The Daily Brief for Benefits Professionals
BenefitsWire
Health & Welfare Plans
July 8, 2026
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10 items · ~3 min read
In this issue
Health & Welfare Plans (5) · Litigation (2) · Regulatory Action and Guidance (1) · General Benefits (2)
Health & Welfare Plans
5 items“Despite repeated warnings from the US Departments of Labor, Health and Human Services, and the Treasury (collectively, the departments) that they prioritize mental health parity compliance, employer health plans continue to not fully comply, as reported in the departments’ 2025 MHPAEA Report to Congress, issued on February 20, 2026....” MORE >>
Source: JD Supra
“ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027. Across the 77 ACA Marketplace insurers in the 16 states and DC that have submitted rate filings so far, most are requesting premium increases of between 10% and 20% for 2027, with 20 insurers requesting premium increases of more than 20%.” MORE >>
Source: KFF
[Regulatory Action and Guidance]
Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate“Prior authorization practices by health insurers have come under scrutiny in recent years, in part spurred by the public sentiment that delays and denials of care are a problem.” MORE >>
Source: KFF
[General Benefits]
AdaptHealth discloses patient data was stolen in cyberattack“A threat actor gained unauthorized access to company systems through a social engineering attack and exfiltrated data, including certain personally identifiable information, protected health information of patients and stored password files associated with insurance billing, according to a July 2 filing with the Securities and Exchange Commission. Based on information obtained to date, AdaptHealth believes that the threat actor gained unauthorized access to certain cloud-based business applications, including internal patient management systems and document storage platforms. The company also confirmed that certain external electronic health record system portals were accessed.” MORE >>
Source: Healthcare Dive
“As questions continue surrounding the coverage of popular glucagon-like peptide-1 (GLP-1) drugs, benefit providers are faced with managing costs while considering the overall health of their plan participants.” MORE >>
Source: Word on Benefits
Litigation
2 items"In Smith v. Unum Life Insurance Company of America, No. 1:21-CV-294-KAC-CHS, 2026 WL 1949312 (E.D. Tenn. July 6, 2026), the United States District Court for the Eastern District of Tennessee upheld the termination of long-term disability benefits under an ERISA-governed group policy, holding that Unum Life Insurance Company of America and Unum Group did not abuse their discretion." MORE >>
Source: Roberts Disability Law
[Health & Welfare Plans]
DOL Continues to Back Plan Sponsors in ERISA Forfeiture Litigation: Three Amicus Briefs Filed in Circuit Court Appeals“The Employee Retirement Income Security Act of 1974 (ERISA) forfeiture litigation landscape continues to evolve as courts continue to weigh in on the viability of this novel theory of ERISA liability.” MORE >>
Source: Holland & Knight
Regulatory Action and Guidance
1 item[General Benefits]
Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) PoliciesCMS issued a proposed rule updating Medicare home health payment rates for calendar year 2027, including recalibration of case-mix weights, LUPA thresholds, and comorbidity subgroups, while also proposing changes to the Home Health Quality Reporting Program, DMEPOS enrollment requirements, and DME benefit expansion for infusion pumps—relevant to self-funded plans coordinating Medicare benefits. MORE >>
Source: CMS
General Benefits
2 items“The modern workplace is changing faster than most benefits strategies can keep up. Employees are overwhelmed by information, HR teams are stretched thin and employers are under increasing pressure to maximize the return on every dollar spent on benefits.” MORE >>
Source: Employee Benefit News
“Those covered by Rhode Island Secure Choice, the program that provides retirement plan coverage to employees of private-sector employers that do not offer it to their employees, now includes self-employed people age 18 or older. ... The new law that allows self-employed people to participate in Rhode Island Secure Choice does not repeal the five-employee threshold, nor amend the threshold to do so. Therefore, private-sector employers in Rhode Island with one to four employees are not required to regist” MORE >>
Source: American Retirement Association