News & Analysis as of

Employer Group Health Plans

Groom Law Group, Chartered

Employer Scores Another Tobacco Premium Surcharge Win

On March 20, a federal court in Ohio dismissed a tobacco premium surcharge lawsuit in its entirety for failure to state a claim. This marks the third time that a federal court has held that ERISA does not require employers...more

Vorys, Sater, Seymour and Pease LLP

From Pensions to Prescriptions: How Thole’s Standing Constraints Keep Shutting Down ERISA Claims

When Congress enacted ERISA in 1974, it established a universal regulatory framework for private employee benefit plans that reflected “a careful balancing between ensuring fair and prompt enforcement of rights under a plan...more

Bradley Arant Boult Cummings LLP

Is Your Group Health Plan Ready for a Compliance Audit?

Employer-sponsored group health plans operate at the intersection of multiple federal regulatory frameworks — ERISA, the ACA, COBRA, HIPAA, the Mental Health Parity and Addiction Equity Act (MHPAEA), and more....more

Fisher Phillips

Top Trends for Employers to Consider This National Employee Benefits Day

Fisher Phillips on

National Employee Benefits Day, which falls on April 2 this year, serves as a good reminder for employers to step back and evaluate how well their benefits offerings support employee well-being, engagement, and productivity....more

Haynes Boone

USPS Postmarking Changes Impact Benefit Plan Notices and Filings

Haynes Boone on

The United States Postal Service (“USPS”) recently issued a final rule that became effective December 24, 2025 to clarify the definition and application of postmarks. The rule provides that a postmark applied at a USPS...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

PBM Reforms May Open a New Era for Group Health Plan Sponsors

The federal Consolidated Appropriations Act of 2026 (CAA 2026) and recent regulatory developments could potentially dramatically overhaul reporting and disclosure requirements for pharmacy benefit managers (PBMs) and give new...more

Mintz

[Podcast] Mintz On Air: Practical Policies — California vs. Canada: A Conversation About Cross-Border Employment Quirks

Mintz on

In the latest episode of the Mintz On Air: Practical Policies podcast, Jen Rubin is joined by Brad Tartick, an Employment Partner in Mintz’s Toronto office, for an unscripted conversation about key similarities in California...more

Fisher Phillips

8 Key HIPAA Compliance Items for Businesses with Self-Insured Health Plans

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Are you a business with a self-insured group health plan? Did you know that it could make part of your business subject to HIPAA? Employers that sponsor self-insured group health plans are subject to complex compliance rules...more

Bricker Graydon Wyatt LLP

Does a Single PTO Policy Still Work for Multi-State Employers?

I’m often asked to review the benefits and paid leave provisions in employer handbooks. Employers tend to focus first on retirement and health benefits, but significant compliance issues show up elsewhere. By far the most...more

Wiley Rein LLP

Major Shifts in PBM Contracting Landscape: Navigating CAA and Other Policy Developments

Wiley Rein LLP on

PBM reform is taking an even deeper turn, as shifts in the obligations imposed on pharmacy benefit managers (PBMs) are taking place at the federal level, directly impacting PBM prescription drug pricing transparency and...more

Fisher Phillips

Employer Checklist for March 2026

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Here are the top 10 workplace compliance items you should tackle in March 2026, based on the latest labor and employment law updates...more

Verrill

Direct-to-Consumer Models for Prescription Drug Coverage: A New Trend in Coverage for GLP-1s

Verrill on

The cost of GLP-1 medications to group health plans continues to increase rapidly as FDA approval expands and the percentage of participants and beneficiaries taking GLP-1 medications rises. This trend is creating significant...more

Epstein Becker & Green

2026 Pharmacy Benefit Manager Reform: What Employers Need to Know

Epstein Becker & Green on

Years of debate and halting efforts to enact pharmacy benefit manager (PBM) reform came to a head in early 2026 with three independent but related federal actions, bringing with them substantial PBM reform....more

