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Health & Welfare Plans Newsletter

September 2, 2025

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[Guidance Overview]

Illinois Enacts New Neonatal Intensive Care Leave Act

"[T]he Neonatal Intensive Care Leave Act (NICLA) ... will require employers with 16 or more employees to provide certain amounts of unpaid leave (depending on the size of the employer) to all employees while any child of the employee is a patient in a neonatal intensive care unit.... The leave may be taken intermittently or consecutively, and employers can also require the leave to be taken in minimum increments of 2 hours."  MORE >>

FordHarrison

[Guidance Overview]

OBBBA Makes Paid Family and Medical Leave Credit More Attractive to Employers

"While more employers may be able to take the credit under the OBBBA, there may still be some challenges.... [T]he compensation limit could minimize the number of employees for whom the employer can take the credit.... [W]hile it is helpful for employers to count paid leave required by state or local law towards the two-week requirement, it could be challenging for employers to exclude that PFML when calculating the credit amount[.]"  MORE >>

Groom Law Group

Strengthening Oversight of Self-Insured Health Plans

"Employers that sponsor their own self-insured health plans rely heavily on third-party administrators (TPAs) and pharmacy benefit managers (PBMs) to process claims, manage networks, control costs, and deliver programs that support a healthier workforce.... This article highlights the essential elements of fiduciary oversight and provides a practical structure for building an oversight function that strengthens compliance and plan performance."  MORE >>

Withum Smith+Brown, PC

Transforming Employer Health Benefits: Large Employers' Activist Role

"Unprecedented external pressures are affecting how employers approach benefit offerings ... [N]early 12 million members covered by health plans could move to an innovative product design by 2030.... Employers are open to alternative network arrangements in pursuit of cost control.... Employers are prepared to scale back solutions that cannot demonstrate a hard ROI or high value to employees.... Redefining the sales playbook: Using data, AI, and demos to deliver value to employers ... Hypercustomize RFP responses ... Move from fixed to pay-for-performance pricing."  MORE >>

McKinsey

When Hospitals and Insurers Fight, Patients Get Caught in the Middle

"18% of non-federal hospitals experienced at least one documented case of public brinksmanship with an insurance company from June 2021 to May 2025 ... Over the same period, 8% of hospitals ultimately went out-of-network with an insurer, at least for a time. Industry observers say long-standing trends like hospital consolidation and rising health care costs contribute to the disputes[.]"  MORE >>

KFF Health News

[Opinion]

Large Employers as Healthcare Innovators: A Call to Activist Leadership

"To effectively drive real innovation and impact in healthcare, CEOs, CFOs and CHROs need to be ... [1] [C]hanging the viewpoint of healthcare from being a cost center to an investment strategy. [2] Demanding clarity and data fluency from vendors and health plans ... [3] Authorizing investments in innovative concepts and deeply monitoring their impact. [4] Building internal competencies around care outcomes."  MORE >>

Summus

Benefits in General

Ninth Circuit: Participant Consent Rules for Plan Arbitration Provisions

"After examining ERISA and the Federal Arbitration Act (FAA), the Ninth Circuit held that the employer could not unilaterally add an arbitration provision to an ERISA plan without obtaining consent from a 'relevant party.' ... The Ninth Circuit rejected the employer's argument that consent was not needed because employers can generally modify ERISA health plans unilaterally." [Platt v. Sodexo, S.A., No. 23-55737 (9th Cir. Aug. 4, 2025)]  MORE >>

Reuters; login may be required

How Close Are Sponsors to Using AI for Plan Personalization?

"Though many of the solutions are geared toward individual investors, they can work for retirement plan participants. Even so, personalized retirement planning powered by AI is in its infancy, and plan sponsors are hardly early adopters of the shiny new tool. But the possibility of tailoring strategies to individual needs -- income, expenses, risk tolerance and long-term goals -- while keeping planning simple and accessible is becoming an increasingly feasible solution."  MORE >>

PLANSPONSOR; registration may be required

How Much Could Taxing Health Benefits Help Social Security?

"[A]dding ESI would raise payroll taxes by about $400 per year on average and reduce Social Security's 75-year shortfall by about 25 percent. This option is somewhat regressive -- as it would collect no additional taxes from earners above the wage cap -- but it could be part of a larger reform package."  MORE >>

Center for Retirement Research [CRR] at Boston College

Press Releases

Hessel and Associates, LLC, Joins Daybright Financial

Daybright Financial

PlanPort Announces Formation of Technical Advisory Board with Distinguished Technology Leaders

PlanPort

TRA Regional Plan Consultant Will Help Oversee MYCTSavings, Encouraging Retirement Readiness for Connecticut Workers Under the State Mandate.

TRA [The Retirement Advantage]

iJoin Partners with Manifest to Make It Easier for Participants to Transfer and Consolidate Their 401(k)s

iJoin

Webinars, Podcasts and Conferences
(Health & Welfare Plans)

Beyond Checkboxes: Annual Enrollment Strategies That Engage and Deliver

ON-DEMAND WEBINAR

bswift

Last Issue's Most Popular Items

Illinois Expands Dependent Coverage Requirements for Fully Insured Health Plans

Sequoia

Self-Insured Health Coverage from 1996 to 2024

Employee Benefit Research Institute [EBRI]

Sixth Circuit Rejects Surcharge as a Remedy Under Section 502(a)(3)

Faegre Drinker

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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.

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