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Health & Welfare Plans Newsletter
October 20, 2025
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💼 5 New Job Opportunities
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[Guidance Overview]
Can Fertility Benefits Be Excepted Benefits? New Tri-Agency FAQs
"On October 16, 2025, the Departments of Treasury, Labor, and Health and Human Services issued [FAQs Part 72], which clarify how employers may offer fertility benefits as a HIPAA excepted benefit under existing regulations.... The FAQs address the current regulations for three categories of excepted benefits: [1] independent, noncoordinated benefits; [2] excepted benefits HRAs; and [3] employee assistance programs
(EAPs)." MORE >>
Groom Law Group
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[Guidance Overview]
New York City Council Passes Bill That Would Expand Safe and Sick Leave Requirements
"On September 25, 2025, the New York City Council sent to the mayor a bill (Int. No. 0780-2024) that would amend the Earned Safe and Sick Time Act (ESSTA) to incorporate the requirements under the New York City Temporary Schedule Change Law. The bill provides additional covered reasons to take ESSTA and would add a bucket of thirty-two hours of unpaid leave in addition to the leave already
provided by the ESSTA. If signed, the bill will take effect 120 days later." MORE >>
Ogletree Deakins
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When Is a Late ERISA Disability Claim Still Timely?
"Courts increasingly recognize that: ... [1] The limitations period typically begins after the full benefit period ends -- not when the disability starts. [2] California law overrides less favorable policy terms.... [3] Courts examine when proof of loss
was truly due, whether the claimant had notice of coverage, and if delays were reasonable." MORE >>
Roberts Disability Law
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Small Business Health Insurance Premiums Could Rise 11% in 2026
"One option worth considering? Partnering with a PEO. It can give your business access to more competitive health plans, plus support with HR, payroll, and compliance, all in one place. For many small businesses, it's a cost-effective way to offer great benefits without
stretching internal resources." MORE >>
OneDigital
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What FEHB Changes Mean for 2026 Federal Employee Health Coverage
"Most federal employees and retirees will pay much more for health coverage next year; the enrollee share of premium is going up 12.3% on average.... [This article will] go through premium changes in popular plans, discuss which ones saw their costs go up above and below the
average, provide enrollment advice for two-person families, explain the government premium contribution, and cover what to expect from FEDVIP options." MORE >>
Government Executive
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Is Medicare's New Provider Search Tool a Step in the Right Direction?
"For this year's open enrollment period, [CMS] released a new tool on the Medicare Plan Finder that allows beneficiaries to enter up to 5 of their preferred providers to more easily view if their doctors are in a plan's network. The tool also lets beneficiaries sort
available plans in their area by whether a 'must-have provider' is in the plan's network.... In previous years, beneficiaries.... would need to go to each plan's website to determine whether their preferred providers were in the plan's network." MORE >>
Henry J. Kaiser Family Foundation
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[Opinion]
California PBM Law Is a Starting Point for Real Transparency
"California's new legislation enacting reform of pharmacy benefit managers is a comprehensive effort to address drug pricing transparency and specifically targets practices that have long obscured the true cost of medications ... The new law takes effect Jan. 1,
2026." MORE >>
Managed Healthcare
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Employee Benefits Jobs
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Selected New Discussions |
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MEWA Plan Never Filed Form M1
"We have a group that inadvertently formed a MEWA a few years ago and never filed the Form M1. They are debating to file them late now. Has anyone had any experience in doing this? Has anyone heard of group paying the very high penalty for not filing: $1992 per day
late?"
BenefitsLink® Message Boards
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Press Releases |
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CalcAir Launches MyCalcAir, Bringing Benefits Software to the Cloud
CalcAir
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PlanPort Announces Support For Defined Benefit Plans and High Volume Customers
PlanPort
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Last Issue's Most Popular Items |
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Proceed with Caution: Standalone GLP-1 Benefits (PDF)
Gallagher
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Ninth Circuit Reverses ERISA Penalties Award, Defines Scope of ERISA Disclosure Limits (PDF)
Thomson Reuters / EBIA
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COVID-19 Vaccine Update: What Employers Should Know
Brown & Brown, Inc.
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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
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