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Health & Welfare Plans Newsletter

January 6, 2026

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💼  9 New Job Opportunities

 

[Official Guidance]

Text of DOL Advisory Opinion FMLA2026-1: Impact of Partial-Week School Closure on FMLA Use (PDF)

"When a school closes for part of a week during which an employee uses less than a full week of FMLA leave, the period during which the school is closed is not counted as FMLA leave, unless the employee was scheduled and expected to work during the period and used FMLA leave for that time. When a school closes for part of a week during which an employee is using a full week of FMLA leave, however, the entire week is counted as FMLA leave."  MORE >>

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

[Official Guidance]

Text of DOL Advisory Opinion FMLA2026-2: Use of FMLA Leave for Travel to and from Medical Appointments (PDF)

"[An] employee may use FMLA-protected leave that counts against his or her FMLA entitlement to travel to or from a medical appointment for a serious health condition. Additionally, a health care provider need not provide an estimate of an employee's travel time to or from an appointment for the medical certification to be complete and sufficient under the Act."  MORE >>

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

[Guidance Overview]

FMLA Travel Time and Snow Days: What the DOL Just Clarified

"FMLA leave can include reasonable travel time to medical appointments. Medical certifications do not need to micromanage commute estimates. Partial‑week closures do not expand or shrink FMLA entitlements. For intermittent or reduced‑schedule leave, charge only the time the employee would have worked and actually missed -- and nothing more."  MORE >>

Pierson Ferdinand LLP

[Guidance Overview]

The Year Ahead: Planning for 2026

"What happened at the end of 2025: [1] Trump Accounts ... [2] Expansion of HSAs ... [3] Reduced Hepatitis B vaccination recommendations ...

"What's expected in 2026: [1] Pharmacy Benefit Manager transparency ... [2] Direct-to-consumer Rx programs ... [3] New HIPAA Security Rules ... [4] New electronic disclosure rules for health plans ... [5] Mental health parity ... [6] Transparency ... [7] Surprise billing adjustments."  MORE >>

Arthur J. Gallagher & Co.

[Guidance Overview]

HIPAA Notice of Privacy Practices Refresh for Self-Insured Group Health Plans: What to Change Before February 16, 2026

"[C]overed entities must update their NPPs to reflect amendments to the HIPAA Privacy Rule that align HIPAA with the federal confidentiality framework for substance use disorder (SUD) treatment records ... [P]lan sponsors should confirm that their NPPs do not reference HIPAA Privacy Rule amendments addressing reproductive health care information that were finalized in 2024 but later vacated and are no longer in effect."  MORE >>

Verrill Dana LLP

[Guidance Overview]

IRS Releases Guidance Related to Recent HSA Changes

"Employers who continuously adopted the telehealth and other remote care services exception since the COVID relief was effective have been assured that their employees' HSA eligibility is not in question ... Telehealth and other remote care services received prior to the applicable deductible being met should not include any in-person services, medical equipment, or prescription drugs supplied in conjunction with telehealth and other remote care services."  MORE >>

Woodruff Sawyer

[Guidance Overview]

Recent Updates to New York City Earned Sick Time Act

"[T]he New York City Earned Safe and Sick Time Act (ESSTA) ... was amended to expand benefits to employees ... by: [1] providing 32 hours of unpaid safe/sick leave to new employees upon hire and to all employees at the beginning of each benefit year, in addition to the required paid safe/sick leave; [2] expanding the categories for which employees can use safe/sick leave; and [3] codifying paid prenatal leave into New York City law. These changes go into effect on February 22, 2026."  MORE >>

Herrick, Feinstein LLP

[Guidance Overview]

Construction Employers Take Note: New York Expands Paid Family Leave Eligibility Beginning in 2027

"On December 19, Governor Kathy Hochul signed Assembly Bill 4727 into law, expanding PFL eligibility to many construction workers who work for multiple employers under a collective bargaining agreement each year. The amendment does not take effect until January 1, 2027, and raises important planning considerations for employers that are parties to these collective bargaining agreements."  MORE >>

Proskauer Rose LLP

The 'Ghost Network' Problem: Key Questions Employers Should Ask

"[T]he US District Court for the District of Minnesota held that an employee adequately stated a claim against the employer plan administrator for maintaining an inaccurate database of medical providers.... [The] decision means employer plan administrators may face possible liability in relying on the provider networks and related directories offered by insurance carriers and TPAs.... [W]hat questions should you ask to monitor your plan's network?" [Orrison v. Mayo Clinic, No. 24-1124 (D. Minn. Sep. 19, 2025)]  MORE >>

Fisher Phillips

Trends That Will Redefine Employee Benefits in 2026

"[1] Care navigation moves from system-level thinking to provider-level performance ... [2] GLP-1 medications become a more complex coverage decision ... [3] Benefits will become more intentional and outcome-focused ... [4] Employers accelerate creative self-funded strategies to regain control from traditional carriers ... Precision is favored over broad strategy in 2026."  MORE >>

Corporate Synergies

One Legacy Insurer Is Rebuilding U.S. Healthcare as a Data Product

"In an era where every big tech player wants a piece of healthcare, Elevance Health is trying something harder: turning a sprawling, legacy insurance business into a modern, data-driven health platform. The company, formerly known as Anthem, is recasting itself not as a payer, but as an integrated healthcare product that coordinates benefits, care, and pharmacy services under one data layer."  MORE >>

