"Although [this checklist identifies] many action items below, through the end of 2025 and in 2026, ... employers will focus their compliance efforts on: [1] potentially implementing design changes under the One Big Beautiful Bill Act (OBBBA); [2] potentially offering an excepted benefit that includes fertility benefits; [3] solidifying fiduciary and cybersecurity practices for health and welfare plans to reduce litigation risk; and [4] ensuring compliance with the recently scaled back requirements under the [MHPAEA] and [HIPAA]"  MORE >>

"On December 20, 2024, HRSA approved updates to the current Women's Preventive Services Guidelines for breast cancer screening for women at average risk and also approved a new guideline regarding patient navigation services for breast and cervical cancer screening. Employers should prepare now for expanded breast cancer screening and navigation coverage requirements applicable to group health plans in 2026, as the new requirements impact plan participants, administration and costs."  MORE >>

"California has once again expanded employee leave protections and benefits ... through  ... Assembly Bill 406 and Senate Bill 590. Together, these new laws broaden employee rights to protected time off, create new obligations for employers, and increase the administrative burden of tracking, approving, and documenting leaves of absence. Employers should carefully review and update their leave policies, manager training, and HR practices to ensure full compliance."  MORE >>

"The panel's brief decision underscores that the Court's 2024 decision in Bristol Holdings (discussed here) applies broadly to state-law causes of action arising from pre-service verification-of-benefits and authorization communications, even where a provider also pleads an alternative ERISA benefits claim pursuant to an assignment of benefits from the member." [Dedicato Treatment Center, Inc. v. Aetna Life Ins. Co., No. 26-6487 (9th Cir. Nov. 24, 2025; unpub.)]  MORE >>

"A federal judge [has] dismissed the primary claims in a lawsuit alleging that Johnson & Johnson had mismanaged prescription drug benefits for employees. Judge Zahid N. Quraishi ... ruled that plaintiffs Ann Lewandowski and Robert Gregory failed to show they had standing to allege that the company had breached its fiduciary duty under [ERISA]." [Lewandowski v. Johnson & Johnson, No. 24-0671 (D.N.J. Nov. 26, 2025)]  MORE >>

"Estimated cash discount use for specialty prescriptions in 2025: 8% to 12% About one out of four pharmacy professionals say it's highly likely consumers will rely on cash pay discounts for 20% of generic drugs or more.... The unsustainable rise in specialty drug costs will prompt bold moves by employers and policymakers.... There will be an intense push for an 'affordability fix' for drugs with no generic equivalent.... Technology will become the long-overdue affordability fix."  MORE >>

"In the first nine months of 2025, new annualized premium totaled $12.7 billion, up 12% over the prior year. Policy count rose 6% year to date (YTD)."  MORE >>

December 3 hearing.  Video and testimony from witnesses [1] Joel White, Council for Affordable Health Coverage; [2] Marcie Strouse, Capitol Benefits Group; and [3] Claudia M. Fegan, MD, Physicians for a National Health Program.  MORE >>

Dec. 2025. "Use Form 4547 to make the election to establish an initial Trump account for the exclusive benefit of a child who is eligible for a Trump account. Also use Form 4547 to make an election for a $1,000 pilot program contribution from the U.S. Treasury to a child's Trump account if they are eligible for the contribution." [Also available: Draft IRS Form 4547: Trump Account Election(s)]  MORE >>

"While there are still several unanswered questions regarding implementation and administration of Trump accounts, the guidance provides employers more clarity on how they can include Trump account contributions among the benefits offered to employees. The IRS included a comment request in Notice 2025-68 on several issues regarding these accounts, and ... additional guidance from IRS [is expected]."  MORE >>

"A Trump account contribution program may be offered via salary reduction under a section 125 cafeteria plan if the contribution is made to the Trump account of the employee's dependent but not if the contribution is made to the Trump account of the employee.... The Treasury Department will select one or more financial institutions as a financial agent to serve as trustee of the initial Trump accounts."  MORE >>

"This [checklist] describes annual cost-of-living increases and includes a summary table of penalties, percentages, and premiums under the employer shared responsibility requirements of Code Section 4980H."  MORE >>

"Employers in the United States saw legislative, regulatory, and judicial developments in the benefits space in 2025, all of which should inform plan sponsor and fiduciary decisions in 2026."  MORE >>

"Gen Z is making it clear on social media and in the workplace that standard benefits won't cut it, and they're ready to tell organizations what they want instead.... [U]nlike their older colleagues, Gen Z doesn't want traditional wellness benefits like gym memberships or counseling services -- instead, they want more control over what's on offer outside of healthcare and retirement. They also want agency over how they can spend those benefit dollars[.]"  MORE >>