"Status as a single ERISA plan is significant for several reasons. If a MEWA is not an ERISA plan, each participating employer is treated as maintaining a separate plan potentially subject to ERISA compliance obligations, such as furnishing summary plan descriptions and filing Form 5500s, rather than those requirements applying at the MEWA level. Also, due to ERISA preemption, a MEWA that is an ERISA plan is somewhat less encumbered by state regulation than one that is not an ERISA plan." [Advisory Opinion 2026-01A]  MORE >>

"The annual PCORI fee must be reported and paid to the IRS by July 31, 2026, via the second quarter Form 720.... Health Insurers are responsible for paying the fee on fully insured health policies.... The employer is responsible for paying the PCORI fee for self-insured health plans. Self-insured plans include level funded plans."  MORE >>

"The 2024 FAQs referenced a fixed annual exclusion limit of $5,250 per employee for educational assistance. The 2026 FAQs provide that, beginning in 2027, the exclusion limit will be indexed for inflation.... Employers should consider updating their programs and administrative systems to account for annual increases beginning in 2027."  MORE >>

"Removing barriers to behavioral health benefits is a national enforcement priority.... 2025 MHPAEA report to Congress describes continuing comparative analysis enforcement.... Agencies intend to propose new MHPAEA rule, and cease defending Biden-era rule.... The agencies anticipate 'significant revisions' to the provisions of the 2024 final rule challenged by ERIC."  MORE >>

"The statute creates the basic framework for the program, but many critical details will be established in regulations and guidance to be issued by the VEC before the program launches in 2028. Employers should begin familiarizing themselves with the new requirements now and develop a plan to ensure future compliance as additional guidance becomes available."  MORE >>

"This decision reinforces the broad scope of ERISA preemption for self-insured health plans. While the Supreme Court's Rutledge decision narrowed preemption in some ways, this ruling illustrates that state laws directly regulating the design and structure of a self-insured plan's benefits, such as AWP laws, are still likely to be preempted." [McKee Foods Corporation v. BFP Inc., No. 25-5416 (6th Cir. Apr. 7, 2026)]  MORE >>

36 pages. "[E]mployers can influence behavior change to better manage health care costs and employee well-being. Claims-based insights and personalized guidance can help -- especially amid rising expenses, inflation pressures, growing mental health needs and a shifting policy landscape.... [This report provides] data-backed insights on the main drivers of rising benefits costs, how to optimize investments, patterns in employee decision-making and emerging solutions that create value for employers and employees."  MORE >>

"An analysis of health plan data ... looked at members with claims in excess of $100k per year. While they accounted for just 1% of the 2.3 million members in the analysis, they drove 34% of total employer healthcare spend in 2025.... [A]reas where focused efforts can help employers rein in costs. [1] Understand your data: Analyzing claims to gain clarity.... [2] Strategic oversight of medical specialty pharmacy and gene/cell therapies.... [3] Take a peekaboo view into neonatal intensive care unit management.... [4] Outlier inpatient stays."  MORE >>

"Preauthorization affects a small share of claims but a big share of spend; make sure it is aimed at truly high-cost, high-impact services.... Ask your carrier/TPA how they are reducing delays, improving communication, and preventing care disruptions.... Request regular reporting on turnaround times, approval/denial trends, and appeals so you can spot issues early and reduce risk."  MORE >>

"The [Patients Deserve Price Tags Act (S 2355/HR 5582)] would codify and expand current hospital price transparency rules that were established in the first Trump administration by extending requirements to clinical diagnostic laboratories, imaging centers, and ambulatory surgical centers. It would also make the prices that hospitals post clearer by requiring actual dollar-and-cents amounts, not estimates, as well as sharply increase financial penalties for hospitals and insurers that fail to disclose their negotiated rates."  MORE >>

"A Voluntary Employees' Beneficiary Association (VEBA) comes with a wide variety of options. As a result, there's no singular framework that can be applied when developing an investment strategy for the assets.... [It] is critical to understand how each of the unique factors should be incorporated when considering an appropriate investment solution."  MORE >>

"The evidence continues to underscore that making healthcare more affordable requires policymakers to address the root causes of high costs head-on through common-sense solutions like cracking down on anti-competitive hospital mergers and implementing site-neutral payment reforms."  MORE >>

"The memorandum, which has no legal effect, was issued by Daniel Aronowitz, Assistant Secretary for EBSA.... The fact that he issued it to the Director of Enforcement of field staff, as well as the field staff, underscores its importance, because the Director of Enforcement issued all prior Field Assistance Bulletins.... The emphasis on not making law by litigation and reducing participant litigation that results only in big payouts for plaintiff class-action lawyers is something the Assistant Secretary wrote about even before being appointed to lead EBSA."  MORE >>