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Health & Welfare Plans Newsletter

September 11, 2025

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[Guidance Overview]

COBRA Coverage During the Election and Premium Period

"The plan may take different approaches to handling coverage during this interim COBRA election/premium period. Regardless of the plan's approach, upon a timely COBRA election and initial premium payment the qualified beneficiary will have continuous and seamless coverage retroactive to the date active coverage ended."  MORE >>

Newfront

[Guidance Overview]

What Are Our Company's Obligations to a Former Employee Receiving COBRA Coverage Who Has Been Called to Active Duty in the Uniformed Services?

"USERRA requires health plans to offer continuation coverage under certain circumstances.... But your former employee will not be entitled to USERRA coverage under your plan because he was not employed by your company when he was called to active duty -- his uniformed service did not cause him to be absent from employment with your company."  MORE >>

Thomson Reuters / EBIA

[Guidance Overview]

San Francisco Contractor-Lessee Health Plan Standards, Pay Rates Updated

"The Department of Public Health (DPH) has announced 2026 minimum standards for covered employees' health coverage starting on Jan. 1, 2026, and alternative payment fee increases effective July 1, 2025. Minimum standards and alternative payments also apply for covered employees at the San Francisco International Airport (SFO) under the Healthy Airport Ordinance (HAO) ... [C]overed service contractors and airport tenants are subject to minimum compensation rates and time-off requirements under the city's Minimum Compensation Ordinance (MCO)."  MORE >>

Mercer

[Guidance Overview]

Massachusetts Extends Law Permitting Pharmacies and Pharmaceutical Manufacturers to Offer Drug Discounts to Consumers

"The Massachusetts law permitting pharmacies and pharmaceutical manufacturers to offer drug discounts to consumers, which was set to expire on January 1, 2026, has recently been extended to January 1, 2031.... [The law] allows pharmacies to provide discounts and free product vouchers to consumers in connection with pharmacy services, items, or prescription transfers. The law also allows pharmaceutical manufacturers to provide discounts, rebates, product vouchers, and other price reductions to individuals’ out-of-pocket drug expenses."  MORE >>

Quarles & Brady LLP

Eleventh Circuit Rules Georgia County Didn't Discriminate by Denying Coverage of Gender-Affirming Surgery

"The decision relies heavily on [Skrmetti, which] upheld Tennessee's ban on gender-affirming care for transgender minors. That decision focused on the right to equal protection under the 14th Amendment, which requires the government to treat similarly situated people the same. The 11th Circuit decision brings similar reasoning to civil rights law on employment discrimination, saying that [the 2020 decision in Bostock, which] ruled transgender people couldn't be discriminated against in the workplace didn't apply to this health insurance question." [Lange v. Houston County, Georgia, No. 22-13626 (11th Cir. Sep. 9, 2025)]  MORE >>

Newsday

California Court of Appeal Affirms Definition of Exempt Employee Under Sick Pay Leave

"Labor Code Section 246 provides multiple methods of calculations for sick time pay -- depending on whether the employee is exempt or non-exempt.... Charter paid Hirdman's sick time at his base rate of pay and did not factor in commissions.... The Court focused on the fact that the legislature chose not to limit the reach of 'exempt employee' in the statute when it very well could have. This means that 'exempt employees' extends to all employees exempt from overtime, including outside salespersons." [Hirdman v. Charter Communications, LLC, No. D084304 (Cal. Ct. App. Aug. 4, 2025)]  MORE >>

CDF Labor Law LLP

Actionable Ways to Get a Better ROI on Your Benefits Program

"Employers must acquire an empathetic understanding of what matters most to their employees when it comes to their health, success, and financial security.... Employers can and should leverage data-driven, insight-generating approaches such as quantitative research to identify areas where employees' perceived value of a benefit does not align with its actual value.... [M]ake sure employees have access to the benefits they most value and need given their life stage and career journey. "  MORE >>

OneDigital

Benefits in General

[Guidance Overview]

DOL Affirms Morgan Stanley's Right To Withhold Deferred Comp From Departing Advisors

"The DOL's opinion, which was requested by Morgan Stanley outside counsel, comes on the heels of a string of arbitration victories for the firm in disputes over deferred compensation. Over the past two years, it has successfully defended at least five consecutive challenges, saving millions of dollars and further solidifying its stance that its plans are lawful and enforceable."  MORE >>

Financial Advisor

[Guidance Overview]

Preparing for DOL Cybersecurity Audits

"Plan sponsors can take the following steps ... [1] Review service provider agreements.... [2] Audit cybersecurity program documents.... [3] Conduct cybersecurity training.... [4] Evaluate cybersecurity insurance policies.... [5] Review cybersecurity capabilities in the RFP process."  MORE >>

Groom Law Group

Employee Benefits Jobs

💼

Regional Vice President, Retirement Sales (South Texas Territory)

Ascensus

Remote / TX

View job as Regional Vice President, Retirement Sales (South Texas Territory) for Ascensus

Press Releases

Voya Financial Joins the Workday Wellness Partner Program to Enhance Employee Wellness Through AI -Powered Benefits

Voya Financial

Webinars, Podcasts and Conferences
(Health & Welfare Plans)

Bridging the Vitality Gap: Turn Employee Insights into High-Impact, High-Utilization Benefits Plans

ON-DEMAND WEBINAR

HUB International

Last Issue's Most Popular Items

Text of DOL Advisory Opinion 2025-03A: Applicability of ERISA to Morgan Stanley Deferred Incentive Compensation Program

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

2025 Annual Employee Benefits Compliance Checklists

Williams Mullen

More Employers Moving Away from 'Big Three' PBMs

FierceHealthcare

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

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