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Individual Patient's Genes May Affect Which GLP-1 Obesity Drugs Work Best

"Knowing which works better is critical for employers' health plans, because anti-obesity drugs now account for about 17% of U.S. employer health plan prescription spending ... The full retail price of the drugs is about $1,400 per month for Victoza; $1,500 per month for Wegovy, a better-known drug that's similar to Victoza; and just $200 per month for Qsymia."

Trump Rescinds Biden-Era Supplemental Health Benefits Notice Requirement

"The executive order that was canceled helped serve as the justification for a warning notice requirement that affected all forms of fixed-indemnity health insurance benefits, including critical illness insurance, cancer insurance, hospital indemnity insurance and accident indemnity insurance."

Vermont Saves: New Auto-IRA Program Requires Employers Without a 401(k) to Enroll Employees

"Vermont is joining the growing list of states -- now 17 -- requiring employers to either enroll tens of thousands of employees in the state plan or offer their own 401(k) plan. The program is a state-run automated savings program (or Roth IRA-style program) in which participants can contribute up to $7,000 a year that is automatically deducted out of an employee's paycheck."

Why the Flawed Hospital Price Transparency Requirements Miss the Mark

"[The hospital price transparency] requirements ... at least in [their] current form, will not drive significant transformation.... Here's why: [1] Current pricing and payment processes lack clarity. [2] Very few fully comply with the HPT and have no incentive to do so. [3] Transparency in some markets may actually drive prices up, not down. [4] About 20% of consumers of health care still account for 80% of the health care spend."

ICHRAs Might Be Adding to Individual Health Plan Sales

"ICHRA enrollees may now account for a noticeable fraction of the 24.3 million Americans who had individual or family major medical coverage March 31, 2024.... [One] sign that some of the new individual enrollment could be ICHRA enrollment is that individual enrollment increased by 3.2 million during a year when the labor market was strong but reported enrollment in employer-sponsored group health plans fell by 1.5 million"

Employer Groups File Brief Against Iowa PBM Law to Protect Self-Funded Plan Flexibility

"The plaintiff is challenging the Iowa law requiring that, among other provisions, 'any willing pharmacy' be included in a prescription drug plan's provider network, including self-insured prescription drug plans governed by ERISA. In October, a federal judge blocked enforcement of several portions of the law, citing potential conflict with ERISA. In its brief, ERIC argued that ERISA preempts Iowa's law because that law directly interferes with prescription-drug benefit plan design and administration [.]" [Iowa Assoc. of Bus. and Ind. v. Ommen, No. 25-0211 (S.D. Iowa Jul. 21, 2025; on appeal to 8th Cir. No. 25-2494)]

PBM Fiduciary Bill Arrives with Bipartisan Support

"[The] PBM Fiduciary, Accountability, Integrity and Reform Act, or PBM FAIR Act [S 3549], would add a PBM fiduciary section to ERISA section 3(21) ... The bill would also add a section to ERISA that would require PBMs and health plans' 'third party administrators' to give an employer plan sponsor or other 'responsible plan fiduciary' detailed compensation disclosures."

Could Subscription Model Be the Answer to U.S. Health Care Cost Woes?

"Subscription care, an all-encompassing term for membership-style primary care services such as direct primary care (DPC), changes the incentives of the doctors and health care providers to be more proactive in managing the patient's health. The model is designed to be a bridge between modern medicine and a more traditional, less complex health care model."

Health Care Costs Expected to Be $13,800 Per Person in 2023

"Faced with the constant upward pressure from health care trends each year, employers are exploring new solutions to trim costs. One approach is to address the high costs associated with patients with chronic and complex health conditions."

ACA Turns Out to Be a Plus for 401(k)s

"Forty-four percent of respondents said the law has created an even greater need to provide employee benefits, while 43 percent said they've already boosted their contributions to employee retirement plans as a result of the reforms. There are, of course, those who are diverging from the pack. Among businesses with fewer than 50 employees, 27 percent said they already have, or will need to, drop retirement benefits."