The Daily Brief for Benefits Professionals
BenefitsWire
Health & Welfare Plans
July 15, 2026
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9 items · ~3 min read
In this issue
Regulatory Action and Guidance (1) · Health & Welfare Plans (4) · Litigation (3) · General Benefits (1)
Regulatory Action and Guidance
1 item“On June 2, 2026, The Department of Health and Human Services (HHS) issued its Notice of Vacatur Regarding Certain Provisions of the 2024 Nondiscrimination in Health Programs and Activities Final Rule indicating that, in accordance with the court's order, the vacated provisions are legally void and that all other provisions of the Section 1557 Rule remain in force. ... On May 15, 2026, the Department of Labor (DOL) Wage and Hour Division (WHD) issued a technical amendment restoring the standards in place in 2024. ... The standard salary level required to qualify for the executive, administrative, and professional (EAP) overtime exemption continues to be $684 per week, or $35,568 annually. The” MORE >>
Source: cbiz.com
Health & Welfare Plans
4 items“The slides also address voluntary paid leave programs and contain a 2026 contribution and maximum benefit table. The GRIST and slide deck have been updated for 2026.” MORE >>
Source: Mercer
“Across 39 Georgia hospitals with comparable commercial rates, the all-inclusive facility rate ranges from under $9,000 to nearly $44,000. Same procedure, same state, same clinical intervention, but a five-fold difference. ... For a self-insured employer with 200 employees, three to five C-sections per year at the expensive end of the distribution instead of the median can mean $60,000 to $100,000 in excess facility costs for just one procedure.” MORE >>
Source: Employee Benefit News
“But a recent analysis of a large employer with a centralized 9-5 workforce showed that as much as 91% of backup childcare usage involved out-of-network providers, according to Upwards, a national care benefits platform. ... When that happens, he explained, vendors charge employers a "half credit" (about $175 to $200) but only pass $100 to the employee. They keep $75 to $100 for processing a receipt, which amounts to a whopping 75% to 100% fee on a $100 employee benefit.” MORE >>
Source: Employee Benefit News
[Regulatory Action and Guidance]
Model State ICHRA Tax Credit Bill Emerges“The National Council of Insurance Legislators (NCOIL) has created a model bill for states to offer state income tax credits to employers sponsoring individual coverage health reimbursement arrangements (ICHRA).” MORE >>
Source: Hall Benefits Law
Litigation
3 items“The Court held that a plaintiff seeking to recover benefits under Section 502(a)(1)(B) must identify the specific plan provisions that allegedly entitle him to the benefits sought and explain how the administrator's decision contravened that language. ... A Section 502(a)(1)(B) claim may be maintained only against the plan or an entity that exercises control over the administration of benefits, and fiduciary liability attaches to a claims administrator only where it exercises more discretion and control than a mere claims processor.” MORE >>
Source: Roberts Disability Law
“The plaintiffs in the J&J case principally allege that the company breached its fiduciary duty by mismanaging the health plan's prescription drug benefit program, costing their ERISA plans and their employees millions of dollars in the form of higher payments for prescription drugs, higher premiums, higher deductibles, higher coinsurance, higher copays, and lower wages or limited wage growth. The complaint argues that J&J breached its fiduciary duty by failing to engage in a prudent and reasoned decision-making process that would have drastically lowered the cost of prescription drugs in general and generic-specialty drugs in particular, and would have resulted in other cost savings for the ” MORE >>
Source: newfront.com
[Health & Welfare Plans]
CVS Caremark reaches settlement with FTC over insulin suit“The deal prevents the drug middleman from discriminating against cheaper drugs in its standard formularies for commercial clients, and requires it to provide a standard offering to plan sponsors that doesn't include rebates. It requires Caremark to include any purchases a patient makes through TrumpRx, President Donald Trump's online drug marketplace, towards the deductible in certain health plans, once regulatory changes make that possible. ... the FTC estimates the settlement will save consumers up to $8.5 billion over the next decade, and another $4.5 billion from passing through rebates at the point of sale alone.” MORE >>
Source: Healthcare Dive
General Benefits
1 item“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.” MORE >>
Source: KFF