Morgan Lewis - ML Benefits

Strengthening Fiduciary Hygiene: Navigating DOL Scrutiny and New Litigation Risks for Health and Welfare Plans

For decades, fiduciary litigation under the Employee Retirement Income Security Act of 1974 (ERISA) was largely concentrated on 401(k) and pension plans. That era has ended. In recent years, we have seen class-action lawsuits...more

Morgan Lewis

Consolidated Appropriations Act of 2026: The New Landscape of PBM Fiduciary Oversight

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The Consolidated Appropriations Act of 2026 (CAA 2026), signed into law on February 3, 2026, includes provisions that reform how group health plans contract with pharmacy benefit managers (PBMs). The legislation is designed...more

Fisher Phillips

Employer FAQs on the Rise of GLP-1 Drugs for Weight Loss and the Workplace Impact

Fisher Phillips on

The rise of prescription medications used for weight loss has reshaped conversations about employer-sponsored health benefits and raised many new questions for employers. You have likely heard of Ozempic and other GLP-1 drugs...more

Ropes & Gray LLP

The Year of PBM Reform? Recent Legal Developments, Including a Proposed Transparency Rule for Self-Insured Group Health Plans

Ropes & Gray LLP on

Less than two months into 2026, several pivotal moments have emerged in the long-running pharmacy benefit manager (“PBM”) reform discussions. This Alert provides an overview of three key developments in the PBM reform...more

Genova Burns LLC

Consolidated Appropriations Act of 2026 Requires Greater Transparency by Pharmacy Benefit Managers

Genova Burns LLC on

On February 3, 2026, Congress passed and President Trump signed into law the Consolidated Appropriations Act of 2026 (CAA). This law imposes significant, long-expected requirements on pharmacy benefit managers (PBMs) and...more

Vorys, Sater, Seymour and Pease LLP

Vorys Benefits Brief: Two Key PBM Developments for Employers - Part Two

On February 3, 2026, President Trump signed the Consolidated Appropriations Act, 2026 (CAA 2026). The CAA 2026 includes significant changes governing pharmacy benefit managers (PBMs) and any entities providing pharmacy...more

Vorys, Sater, Seymour and Pease LLP

Vorys Benefits Brief: Two Key PBM Developments for Employers - Part One

On January 30, 2026, the Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA) published a proposed regulation that would significantly increase transparency requirements for pharmacy benefit managers...more

Groom Law Group, Chartered

The Ghost in the Machine (Readable Files): Proposed Transparency in Coverage Amendments Attempt to Shed Additional Light on Health...

The push to health care transparency continues. During the first Trump administration, the Centers for Medicare and Medicaid Services (“CMS”), with the Department of Labor (“DOL”) and the Department of the Treasury/Internal...more

Davis Wright Tremaine LLP

HIPAA Privacy Notice Upcoming Deadline

Employers with group health plans need to confirm that their HIPAA Privacy Notices are updated no later than February 16, 2026, to reflect changes required by the 2024 Privacy Rule....more

Blank Rome LLP

Reimagining Employer-Sponsored Healthcare with Jack Hill of Nomi Health

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Season 2, Episode 2: Reimagining Employer-Sponsored Healthcare with Jack Hill of Nomi Health In this episode of BRight Minds in Healthcare Delivery, host Eric Tower speaks with Jack Hill, Senior Vice President of Enterprise...more

Hanson Bridgett

2026 Employee Benefits Webinar - Private Sector Employers

Hanson Bridgett on

Above-the-line federal income tax deduction for qualified OT compensation. Effective 2025-2028, up to $12,500 ($25,000 if joint return) w/ phase-out....more

Akerman LLP - HR Defense

GLP-1 Medications: What Employers Need to Know About Rising Costs, Coverage Choices, and Managing Legal Risks

GLP-1 medications, originally developed for diabetes and now widely used for weight management, are rapidly becoming a major cost concern for employer health plans. Annual costs per user often exceed $10,000, and demand is...more

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