Insights

This month’s focus is on three key areas to strengthen your business: enhancing cyber security, supporting employees through menopause, and refining recruitment strategy.

Health and welfare plans subject to ERISA's Form 5500 reporting requirements (generally, plans with 100 or more participants) must report certain information to the DOL. For plans with fully insured coverage, this reporting obligation includes specific information about each insurance policy using the form's Schedule A (Insurance Information). Insurers are statutorily required to provide Schedule A information to plans. Although most insurers generally do so, issues arise that sometimes result

This article includes our new "NFP Observations" format, which combines compliance information with commentary and practical insights from our Benefits Compliance team. The Mental Health Parity and Addiction Equity Act (MHPAEA) aims to ensure equitable coverage for mental health and substance use disorder benefits. However, recent developments have cast a shadow of uncertainty over its rules and enforcement. The Trump administration has announced plans to reexamine and potentially roll back reg

On April 10, 2025, Faulk Co. vs. Becerra, a federal court in the Northern District of Texas Fort Worth Division granted the plaintiff’s motion for summary judgment after determining that the IRS lacked the authority to impose penalties on the plaintiff for failing to offer its employees coverage as required under the ACA. The plaintiff stopped offering minimum essential health insurance coverage to its employees in 2019. The ACA requires employers with 50 or more employees to offer that coverag

On April 15, 2025, President Trump signed an executive order titled “Lowering Drug Prices by Once Again Putting Americans First.” As outlined in the accompanying fact sheet, the new executive order expands upon numerous initiatives introduced during the first Trump administration and calls for improved disclosure of PBM compensation to group health plans. It follows a February executive order focused on healthcare transparency requirements, which we covered in our March 4, 2025, article. Overvi

On March 31, 2025, a U.S. District Court for the Eastern District of California allowed a class action to proceed over the use of an insurer’s automated, AI-based algorithm called PxDx. In 2023, Cigna Corporation and Cigna Health and Life Insurance Company (Cigna) were sued in U.S. District Court following the release of a ProPublica report that they relied on PxDx algorithms to reject plan participant claims without review by Cigna doctors. The case cited reporting by ProPublica that PxDx deni

The current focus on ERISA health and welfare plan fiduciary obligations is likely here to stay.

In this quarter's The WellCents^® Show, the hosts explore key financial topics, including alternative investments such as gold, silver, and cryptocurrencies.

On March 24, 2025, in Navarro v. Wells Fargo & Co., a federal court in the District of Minnesota dismissed a case alleging that an employer failed to meet its fiduciary duty to its group health plan when it mismanaged the plan’s prescription drug benefit. The plaintiffs were former employees of the defendant employer, which sponsors and administers the health plan the plaintiffs participated in. The plaintiffs alleged that the defendant violated the fiduciary duties imposed upon it by ERISA