Insights

The short answer is probably not. Employers often cannot automatically cancel medical benefits just because the employee changes to a part-time position. The long answer, which we will explore, depends on factors such as employer size, the measurement method being used, and employee tenure. Employer Size As a refresher, the ACA’s employer mandate applies to employers with 50 or more employees (including part-time employees or full-time equivalent employees) in the previous calendar year. If the

On March 9, 2026, in Stern v. JPMorgan Chase & Co., a New York federal district court allowed an ERISA class action to proceed in part, finding participants plausibly alleged prohibited transactions arising from JPMorgan’s PBM contracting and related payments. As a result, the case will move forward to the next phase, which means increased costs for JP Morgan as litigation, and potentially discovery, proceed. The decision highlights increased litigation risk for plan sponsors around PBM sel

On March 6, 2026, in Navarro v. Wells Fargo & Co., a Minnesota district court dismissed an ERISA fiduciary breach case filed against defendant Wells Fargo for allegedly mismanaging its group prescription drug benefits. The court found that the plaintiffs had, once again, failed to show they had suffered a concrete injury caused by the defendant’s actions to establish the legal “standing” necessary to proceed with the case. Background The Wells Fargo case is one of several recent high-profil

On February 23, 2026, the Congressional Research Service (CRS) released a report on trends in HSA usage. The report presented key findings on HSA utilization, enrollment, and contributions based on recent data and surveys. HSAs were established as a tax-advantaged financial instrument that allows individuals to accumulate and utilize funds for unreimbursed medical expenses, such as deductibles, copayments, coinsurance, and services not covered by insurance. Eligibility for HSA contributions is

From regulatory actions to market innovations in the pharmacy benefits landscape, here’s a recap of key events from late 2025 and their implications for the year ahead.

Medical and pharmacy cost containment leads 2026 benefits trends as rising GLP-1 demand reshapes talent expectations. Employers are leveraging data, third-party solutions and AI governance to manage costs, improve communication, close benefits gaps.

On February 3, 2026, the president signed into law the Consolidated Appropriations Act, 2026 (CAA 2026), which includes significant pharmacy benefit manager (PBM) reforms that will impact all group health plans.  

On January 30, 2026, the Employee Benefits Security Administration (EBSA), the DOL agency responsible for enforcement of ERISA, reported monetary recoveries totaling over $1.4 billion in its report on enforcement activities for fiscal year (FY) 2025. The EBSA oversees approximately 2.8 million health plans, as well as welfare benefit plans and private pension plans. These ERISA-covered plans cover over 150 million workers, retirees, and dependents who participate in private-sector pension and w

Likely no. Employer STD policies are typically not sufficient to meet state PFML requirements. While STD policies are designed to provide income replacement for an employee’s own serious health condition, PFML programs provide income replacement for a much broader scope of leave reasons. Additionally, PFML program requirements are state-specific, and a basic STD plan typically will not satisfy each state’s unique requirements.   Statutory PFML programs generally apply to an employee who wo