The recent rise in state law regulation of pharmacy benefit managers (PBMs) and prescription drug pricing continues to test the limits of preemption under the Employee Retirement Income Security Act of 1974, as amended (ERISA).
Continue Reading ERISA Preemption – Alive and WellReminder: Group Health Plans Should Update HIPAA Notice of Privacy Practices by February 16
Many people see the start of a new year as a time to refresh and renew themselves. For covered entities under HIPAA, which include group health plans, it’s also time to refresh and renew your HIPAA Notice of Privacy Practices (Privacy Notice) to address the changes made to the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations at 42 CFR part 2 (Part 2). The deadline for updating Privacy Notices to reflect these amendments is February 16, 2026.
Continue Reading Reminder: Group Health Plans Should Update HIPAA Notice of Privacy Practices by February 16What Trump’s Deal on GLP-1 Costs Could Mean for Employers
The high cost of GLP-1 weight loss drugs has significantly affected employer prescription drug spending over the past year, leading many organizations to limit or even eliminate coverage. These unexpected costs have created challenges for employers balancing plan affordability with employee access.
Continue Reading What Trump’s Deal on GLP-1 Costs Could Mean for EmployersNavigating the Evolving Landscape of State PBM Laws
The legal landscape for pharmacy benefit managers (PBMs) continues to shift as states pass new laws and courts weigh in on how those laws interact with federal ERISA requirements. These developments are creating new challenges for self-funded health plans trying to stay compliant.
Continue Reading Navigating the Evolving Landscape of State PBM Laws2025 ERISA Welfare Plan Automatic Participant Disclosures Checklist
We recognize that many companies sponsor ERISA welfare benefit plans and will soon be undergoing their open enrollment process and issuing related participant communications. To assist with that process, we have prepared an Automatic Participant Disclosures Checklist for use during open enrollment and throughout the plan year. Note that some of these disclosures may be delivered electronically under certain circumstances.
Continue Reading 2025 ERISA Welfare Plan Automatic Participant Disclosures ChecklistReminder – Annual Deadline (July 31) to Report and Pay PCORI Fee is Approaching
The annual filing (and fee payment) for applicable self-insured health plans and specified health insurance policies used to fund the Patient-Centered Outcomes Research Institute (PCORI fee) is due by Thursday, July 31, 2025. Internal Revenue Service (IRS) Form 720, Quarterly Federal Excise Tax Return, is used to report and pay (in Part II, IRS No. 133, on page 2) the annual PCORI fee.
Continue Reading Reminder – Annual Deadline (July 31) to Report and Pay PCORI Fee is ApproachingStuck in the Middle: Self-Funded Health Plans and Recent Challenges to State PBM Laws
In recent years, prescription drug prices have been top-of-mind for state legislators, who have responded by passing laws that seek to control that pricing in a variety of ways, including by regulating pharmacy benefit managers (PBMs).
Continue Reading Stuck in the Middle: Self-Funded Health Plans and Recent Challenges to State PBM LawsIRS Guidance Regarding ACA Employer Information Reporting Requirements
As announced in our previous HR Law Talk blog post, the Paperwork Burden Reduction Act (PBRA) made important changes to employers’ responsibilities to furnish information to employees under the Affordable Care Act (ACA). As part of the changes, employers may now provide “clear, conspicuous, and accessible” notice that individuals may request their Form 1095-B or 1095-C and distribute a Form 1095 only to individuals who request a copy, rather than furnish a Form 1095 annually to each covered individual. Recently, the Internal Revenue Service (IRS) released additional guidance for employers, with more details about satisfying the notice requirement.
Continue Reading IRS Guidance Regarding ACA Employer Information Reporting RequirementsUpdated Voluntary Fiduciary Correction Program for ERISA Plans Includes Self-Correction Features
As announced in our previous HR Law Talk blog post, on January 15, the U.S. Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA) published a much anticipated amended and restated version of the Voluntary Fiduciary Correction Program (VFCP) in the Federal Register, which now includes two self-correction features. The VFCP, initially adopted in 2002 and last amended in 2006, allows ERISA plan administrators, plan sponsors, and other plan officials to correct certain fiduciary breaches and receive relief from potential DOL civil enforcement actions.
Continue Reading Updated Voluntary Fiduciary Correction Program for ERISA Plans Includes Self-Correction Features2025 Changes to ACA Employer Information Reporting Obligations and the Employer Shared Responsibility Penalties
In December 2024, Congress and President Biden passed two laws—the Paperwork Burden Reduction Act (PBRA) and the Employer Reporting Improvement Act (ERIA)—that made important changes to employers’ responsibilities regarding furnishing information to employees under the Affordable Care Act (ACA) information reporting provisions as well as the response deadlines and the statute of limitations for the employer shared responsibility penalty assessments.
Continue Reading 2025 Changes to ACA Employer Information Reporting Obligations and the Employer Shared Responsibility Penalties