"The One Big Beautiful Bill Act has agencies working to create new guidance and regulations for telehealth, health savings accounts, and dependent care assistance programs. Ongoing litigation has paused enforcement of Mental Health Parity and Addiction Equity Act rules. Litigation impacts other aspects of health plan administration and design."  MORE >>

"If your organization offers an ICHRA, you are legally required to complete ACA reporting, no matter your group size. It’s one of the most commonly overlooked compliance requirements, but skipping it can lead to costly penalties and unnecessary stress at year-end."  MORE >>

"The Ninth Circuit's decision highlights the unsettled landscape of Section 1557's application to employer-sponsored health plans and TPAs. It is also part of a wave of litigation over health plan exclusions of coverage for gender-affirming care. As the regulations remain in flux and courts grapple with their interpretation, plan sponsors and TPAs should closely monitor developments and remain mindful that factual nuances may determine liability." [Pritchard v. Blue Cross Blue Shield of Illinois, No. 23-4331 (9th Cir. Nov. 17, 2025)]  MORE >>

"In looking toward 2026, there is no shortage of developments that employers and their partners will face.... [E]ach trend includes critical action steps to help employers proactively address trends on the horizon.... [1] The challenging cost environment ... [2] Disruption becomes essential ... [3] A sharpened focus on fundamentals ... [4] Rewriting the pharmacy benefits playbook ... [5] Raising the bar on vendor partnerships ... [6] The drive to innovate ... [7] The rapid adoption of AI ... [8] Policy changes ahead will impact the employer role."  MORE >>

"Coverage decisions should align with fiduciary obligations to balance cost with access to care. Keep in mind that the questions (and potential options) may change depending on how your plan is funded (fully insured, self-funded, etc.), the goals and objectives of your benefit offerings, and the current/projected utilization of these prescription drugs for your plan. Here are some key questions to ask your plan advisors, insurers, and PBMs (pharmacy benefit managers)."  MORE >>

"Employers using transparent PBMs were 1.6 times more likely to report lower premiums and 30% less likely to report higher premiums. Additionally, employers with transparent claims access say they are more likely to actively implement value strategies. The share of employers using transparent PBMs rose from 12% to 31%, and 61% of employers have either changed vendors from the largest PBMs or are considering working with transparent PBMs."  MORE >>

"[1] General year-end action items ... [2] Retirement plan operational compliance (SECURE 2.0 deadlines).... Prepare for mandatory Roth catch-up implementation.... Address plan forfeiture balances.... Finalize tax-exempt 457(b) plan amendments.... Review and amend plan documents for discretionary changes.... Encourage participant data review.... [3] Health and welfare plan action items.... Evaluate the impact of the one big beautiful bill act (OBBBA) on plan design.... Strengthen group health plan fiduciary and cybersecurity practices."   MORE >>

"Pursuant to ERISA Section 515, duress is among the defenses that cannot be used as a defense in an action by trust funds to collect delinquent contributions. A claim for economic duress may be preempted by ERISA. A violation of ERISA's claims procedures rule could constitute duress.... While duress can be alleged with respect to a designation of beneficiary or with respect to an agreement to arbitrate, or a forum selection clause, it arises most frequently in the employee benefits context in connection with the validity of releases."  MORE >>