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Analysis Suggests Anthem Deal Could Raise Health Costs

"Anthem has said the added heft will work for employers, not against them. A bigger Anthem, it emphasizes, could drive better deals from doctors and hospitals and pass savings onto these customers. In addition, Anthem has argued that there still will be plenty of competition: large employers pit smaller, local insurers' bids against those of large national carriers in regional markets.... But an Aon Hewitt analysis of benefits data for Reuters found that a majority of large employers buy worker health benefits from just one or two insurers."

Retirement Plans Tap Multiple Managers After PIMCO Drama

"More than 27,000 of the largest corporate 401(k) plans in the country had over $80 billion in the [PIMCO] Total Return Fund at the end of 2013 ... The roster included Wal-Mart's $20.6 billion plan, the largest in the country by participants, as well as Raytheon's and Verizon's.... There is no data on how many plans have replaced PIMCO Total Return for multiple managers or team managed funds, but advisers who consult retirement plans with tens of billions of dollars in assets told Reuters they are doing so."

As Obamacare Tech Woes Mounted, Contractor Payments Soared

"As U.S. officials warned that the technology behind Obamacare might not be ready to launch on October 1, the administration was pouring tens of millions of dollars more than it had planned into the federal website meant to enroll Americans in the biggest new social program since the 1960s. A Reuters review of government documents shows that the contract to build the federal Healthcare.gov online insurance website ... tripled in potential total value to nearly $292 million as new money was assigned to the work beginning in April this year."

More Health Plan Participants Checking Out Prices (PDF)

The latest Thomson Reuters-NPR Health Poll found that a 16 percent of Americans indicated they sought pricing information before receiving healthcare services, and of those who did, 49 percent received this information from insurance companies. This represents a significant shift from when respondents were asked the same questions in 2010, when only 11 percent said they sought such pricing information.

COBRA Lawsuit Against Tribal Casino Survives Dismissal (PDF)

"ERISA's COBRA provisions generally do not apply to a group health plan sponsored by an Indian tribal government if the plan qualifies as a governmental plan. For this exemption to apply, all participants must be employees of the tribal entity, and substantially all of their services must be in the performance of essential governmental functions -- not commercial activities such as operating a casino or hotel.... [B]ased solely on the facts in the opinion, the Tribe's reliance on COBRA's gross misconduct exception seems shaky at best." [Meilstrup v. Standing Rock Sioux Tribe, No. 25-0162 (D.N.D. Oct. 9, 2025)]

Final Forms and Instructions for 2025 ACA Reporting Are Available (PDF)

"With the issuance of the final forms and instructions ... filers should have all the tools they need to prepare for filing the 2025 forms. Filers should note the Paperwork Burden Reduction Act and the Employer Reporting Improvement Act changes, including that forms can be delivered electronically with consent, the date of birth can be used if a TIN isn't available, and ACA penalty assessments have a six-year limit starting with returns due after December 31, 2024"

Do We Have to File a Gag Clause Prohibition Compliance Attestation Every Year?

"The GCPCA attests to a health plan's (or insurer's) compliance with the prohibition against 'gag clauses' in any agreements with providers, provider networks, or entities offering provider network access -- including downstream agreements entered into by plan service providers.... An attestation of compliance with the gag clause prohibition must be made by December 31 each calendar year."

District Court Dismisses Challenge to Tobacco Surcharges Under Wellness Program

"The court found that the disputed surcharge did not violate rules prohibiting discrimination on the basis of a health-status related factor under [ERISA] ... The court also concluded that the participant lacked Article III standing to bring a fiduciary breach claim under ERISA." [Williams v. Bally's Management Group, LLC, No. 25-00147 (D.R.I. Nov. 4, 2025)]

Do We Still Have to Comply with the HIPAA Privacy Rule to Support Reproductive Health Care? (PDF)

"[C]overed entities and business associates do not need to update HIPAA policies and procedures, risk assessments, business associate agreements, and training for the 2024 Privacy Rule. Covered entities and business associates who took actions to comply with the 2024 Privacy Rule before the nationwide injunction was issued should consult legal counsel regarding further actions."

District Court Vacates ACA Section 1557 Gender-Identity Discrimination Rules

"Focusing on the legal and historical distinctions between Title VII and Title IX, this case limits the scope of Section 1557's protections. Although the gender-identity discrimination provisions had already been blocked from enforcement, this decision officially vacates the rules." [Tennessee v. Kennedy, No. 24-0161 (S.D. Miss. Oct. 22, 2025)]