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Health & Welfare Plans Newsletter
August 20, 2025
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💼 2 New Job Opportunities
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[Guidance Overview]
Medical Loss Ratio (MLR) Rebates: What Employers Need to Know
"When rebates are required in the group markets, they are usually modest -- often $10 to $30 per employee. Issuing checks for these amounts can create unnecessary administrative work and may also result in taxable income for employees, particularly when a
Section 125 Premium Only Plan (POP) is in place. To minimize the burden, many employers: [1] Apply the rebate toward future premium payments. [2] Use the funds to enhance benefits rather than issuing checks." MORE >>
Word & Brown
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[Guidance Overview]
Coverage for Gender-Affirming Care Will Be Eliminated from FEHB Plans in 2026
"Earlier this year, OPM issued guidance that eliminated gender-affirming care for individuals under the age of 19 but preserved the option for carriers to continue offering it to older patients.... This latest notice from OPM now eliminates that discretion entirely, prohibiting coverage of gender-affirming care for individuals of any age under the FEHB program." MORE >>
Government Executive
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[Guidance Overview]
2026 HSA Guide (PDF)
19 pages. Covers [1] Eligibility, [2] Contributions, [3] Distributions and [4] Reporting. MORE >>
Brown & Brown, Inc.
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Second Circuit Rules Disability Claimant Didn't Waive Her Right to Sue for Benefits
"[T]he Second Circuit ruled that no reasonable jury 'could conclude that Schuyler actually believed that she was waiving her claim for LTD benefits from Sun Life when she signed the agreement,' and thus she 'didn't knowingly and voluntarily waive her right to
pursue her LTD against Sun Life.' The court therefore reversed the judgment below and remanded for further proceedings." [Schuyler v. Sun Life Assurance Co. of Canada, No. 23-498 (2d Cir. Aug. 14, 2025)] MORE >>
Kantor & Kantor
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District Court Allows ERISA Fiduciary Breach Claim Over Life Insurance Continuation
"[T]he court addressed whether Tufts Medical Center and its HR director breached their fiduciary duties under ERISA when they failed to advise [the doctor] and his widow ... of the option to continue his life insurance coverage following his terminal cancer diagnosis. The
ruling offers important guidance on fiduciary obligations of plan administrators and HR personnel, particularly in situations where beneficiaries face life-altering illnesses." [Erban v. Tufts Med. Ctr. Physicians Org., Inc., No. 22-11193 (D. Mass. Aug. 12,
2025)] MORE >>
Roberts Disability Law
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[Sponsor]
Register for the 2025 CCA Annual Meeting before Sept. 21 and Save
This three-day meeting includes 16 healthcare sessions covering the ever-changing state of the healthcare market. Topics include the role of cost transparency, Artificial Intelligence, Medicare, Medicaid, digital health innovations. 18.5 CPD credits.
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![Sponsored by Conference of Consulting Actuaries [CCA] Sponsored by Conference of Consulting Actuaries [CCA]](https://benefitslink.com/bnrs/2025/cca-2025annual-inline.jpg)
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If You Sponsor a Health Plan, You're a Fiduciary
"[R]ecent legal developments, including the Consolidated Appropriations Act (CAA) of 2021 and pivotal court rulings, serve as a sharp reminder [to employers] that they are, in fact, fiduciaries under ERISA, with all the responsibilities and liabilities that come with that
role.... [This article explores] the often-overlooked fiduciary responsibilities employers have when sponsoring health care plans and the need for plan sponsors to understand, document, and defend their fiduciary processes under the new standards." MORE >>
American Retirement Association [ARA]
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Benefits in General |
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[Guidance Overview]
USERRA in the Spotlight: What the Latest Domestic Deployments Mean for Your Workforce
"The Trump administration has deployed troops to Los Angeles and Washington, D.C., in recent months, and the president has named four more cities where he intends to deploy troops. Employers must provide job-protected leave to service members who are called to military duty.
Domestic deployments for natural disasters or other emergencies may impact private employers with regard to their staffing levels, compensation costs, and employee benefits administration." MORE >>
Ogletree Deakins
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OMB Says Regulatory Agenda Was Published Prematurely Last Week
"A spokesperson for the Office of Management and Budget (OMB) explained that the unified regulatory agenda that was briefly published last week was a draft version that was published by accident. An OMB spokesperson explained that 'The President's Unified Agenda has yet
to be released. A now-former GSA contractor inadvertently posted a draft version.' The spokesperson did not say if the contractor was terminated or resigned, and did not comment on how accurate the draft version is or when a final might be expected." MORE >>
Plan Sponsor Council of America [PSCA]
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Employee Benefits Jobs
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Webinars, Podcasts and Conferences (Health & Welfare Plans) |
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Family Medical Leave Act (FMLA) and Health Benefit Plans
ON-DEMAND WEBINAR
Brown & Brown
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Navigate Total Rewards, Fringe Benefits, and Tax Strategies
ON-DEMAND WEBINAR
Moss Adams
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sThe Changing Landscape for Health Plans: Impacts of the One Big Beautiful Bill and Health Care Trends
September 11, 2025 in OH
Worldwide Employee Benefits Network [WEB] - Northeast Ohio Chapter
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Vorys 2025 Benefits Conference
September 16, 2025 in OH
Vorys
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Last Issue's Most Popular Items |
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Gone But Not Forgotten: How to Handle Final Pay and Benefits When an Employee Passes Away
Seyfarth
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Measuring How GLP-1 Medications Impact the Total Cost of Care (PDF)
Milliman
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Health Provisions in PL 119-21, the FY2025 Reconciliation Law
Congressional Research Service [CRS]
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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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