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Health & Welfare Plans Newsletter

April 1, 2026

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[Guidance Overview]

FMLA and ADA Compliance Keys for Employers

"[1] FMLA and ADA overlap but serve different purposes ... [2] Why the ADA interactive process is required for accommodation requests ... [3] Rigid leave policies can create ADA liability ... [4] Why documentation is critical for FMLA and ADA compliance ... [5] When to err on the side of caution under FMLA and ADA."  MORE >>

Constangy, Brooks, Smith & Prophete, LLP

[Guidance Overview]

San Francisco HCSO Employer Annual Reporting Form Due May 1

"The San Francisco Office of Labor Standards Enforcement (OLSE) has opened the Health Care Security Ordinance (HCSO) Employer Annual Reporting Form (ARF) website. All covered employers must submit the required reporting on the 2025 calendar year by May 1, 2026. Employers required to complete the reporting will find many useful resources on the ARF website, including instructions, previews, an educational webinar with slides, FAQs, and the reporting form itself."  MORE >>

Newfront

Insurer's Own Evidence Dooms Benefit Termination

"[T]he court applied de novo review after finding that First Reliance Standard committed multiple non-inadvertent violations of the [DOL's] claims-procedure regulation ... in processing Booth's internal appeal. The court found that Booth was Totally Disabled under the policy's 'any occupation' standard, and that the insurer's own vocational evidence -- not just the claimant's -- established that she could not perform any occupation her education, training, or experience would reasonably allow." [Booth v. First Reliance Standard Life Ins. Co., No. 24-3927 (S.D.N.Y. Mar. 30, 2026)]  MORE >>

Roberts Disability Law

District Court Favors Employee in Determining Extent of LTD Benefits Reinstatement

"[The District Court] ruled that when the administrator of a long-term disability (LTD) plan abused its discretion in denying LTD benefits, the employee was entitled to a retroactive reinstatement of benefits from the time his benefits were terminated through the date of the court’s decision." [Ehrlich v. Hartford Life & Accident Ins. Co., No. 20-2284 (N.D. Calif. Mar. 28, 2025)]   MORE >>

The Wagner Law Group

PBM Reform Was a Start; Now Make Health Plan Claims Transparent

"In the commercial market, drug spending is substantial. Yet hospital and facility services account for the largest share of medical expenditures—and therefore represent the greatest financial exposure for self-insured employers. Understanding why requires a closer look at how these employer plans work."  MORE >>

Newsweek

Why Employers Should Embrace ERISA Coverage of Their Severance Plans

"ERISA coverage provides for many advantages, and the related compliance requirements are not particularly onerous. This article discusses what causes a severance plan to be subject to ERISA, the consequences that result, and the advantages of ERISA coverage."  MORE >>

Trucker Huss

West Virginia Tackles Prior Authorization

"West Virginia’s Public Employees Insurance Agency enrolls nearly 215,000 people — state workers, as well as their spouses and dependents. The new law, which will take effect June 10, will allow plan members who have been approved for a course of treatment to pursue an alternative, medically appropriate treatment of equal or lesser value without the need for another approval from the state-based health plan."  MORE >>

NBC News

Delaware Paid Leave Deadline Hits for Employer Reports

"Employers in Delaware with 10 or more eligible employees must submit required hours and wage reports to the [DOL] by the end of a 90-day grace period on Tuesday, March 31, in order for workers to receive benefits through the state's Paid Leave program, which began Jan. 1.... [A]bout 6,000 employers in Delaware fit that requirement and noted the reports are quarterly for all of 2025 and are typically due 30 days after the end of each quarter."  MORE >>

WDEL

[Opinion]

Analysis Reveals 'Staggering' and 'Alarming' Consequences of Provider-Driven Abuse of the No Surprises Act

"Dispute volume in the first half of 2025 more than doubled from the same period in 2024 -- driven largely by a small number of private equity-backed providers and IDR middlemen effectively rigging the system to extract payouts that can be 'three to nine times in-network rates' ... This provider-driven abuse of the No Surprises Act contributes to higher premium costs, fueling the health care affordability crisis impacting every American."  MORE >>

