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Health & Welfare Plans Newsletter

January 14, 2026

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💼  2 New Job Opportunities

 

[Guidance Overview]

HIPAA Notice of Privacy Practices Updates Required by February 16

"[H]ealth plans must update their NPPs by February 16 to ... [1] Describe any use or disclosure that is prohibited or materially limited by Part 2. [2] Describe the limitations on use and disclosure of Part 2 records in legal proceedings without the individual's written consent or a court order. [3] Provide a clear and conspicuous opportunity to opt out of fundraising communications before the covered entity uses Part 2 records for fundraising purposes."  MORE >>

Proskauer

[Guidance Overview]

DOL Issues New FMLA Opinion Letters

"School employers specifically should ensure they have practices in place to monitor exactly when employees' use of FMLA leave coincides with school closings, regardless of whether those closings are planned or unplanned.... FMLA-covered employers should account for travel time associated with medical appointments when evaluating employees' requests for FMLA leave for their own serious health condition or a family member's serious health condition."  MORE >>

Duane Morris LLP

[Guidance Overview]

Navigating FMLA: DOL's New Opinion Letter Clarifies Travel Time

"The DOL confirmed in [Advisory Opinion FMLA2026-2] that FMLA leave may be used for time spent traveling to and from a medical appointment for a serious health condition. It also confirmed that a healthcare provider need not provide an estimate of travel time. The opinion letter provides helpful examples of when travel time is and is not related to a serious health condition."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Snow Days and the FMLA: DOL Clarifies How Partial-Week Closures Count Toward Leave

"[DOL Opinion Letter FMLA2026-1] explains how partial-week closures interact with both intermittent and full-week FMLA leave, and it reinforces prior guidance regarding holidays and full-week shutdowns.... When an employee is on a full week of FMLA leave, a partial-week closure does not change the calculation; the full week still counts as FMLA leave. The calculation of FMLA leave usage is not affected by whether the closure was planned or unplanned, or the reason for it."  MORE >>

Ogletree Deakins

[Guidance Overview]

OCR's Latest HIPAA Guidance: Strategic Measures to Protect Your Systems and Data

"[OCR's] January 2026 Cybersecurity Newsletter ... reinforces OCR's continued expectation that HIPAA covered entities and business associates proactively reduce cybersecurity risks to electronic protected health information (ePHI) through ongoing technical and operational safeguards.... Privacy and security officers should also consider these recommendations as a baseline for risk management responsibilities and consider integrating the safeguards into internal auditing programs."  MORE >>

Baker Donelson

[Guidance Overview]

IRS Clarifies Taxation of State and DC PFML Contributions, Benefits

"Revenue Ruling 2025-4 gives employers long-awaited guidance on the federal tax treatment of contributions and benefits mandated by state paid family and medical leave (PFML) laws.... In December 2025, IRS issued Notice 2026-6 extending much of the transitional relief provided in Rev. Rul. 2025-4 through the 2026 tax year. IRS issued the notice in response to several states needing more time to change systems and budgets, as well as related reporting responsibilities. "  MORE >>

Mercer

District Court Recognizes Plausible Fiduciary Breach Based on Failure to Affirmatively Disclose Coverage Information in Special Circumstances

"This decision reinforces that ERISA fiduciaries may face liability not only for misleading statements, but also for silence, where they possess specific knowledge that a participant is terminally ill or permanently disabled and at risk of losing valuable coverage. While routine, accurate plan communications may satisfy ERISA's baseline disclosure requirements, they may be insufficient in 'special circumstances' requiring affirmative disclosure of critical benefit protections." [Atkins v. Prudential Ins. Co. of Am., No. 25-2912 (N.D. Ga. Jan. 12, 2026)]  MORE >>

Roberts Disability Law

Supplemental Benefits Are the New Target for Excessive Fee Lawsuits

"The lawsuits are not limited to employers. The complaints further contend that the brokers themselves are functional fiduciaries under ERISA because they exercise discretion in recommending, implementing, and managing the voluntary benefit plans -- and then violated their fiduciary duties by steering plans toward arrangements that allowed the brokers to pay themselves excessive commissions. Because these commissions were paid entirely out of the premiums for the voluntary benefits (which were 100% paid by employees), the complaints allege that plan assets were impermissibly used and the value of the benefits were diminished."  MORE >>

