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Health & Welfare Plans Newsletter

December 12, 2025

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[Guidance Overview]

Permanent, Improved Tax Credit for Paid Family and Medical Leave (PDF)

"Beginning in 2026, more employers providing paid family and medical leave that meets certain requirements can take advantage of a general business tax credit ranging from 12.5% to 25% of wages paid to qualifying employees for up to 12 weeks of family and medical leave per taxable year."  MORE >>

Mercer

[Guidance Overview]

IRS Issues Guidance on HSA-Related OBBBA Changes (PDF)

"[T]he OBBBA made permanent the safe harbor allowing high-deductible health plans (HDHPs) to cover telehealth and other remote care services before the minimum deductible is satisfied without losing their HDHP status. These services are also considered disregarded coverage on a permanent basis and thus will not cause a loss of HSA eligibility. "  MORE >>

Thomson Reuters / EBIA

[Guidance Overview]

Does Hiring a Business Associate to Conduct Electronic Health Plan Transactions Absolve a Health Plan of HIPAA Liability? (PDF)

"If your company sponsors a self-insured health plan and hires a TPA to handle administrative tasks -- such as processing claims and making payments -- your health plan is still responsible for complying with HIPAA's electronic transaction standards. The electronic transaction standards apply to a range of financial and administrative activities ... Even if a health plan delegates duties to third parties, the health plan remains ultimately responsible for compliance."  MORE >>

Thomson Reuters / EBIA

[Guidance Overview]

New York City Council Expands Safe and Sick Leave Laws

"Prior to February 2026, New York City employers should: [1] Update policies, notices, and human resources and accounting systems to reflect two distinct sick and safe leave entitlements: [a] Existing ESSTA paid sick and safe time. [b] A new 32-hour unpaid sick and safe bank available at hire and each January 1 thereafter. [2] Offer training to handle expanded qualifying reasons for sick and safe time and to respond 'as soon as practicable' to TSCA schedule-change requests, recognizing that employees need not accept alternatives."  MORE >>

ArentFox Schiff LLP

Which Wellness Benefits Are Most Effective

"Wellness benefits should be calibrated to an employer’s population, and can provide value in terms of increased retention and productivity[.]"  MORE >>

Plan Sponsor Council of America [PSCA]

TrumpRx and GLP-1s: Impacts on Drug Pricing and Employer Strategy

"The move toward DTC access should not be viewed as a short-term marketing trend, but rather a strategic reconfiguration of the pharmaceutical value chain ... DTC models let manufacturers control pricing, data ownership and delivery. This changes the traditional role of [PBMs] as intermediaries. The launch of TrumpRx further underscores growing policy support for bypassing PBMs entirely."  MORE >>

WTW

2026 ACA Premium Landscape: What Health Insurers Need to Know and Do (PDF)

16 pages. "With enhanced subsidies expiring, benchmark silver premiums rising by an average of 30%, and consumer purchasing patterns expected to shift dramatically, health insurers in 2026 face both unprecedented challenges and strategic opportunities."  MORE >>

Milliman

CMS Unveils New Model Aimed at Functional, Lifestyle Medicine

"Under the Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence, or MAHA ELEVATE, model, the Centers for Medicare & Medicaid Services (CMS) will make $100 million available to support as many as 30 proposals to promote health and preventive care in three-year agreements."  MORE >>

FierceHealthcare

Benefits in General

[Official Guidance]

IRS Disaster Relief Notice MN-2025-01, for Taxpayers Impacted by Severe Storms and Straight-Line Winds in Leech Lake Band of Ojibwe

"[I]ndividuals and businesses ... affected by severe storms and straight-line winds that began on June 21, 2025 ... now have until Feb.2, 2026, to file various federal individual and business tax returns and make tax payments.... [I]ndividuals and households that reside or have a business on the Leech Lake Reservation in Minnesota qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

IRS Issues Initial Guidance Regarding Trump Accounts

"Employers may make contributions of up to $2,500 (subject to cost-of-living adjustments after 2027) per calendar year to the Trump account of an employee (or the employee's dependent) that will be excluded from the employee's gross income. An employer must make contributions under a 'Trump account contribution program,' which is a separate written plan maintained by the employer for the exclusive benefits of its employees that meets requirements regarding discrimination, eligibility, notification, statements and benefits similar to the requirements of a dependent care assistance program under Section 129 of the Internal Revenue Code."  MORE >>

Skadden

[Guidance Overview]

Introduction to Trump Accounts

"Financial institutions that currently offer IRAs will want to consider whether they want to add this new account option. Although the rules are similar to IRAs, there are a number of nuanced differences that will require careful set-up.... Employers should consider whether they want to add Trump Account contributions to their employee benefit line-up. Employers who do so will need to establish a Section 128(c) Trump Account contribution program."  MORE >>

Vorys

[Guidance Overview]

Preview of Expected Guidance for Employers on 'Trump Accounts' and Upcoming Regs Announced

"Employers who wish to make contributions to Trump Accounts starting next year will be required to establish a separate written plan (and, if applicable, may be required update its Code Section 125 cafeteria plan document to enable employee pre-tax contributions). Employers may also consider other steps that may be required to operationalize contributions."  MORE >>

Patterson Belknap Webb & Tyler LLP

2025 ERISA Litigation: Forfeitures, Investments, and Health Plans Take Center Stage

"Traditional excessive fee lawsuits remain a major share of ERISA filings, but the contours of those claims are shifting.... One of the most notable developments of 2025 is the surge in lawsuits challenging how employers use 401(k) forfeitures ... To date, more than 80 cases have been filed since the wave began back in 2023, with over 30 cases having been filed just since May of this year.... Recent years have seen new lawsuits challenging what ERISA group health plans pay for prescription drugs. These cases have faced major obstacles[.]"  MORE >>

Jackson Lewis P.C.

Employee Benefits Jobs

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Lead Plan Compliance Administration Analyst - Retirement Plans

Ameritas

Remote

View job as Lead Plan Compliance Administration Analyst - Retirement Plans for Ameritas

Press Releases

The Hill Names ERIC’s James Gelfand as a 2025 Top Lobbyist

ERIC [ERISA Industry Committee]

Last Issue's Most Popular Items

Text of CMS ICHRA Employer LCSP Premium Look-Up Table for 2026 Plan Year

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Summary of 2026 Benefit-Related Cost-of-Living Adjustments (PDF)

Mercer

IRS Guidance on Trump Accounts Addresses Cafeteria Plans and Employer Contributions, Announces Regs on the Way

Thomson Reuters / EBIA

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

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