"Under Section 4980H(c)(5), in the case of any calendar year after 2014, the applicable dollar amounts of $2,000 and $3,000 under Section 4980H(c)(1) and (b)(1), respectively, are increased by an amount equal to the product of such dollar amount and the premium adjustment percentage for the calendar year.... (HHS) published the premium adjustment percentage for 2027 on January 29, 2026  ... For calendar year 2026, the adjusted $2,000 amount under Section 4980H(c)(1) is $3,780, and the adjusted $3,000 amount under Section 4980H(b)(1) is $5,670."  MORE >>

"While HIPAA included employer-sponsored health plans within the definition of a HIPAA covered entity, OCR is -- for the first time in OCR's enforcement history -- applying its long-standing enforcement agenda directly to the employer health plan context. This activity is a reminder that HIPAA applicability is an overlooked legal risk for many major employers."  MORE >>

13 pages. "Maryland finalized paid family and medical leave (PFML) regulations in advance of contributions starting next year. New York and Washington, DC, tweaked their PFML laws. Oregon issued guidance on PFML and paid sick and safe leave (PSSL).... Florida, Ohio, and Virginia passed significant pharmacy benefit manager (PBM) laws while Maine clarified a prior law through regulations. New Mexico and South Dakota focused on prior authorization.... Mississippi eased access to association health plans, and a Wyoming law enabled independent contractors to open portable benefit accounts.... San Francisco's new methodology for compliance with the Healthy Airport Ordinance (HAO) started."  MORE >>

"Creditable prescription drug coverage is defined as coverage that is equal to or greater than the actuarial value of standard Medicare Part D coverage.... Plan sponsors can determine creditable status using either a simplified determination method or an actuarial evaluation. Employer Group Waiver Plans (EGWPs) and Retiree Drug Subsidy applicants are required to use actuarial valuation.... CMS introduced a new simplified determination -- optional in 2026 and mandatory in 2027 and beyond. The only change from 2026 to 2027 is a one percentage point increase in required value."  MORE >>

"The breach of fiduciary duty claims in tobacco surcharge cases fit comfortably within the broad insuring agreements found in most fiduciary liability insurance policies. The discriminatory surcharge and reasonable alternatives claims also arise from the duties imposed by ERISA and are arguably covered under these policies."  MORE >>

22 pages. "The purpose of this [report] is to inform ERISA health plan sponsors and trustees about why it is vital to address provider errors -- meaning recovering provider overpayments and correcting underpayments. The report also offers advice for choosing a vendor specializing in these services.... Administrators of self-funded health plans bear a fiduciary responsibility under ERISA to protect plan assets, which includes proactively pursuing and recovering any overpayments. Equally critical is the fiduciary obligation to ensure that providers are not undercompensated to the detriment of plan participants."  MORE >>

"Direct-to-consumer reimbursement models have emerged as a compelling alternative, enabling participants to obtain these medications at reduced prices while shifting claims processing outside traditional PBM frameworks. [This article outlines] the key legal and administrative considerations plan sponsors must address before adopting these arrangements."  MORE >>

"The US drug pricing environment is shifting rapidly ... States, federal agencies, and the courts are all driving reforms that affect pharmacy costs, benefit design, and contract strategy. Employers will face more variability, more oversight and more pressure to make informed decisions quickly.... This white paper summarizes the major forces shaping 2026 and provides practical, employer focused guidance on how to navigate this environment."  MORE >>

"Many primary care clinics (PCCs) participating in the Minnesota State Employee Group Insurance Program (SEGIP) are willing to lower their prices to attain better tier placement, although they face obstacles to lowering total costs of care (which include specialists, hospitals, and pharmaceuticals). Patients are more likely to choose lower-tier (i.e., lower -- cost sharing) PCCs, but such selections are limited by inertia once an initial selection has been made, and patients' behavior is less cost-sensitive when it comes to receiving care from specialists, hospitals, and pharmaceutical providers."  MORE >>

"More than a quarter of Gen Z learning another language through Preply currently live abroad or have done so in the past, and another 38% say they would consider it in the future. Career advancement is a leading motivator: 26% cite it as a top reason for learning a new language, more than any other generation. About one in five say they study languages to increase their salary or improve job security, while 13% believe it could help them break into a new field. Nearly half also think speaking a second language would open up job opportunities overseas."  MORE >>

"The core defect lies in the Independent Dispute Resolution (IDR) process. This system was envisioned as a rare backstop, with initial government estimates projecting a mere 17,000 arbitration cases annually. Instead, providers flooded the zone with 1.2 million cases in just the first half of last year alone, and they are winning around 88 percent of the time. Out of network doctors now plead their cases to government approved arbitrators. These victories often result in fees hundreds of times higher than what providers could ever negotiate directly with insurers."  MORE >>

"Over the past few years, plan sponsors, services providers, and trade associations have been increasingly vocal about issues with EBSA's enforcement. FAB 2026-01 appears designed to address many of the key concerns, including the length of time of investigations and attempts to regulate through enforcement. This represents a fundamental shift in DOL's relationship with the regulated community, though the ultimate impact will depend, in large part, on how it is implemented by the DOL regional offices."  MORE >>