"[J]udges on an Eighth Circuit Court of Appeals Panel briefly questioned the pharmacy benefit managers (PBMs) accused by the [FTC] of artificially inflating insulin prices by rigging the pharmaceutical supply chain in their favor and preventing patients from accessing affordable life-saving drugs. These PBMs are attempting to stop the FTC's internal proceedings against them while the constitutional challenge plays out.... Essentially, the PBMs are arguing that they will be irreparably harmed if their claims are adjudicated in the FTC's internal administrative proceedings instead of federal court." [Express Scripts, Inc., v. FTC, No. 24-1549 (E.D. Mo. Feb. 18, 2025; on appeal to 8th Cir No. 25-1383; oral arg. Nov. 19, 2025)]  MORE >>

"The court held that the insurer's interpretation of its preexisting condition clause -- which deemed any treatment for any symptom consistent with a later-diagnosed disease as 'treatment for' that disease -- was both wrong and unreasonable, even under the deferential arbitrary-and-capricious standard." [Johnson v. Reliance Standard Life Ins. Co., No. 23-13443 (11th Cir. Nov. 21, 2025)]  MORE >>

"The court allowed the plan participant's ERISA fiduciary breach claim to proceed, which was based on an alleged failure to disclose certain information about the pricing methodology for out-of-network providers. The court also allowed a claim under the No Surprises Act to move forward, which arose from the alleged failure to maintain an accurate provider database.... [T]he court rejected the plan's argument that violations of the No Surprises Act occur only when provider directories list out-of-network providers as in-network, finding no legal support for the claim." [Orrison v. Mayo Clinic, No. 24-1124 (D. Minn. Sep. 19, 2025)]  MORE >>

"[T]he Health Savings Account (HSA) Consumer Protection Act [HR 6183] ... [would] [1] Remove the exception that permits HSA use for non-health care services without penalty at age 65.... [2] Place income limitations around the payroll tax exemption for HSA contributions.... [3] Require individuals to substantiate that their distributions from HSAs are for qualified medical expenses.... [4] Ensure that institutions offering HSAs do not charge excessive fees and meet basic transparency requirements[.]"  MORE >>

"[P]roposals have emerged from some Republicans in Congress to effectively repeal some or all of the ACA premium tax credits and replace them with contributions to Health Savings Accounts (HSAs) or something similar."  MORE >>

"[The authors] study how saving behavior responds to the Health Savings Account (HSA) 'catch-up' contribution provision, which raises HSA contribution limits for individuals aged 55 and older.... [They] find a sharp increase in contributions among those previously near the limit and smaller increases among unconstrained savers. Induced contributions ... do not appear to crowd out retirement savings. Responses are strongest among payroll contributors and long-term savers.... [M]arried couples do not appear to coordinate their HSA behavior to take advantage of the complex spousal rules governing catch-up contributions."  MORE >>

"[W]ell-crafted 408(b)(2) Rulemaking should aim to balance meaningful transparency with appropriate safeguards as outlined below, recognizing that new requirements have the potential to increase, rather than decrease meritless litigation against plan fiduciaries who continue to exercise prudence and loyalty in carrying out their ERISA duties. The development of clear rules, including a process- based safe harbor as discussed below, will allow plan fiduciaries to more ably defeat such frivolous litigation, including potentially in a more efficient manner."  MORE >>

"The period immediately following the deadline is a critical time to reflect, correct, and prepare.... [1] Conduct a Post-Filing Review.... [2] Address operational errors promptly.... [3] Update documentation and plan amendments.... [4] Evaluate internal controls.... [5] Plan ahead for next year."  MORE >>

"Nearly half (46%) of all surveyed employees said they found the volume of communication they receive about benefits, pay and well-being to be overwhelming, up five percentage points from the 2024 study. However, non-managerial employees (28%) were much less likely to think there is too much communication than those in middle management/supervisory roles (55%) and in senior management (66%)."  MORE >>