ON-DEMAND WEBINAR
Sun Life U.S.
|
|
Take It Or Leave It Episode 44: AI and Absences: Ethics and Boundaries in Leaves and Accommodations
PODCAST
Seyfarth Shaw LLP
|
|
Movement as Medicine
August 12, 2025 WEBINAR
Brown & Brown
|
|
Employee Benefits 2025 Legal Update: Trends, Compliance, and Litigation
August 20, 2025 WEBINAR
McAfee & Taft
|
|
HSAs -- Advanced
September 9, 2025 WEBINAR
Ascensus
|
|
|
Last Issue's Most Popular Items |
|
OBBBA's Impact on Employee Benefit Plans, Programs, and Arrangements
McDermott Will & Emery
|
|
Illinois Mandates Parent Coverage in Health Insurance Plans
HUB International
|
|
Employers Struggle as GLP-1 Costs Climb
Willis Towers Watson
|
|
Unsubscribe |
Change Email Address
Search Past Issues |
Privacy Policy
Submit an Article |
Contact Us |
Advertise Here
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.
Links to web sites other than BenefitsLink.com and EmployeeBenefitsJobs.com are offered as a service to our readers. We are not involved in their production and are not responsible for their content.
|