AHIP

[Opinion]

The New Ideas Conundrum in Health Policy

"Democrats are casting about for new health reform ideas in the hope that they can gain traction in the run-up to 2028 and be enacted afterward.... There are at least three equally important big priorities Democrats will be thinking about that are in themselves challenging and, in a world of limited dollars and political capital, will be in tension."  MORE >>

Henry J. Kaiser Family Foundation

Benefits in General

Regulators Ponder Increasing Complexities of Life Insurance and Annuity Illustrations

"The path to changes to rules governing life insurance and annuity illustrations is sure to be a long one.... The new Life Insurance and Annuities Illustrations Working Group, established by the National Association of Insurance Commissioners, held its second call to discuss the 11 comment letters it received ... Regulators highlighted examples of annuity illustrations suggesting annual returns between 10% and 27%, prompting questions about whether consumers are receiving an accurate picture of potential performance at the point of sale."  MORE >>

Insurance News Net

[Opinion]

Reasserting ERISA's Private Enforcement Design: A Rebuttal to EBSA's 'Frivolous Litigation' Narrative

"Recent statements by the EBSA leadership and Assistant DOL Secretary, Daniel Aronowitz, frame ERISA litigation as abusive,' 'frivolous,' and in need of increased structural restrictions.... This position ... is inconsistent with ERISA's statutory design, controlling Supreme court precedent, and the legislative history of ERISA itself. Properly understood, ERISA depends upon participant-driven litigation as a primary enforcement mechanism.... [E]fforts to restrict access to the courts undermine -- not further -- ERISA's core purposes."  MORE >>

The Prudent Investment Adviser Rules

Employee Benefits Jobs

💼

Regional Vice President, Sales

MAP Retirement

Remote

View job as Regional Vice President, Sales for MAP Retirement

💼

Retirement Plan Consultant

MAP Retirement

Remote

View job as Retirement Plan Consultant for MAP Retirement

💼

Plan Consultant - DB/CB

MAP Retirement

Remote

View job as Plan Consultant - DB/CB for MAP Retirement

💼

Retirement Relationship Manager

MAP Retirement

Remote

View job as Retirement Relationship Manager for MAP Retirement

💼

Quality Review Specialist

MAP Retirement

Remote

View job as Quality Review Specialist for MAP Retirement

💼

Senior Retirement Plan Administrator (TPA)

Public Accounting Firm

Eugene OR / Bend OR / Corvallis OR / Lake Oswego OR / Hybrid

💼

Retirement Plan Consultant

The MandMarblestone Group, llc

Remote

View job as Retirement Plan Consultant for The MandMarblestone Group, llc

💼

Relationship Manager, DB

Trinity Pension Consultants

Remote / Barberton OH

View job as Relationship Manager, DB for Trinity Pension Consultants

💼

Sr. Analyst - DC

EGPS

Remote / Baxter MN

View job as Sr. Analyst - DC for EGPS

💼

Retirement Plan Consultant - DC

EGPS

Remote / Baxter MN

View job as Retirement Plan Consultant - DC for EGPS

Press Releases

The Cerrado Group Announces SetAway, LLC as Newest Member Firm

SetAway, LLC

Participation in TIAA’s Lifetime Income Solutions Accelerates as Plan Sponsors Embrace Annuity-Embedded Defaults

TIAA

Webinars, Podcasts and Conferences
(Health & Welfare Plans)

Health Benefit Fiduciary Duties: Data-Driven Decisions – Let’s talk payment integrity

April 15, 2026 WEBINAR

PLANSPONSOR

Advancements in Women's Health: Advancements and Trends in Women's Workplace Benefits

April 16, 2026 in GA

Worldwide Employee Benefits Network [WEB] - Atlanta Chapter

Last Issue's Most Popular Items

IRS Provides Initial Guidance Regarding Trump Accounts (PDF)

The Wagner Law Group

U.S. Health Care Coverage and Spending

Congressional Research Service [CRS]

The FTC-Express Scripts Settlement: Separating Signal from Noise in PBM Reform

Gallagher

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

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