"Health plan sponsors continue to report issues navigating the IDR process and tend to pay significantly more for [out-of-network (OON)] services under the IDR process than if in-network rates applied.... Sponsors of fully insured plans are unlikely to have control over the IDR process because the insurer is responsible. Sponsors and fiduciaries of self-insured plans may want to request regular reporting from the plan's third-party administrator (TPA), if applicable, about the plan payments through the IDR process[.]"  MORE >>

"Despite vacating provisions in the regulations relating to reproductive health care information, the Purl ruling kept intact regulations at 42 CFR part 2, relating to the protection of SUD Records. This means that, effective February 16, 2026, group health plans must update their policies and Privacy Notices to reflect the stringent protections applicable to certain SUD records[.]"  MORE >>

"The federal Reproductive Health Care Privacy Protections are no longer in effect. Covered entities are no longer required to include them in their HIPAA policies and procedures. Covered entities and business associates are no longer required to comply with the related attestation requirements.... [T]he NPP requirements regarding the use and disclosure of Part 2 records remain in effect."  MORE >>

43 pages; Sep. 23, 2025. "No additional states enacted new PFML programs in 2024 or 2025. Contributions in Delaware and Maine started on Jan. 1, and will start on Jan. 1, 2026, in Minnesota. Benefits will start in 2026 -- in January for Delaware and Minnesota and in May for Maine. In Maryland, contributions will start on Jan. 1, 2027, and benefits will start no later than Jan. 3, 2028." [Also available: Paid Family and Medical Leave Snapshots across the US (slide deck)]  MORE >>

"The Fifth Circuit recently affirmed summary judgment for an employer in a case where a longtime employee claimed, through one count labeled as FMLA discrimination, interference, and retaliation, that she was fired after taking leave. But she and her doctor admitted she could still perform the functions of her job throughout the leave period. That admission doomed her claim because she was never entitled to FMLA protections in the first place." [Holland v. Texas Christian Univ., No. 25-10567 (5th Cir. Sep. 8, 2025)]  MORE >>

"[The District Court] granted a preliminary injunction preventing beneficiaries from pursuing claims in the Cheyenne River Sioux Tribal Court over disputed life insurance proceeds. The court held that because the benefits arose under an ERISA-governed plan, federal jurisdiction was exclusive and tribal courts lacked authority to adjudicate the dispute." [Metropolitan Life Ins. Co. v. Mundahl, No. 24-3029 (D.S.D. Sep. 19, 2025)]  MORE >>

"This article discusses the power of personalized communications to increase participation, enhance employee satisfaction and maximize the impact of benefits programs. It covers building personas based on demographic data, tailoring messaging to the personas and using technology, including artificial intelligence, to enhance personalization. It also includes four tips for more effective benefits communications."  MORE >>

"This decision reinforces the Ninth Circuit's narrow interpretation of Section 104, limiting disclosures to documents directly relevant to participants' understanding of their benefits and procedures. It also highlights the role of COVID-19 disaster relief orders in excusing compliance delays, where plan administrators act in good faith and provide documents as soon as practicable." [Zavislak v. Netflix, Inc., No. 24-4156 (9th Cir. Sep. 24, 2025; unpub.)]  MORE >>

"As savings have become the leading financial priority for Americans amid stubbornly high prices and a weaker labor market -- and as employers look to boost productivity by improving workers' financial well-being -- a growing number of employers are introducing emergency-savings accounts, or ESAs, as a dedicated benefit alongside established workplace savings programs such as 401(k)s and health savings accounts."  MORE >>

"Plan Sponsors: Start with simple, broadly appealing features like retirement income estimation and financial goal tracking before introducing more complex tools. Positioning AI as a complement to human advisors can reinforce that AI use increases -- not replaces -- engagement with financial professionals."  MORE >>