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Health & Welfare Plans Newsletter

November 6, 2025

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[Guidance Overview]

DOL Releases Guidance on Fertility Coverage

"The FAQs make clear that a plan may offer fertility benefits as an independent, noncoordinated excepted benefit, and thus be exempt from ACA requirements, if the following conditions are met: [1] the benefits are provided under a separate insurance policy; [2] there is no coordination between the independent benefit and any exclusion under a related group health plan; and [3] the benefits are payable without regard to whether benefits are provided for the same condition under a related group health plan."  MORE >>

Slevin & Hart, P.C.

[Guidance Overview]

New York City Employers Face New Obligations as City Council Changes Sick/Safe Leave Requirements

"[T]he City amended its Earned Sick and Safe Time Act (ESSTA) and its Temporary Schedule Change Act (TSCA) to establish a new unpaid leave requirement in addition to existing paid leave requirements and to expand the permissible uses for employee sick/safe leave. These changes will take effect on February 22, 2026."  MORE >>

Mintz

[Guidance Overview]

New York City Amends Sick Time Law to Require New Unpaid Leave and Permit New Covered Uses

"The amended ESSTA requires employers to make available the additional 32 hours of unpaid safe/sick time immediately at hire, as well as to 'frontload' it at the start of each new benefit year. The unpaid safe/sick time may be used immediately by employees upon receipt. Further, under the amended ESSTA, if an employee communicates to their employer that they need time off for a purpose covered by safe/sick time, the employer must provide paid safe/sick time unless the employee has no such time available or the employee specifically requests to use other leave in lieu of paid safe/sick time."  MORE >>

Littler

[Guidance Overview]

Minnesota Paid Leave Law Set to Take Effect January 1, 2026

"With broad coverage, up to 20 weeks of leave and paid benefits per leave year, and complex coordination requirements, employers should prepare now to ensure compliance."  MORE >>

Lathrop GPM

District Court Vacates ACA Section 1557 Gender-Identity Discrimination Rules

"Focusing on the legal and historical distinctions between Title VII and Title IX, this case limits the scope of Section 1557's protections. Although the gender-identity discrimination provisions had already been blocked from enforcement, this decision officially vacates the rules." [Tennessee v. Kennedy, No. 24-0161 (S.D. Miss. Oct. 22, 2025)]  MORE >>

Thomson Reuters / EBIA

Benefit Leaders Double Down on Wellness, But Struggle with Strategy

"[B]enefit leaders are focused first on ensuring employees feel supported and engaged before leveraging benefits as broader tools for culture, performance or reputation building. While empathetic leadership is a win for employees, there remain challenges for benefit managers in striking the right balance."  MORE >>

Employee Benefit News [EBN]

[Opinion]

This Is Not a Bill: User Perspective on EOBs

"When faced with a document they can't decode, members often disengage until a problem (like an unexpected bill) forces them back in. This defensive strategy might protect users' mental bandwidth in the short term, but the accompanying 'avoidance penalty' leads to real costs on both sides. Confused members delay payments, call support more often, and dispute bills they don't understand. They also lose the ability to plan for healthcare expenses or make confident care decisions -- leaving them frustrated and financially uncertain."  MORE >>

Corporate Insight

Benefits in General

[Official Guidance]

Draft of 2026 IRS Publication 15-A: Employer's Supplemental Tax Guide (PDF)

29 pages. "What's New: [1] Social security and Medicare taxes for 2025.... [2] Moving expense reimbursements.... [3] Employer contributions to Trump accounts."  MORE >>

Internal Revenue Service [IRS]

Employee Benefits Jobs

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Staff Accountant

BPAS

Huntingdon Valley PA / Hybrid

View job as Staff Accountant for BPAS

Selected New Discussions

Amendment Deadline for Increased DCAP Limit

"Normally, for 2026, the plan would need to be amended to allow the increased limit by 12/31/2025? Has there been any guidance on allowing a later amendment date, due to the fact that the legislation only passed this Summer?"

BenefitsLink® Message Boards

Press Releases

Trucker Huss Ranked in the 2026 Best Law Firms List

Trucker Huss

The Wagner Law Group Ranked 'Tier 1' ERISA and Employee Benefits Law Firm for 2026

The Wagner Law Group P.C.

Janet Dhillon sworn in as PBGC director

PBGC [Pension Benefit Guaranty Corporation]

Webinars, Podcasts and Conferences
(Health & Welfare Plans)

ICHRAs and the Future of Small Group Insurance

November 18, 2025 WEBINAR

Savoy

Last Issue's Most Popular Items

HIPAA Security Rule: Still on Track for Finalization

Alston & Bird

Text of Instructions for 2025 IRS Forms 1094-C and 1095-C: Employer-Provided Health Insurance Offer and Coverage (PDF)

Internal Revenue Service [IRS]

District Court: ERISA Does Not Require Retroactive Reimbursement of Wellness Program Tobacco Surcharges

Roberts Disability Law

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

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