Challenge to Use of Automated Algorithm in Benefit Decisions Allowed to Proceed
Kisting-Leung v. Cigna Corp., 2025 WL 958389 (E.D. Cal. 2025) A group of participants in different employer-sponsored health plans brought …
Court Dismisses PBM Expenses Lawsuit, but Expresses Sympathy for Participants
Navarro v. Wells Fargo, 2025 WL 897717 (D. Minn. 2025) Available at https://www.govinfo.gov/content/pkg/USCOURTS-mnd-0_24-cv-03043/pdf/USCOURTS-mnd-0_24-cv-03043-0.pdf A group of former participants in a …
What Health Coverage Must Be Offered to Avoid or Minimize Employer Shared Responsibility Penalty Exposure?
QUESTION: We are an employer subject to Code § 4980H. In order to avoid employer shared responsibility penalties, what health …
Who Must Receive SPDs for ERISA Health and Welfare Plans?
QUESTION: We are reviewing the SPD procedures for our ERISA health and welfare plans and need some guidance. Who must …
ERISA Ruling Highlights Importance of Detailed Denial Notices
Doe v. Deloitte LLP Grp. Ins. Plan, 2025 WL 586670 (S.D.N.Y. 2025) A participant in an employer sponsored health plan …
What Self-Correction Options Are Available for 401(k) Plan Fiduciary Mistakes?
QUESTION: We understand that the DOL has added a self-correction component under the Voluntary Fiduciary Correction (VFC) Program. What errors …
IRS Provides Guidance on Alternative Manner of ACA Reporting
Notice 2025-15 The IRS has released Notice 2025-15, which provides guidance on the Paperwork Burden Reduction Act provisions on how …
Can Employees Change Health FSA Elections Midyear If They Are Prevented From Receiving Medical Care That They Anticipated When Elections Were Made?
QUESTION: I administer our company’s health FSA, and employees often ask me if they can reduce their contributions because something …
May We Terminate COBRA Coverage If a Qualified Beneficiary Pays Less Than the Full Premium Amount?
QUESTION: Once a timely COBRA election and initial premium payment have been made, our employer-sponsored group health plan automatically terminates …
Can Our DCAP Reimburse Application Fees, Deposits, and Similar Expenses?
QUESTION: A DCAP participant has asked to be reimbursed for an application fee paid to a day-care center. Can our …