On March 4, the IRS issued an information collection request under the Paperwork Reduction Act (“PRA”) regarding the ACA’s external review process’ notice and disclosure requirements and the No Surprises Act (“NSA”). The PRA...more
On December 9, 2025, the IRS issued Notice 2026-05, which provides guidance on the HSA provisions in the One Big Beautiful Bill Act (“OBBB”). The Notice provides much-anticipated guidance right before many of these provisions...more
The Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule (“Proposed Rule”) on November 28 that would remove the requirement for Health Reimbursement Arrangements (“HRAs”) to report creditable coverage...more
12/10/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Deregulation ,
Disclosure Requirements ,
Employee Benefits ,
Employer Group Health Plans ,
Executive Orders ,
Medicare Part D ,
Notice Requirements ,
Popular ,
Proposed Rules ,
Reporting Requirements
On November 21, 2025, the IRS released private letter ruling (“PLR”) 202547007, which provides helpful clarification that retirees whose pension benefits have been annuitized are considered “retired employees” for purposes of...more
Plaintiffs continue to file lawsuits against employers challenging wellness programs that impose a health insurance premium surcharge on participants if they use tobacco and do not complete a tobacco cessation course—in...more
On October 16, 2025, the Departments of Treasury, Labor, and Health and Human Services issued FAQs about Affordable Care Act Implementation Part 72, which clarify how employers may offer fertility benefits as a HIPAA excepted...more
10/22/2025
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Executive Orders ,
Fertility Treatments ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
HRA ,
HSA ,
New Guidance ,
Regulatory Requirements ,
U.S. Treasury
On October 9, 2025, the IRS issued Rev. Proc. 2025-32, which announces the 2026 indexed limits for certain health and welfare benefits. This is in addition to the limits the IRS announced in Rev. Proc. 2025-19 on May 1,...more
On September 18 and 19, 2025, the Advisory Committee on Immunization Practices (“ACIP”) of the Centers for Disease Control and Prevention (“CDC”) revised its recommendations regarding the COVID-19 vaccine and the combined...more
10/22/2025
/ ACIP ,
Affordable Care Act ,
Centers for Disease Control and Prevention (CDC) ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare ,
Insurance Regulations ,
Patient Access ,
Public Health ,
Regulatory Requirements ,
Vaccinations
On July 4, President Trump signed into law the One Big Beautiful Bill Act (the “OBBB”). Below we outline the key provisions impacting plan sponsors related to their health and welfare plans. Many of these provisions are...more
The U.S. District Court for the District of Maine recently dismissed two separate suits alleging that health plans’ coverage exclusion for weight loss drugs constitutes unlawful disability discrimination. Both complaints...more
5/14/2025
/ Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Appeals ,
Class Action ,
Disability Discrimination ,
Employer Group Health Plans ,
Health Insurance ,
Insurance Litigation ,
Obesity ,
Prescription Drugs ,
Section 1557
In fall 2024, plaintiffs filed a wave of putative class action lawsuits against employers challenging wellness programs that impose a health coverage premium surcharge on participants if they do use tobacco or do not complete...more
On January 16, 2025, the Internal Revenue Service (“IRS”) issued Revenue Ruling 2025-4 (the “Rev. Rul.”). The Rev. Rul. provides guidance on the federal tax treatment of contributions to and benefits paid under a state paid...more
In December 2024, the U.S. Equal Employment Opportunity Commission (“EEOC”) published a fact sheet addressing how federal nondiscrimination laws, such as the Americans with Disabilities Act (“ADA”), may apply to an employer’s...more
In late December, President Biden signed into law relief related to Code section 4980H employer mandate penalties and Code section 6055 minimum essential coverage (“MEC”) and Code section 6056 employer mandate reporting on...more
On December 4, 2024, a federal court in the Eastern District of Texas issued a ruling vacating the notice requirement under the final regulations (the “Final Rule”) on hospital and other fixed indemnity insurance (“Fixed...more
On December 2, the IRS issued Notice 2024-83, which increased the PCORI fee from $3.22 per covered life to $3.47 per covered life for policy and plan years that end on or after October 1, 2024 and before October 1, 2025....more
On November 8, the Departments of Labor and Treasury (the “Departments”) issued guidance extending certain deadlines related to retirement, health, and welfare plans in response to Hurricane Helene, Tropical Storm Helene, and...more
On October 17, 2024, the IRS issued two Notices: one regarding preventive care services that an HSA-compatible high deductible health plan (“HDHP”) can cover on a pre-deductible basis and another allowing the cost of condoms...more
On October 22, 2024, the IRS issued Rev. Proc. 2024-40, which announces the 2025 indexed limits for certain health and welfare benefits. This is in addition to the limits that the IRS announced on May 9, 2024 in Rev. Proc....more
There is a new series of putative class action lawsuits in which the plaintiffs allege that employers that sponsor self-funded health plans with health plan premium surcharges related to tobacco use or vaccination status...more
On May 20, 2024, the IRS issued private letter ruling (“PLR”) 202434006 (the “2024 PLR”) that permits employees to allocate an employer contribution among various benefits outside of a cafeteria plan. The IRS has previously...more
On June 17, 2024, the IRS issued Fact Sheet 2024-22, which includes nine FAQs about educational assistance programs. The Fact Sheet also links to a sample program document for employers....more
On June 21, 2024, the United States Court of Appeals for the Fifth Circuit (“Fifth Circuit”) issued its ruling in Braidwood v. Becerra. The court determined that the Affordable Care Act’s (“ACA”) requirement that group...more
Earlier this year, a Johnson & Johnson (“J&J”) employee brought a class action complaint (the “Complaint”) against J&J alleging fiduciary breaches under ERISA related to the prescription drug coverage under J&J’s self-funded...more
The Department of Labor (“DOL”) recently released a final regulation (the “Fiduciary Rule”) redefining “investment advice” under the Employee Retirement Income Security Act of 1974, as amended (“ERISA”) and section 4975 of...more