"The statutory language in the CAA requires plans to conduct the NQTL comparative analysis.... [S]elf-funded plans must be able to produce a written NQTL comparative analysis demonstrating parity between mental health/substance use disorder benefits and medical/surgical benefits, upon request by regulators or participants. Litigation related to the 2024 MHPAEA final rules hasn't eliminated or paused this requirement."  MORE >>

"The Conduent incident is one of the largest reported health care data breaches in U.S. history and appears to have involved sensitive personal and protected health information. Even when a breach occurs at a third-party subcontractor, the employers' health plans may still have obligations under HIPAA. Because of the significant potential penalties for failure to report a breach, it is important to for employers with self-funded group health plans to take prompt steps to assess whether the plan's data has been affected and whether any obligations have been triggered for the plan."  MORE >>

"[A]ffordability is the resounding concern for employers, consistent with last year's results.... Other areas of consistent focus from the country's top employers were the need for enhanced transparency and more sophisticated data analytics tools, signaling their intent to more closely scrutinize newly available information to effectively combat price increases."  MORE >>

"ERIC recommends that the Department go even further in final regulations.... [T]he Department must clearly state that GPOs must disclose the compensation they receive in connection with providing 'pharmacy benefit management services' to a self-insured plan.... [T]he Department must also specifically enumerate a list of entities that would be subject to these proposed regulations through their affiliation with offshore GPOs ... In short, each and every entity woven into this type of structure must be listed as an entity that is subject to the proposed Compensation Disclosure requirements."  MORE >>

"The proposed rule appropriately recognizes that disclosure alone is insufficient without standardization. Disclosures must be structured in a manner that enables meaningful comparison across PBMs, contract arrangements, and plan years. Without comparability, even detailed disclosures will fail to support effective fiduciary decision-making or competition in the marketplace."  MORE >>

Video of April 16 hearing. Opening Statement: Rep. Rick Allen (R-GA); Witness: The Honorable Daniel Aronowitz, Assistant Secretary, Employee Benefits Security Administration (EBSA).  MORE >>

"To provide clarity and expand access to these flexible contribution options, the [Optimizing Participant Tax Incentives through Optional Noncash Selections -- or OPTIONS -- Act (HR 8314)] would amend Section 125 of the Internal Revenue Code to establish a 'qualified benefits option plan' allowing participants to elect to allocate employer contributions among qualified benefits. The legislation further stipulates, however, that participants may not elect to receive cash or any other taxable benefits instead of qualified benefits."  MORE >>