The U.S. Department of Labor (DOL), U.S. Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) have issued FAQs About Consolidated Appropriations Act, 2021 Implementation Part 69. The FAQs provide guidance on the calculation of the qualifying payment amount (QPA) used in the independent dispute resolution (IDR) process under the No Surprises Act. The FAQs also extended enforcement Read More

Employers are facing multiple challenges this year in providing competitive and quality health care benefits for employees. Skyrocketing costs, increased fiduciary risk, and a constantly evolving legal and political landscape all are impacting the ability of employers to effectively provide healthcare benefits. Nonetheless, employers appear dedicated to continuing to provide these benefits, with an estimated 43% Read More

The U.S. Department of Treasury and the Internal Revenue Service (IRS) has proposed regulations concerning SECURE Act 2.0 changes to retirement plan catch-up contributions. The changes include increased catch-up contributions for plan participants between ages 60 and 63 and mandatory Roth tax treatment for catch-up contributions made by certain 401(k) plan participants. Increased Catch-Up Contributions for Certain Read More

The Health Resources and Service Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) approved updated preventive services guidelines for women on December 20, 2024. Under the Affordable Care Act (ACA), group health plans and insurers, with the exception of non-grandfathered plans[1], must cover certain preventive health services without cost-sharing. The updated HRSA guidelines apply to Read More

In December 2024, the unlikely pairing of Sen. Elizabeth Warren, D-Mass. and Sen. Josh Hawley, R-Mo. introduced a bipartisan bill entitled the Patients Before Monopolies Act. Reps. Diana Harshbarger, R-Tenn, and Jake Auchincloss, D-Mass., introduced the same bill in the House. However, the bill died at the close of the final session for Congress on January 3, 2025. With the change in administration, it is unclear Read More

The Federal Trade Commission (FTC) recently issued a second interim report concerning the mark-ups on high-cost generic specialty drugs sold at pharmacies owned by the three largest pharmacy benefit managers (PBMs). This report follows a July 2024 report in which the FTC found that the biggest PBMs paid higher drug prices to their pharmacies than other pharmacies. The PBMs at issue include Cigna’s Express Scripts Read More

The U.S. Supreme Court has rejected the petition for certiorari filed by Tenneco, an auto parts manufacturer, and its subsidiary, Driv Automotive, Inc., seeking to enforce an arbitration provision in its ERISA-governed retirement plan. Tenneco sought a resolution of the ongoing split in the circuit courts of appeal about the enforceability of arbitration provisions in ERISA-covered plans. The continuing split has Read More

Excessive fee class action litigation under the Employee Retirement Income Security Act (ERISA) has dramatically increased by 35% in 2024, along with other ERISA class action cases. This surge has been particularly heavy in the last half of the year, likely relying on record-high settlements favoring plaintiffs in the past three consecutive years. While major legacy cases have reached settlement, plaintiff law firms Read More

Investment monolith BlackRock has officially withdrawn from the Net Zero Asset Managers Initiative, a coalition of corporations pledging to reach zero-carbon emissions by 2050. BlackRock joins Morgan Stanley, Bank of America, JP Morgan Chase, and others in abandoning the climate coalition, which was once a concerted effort by corporations to adopt energy conservation efforts and sustainable investing. The Read More

The ERISA Industry Committee, Cigna, and the National Labor Alliance of Health Care Coalitions recently sued the state of Minnesota over its new PBM regulation law. In their suit, the plaintiffs allege that the state law violates the Employee Retirement Income Security Act (ERISA), which preempts state regulation of employee benefit plans. They also claim the law violates the U.S. Constitution. The Minnesota PBM Read More