The Daily Brief for Benefits Professionals
BenefitsWire
Health & Welfare Plans
July 16, 2026
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8 items · ~3 min read
Top of the Brief
Fertility benefits: Market landscape and employer considerations“Employers continue to view fertility coverage as a strategic benefit for attraction and retention, supporting diverse paths to parenthood. This includes employees facing medical or age-related barriers, those pursuing assisted reproduction, and single individuals or couples building families through various means. Meanwhile, decisions to expand this benefit are increasingly shaped by cost pressures and evolving market conditions, including broader state fertility coverage mandates in 2026 and continued growth in the assisted reproductive technology market.”
In this issue
Regulatory Action and Guidance (3) · Health & Welfare Plans (2) · Litigation (1) · General Benefits (2)
Regulatory Action and Guidance
3 items“Employers must designate and clearly communicate the accrual year to each employee. If no accrual year is defined, it defaults to the calendar year. Any changes to the accrual year must be: Hours Worked and Eligibility Eligibility: An employee is eligible for ESST based on a “good faith” determinationof whether an employee is anticipated to perform work for at least eighty hours per year in Minnesota. “Good faith” means the employer, at a minimum, evaluated the employee’s anticipated work schedule and location of hours in a way that is not knowingly false or in reckless disregard of the truth.” MORE >>
Source: Ogletree Deakins
"The Federal Trade Commission (FTC) continues its effort to reach settlements with the “Big Three” pharmacy benefit manager (PBM) groups over allegations of insulin price fixing, announcing Tuesday that it has finalized an agreement with CVS Health’s Caremark that will force the company to make changes to its business operations." MORE >>
Source: healthexec.com
The FDA is holding a public hearing to gather feedback on issues related to the potential future therapeutic use of psychedelic drugs in supervised settings. This follows increased interest in their therapeutic potential. MORE >>
Source: FDA
Health & Welfare Plans
2 items“Employers continue to view fertility coverage as a strategic benefit for attraction and retention, supporting diverse paths to parenthood. This includes employees facing medical or age-related barriers, those pursuing assisted reproduction, and single individuals or couples building families through various means. Meanwhile, decisions to expand this benefit are increasingly shaped by cost pressures and evolving market conditions, including broader state fertility coverage mandates in 2026 and continued growth in the assisted reproductive technology market.” MORE >>
Source: Milliman
“According to Pareto's 2026 State of Healthcare Spend report, 79% of small and midsize businesses (SMBs) reported double-digit healthcare spending increases in the past year, including one in five that saw costs rise by 30% or more. That's pushing many employers to move beyond annual renewal discussions and reevaluate how they pay for healthcare expenses, manage risks, and control long-term costs, said Dena Bravata, Pareto's clinical advisor. "Many of those employers are now — for the first time — investigating changing from being fully insured to self-insurance, and with that comes the need for those employers to have benefit brokers who can guide them through that transition," Bravata said.” MORE >>
Source: Employee Benefit News
Litigation
1 item“In Advanced Gynecology & Laparoscopy of North Jersey P.C. v. Cigna Health & Life Insurance Co., No. 24-2212, 2026 WL 2030368 (3d Cir. July 13, 2026), nearly two dozen New Jersey healthcare practices, providing out-of-network services to Cigna subscribers who had assigned their plan benefits, alleged that Cigna systematically underpaid them for thousands of elective and emergency claims in violation of the terms of Cigna’s ERISA plans. The District Court for the District of New Jersey dismissed the third amended complaint with prejudice, and the practices appealed the dismissal of their ERISA benefit-recovery, ERISA fiduciary-duty, and RICO claims, as well as the earlier dismissal with prejud” MORE >>
Source: Roberts Disability Law
General Benefits
2 items“The answer: the brand must plausibly allege that the generic drug manufacturer actively encouraged infringement. As described in our prior articles on induced infringement and skinny labeling, the core issue has revolved around what pleadings are necessary to plausibly allege induced infringement in the context of a carve-out prescribed by 21 U.S.C. 355(j)(2)(A)(viii) (“skinny label” or Section viii carve-out) in order to survive a motion to dismiss. “Skinny labeling” is a mechanism that allows generic manufacturers to remove or “carve out” patented indications from their labels, such that the generic company does not need to make a Paragraph IV certification as to patents on the carved-out ” MORE >>
Source: Troutman Pepper Locke
[Regulatory Action and Guidance]
Democrats Ask DOL to Ditch Proposed Independent Contractor Rule in Favor of 2024 Standard“Democratic members of the House Labor Caucus have asked the U.S. Department of Labor (DOL) to rescind its proposed independent contractor rule and return to the stronger 2024 standard established during the Biden administration. The DOL’s currently proposed rule would rescind the 2024 rule on employee classification and return to a standard similar to the one the DOL used in 2021. According to the DOL, the proposed approach is consistent with federal court precedent and makes it easier to distinguish between employees and independent contractors under the Fair Labor Standards Act (FLSA). However, Democrats characterize the proposed rule as a weakening of the current standard, which increases” MORE >>
Source: Hall Benefits Law