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Health & Welfare Plans Newsletter
January 21, 2026
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💼 9 New Job Opportunities
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[Guidance Overview]
February Deadline: HIPAA Covered Entities Must Update Notices of Privacy Practices
"Updating an NPP is rarely a simple drafting exercise, often requiring coordination across legal, compliance, privacy, IT, and operational teams to ensure notice language aligns with real-world data use and disclosure practices. In some cases, updating the NPP may also
necessitate changes to internal policies, consent workflows, training materials, or vendor arrangements." MORE >>
Fenwick & West LLP
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[Guidance Overview]
DOL Updates FY 2026 Health Plan Enforcement Priorities
"EBSA intends to prioritize investigations in the following health plan areas: [1] Cybersecurity and data protection ... [2] Mental health and substance use disorder parity ... [3] Surprise billing compliance ... [4] Protections of employee
contributions ... EBSA reaffirmed its ongoing efforts to identify abusive or fraudulent Multiple Employer Welfare Arrangements (MEWAs)." MORE >>
Morgan Lewis
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[Guidance Overview]
New Jersey Small Employers: Get Ready to Provide Your Employees with 12 Weeks of Job Protected Leave
"[T]he New Jersey Family Leave Act (NJFLA) ... allows eligible employees to take 12 weeks of job protected leave per year to bond with a newborn baby or to care for a family member with a serious health condition. The amendments lower eligibility requirements making most
employees eligible for leave." MORE >>
Genova Burns LLC
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[Guidance Overview]
New Year, New Massachusetts Paid Family and Medical Leave Amounts
"For 2026, the maximum benefit amount has been increased to $1,230.39 per week.... [T]he increased amount of weekly wage-replacement benefits available to employees has not resulted in any increase to the PFML contribution rate for 2026. For employers with 25 or more covered
individuals, the contribution rate will remain at 0.88% of eligible employee wages. For employers with fewer than 25 covered individuals, the contribution rate will remain at 0.46%." MORE >>
Foley & Lardner LLP
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District Court Finds Wellness Program 'Full Reward' Need Not Be Retroactive
"Bally's countered that the statutory language requiring a 'full reward' does not explicitly mandate retroactive reimbursement of previously paid surcharges. The court agreed with this interpretation, holding that prospective elimination of the surcharge satisfied the
'full reward' requirement as a matter of law. This holding is significant because it directly contradicts the position taken in the preamble to the [DOL's] final regulations, which describes 'full reward' as requiring retroactive reimbursement for the entire plan
year." [Williams v. Bally"s Management Group, LLC, No. 25-00147 (D.R.I. Nov. 4, 2025)] MORE >>
HUB International
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ERISA Lawsuit Fails as Facial Surgery Was Deemed 'Cosmetic'
"The worker alleged WSP denied her medically necessary treatment for her gender dysphoria when it refused to cover facial feminization surgery. WSP, in contrast, said the worker had 'not identified a term of the plan that it allegedly violated' and that the treatment
sought was 'expressly excluded by the plan's terms.' The judge sided with WSP, contending that while it accepted the worker's claims about the noncosmetic benefits of such surgery, they were 'ultimately beside the point' when it came to the ERISA claim at hand." [Cox v. WSP USA Inc. Group Insurance Plan, No. 24-8812 (N.D. Calif. Jan. 16, 2026)] MORE >>
HR Dive
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ERISA Voluntary Benefits Lawsuits: What Benefits Admins Need to Know
"The complaints show consultants earning 22% to nearly 40% of premiums, far above the typical 10% industry standard.... When only 25-35 cents of every premium dollar goes to paying claims, with the rest consumed by commissions and administrative costs, the math simply doesn't
support fiduciary prudence.... What plan sponsors should do: ... [1] Request complete disclosures ... [2] Audit voluntary benefits ... [3] Document fiduciary oversight ... [4] Restructure conflicted relationships." MORE >>
Ameriflex
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New Wave of ERISA Class Action Lawsuits Name Brokers as Defendants
"The complaints advance a unified and increasingly familiar theory: once voluntary benefits are offered through an ERISA-governed welfare plan, they are subject to ERISA's full fiduciary framework.... According to the plaintiffs, failures in process, rather than outcomes
alone, caused plan participants to pay excessive and unreasonable premiums, while brokers and other service providers reaped outsized financial benefits." MORE >>
Buchanan Ingersoll & Rooney PC
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2026 Workplace Wellness Trends: Insights for Employers
"7 in 10 employers offer or are developing a workplace wellness program, and most believe wellness should be integrated across all benefits -- not siloed.... Budget constraints and lack of time remain the biggest hurdles. Education, affordability, and clear ROI are key
drivers for future investment.... 75% of programs include mental and behavioral health support, up from 52% in 2023." MORE >>
EPIC
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Metabolic Health Should Be Every Employer's Benefits Priority
"Metabolic health, the body’s ability to efficiently convert food into energy, is central. When that system falters, it drives a cascade of problems: elevated blood sugar, hypertension, fatigue, depression and more. Its effects ripple through the workplace, increasing time
away, lowering performance and driving costs higher. Despite its impact, metabolic health rarely appears on the HR dashboard. That oversight is costing employers more than they realize." MORE >>
Corporate Synergies
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Benefits in General |
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[Guidance Overview]
Planning for Your Next DOL Investigation Just Got Easier
"EBSA stated that its investigations will continue to evaluate how plans and service providers protect against cybersecurity threats.... [T]he Mental Health Parity and Addiction Equity Act and its 2013 regulations, as well as the Consolidated Appropriations Act, 2021,
remain ... an enforcement priority.... EBSA will be focusing enforcement efforts on the implementation of the No Surprises Act ... EBSA will be reviewing pension plan practices to notify participants who are approaching normal retirement age and required minimum distribution age[.]" MORE >>
Proskauer
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Employee Benefits Jobs
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Press Releases |
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Industry Veterans Launch The Judi Group, the First Health Benefits Advisory Firm Focused on Fiduciary Compliance, Cost Control, and Plan Oversight for Employers
Judi Health
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Webinars, Podcasts and Conferences (Health & Welfare Plans) |
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Culture, Change and the Future: Benefits, AI and Leadership
PODCAST
Brown & Brown
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Last Issue's Most Popular Items |
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Employer Sponsors of Self-Funded Health Plans: February 16 Deadline to Update and Distribute HIPAA Notice of Privacy Practices
Miller Johnson
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New Wave of ERISA Litigation Targets Voluntary Benefit Plans
Holland & Knight
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GLP-1s Cannot Be Proven to Save an Employer Money
Craig Gottwals via Substack; registration may be required
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Copyright 2026 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.
BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
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