607 pages. "This document sets forth these final rules related to certain provisions of the No Surprises Act regarding the Federal independent dispute resolution (IDR) process, which was established as part of the Consolidated Appropriations Act, 2021 (CAA). These rules finalize new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act. These final rules also require plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice (ERA) to an entity that does not have a contractual relationship with the plan or issuer. This document also finalizes amendments to certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review process, and the payment and collection of administrative fees and certified IDR entity fees. This document also finalizes the definition of bundled payment arrangements, amends requirements related to batched items and services and amends the rules for extensions of timeframes due to extenuating circumstances. Additionally, this document finalizes provisions that require plans and issuers to register in the Federal IDR portal."  MORE >>

38 pages. "This 2027 Final Letter provides updates on operational and technical guidance for the 2027 plan year for issuers seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Exchanges (FFEs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs). It also describes how parts of this 2027 Final Letter apply to issuers in State-based Exchanges on the Federal Platform (SBE-FPs).... The 2027 Final Letter focuses on guidance that has been updated for the 2027 plan year[.]"  MORE >>

"These final rules will improve the functioning of the Federal IDR process by streamlining communication between payers, providers, and certified IDR entities and clarifying timelines and processes.... [T]he Departments are finalizing a requirement for payers to communicate information to providers by using specific claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs) when they provide any paper or electronic remittance advice to an entity that does not have a contractual relationship with the payer.... [T]he Departments are finalizing several changes to the open negotiation requirements.... the Departments are finalizing a few amendments to the current batching provisions.... The Departments are also finalizing a revision to the types of extenuating circumstances in which the Federal IDR process time periods may be extended.... The requirement that payers communicate information using CARCs and RARCs and the modifications to the regulations addressing information to be shared about the QPA will take effect on the effective date of the final rules."  MORE >>

"Virginia first adopted paid sick leave requirements in 2021 for home health workers. Now, SB199/HB5 will significantly expand coverage to all employees of private employers and state and local governments ... Covered employees must accrue a minimum of one hour of paid sick leave for every 30 hours worked, beginning at hire.... The reasons for the use of leave are expanded to include services related to domestic violence, sexual assault, or stalking."  MORE >>

"Virginia enacted a paid sick leave law that will apply to nearly all employers in the Commonwealth. Covered employees will be able to accrue an hour of paid sick leave for every 30 hours worked. The law will have a staggered implementation date by employer size."  MORE >>

"The proposed rule would permit, but not require, plans to offer coverage on a limited excepted benefit basis for the diagnosis, mitigation, and treatment of infertility or infertility-related reproductive health conditions provided by medical professionals authorized under applicable law. Participants generally would not be required to enroll in the employer's group health plan coverage in order to enroll in limited excepted benefit fertility coverage."  MORE >>

"Under the proposal, fertility benefits will qualify as excepted benefits under the limited excepted benefit category if they meet the following four requirements (described below in more detail): Coverage must be limited to fertility benefits Benefits cannot exceed the applicable lifetime dollar limit The fertility benefits cannot be an integral part of the plan Participants and beneficiaries must be provided a written notice that describes the coverage"  MORE >>

"[T]he Sixth Circuit rejected the opposing approach of other Circuits, which suggested that post-payment reimbursement disputes fall outside ERISA's enforcement provisions.... In distinguishing those cases, the Sixth Circuit pointed out that those decisions involved situations where the insureds challenged their insurers' reimbursement rights based on a state statute, whereas Mr. Patterson asserted that 'his entitlement to benefits originate[d] with the 'terms and conditions' of his plan -- not some freestanding source of state law.' " [Patterson v. UnitedHealth Group, Inc., No. 25-3175 (6th Cir. Dec. 2, 2025)]  MORE >>

"Oregon Potato claims that Marsh violated [ERISA] by using a consulting firm ... to manage the company's health plan.... According to [the lawsuit, the defendants] recommended in 2023 that the company switch from a fully insured health plan to a guaranteed level-funded premium plan. The arrangement allegedly enabled [the consulting firm] to collect excessive fees and disadvantaged plan participants, who failed to receive medical benefits for the guaranteed premiums they paid." [Oregon Potato Co. v. Strong, No. 25-5139 (E.D. Wash. Mar. 2, 2026)]  MORE >>

"Courts across the country continue to see a steady stream of litigation from employees who claim their employers crossed the line between permissible contact and unlawful interference during FMLA leave.... [E]mployers may make reasonable, limited contact with employees on FMLA leave, but requiring work performance or imposing more than a de minimis burden can support a claim, depending on frequency, tone, and impact."  MORE >>

"For many employers, there's no clear fix to the spending surge. Traditional plan options to lower expenses have netted only limited benefits. High-deductible health plans push the cost to the employee; wellness programs have low uptake and little data supporting their efficacy; value-based care is difficult to implement; and pharmacy costs continue to rise even with the growth of transparent pharmacy benefit managers (PBMs).... The challenge is implementing changes that fit into the employer's culture so that employees embrace the new approach."  MORE >>

"Seventy percent of employers have defined key performance indicators for those investments, but just 13% conduct standardized recurring reporting ... More than half of organizations surveyed spend at least $1 million annually on education benefits, while nearly one in four invests $5 million or more."  MORE >>

"If adopted, the proposal would require covered employers to provide eligible employees with up to 18 weeks of paid parental leave and to comply with broader paid sick leave requirements. If enacted, Allegheny County would become the first county in Pennsylvania to mandate paid parental leave for private employers. The proposal is currently in a public comment period and could move toward adoption later this year."  MORE >>