Employer-sponsored group health plans are facing a growing wave of ERISA class action lawsuits, and the claims are getting bolder, including claims of “financial dominance”. In our previous post on this topic, we analyzed Barbich et al. v. Northwestern University et al., No. 1:25-cv-06849 (N.D. Ill.), which introduced a novel “financial dominance” theory
On April 23, 2026, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced settlements with four health entities following investigations into ransomware breaches that exposed unsecured electronic protected health information (“ePHI”). While ransomware enforcement actions are not new, one of the four settlements stands out as a landmark: for
Artificial intelligence (“AI”) tools are increasingly being deployed across the employee benefits landscape: from claims administration and customer service to investment analysis and participant engagement. While these technologies promise efficiency and cost savings, recent litigation and regulatory activity underscore that the use of AI in benefits administration carries meaningful legal and fiduciary risk. Below we
The Departments of Health and Human Services, Labor, and the Treasury (Departments) recently released the Federal Independent Dispute Resolution (IDR) public use files (PUF) and supplemental tables for the third and fourth quarters of 2025, and the numbers should get the attention of every plan sponsor and fiduciary overseeing a self-insured group health plan. The
In less than three months, two federal courts of appeals have held that ERISA’s actuarial-equivalence requirement mandates reasonable actuarial assumptions, rather than assumptions that simply produce mathematically equivalent optional forms of benefits to the default form of payment. In Reichert v. Kellogg Co., decided March 16, 2026, the Sixth Circuit reversed dismissals of actions
DOL’s guidance gives employers room to fund or facilitate Trump Account contributions without creating an ERISA plan.
When Congress created Trump accounts under the One Big Beautiful Bill Act, one of the questions employers quickly focused on is whether providing employees with a plan under which contributions may be made to Trump accounts would constitute
The Departments of Health and Human Services, Labor, and the Treasury, as well as the Office of Personnel Management (Departments) recently finalized the Independent Dispute Resolution (IDR) Operations rule under the No Surprises Act (NSA). Although many self-funded group health plan fiduciaries won’t have to deal directly with the operational changes to the federal IDR
On May 21, 2026, the Supreme Court handed down a unanimous opinion in M & K Employee Solutions v. Trustees of the IAM National Pension Fund, and if you’re an employer who’s ever thought about walking away from an underfunded multiemployer pension plan, you should be paying attention.
The question was deceptively simple: when
A recent excellent New York Times article explains how a change in law first effective in 2022 has quickly come to be used by out-of-network providers to obtain significant overpayments for routine medical procedures. Not stated in the article is the impact on self-funded group health plans and the sponsors of those plans. Specifically, the
The Departments of Labor, Health and Human Services, and the Treasury (the “Departments”) recently released their 2025 Report to Congress on enforcement activity under the Mental Health Parity and Addiction Equity Act (“MHPAEA”).
MHPAEA is a federal law that generally requires group health plans and health insurance issuers that provide mental health or substance