The Senate Judiciary Committee unanimously approved the bipartisan Prescription Pricing for the People Act of 2025. The Act requires the Federal Trade Commission (FTC) to issue a final report on the prescription drug market. The report must include the overall impact of how pharmacy benefit managers (PBMs) and other third parties affect how much patients and insurance companies pay for drugs. The FTC released an Read More

Rep. Tim Wahlberg, R-Mich., has reintroduced the Association Health Plan (AHP) Acts bill, which now may have a better chance of success. AHPs allow individuals or employers to join together to purchase health care coverage more easily. Walberg has been a long-time supporter of AHPs and has introduced similar bills since 2018. However, he now serves as the chairman of the House Education and the Workforce Read More

Following a rare trial in a 401(k) excessive fee lawsuit in a New York federal district court, the jury awarded more than $38 million to over 26,000 current and former bank employees. The case is Khan et al. v. Board of Directors of Pentegra Defined Contribution Plan, No. 7:2020cv07561 (S.D.N.Y. 2023). The case involves the Multiple Employer Defined Contribution Plan for Financial Institutions, which Pentegra’s Read More

A federal district court has ruled that the Employee Retirement Income Security Act (ERISA) preempts a state’s “any willing provider” (AWP) law as applied to self-insured health plans. The case is McKee Foods Corp. v. BFP, Inc., 2025 WL 968404 (E.D. Tenn. 2025). In McKee, an employer offered a self-insured health plan, including prescription drug benefits. The plan’s pharmacy benefit manager (PBM) excluded a Read More

In Faulk Company, Inc. v. Becerra, 2025 WL1085080 (N.D. Tex. 2025), an employer sued the U.S. Department of Health and Human Services (HHS) for failure to offer minimum essential coverage under the Affordable Care Act (ACA). The suit arose after the Internal Revenue Service (IRS) issued a Letter 226-J to the employer, which proposed shared responsibility penalties for this ACA violation. Before the IRS can propose Read More

Anthem has settled a class action lawsuit brought by participants in employee health plans it administers, following negotiations and private mediation. The plan participants claim that Anthem violated the Employee Retirement Income Security Act (ERISA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) by improperly denying coverage for inpatient mental health and substance use disorder treatment based Read More

A California federal district court has declined a plan administrator’s motion to dismiss a class action lawsuit for wrongful denial of benefits and breach of fiduciary duty. The plaintiffs, a group of participants in various employer-sponsored health plans, blame the administrator’s use of an automated algorithm to make decisions on participants’ benefits claims as the basis for their lawsuit. The plan participants Read More

Giant Eagle, a grocery store chain, has settled a class action lawsuit alleging violations of the Employee Retirement Income Security Act (ERISA) led by a former employee. The suit alleged that the company breached its fiduciary duty by failing to contain administrative and recordkeeping costs for the company’s 401(k) plan and act in the plan participants’ best interests, costing them millions. The terms of the Read More

The Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) has announced a settlement with a business associate that provides wellness plans to various clients nationwide. OCR had been investigating the business associate for violating HIPAA’s security rule after filing four breach reports within three months stating that electronic protected health information (ePHI) was Read More

A federal district court judge found that portions of a Tennessee law regulating pharmacy benefit managers (PBMs) conflict with the Employment Retirement Income Security Act (ERISA). Therefore, the court ruled that Tennessee is permanently barred from enforcing those portions of the law against McKee Foods Corporation or other benefits plans governed by ERISA. The case is McKee Foods Corporation v. BFP Inc., Case Read More