"ALEs must furnish the 2025 Forms 1095-C to employees no later than March 2, 2026. Alternatively, ALEs have a new option available to instead post an online notice of availability for employees to request their form. Regardless, ALEs must electronically file the Forms 1094-C and 1095-C with the IRS no later than March 31, 2026. Non-ALEs sponsoring a self-insured plan (including a level funded plan) face the same deadlines for the Forms 1094-B and 1095-B."  MORE >>

"[E]mployers will have to provide a minimum of 32 hours of unpaid safe/sick time to new employees upon hire and to all employees at the start of each calendar year.... [T]he amendments broaden the permissible reasons for employees to use safe/sick leave under ESSTA.... [T]he amendments codify changes to ESSTA Rules ... to provide employees with 20 hours of paid prenatal leave during any 52-week calendar period."  MORE >>

"The survey of health insurers found that the average cost of medical health benefits will increase by 10.3% globally next year. This follows rises of 10% in 2025 and 9.5% in 2024.... [O]ver half (55%) of insurers that expect higher trends expect these elevated levels to persist for more than three years, driven by high medical costs, regional pressures on pharmacy and outpatient services and global structural factors."  MORE >>

"[T]he key isn't just knowing that pooling exists; it's understanding how to manage it strategically: [1] Track large claims proactively ... [2] Evaluate pooling levels ... [3] Understand carrier behavior ... [4] Plan for the inevitable."  MORE >>

27 pages. "Ninety-six percent of employers say their benefits budget has grown during the past two years ... Nearly three-quarters of organizations list health care costs as an issue their benefits program is designed to address, yet only 11 percent offer accident, critical illness, and hospital indemnity insurance.... More than one in three organizations that offer dental, vision, or supplemental health benefits say enrollment for each of these benefits is higher than expected.... Sixty-five percent of employers see room for improvement in how they communicate to employees about benefits. "  MORE >>

"A federal appeals court affirmed summary judgment for the employer on an employee's Family and Medical Leave Act (FMLA) interference and retaliation claims. The court held that the company would have fired him for safety violations regardless of his FMLA leave, which defeated both claims." [Wilkie v. Outokumpu Stainless USA, LLC, No. 24-14109 (11th Cir. Nov. 4, 2025)]  MORE >>

"The administration ... announced an agreement to lower prices and expand access to [GLP-1s] for weight loss for those in the Medicare Part D and Medicaid programs as well as direct-to-consumer (DTC) purchasing.... It is unclear whether the pricing agreement will extend to group health plans."  MORE >>

"A major challenge with the Transparency in Coverage (TiC) data ... is that many rates relate to providers and groups that do not provide those services.... These negotiated rates -- known as ghost rates -- undermine the goals of transparency data ... Across a combination of all 61 insurers, 91.8% of all the negotiated rates were ghost rates.... To maximize the potential of the TiC data, CMS 8 should require payers to include volume information, allowing users to quickly identify ghost rates."  MORE >>

"Eli Lilly is dropping CVS Health's drug benefit plan for its employees after the healthcare conglomerate stopped covering the company's weight-loss drug in favor of Novo Nordisk's rival medication ... Beginning January 1, Lilly employees covered by the company's medical plan will be automatically enrolled for coverage through pharmacy benefit manager Rightway ... a pharmacy benefit manager that works on a fee basis."  MORE >>

"PBMs play a powerful role in determining which medications are accessible and affordable. Today, three PBMs process nearly 80% of prescription drug claims in the U.S., giving them immense market power. This consolidation has created a skewed marketplace that drives up drug costs, limits patient choice, and makes it difficult for employers to negotiate contract terms for medications.... These consequences are real, and they are urgent to address."  MORE >>

"HB 1437 delays the date that contractors must begin paying apprentices full journeyworker fringe benefits on public works projects to July 1, 2026.... HB 1437 has not been signed into law by Governor Pritzker, but he is expected to do so in the coming weeks."  MORE >>

"[T]here will be no decrease in the amount of ERISA litigation as long as the main proponents and beneficiaries of frivolous litigation in this country remain rooted.... Defense lawyers who might sympathize with the plight of their clients have no incentive to curtail baseless lawsuits as it means fees for them ... Big settlements mean big profits [for insurers] since loss ratios determine premium rates.... [S]tate governments get a premium tax from insurance companies as a percentage ... of the premiums written in each state."  MORE >>