The Weekly Highlights for Benefits Professionals
BenefitsWire
Health & Welfare Plans
Week of July 3, 2026
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12 items · ~4 min read
In this issue
Regulatory Action and Guidance (8) · Health & Welfare Plans (3) · Litigation (1)
Regulatory Action and Guidance
8 items“The 2026 ACA affordability safe harbor increased to 9.96% (up from 9.02%), giving employers more flexibility in employee premium contributions, but ACA employer shared responsibility penalties saw their largest single-year increase in history (15%), reaching up to $3,340 per employee for failure to offer coverage and up to $5,010 per employee for an unaffordable offer.” MORE >>
Source: Hub International
“Forgot Your Password? If you do not yet have an ERIC Online profile or user name and password, please create one using Create Profile Form. If you need assistance with your user name/password or profile, please contact ERIC at (202) 789-1400.” MORE >>
Source: ERIC
“The new federal PBM reforms are effective for plan years beginning on or after 30 months from the date of the CAA 2026's enactment. For calendar plan years, the effective date is January 1, 2029. ... All contractual arrangements with PBMs entered into by employer-sponsored group health plans and health insurance carriers are prohibited from limiting or delaying the disclosure of certain types of information to the plan. ... PBMs that serve self-insured plans sponsored by a "specified large employer" or that qualify as a "specified large plan" are subject to the most extensive reporting requirements. ... A "specified large employer" is defined as having averaged at least 100 employees on busi” MORE >>
Source: Newfront
“Maximum annual HSA contributions will rise from $4,400 to $4,500 for those with self-only insurance coverage, and from $8,750 to $9,000 for those with family coverage. Minimum deductible amounts for qualifying high deductible health plans will increase from $1,700 for self-only coverage to $1,750, and from $3,400 to $3,500 for a family plan. Maximum out-of-pocket amounts under self-only coverage will rise from $8,500 to $8,700, and from $17,000 to $17,400 for family coverage.” MORE >>
Source: Ascensus
“Virginia is the first state since 2023 to enact a law (2026 Chs. 981/1093, SB 2/HB 1207) establishing a mandatory paid family and medical leave (PFML) insurance program. By October 1, 2027 (and annually thereafter), the Virginia Employment Commission (VEC) will set the contribution rate, based on wages and capped at the Social Security taxable wage base (SS Max). Contributions — evenly split between employers and employees, with an exception for certain small employers — will start on April 1, 2028. Benefits will first become available on December 1, 2028.” MORE >>
Source: Mercer
“In accordance with the Paperwork Reduction Act of 1995, the IRS is inviting comments on the information collection request outlined in this notice.” MORE >>
Source: IRS
“The Supreme Court held 6-3 that Congress may not restrict the President's power to remove members of so-called independent executive agencies, overruling Humphrey's Executor v. United States. ... The FTC Act's removal restrictions violate the separation of powers and Humphrey's Executor is overruled.” MORE >>
Source: Gibson Dunn
“Electronic Delivery of Information Under the Federal Securities Laws was submitted this week to the Office of Information and Regulatory Affairs, the final stop in the federal rulemaking process before publication. ... A provision in the SECURE 2.0 Act of 2022, for example, requires retirement plans to provide at least one paper benefit statement per year for defined contribution plans and one every three years for defined benefit plans, starting with plan years that begin on or after January 1, 2026. ... The Department of Labor proposed a rule earlier this year that would require the annual paper statement, but in response to industry concerns, the department vowed not to take enforcement a” MORE >>
Source: PLANSPONSOR
Health & Welfare Plans
3 items“On June 25, 2026, the Supreme Court of the United States decided Monsanto v. Durnell, No.” MORE >>
Source: Faegre Drinker
“Articles + Publications June 29, 2026 Ryan Last Edward M. Nogay Michael S. Lowe Ethan G.” MORE >>
Source: Troutman Pepper Locke
“The new law's notice requirement, going into effect in late 2028 for all size employers regardless of ERISA status, imposes a $10,000 per day penalty for failing to provide the required notice. ... For changes to ERISA plans, fiduciaries have an obligation to review compensation and contracts for reasonableness to avoid engaging in a prohibited transaction. ... this is the largest penalty seen thus far for failing to provide a specific notice.” MORE >>
Source: Nava Benefits
Litigation
1 item[ERISA Litigation]
Third Circuit Holds ERISA Preempts Out-of-Network Physician’s Defamation Claim Over Statements in Explanation of Benefits Forms“In Ahn v. Cigna Health and Life Insurance Company, No. 25-1723, — F.4th —-, 2026 WL 1813215 (3d Cir. June 24, 2026), in a matter of first impression, the Third Circuit held that ERISA Section 514(a) preempts a healthcare provider's state-law defamation claim based on allegedly false statements in explanation of benefits (EOB) forms that an insurer sent to plan beneficiaries. ... The court held that preemption applied for a second, independent reason. Plaintiff's claim interfered with nationally uniform plan administration because subjecting EOB forms to the defamation law of every state in which participants reside or seek services would force administrators to master the laws of 50 states, ” MORE >>
Source: Roberts Disability Law