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Health & Welfare Plans Newsletter
September 23, 2025
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💼 New Job Opportunity Today
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[Guidance Overview]
Illinois Enacts New $15 PBM Fee Effective 2026
"Where Illinois [HB 1697] breaks new ground is by assessing
an annual fee of $15 per member on PBMs covering participants in the state. The fee is effective starting January 1, 2026, and is intended to fund grants for pharmacies in underserved and low-income areas. This is unlike legislation previously seen in other states." MORE >>
HUB International
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[Sponsor]
2026 Onsite Employee Health & Wellness Centers Summit
January 15-16, 2026 • Caesars Palace Hotel • Las Vegas, NV. Leading strategies to build & expand onsite health & wellness centers: reduce medical expenses, ensure/maintain a competitive benefits strategy and achieve a high-performing & healthy workforce.
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[Guidance Overview]
Employer Actions Required for Minnesota Paid Leave Program
"Starting January 1, 2026, eligible employees in Minnesota will be able to take up to 20 weeks of paid leave with up to 12 weeks for a serious health condition and up to 12 weeks for family and safe leave.... [Employers must notify] individual employees directly in their
native language within 30 days of hire or by December 1, 2025, 30 days before premium collection begins. Employers need employees to affirmatively acknowledge receipt or demonstrate how their workforce was notified." MORE >>
Sequoia
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[Guidance Overview]
October 15 Is Deadline for Prescription Drug Notices and Extended Deadline for Form 5500s
"Does your company's health plan provide prescription drug coverage? If so, you have until October 15, 2025 to send a notice to individuals who are enrolled in Medicare Part A or Part B and are eligible for the company's health plan. The notice lets recipients know
whether the company's prescription drug coverage is 'creditable' or 'non-creditable.' " MORE >>
Venable LLP
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New Flurry of Litigation Challenging Wellness Programs
"More than one dozen class action lawsuits were filed this year challenging wellness programs that increased group health plan premiums for participants who use tobacco.... [These] lawsuits largely stem from alleged deficiencies in the [reasonable alternative standard (RAS)]
requirement or its implementation, including failing to provide the notice of a RAS in all plan materials, communicating misleading information regarding the RAS, failing to provide a RAS altogether, and failing to make the full wellness program reward available to individuals who complete the RAS." MORE >>
Kutak Rock LLP
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Employers Prepare for Disruptive and Transformative Health Plan Changes
"U.S. employers project their healthcare costs, before plan changes, will increase by 9.1% in 2026, compared with 8.1% in 2025 and 7.0% in 2024.... Cost pressures have prompted one in three employers to consider making significant changes to their healthcare programs within the
next three years." MORE >>
Willis Towers Watson
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Medicare Premiums Are Set to Soar: What to Expect Over the Next Decade
"The largest year-over-year jump is expected between 2025 and 2026, with a projected increase of $21.50, setting the 2026 Part B premium at $206.50, up from $185.00.... The [2025 Medicare Trustees Report] estimates that the standard monthly premium for Medicare Part B will potentially reach almost $350 by 2034. If the estimates are accurate, the Part B premium is expected to increase by 188% by 2034." MORE >>
Kiplinger
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In 2025, Part D Beneficiaries Are Spending Less Than $1,000 on Average to Satisfy the $2,000 Out-of-Pocket Maximum
"This white paper examines trends in actual out-of-pocket (OOP) costs among Medicare Part D beneficiaries from 2023 through early 2025, to understand the net impact of the key forces outlined above. [The] analysis summarizes the proportion of beneficiaries reaching the
catastrophic coverage phase each year, their associated OOP costs, and the timing of these events." MORE >>
Milliman
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Benefits in General |
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[Official Guidance]
Text of IRS Notice 2025-54: 2025-2026 Special Per Diem Rates (PDF)
"This annual notice provides the 2024-2025 special per diem rates for taxpayers to use in substantiating the amount of ordinary and necessary business expenses incurred while traveling away from home, specifically [1] the special transportation industry meal and incidental
expenses (M&IE) rates, [2] the rate for the incidental expenses only deduction, and [3] the rates and list of high-cost localities for purposes of the high-low substantiation method." MORE >>
Internal Revenue Service [IRS]
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When an Employee Is Dismissed: A Resource Guide for HR and Benefits Professionals
"The departure of an employee, regardless of the reason, sets off a chain of events affecting wages, bonuses, equity awards, retirement benefits, health coverage, and other company-sponsored programs. The manner in which each of these benefits is handled will depend on the
termination circumstances, the precise language of the governing documents, and the applicable legal requirements. Mistakes can be costly ... so it is essential to approach each dismissal situation with care and consistency." MORE >>
Foley & Lardner LLP
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Employee Benefits Jobs
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Press Releases |
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BCG Expands Pension Risk Consulting Expertise with Addition of Industry Veterans Sablak and Mossing
BCG Pension Risk Consultants
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Human Interest Sets a New Industry Standard with Automated 401(k) Audits
Human Interest
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Four Kantor & Kantor Attorneys Honored in The Best Lawyers in America® 2026 Edition
Kantor & Kantor LLP
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Last Issue's Most Popular Items |
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New Bill Would Promote ICHRAs
Groom Law Group
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The Future of Metabolic Health and Weight Loss Drugs: Projecting Mortality Reductions
Swiss Re Group
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Eleventh Circuit: Plan's Gender-Affirming Surgery Exclusion Does Not Violate Title VII (PDF)
Thomson Reuters / EBIA
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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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