The Daily Brief for Benefits Professionals
BenefitsWire
Health & Welfare Plans
July 17, 2026
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12 items · ~4 min read
Top of the Brief
Mid-year mini open enrollment events part 1: Change to the employee-share of the health plan premium"Section 125 cafeteria plan rules allow employees to change health plan elections mid-year when employers make significant changes to the employee-share of the premium, creating a mini open enrollment."
In this issue
Regulatory Action and Guidance (2) · Health & Welfare Plans (5) · Litigation (3) · General Benefits (2)
Regulatory Action and Guidance
2 items“On July 8, 2026, the US Treasury Department and the Internal Revenue Service (IRS) released final regulations under the life insurance policy transfer rules. The final rules generally adopt the proposed regulations that were released in May 2023 with some changes discussed below. The new regulations are meant to address concerns with regard to changes made by Treasury regulations issued in 2019 under Section 101 for reportable policy sales that caused new contracts issued with respect to a Section 1035 transaction to be subject to the transfer-for-value rules even though no reportable policy sale was involved.” MORE >>
Source: Faegre Drinker
CMS proposed changes to the Medicare physician fee schedule and other Part B payment policies, including new rules for the Medicare Prescription Drug Inflation Rebate Program and updates to the Medicare Shared Savings Program. MORE >>
Source: Federal Register
Health & Welfare Plans
5 items“The Business of Health with Chip Kahn July 14, 2026 Video Audio Listen On: Apple Spotify YouTube Music Episode 12, AI Series: Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI) and the Peterson Center on Healthcare, joins Chip to discuss who really benefits as AI moves into health care’s back office.” MORE >>
Source: KFF
“New Jersey employers must adapt to significant amendments to the New Jersey Family Leave Act (NJFLA) taking effect July 17. These changes will expand coverage to smaller businesses, reduce the waiting periods for new employees to qualify for leave, and create new job restoration and benefit selection rights. HR teams and managers should be ready to implement these changes on day one. Is your business ready? Read on for a recap of the new amendments and a final compliance checklist you can put to...” MORE >>
Source: JD Supra
“Cost remains a major factor for employers as the popular drug for weight loss represented 11.4% of annual claims for corporations in 2025. Only 36% of employers cover GLP-1s for weight loss, per the report, and just 9% of those that don’t provide coverage are considering it. Despite limited coverage, U.S. adult use of the drugs for weight loss is at an all-time high, new Gallup research shows. Eleven percent of the 5,065 adults surveyed in May and June said they take GLP-1 medications to lose weight, nearly quadruple the share who said so only two years earlier.” MORE >>
Source: HR Dive
"Section 125 cafeteria plan rules allow employees to change health plan elections mid-year when employers make significant changes to the employee-share of the premium, creating a mini open enrollment." MORE >>
Source: WTW
[Regulatory Action and Guidance]
No Surprises Act IDR Services Favors Providers, Increases Costs for Insurers“According to data compiled in the Turquoise tool, IDR services decided 225,795 cases in the second quarter of 2025 involving physicians’ billings for emergency department visits with a “moderate level of medical decision making.” In those cases, IDR services ruled in favor of the medical providers over 85% of the time, with a median award of $795. This figure is much greater than the median amount that commercial insurers pay for the same service in the same markets, which is $140. Based on this data, IDR awards increased commercial insurers’ costs in these cases by an aggregate of $637 million.” MORE >>
Source: Hall Benefits Law
Litigation
3 items“In De Mello v. First Unum Life Insurance Company, No. 25-cv-7933 (LJL), 2026 WL 2032059 (S.D.N.Y. July 14, 2026), United States District Judge Lewis J. Liman denied an ERISA long-term disability claimant’s motion to compel discovery into matters outside the administrative record. Plaintiff participates in an employee welfare benefit plan sponsored by his law firm employer, which provided long-term disability coverage through a policy issued and administered by Defendant. After contracting COVID-19 in December 2021 and being diagnosed with long COVID, Plaintiff submitted a claim for long-term disability benefits, which Defendant denied based on the file reviews of three doctors.” MORE >>
Source: Roberts Disability Law
“Quick Hits On May 13, 2026, the New York State Legislature passed Senate Bill S4424-A, titled the “Anti-Waiver of Employment Rights Act.” MORE >>
Source: Ogletree Deakins
“On July 8, the U.S. District Court for the District of Maryland heard oral argument in City of Columbus v. Kennedy (Columbus II), which challenges CMS’s 2027 Notice of Benefit and Payment Parameters Final Rule (NBPP final rule). Following argument, the Court directed the parties to file supplemental briefs on two questions: whether relief could be implemented without unduly disrupting the Marketplace for the 2027 plan year, and whether staying the catastrophic-plan guidance would affect people currently enrolled in that coverage. The Defendant argues that reinstatement of standardized plan requirements would be impracticable. Their supporting declaration, from CCIIO Deputy Director for Polic” MORE >>
Source: Groom Law Group
General Benefits
2 items[Regulatory Action and Guidance]
Social Security COLA Projections Drop as Inflation Eases in June“Nonpartisan seniors’ group The Senior Citizens League (TSCL) predicts this year’s COLA to be 3.8%, unchanged from last month’s forecasts but still 1% higher from 2026’s official figure of 2.8%. If TSCL’s projected 2027 COLA went into effect today, average benefits would increase by $73.62, or from $1,937.53 to $2,011.15. Meanwhile, Mary Johnson, an independent Social Security and Medicare analyst, forecasts the 2027 COLA at 3.7%, as inflation dropped for the month of June.” MORE >>
Source: 401(k) Specialist
[Regulatory Action and Guidance]
SEC Proposes E-Delivery as Default for Investor Communications“The Securities and Exchange Commission on Thursday proposed a rule that would make electronic delivery the default for most required investor communications, replacing a decades-old system that generally requires paper delivery unless investors affirmatively opt into electronic communications. The proposed Regulation E-Delivery, announced today, would permit issuers, broker/dealers, investment advisers and other regulated entities to satisfy federal securities law delivery requirements by electronically providing required documents, while preserving investors’ ability to continue receiving paper copies upon request. The proposal would cover a broad range of disclosures, including mutual fund” MORE >>
Source: PLANADVISER