"These requirements will give employers unprecedented visibility into critical PBM information that may help contain rising health care costs. However, increased access to information also brings greater responsibility. Employers must ensure that PBMs provide the required information and that the information is prudently reviewed and acted upon once received. In addition, the expanded disclosure obligations may lead PBMs to increase their administrative fees."  MORE >>

"Plan sponsors and PBMs should anticipate that the DOL's final rule may be significantly revised to coordinate with CAA 2026's requirements. In particular, the DOL may need to reconsider its proposed July 1, 2026 applicability date, given that CAA 2026 does not take effect until January 1, 2029 for calendar-year plans, creating a potential gap period during which the DOL's more limited disclosure requirements would apply to self-insured ERISA plans before the broader CAA 2026 mandates take effect ... [A table] compares key elements of CAA 2026 and the DOL Proposed Rules."  MORE >>

"Other health coverage (including Medicare entitlement) that was in effect before a COBRA election does not disqualify a qualified beneficiary from electing COBRA. And because of the spouse's disability, COBRA coverage must be provided to everyone in the family for an extended period of up to 29 months."  MORE >>

"The 2026 Amendments lower the employer-size threshold from 30 to 15 employees. They also ease eligibility to three months' tenure and 250 base hours in the prior 12 months.... The law adds a standalone reinstatement right for employees who receive Temporary Disability Insurance (TDI) or Family Leave Insurance (FLI) benefits.... Employers should quickly update policies, train managers on reinstatement/anti-retaliation, reconfigure timekeeping for 'base hours' and prepare notices."  MORE >>

"New Jersey employers employing between 15 and 29 employees who are currently not covered by the NJFLA will have obligations under the NJFLA beginning 17 July 2026. Employers both currently and newly covered by the NJFLA will need to consider the significantly reduced criteria for employees to become eligible for NJFLA leave."  MORE >>

"The court applied abuse‑of‑discretion review and concluded that the denial was supported by the plan's medical‑necessity criteria and the administrative record. The dissent, however, argued that the majority failed to meaningfully account for a structural conflict of interest and for the administrator's handling of treating‑provider evidence and prior failed lower levels of care." [R.R. v. California Physicians' Service d/b/a Blue Shield of California, No. 22-7707 (9th Cir. Jan. 27, 2026; unpub.)]  MORE >>

"These filings signal a coordinated litigation strategy that could fundamentally reclassify certain 'voluntary' benefits as ERISA‑covered plans, significantly expanding fiduciary exposure for employers. By targeting both employers and national benefits consultants, the lawsuits raise the stakes for plan design, vendor relationships, and long‑standing assumptions about ERISA's safe‑harbor boundaries."  MORE >>

"in light of this new set of lawsuits, employers that have historically assumed their voluntary benefits are exempt from ERISA's fiduciary duties should take a fresh look and really make sure they qualify for that exemption. In general, voluntary benefits may avoid ERISA if they meet the [DOL's] ERISA voluntary plan safe harbor ... Many employers have assumed their voluntary plans are not subject to ERISA, but these lawsuits challenge that assumption."  MORE >>

"The trial court granted partial summary judgment to the plaintiffs, finding that the company had failed to post the required written notice ... The court ... also devised a process for determining damages owed to all 'similarly situated employees.' On appeal, the New Jersey Appellate Division upheld the trial court's decision. In doing so, the court gave some helpful direction to employers looking to avoid the same fate as this employer." [Cano and Bonelli v. County Concrete Corp., No. A-0056-24 (Sup. Ct. N.J. App. Div. Jan. 28, 2026)]  MORE >>

Video of Feb. 11 hearing, with testimony by: [1] Lori M. Reilly, Esq., PhRMA; [2] John F. Crowley, Biotechnology Innovation Organization; [3] John Murphy, Association for Accessible Medicines; [4] David Marin, Pharmaceutical Care Management Association; [5] Angie Boliver, Healthcare Supply Chain Association; [6] Chester "Chip" Davis, Jr., Healthcare Distribution Alliance; [7] James Gelfand, The ERISA Industry Committee; [8] Douglas Hoey, National Community Pharmacists Association.  MORE >>

"This CRS report contributes to the existing literature by using a more contemporary and market-based benchmark of IDR-participating providers' in-network rates, offering a distinct perspective on the extent to which IDR determinations for services provided OON diverge from the negotiated in-network rates of providers that participate in the IDR process." [R48851 Feb. 10, 2026]  MORE >>

"In addition to no formal meetings, there was 'no correspondence, no communications, no nothing' in 2025. Multiple members inquired about the status of the EAC in 2025 and none of those inquiries were answered ... The website for the Council confirms there was no output for 2025 and lists no nominees or an agenda for 2026."  MORE >>