Ad Hoc News

Why Employers Should Form a Welfare Plan Fiduciary Committee

"Without a committee, board members and/or senior executives are likely to be fiduciaries of the welfare plans, often without the capacity for detailed oversight.... Regular meetings, formal agendas, and minutes demonstrating competitive bidding, fee benchmarking, and vendor review create an evidentiary record that can help defend against litigation.... Committees can scrutinize PBM pricing, carrier renewals, and broker compensation ... to confirm reasonableness and alignment with participant interests."  MORE >>

Bradley

[Opinion]

The Missing Piece: Why Employers Still Can't Solve the Health Care Puzzle

"In this article, [the authors] first examine why the current wave of transparency initiatives has fallen short of delivering actionable insights for employers. Next, [they] outline what meaningful data access should look like and why it matters.... Finally, [they] consider policy implications and what steps are needed to make transparency truly work for employers."  MORE >>

Health Affairs Forefront

Benefits in General

[Official Guidance]

Text of IRS Rev. Proc. 2026-4: Determination Letter Procedures (PDF)

"This revenue procedure explains how the [IRS] (Service) provides advice to taxpayers on issues under the jurisdiction of the Commissioner, Tax Exempt and Government Entities Division, Employee Plans Rulings and Agreements Office (Employee Plans Rulings and Agreements). It also details the types of advice available to taxpayers, and the procedures for requesting and receiving such advice."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

IRS Provides Initial Guidance Regarding Trump Accounts

"Employers may make their employer contributions or may facilitate employee salary reduction contributions. The employer contributions will not be taxable income to the employee. The employee salary reduction contributions will be taken on a pre-tax basis. In order for either type of contribution to occur, the employer must adopt a Trump Account Contribution Program."  MORE >>

Venable LLP

Employee Benefits Jobs

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Manager of Client Service

EPIC RPS

Remote / Norwich NY

View job as Manager of Client Service for EPIC RPS

💼

Regional Sales Director-Heartland

July Business Services

Remote / Waco TX / IL

View job as Regional Sales Director-Heartland for July Business Services

💼

Regional Sales Director-Mid Atlantic

July Business Services

Waco TX / DC

View job as Regional Sales Director-Mid Atlantic for July Business Services

💼

Director, Strategic Accounts and Channel Development

July Business Services

Remote / Waco TX

View job as Director, Strategic Accounts and Channel Development for July Business Services

💼

Internal Channel Sales Team Lead

July Business Services

Remote / Waco TX

View job as Internal Channel Sales Team Lead for July Business Services

💼

Conversion & Installation Manager

ERISA Services, Inc.

Remote

View job as Conversion & Installation Manager for ERISA Services, Inc.

💼

Retirement Plan Peer Review and Technical Specialist

ERISA Services, Inc.

Remote

View job as Retirement Plan Peer Review and Technical Specialist for ERISA Services, Inc.

💼

Distribution Specialist

ERISA Services, Inc.

Remote

View job as Distribution Specialist for ERISA Services, Inc.

💼

TPA Retirement Plan Relationship Manager

ERISA Services Inc.

Remote / Knoxville TN

View job as TPA Retirement Plan Relationship Manager for ERISA Services Inc.

Selected New Discussions

ACA - Allocated Reduction for 1 Employee ALEM

"I have a client with 120 employees (All Full-time) who is currently ACA-compliant with their offer of coverage. They are creating a new entity with only one employee (Full-Time), but with identical ownership to the existing business, so this new entity will be considered an ALE Member within the same controlled group. I'm trying to confirm what their ACA penalty exposure would be if they decide not to offer benefits under this new entity.

For Penalty A, my understanding is that the new entity would be exempt due to the allocated reduction of 30 full-time employees. The allocation for the new entity's share of the 30-employee reduction would be: (1 / 121) × 30 = 0.24.... [T]his would round up to 1, and since the new entity has only 1 employee, Penalty A wouldn't apply? ... My next question is, Would Penalty B also not apply since no offer of coverage is made? It appears that a requirement for penalty B to apply is an offer of coverage."

BenefitsLink® Message Boards

Press Releases

The Cerrado Group Announces Atlantic Pension Services as Newest Member Firm

The Cerrado Group

Boutwell Fay LLP Welcomes Jeffrey Penn to the Firm

Boutwell Fay LLP

Webinars, Podcasts and Conferences
(Health & Welfare Plans)

Navigating Medicare Rules for Employer Group Health Plans ​

February 10, 2026 WEBINAR

UBA [United Benefit Advisors]

ERISA Litigation Update

February 25, 2026 in NY

Worldwide Employee Benefits Network [WEB] - New York Chapter

Benefits Briefing 2026

March 4, 2026 WEBINAR

Trucker Huss

Defending (and Defeating) Mental Health Parity and Addiction Equity Act Claims

March 13, 2026 WEBINAR

BARBRI

Last Issue's Most Popular Items

2026 EB Compliance Guides

Pensions & Investments

ERISA Bar Awaits Appellate Court Decisions on Forfeitures, Pensions, Smoker Fees

Bloomberg Law

DOL Limited Amnesty Program for Form 5500 Filings Expanded to Form M-1 Filings

Groom Law Group

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

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