Groom Law Group

The Rise of 'Financially Dominated' Coverage Claims for Employer Health Plans

"Plaintiffs' firms have recently advanced a new theory: that employers breach their fiduciary duties by offering health insurance options so expensive relative to other options as to provide no reasonable value.... Plaintiffs attempt to analogize it to fiduciary obligations in 401(k) plan menu design, arguing that just as fiduciaries must monitor investment options, they must also ensure that health plan options are balanced and non-duplicative."  MORE >>

PLANSPONSOR; registration may be required

State of Denial: How Insurance Companies Impact Health Care Today

"[H]ealth insurance companies are only required to report denial data for plans purchased through healthcare.gov. A CBS News analysis of about 1.3 billion federal health insurance claims across three years shows that, in 2024, insurers denied 19% of in-network claims -- about 1 in 5."  MORE >>

CBS MoneyWatch

Surprise Medical Bills and Employee Advocacy

"A strong employee advocacy program can help plan participants navigate a high medical bill and work to ensure that a participant only pays what they should.... Advocates can 'pre-educate' employees on what care is covered and which facilities will take their insurance."  MORE >>

Corporate Synergies

Why Lean Teams Are Turning to Outsourcing for Compensation and Benefits

"40% of organizations expect to increase their investment in third-party outsourcing.... 57% of companies outsource HR processes and 54% outsource finance tasks.... 67% have adopted outcome-based models that focus on results, while the share citing cost reduction as the primary driver has dropped to just 34%. So, what compensation and benefits processes make sense to outsource, and how do you explore this kind of partnership?"  MORE >>

Sequoia

Benefits in General

[Guidance Overview]

USPS Final Postmark Rules May Complicate Timely Tax Filings

"Recently finalized rules from the United States Postal Service seek to clarify that the date on a postmark does not 'necessarily represent either the place at which, or the date on which, the Postal Service first accepted possession of the mailpiece' ... [T]axpayers filing tax returns and other tax documents by traditional first-class mail, and to which a filing deadline applies, should adjust by mailing the document earlier, requesting and obtaining a manual postmark at a retail counter at the time of mailing, and/or obtaining a certificate of mailing at such time. Failing to do so runs the risk that a return, payment, or other document that is timely turned over to USPS will be postmarked after the filing or due date, with associated and sometimes significant financial consequences. "  MORE >>

Morgan Lewis

Employee Benefits Jobs

💼

Inside Sales Professional

ArmadaCare

Hunt Valley MD / Hybrid

View job as Inside Sales Professional for ArmadaCare

💼

Regional Sales Director

ArmadaCare

Remote

View job as Regional Sales Director for ArmadaCare

Press Releases

WTW Launches Health Transparency Optimizer, a Solution That Evaluates Healthcare Pricing Data

WTW

Prime Pensions Enters the Arizona Market with the Acquisition of the Raymond Company

Prime Pensions

Russell Investments to Match U.S. Government Contributions to Trump Accounts for Employees’ Children

Russell Investments

Webinars, Podcasts and Conferences
(Health & Welfare Plans)

Employer Shared Responsibility Reporting

January 21, 2026 WEBINAR

Savoy

2027 ACA Considerations: Proposed NBPP and Other Key Changes and Trends

February 4, 2026 WEBINAR

Wakely Consulting Group

ERISA Claims and Appeals Procedures: DOL Regulations, Plan Terms, Compliance, and More

February 23, 2026 WEBINAR

BARBRI

Severance Plans and ERISA Compliance: Limiting Liability in Design and Implementation of Severance Arrangements

March 3, 2026 WEBINAR

BARBRI

Emerging Trends in Health Plan Vendor Selection and Monitoring

April 8, 2026 in NY

Worldwide Employee Benefits Network [WEB] - New York Chapter

Last Issue's Most Popular Items

Text of IRS Notice 2025-65: Calculating the Qualifying Payment Amount in 2026 (PDF)

Internal Revenue Service [IRS]

GLP-1 Research Reveals Long-Term Employer Cost Savings and Significant Reductions in Cancer Risk for Women

Aon

'Deskless' Workers Need Support with Workplace Benefits

InsuranceNewsNet.com

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

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