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Alaska Eliminates TPA Licensing Exemptions, Expanding Licensing Requirements

"The new amendments to the TPA laws require a TPA doing business in Alaska to now be licensed in Alaska unless they fall within a few, narrow remaining exemptions, such as exclusively providing services to ERISA plans or employees of an insurer acting within the scope of the insurer's license."

District Court Dismisses ERISA Fee Suit Against Kellogg, Reinforcing Pleading Standards for Plan Sponsors

"The decision reinforces that ERISA plaintiffs must allege specific, like‑for‑like comparisons to survive a motion to dismiss.... For plan sponsors, the ruling underscores that well‑documented, routine recordkeeping arrangements and monitoring processes can help defeat speculative ERISA fee litigation at the pleading stage." [Fleming v. Kellogg, No. 22-0593 (W.D. Mich. Dec. 8, 2025)]

New Year, New Dependent Care FSA Limits: Don't Forget to Amend Your Plan!

"The One Big Beautiful Bill Act allows employers to raise the dependent care FSA exclusion limit starting Jan. 1, 2026. This is the first time since 1986 and offers meaningful additional tax savings for employees. Employers must amend plan documents to implement the higher limit. Without a formal update, plans will not be able to offer the increased contribution cap in 2026. Plan amendments must be executed by Dec. 31, 2025 to adopt the new limit."

Critical Deadline for All HIPAA Covered Entities: Update Notices of Privacy Practices Related to SUD Information

"All HIPAA Covered Entities must update their Notice of Privacy Practices (NPP) by February 16, 2026, to address certain uses and disclosures of Part 2 Records. Additionally, all Part 2 programs (including those that are not HIPAA Covered Entities) must make comprehensive changes to their privacy notices by February 16, 2026, to include additional statements."

Arbitration in ERISA Litigation: Supreme Court Declines Review as Circuit Split Persists

"The Supreme Court has twice declined to review ERISA arbitration cases, offering no signal that it plans to resolve the growing appellate divide.... [T]he appellate circuits remain divided on broad applicability of the doctrine. Notably, the Supreme Court has not yet been asked to weigh in on a decision upholding individual arbitration provisions ... [T]hat opportunity may arise if the Ninth or Eleventh Circuits affirm a recent Central District of California ruling that found individual arbitration requirements enforceable under ERISA Section 502(a)(2)." [Yagy v. Tetra Tech, Inc., No. 24-1394 (C.D. Calif. May 17, 2024)]

Benefits and Executive Comp Provisions in the One Big Beautiful Bill

"[E]xpanded flexibility for health savings accounts (HSAs) and new restrictions on premium tax credit eligibility ... may reduce the risk of triggering an employer shared responsibility penalty under the [ACA].... Limiting the deduction of excessive remuneration.... Expanding the application of excise tax on excess compensation within tax-exempt organizations."

Regulatory Trend: Safeguarding Mental Health in an AI-Enabled World

"New York is the first state to enact mental health-focused statutory provisions for 'AI Companions,' requiring user disclosures and suicide prevention measures for emotionally interactive AI systems.... [C]hatbots, digital wellness tools, mental health apps or even productivity assistants with emotionally aware features could fall within the scope of AI Companions depending on how they interact with users[.]"

New Reporting Requirements for TPAs, PBMs and Insurers in Indiana

"Beginning July 1, 2025, PBMs, TPAs and insurers in Indiana must annually report certain ownership information to the Indiana Insurance Department ... no later than August 30th of each year. Disclosures must include any party with 5%+ ownership, controlling interest or private equity involvement along with identifying details. A $1,000 daily penalty may apply for late filings."

Sixth Circuit Holds TPAs Do Not Get a Free Pass from ERISA's Fiduciary Duties

"Employers overseeing the day-to-day management of their plans should also be able to use the ruling to seek disclosure of information about the pricing and payment of claims, which in the past TPAs have been unwilling to share. In their role as an ERISA fiduciaries, TPAs will be obligated to disclose this information when requested by a plan administrator looking to properly administer its plan." [Tiara Yachts, Inc. v. Blue Cross Blue Shield of Mich., No. 24-1223 (6th Cir. May 21, 2025)]

Florida Regulatory Action Highlights Need for Insurers to Use Licensed TPAs

"A Florida-based [HMO] was fined for contracting with a [TPA] that was not licensed in Florida, violating its statutory obligation to ensure competent administration under Florida law. The HMO ... was fined $10,000 and agreed that any future violations would be considered willful and could lead to more severe regulatory action. This case underscores the importance of insurers and HMOs verifying the licensure status of all TPAs before entering into business arrangements."