"The new amendment requires that fully insured health plans issued in Illinois must extend coverage to eligible dependent parents and stepparents of insured individuals, provided they reside within the health plan's service area.... This coverage requirement applies to health insurance policies issued, amended, delivered, or renewed in Illinois on or after January 1, 2026."  MORE >>

"[T]he state of West Virginia ... filed a federal court action against pharmacy benefit manager (PBM) Express Scripts Inc. (ESI) based on its alleged role in manipulating and exacerbating the opioid overdose epidemic. The West Virginia attorney general asserts that ESI, as a PBM, held a 'uniquely powerful position' within the 'prescription drug ecosystem.' " [West Virginia v. Evernorth Health, Inc., No. 25-0182 (N.D.W.V. complaint filed Aug. 15, 2025)]  MORE >>

"The Fifth Circuit has now sent the case back to the trial court ... In so doing, the court specifically noted that its prior opinion directed the trial court to address the 'compelling -- and largely unrebutted -- arguments' raised on appeal that HRSA and ACIP members were appointed in a manner that violated the Administrative Procedure Act." [Kennedy v. Braidwood Management, Inc., No. 24-316 (S. Ct. Jun. 27, 2025; 5th Cir. No. 23-10326 remanded Aug. 26, 2025)]   MORE >>

"[K]ey components necessary to lay the groundwork for a successful annual enrollment season: [1] Strategic planning ... [2] System configuration: enrollment portal and payroll system ... [3] Employee communication and education ... [4] Compliance considerations ... [5] Post-annual enrollment follow-up."  MORE >>

"Employees need more than just vacation days. Clear leave policies signal trust and support when life happens. This blog breaks down the most common types of leave, from bereavement leave to floating holidays, and shows how thoughtful policies strengthen equity, well-being, and retention."  MORE >>

"The share of private-sector establishments offering health plans that include at least one self-insured option has generally increased since the mid-1990s, well before the ACA.... Large firms are far more likely than small and medium-sized firms to offer a self-insured plan. Since the ACA's major provisions took effect, self-insurance rates have risen among small and medium-sized firms, while declining among larger firms -- though these trends may have begun to reverse in 2024."  MORE >>

"[T]his issue brief ... examines the findings of the Medicare Trustees Report with respect to program solvency and sustainability.... The longer that corrective measures are delayed, the worse the financial challenges will become and, in turn, the greater the burden that is likely to be imposed on beneficiaries, providers, and taxpayers."  MORE >>

"The Sixth Circuit recently addressed whether 'equitable relief' under ERISA includes the remedy of 'surcharge.' Following a 2023 decision from the Fourth Circuit, the Sixth Circuit concluded that it does not. The courts reached this conclusion by engaging in an analysis that more litigants and courts should be conducting in ERISA cases." [Aldridge v. Regions Bank, No. 24-5603 (6th Cir. Jul. 17, 2025)]  MORE >>