Insights

In short, yes. Self-insured plans have compliance obligations in addition to what is required for fully insured plans. As a reminder, a level-funded plan is considered a self-insured plan for benefits compliance purposes. Therefore, a plan transitioning from a fully insured plan to a self-insured or level-funded plan should be aware of the additional compliance obligations, including (but not limited to) requirements under the ACA, HIPAA, ERISA, Section 105 nondiscrimination rules, and federal

On March 31, 2025, in McKee Foods Corporation v. BFP, Inc., the U.S. District Court for the Eastern District of Tennessee ruled that ERISA preempts key provisions of Tennessee laws that require employers to include “any willing pharmacy” in their group benefit plan networks. The court’s ruling is a positive development for sponsors of self-insured ERISA plans. Background ERISA, as federal law, generally preempts (i.e., supersedes) conflicting state laws that regulate employer-sponsored employe

Our experts explore the key factors driving the construction productivity gap and share actionable strategies to improve efficiency, mitigate risk and drive growth.

This article includes our new "NFP Observations" format, which combines compliance information with commentary and practical insights from our Benefits Compliance team. Telehealth benefits experienced a rapid surge in utilization during the COVID-19 pandemic. Even now, almost two years after the national public health emergency was declared over, telehealth benefits remain a popular component of many group health plans. According to the Kaiser Family Foundation’s 2023 Employer Health Benefits S

To be clear, maternity leave is provided only to birth parents to attend prenatal care, for pregnancy-related disability and to recover from childbirth (e.g., severe morning sickness or complications requiring bed rest). If an employer sponsors short-term disability (STD) benefits, the STD policy generally covers pregnancy-related disability, though coverage and eligibility vary based on the specific policy. In contrast, parental leave (aka bonding leave) is for any parent to take time off to b

On February 4, 2025, a federal court in the Middle District of Florida Tampa Division denied a defendant’s motion to dismiss a case alleging that the defendant issued a deficient COBRA election notice.  The plaintiff is a former employee of the defendant's employer, which sponsors and administers the health plan the plaintiff participated in. The defendant terminated the plaintiff’s employment, but not for gross misconduct. The defendant is subject to federal COBRA, and the plaintiff’s ter

The Council of Insurance Agents & Brokers (CIAB) and the American Benefits Council (ABC) recently released a study by Ernst & Young (E&Y), which examined the impact of the tax exclusion on employer-provided health insurance. The study reviewed the effects of limiting the income and payroll tax exclusion for employment-based health insurance to the 75th percentile of premiums, effective January 2026. The study was based on a model similar to those used by the Congressional Budget Off

On March 10, 2025, in Lewandowski v. Johnson & Johnson, et al., the original plaintiff, Ann Lewandowski, amended her ERISA fiduciary breach complaint and added another plaintiff, Robert Gregory, to the putative class action lawsuit. The amended complaint attempts to address deficiencies in the plaintiff’s prior claims, which were previously dismissed by a New Jersey district court due to lack of legal standing. The Background As reported in our March 12, 2024, article, the lawsuit alleges t

Modern employee development must go beyond basic training to foster a culture of sustained growth and learning.