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DOL Releases Guidance on Fertility Coverage

"The FAQs make clear that a plan may offer fertility benefits as an independent, noncoordinated excepted benefit, and thus be exempt from ACA requirements, if the following conditions are met: [1] the benefits are provided under a separate insurance policy; [2] there is no coordination between the independent benefit and any exclusion under a related group health plan; and [3] the benefits are payable without regard to whether benefits are provided for the same condition under a related group health plan."

District Court Vacates HIPAA Reproductive Health Rule

"As a result of the court's ruling, it appears that plans are no longer required, and may not be permitted, to apply the presumption of lawfulness or to obtain an attestation before disclosing PHI related to reproductive healthcare in response to criminal, civil or administrative investigations. Further, no updates would be required to plans' HIPAA privacy policies, notices of privacy practices and business associate agreements to reflect the disclosure restrictions with respect to reproductive healthcare PHI." [Purl v. HHS, No. 24-0228 (N.D. Tex. Jun. 18, 2025)]

Sixth Circuit Rules Third-Party Administrator May Be Liable as ERISA Fiduciary

"The Sixth Circuit disagreed and held that a dispute arising from contractual terms may still give rise to claims for breach of fiduciary duties under ERISA, and BCBSM is not shielded from liability merely because its overall business practices affect many plans." [Tiara Yachts, Inc. v. Blue Cross Blue Shield of Mich., No. 24-1223 (6th Cir. May 21, 2025)]

DOL Softens Stance on 401(k) Investment in Cryptocurrency

"[W]hile plan fiduciaries must consider all relevant facts and circumstances when evaluating and selecting investment options, DOL is neither endorsing nor prohibiting the inclusion of cryptocurrency investment options. In addition to cryptocurrency, [CAR 2025-01] advises that the same reasoning and principles apply to investments in a wide range of digital assets, including tokens, coins, crypto assets, and other crypto derivatives."

IRS Issues Guidance on Matching Contributions for Qualified Student Loan Payments

"Matching contributions made on behalf of QSLPs still must satisfy non-discrimination testing, just like employer matching contributions based on elective deferrals into a plan. When determining whether a plan passes the [ADP] test, the plan can either apply a single ADP test for all participants or apply separate ADP tests for those who receive QSLP matching contributions and those who do not."

IRS Issues Guidance on Emergency Expense and Domestic Abuse Distributions Under SECURE 2.0

"[SECURE 2.0] added two new exemptions from [the] 10% additional tax ... If the plan does not offer these distributions, the participant is permitted to treat an otherwise permissible distribution under the plan as exempted to avoid the 10% additional tax."

IRS Notice Clarifies Several Provisions of SECURE 2.0

"[Notice 2024-02] provides an additional year for plans to adopt plan amendments pursuant to the Act. As a result, non-governmental qualified plans must be amended by December 31, 2026, while applicable collectively bargained plans have until December 31, 2028 to make the required amendments and governmental plans must be amended by December 31, 2029."

Transparency in Coverage Update: Status of Current Enforcement and Future Rulemaking

"[A]ll covered plans will need to move ahead with publishing machine-readable files with prescription drug cost information, but future guidance will be issued on the implementation timeline for those plans that have relied on the enforcement delay. Also, plans that use alternative reimbursement arrangements for in-network providers will no longer be able to use the safe harbor that was previously available for reporting in-network rates."

IRS Delays Roth Catch-Up Contribution Requirement Under SECURE 2.0 Act

"[IRS Notice 2023-62] addresses confusion over an apparent drafting error in the Act that could be read to eliminate catch-up contributions altogether. The Notice clarifies that eligible participants over age 50 may continue to make catch-up contributions, regardless of income."

Tenth Circuit Holds ERISA Preempts State PBM Regulation

"The court's opinion distinguished the case from Rutledge v. Pharmaceutical Care Management Association (PCMA), in which the Supreme Court held that an Arkansas law requiring PBMs to tie their reimbursement rates to pharmacies' costs was not preempted by ERISA because it did not dictate plan choices. The 10th Circuit reasoned that, whereas the Arkansas law at issue in Rutledge merely resulted in an increase of costs for the PBM, the Act goes further by potentially having a direct effect on a plan's network design, and therefore 'governs a central matter of plan administration.' " [PCMA v. Mulready, No. 22-6074 (10th Cir. Aug. 15, 2023)]