The Daily Brief for Benefits Professionals
BenefitsWire
Health & Welfare Plans
August 28, 2026
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10 items · ~3 min read
Top of the Brief
Clearing the Air: Tri-Agencies Issue Enforcement Relief on the Wellness Program “Full Reward” Requirement“In the FAQs, the Departments announced that they will not take enforcement action against a plan or issuer that provides a health-contingent wellness program reward only on a prospective basis—that is, from the date a participant satisfies a reasonable alternative standard—rather than retroactively to the first day of the plan year. The Departments also clarified the types of information that employers must disclose about a wellness program.”
In this issue
Regulatory Action and Guidance (4) · Health & Welfare Plans (4) · Litigation (1) · General Benefits (1)
Regulatory Action and Guidance
4 items“In the FAQs, the Departments announced that they will not take enforcement action against a plan or issuer that provides a health-contingent wellness program reward only on a prospective basis—that is, from the date a participant satisfies a reasonable alternative standard—rather than retroactively to the first day of the plan year. The Departments also clarified the types of information that employers must disclose about a wellness program.” MORE >>
Source: Groom Law Group
“On July 23, the DOL published a proposed rule to create a new electronic disclosure safe harbor for Employee Retirement Income Security Act (ERISA)-covered group health plans. If finalized, employers and other plan administrators could post required plan documents online and send participants a notice of internet availability (NOIA), rather than mailing paper copies. The DOL's Employee Benefits Security Administration is accepting public comment on the proposal through September 21.” MORE >>
Source: insurancebusinessmag.com
“New tri-agency FAQ guidance issued on August 26, 2026, addresses elements of the 2013 wellness program regulations have been the subject of dozens of class actions in recent years. While this non-binding guidance does not amend the existing regulations, it gives courts a window into the agencies’ interpretation of these longstanding wellness program rules.” MORE >>
Source: National Law Review
“The FAQs issued this week give employers “helpful guidance as they structure their wellness program surcharges, specifically with respect to a reprieve on certain DOL enforcement actions,” he said. Still, Collins said, while this guidance is helpful, employers must remember that the risks in this area largely came from workers picking apart wellness programs through class-action lawsuits.” MORE >>
Source: HR Dive
Health & Welfare Plans
4 items“With healthcare costs expected to rise by 9% in 2027, employers are feeling the cumulative impact of years of increases, forcing many to take a hard look at how they offer medical benefits. The volatility employers have experienced in healthcare costs over the last decade is unprecedented, according to Business Group on Health's 2027 Employer Healthcare Strategy Survey, with costs rising at roughly twice the rate of inflation.” MORE >>
Source: Employee Benefit News
“Healthcare costs may increase by nearly 10% next year, according to the latest edition of the Business Group on Health’s annual survey of large U.S. employers, which BGH executives called a sign of the “unprecedented” environment that employee benefits teams face. 2025 marked the third consecutive year in which actual healthcare costs exceeded BGH members’ projections. Respondents included 127 employers representing 8.7 million covered U.S. individuals.” MORE >>
Source: HR Dive
“Accelerating dispute volumes and sky-high award amounts are inflating how much independent dispute resolution is costing the U.S., according to new Georgetown research.” MORE >>
Source: Healthcare Dive
“The rule is simple: When premiums are paid on a pre-tax basis, only amounts paid to reimburse actual, unreimbursed medical care expenses are excludable under the Internal Revenue Code. When premiums are paid on a pre-tax basis and a benefit is paid regardless of whether the employee incurred an out‑of‑pocket medical expense, that payment is taxable. Sections 106 and 125 let employers and employees pay for health coverage on a pre-tax basis, but they do not permit arrangements that purport to convert general cash payments into tax-free income. In 2002, Treasury and the IRS issued revenue rulings making clear that reimbursements of employer-paid premiums and “advance reimbursements” or similar” MORE >>
Source: Thompson Hine (ERISA Litigation & Compliance)
Litigation
1 item“Arkansas Insurance Department Rule 128 protects pharmacies operating in Arkansas from being paid below “fair and reasonable” rates for dispensing medications. Two of its requirements were at issue. First, the Dispensing Fee Requirement authorizes the Insurance Commissioner to require health plans to pay additional dispensing fees to pharmacies where the Commissioner determines a plan’s payment program is not fair and reasonable. Second, the Reporting Requirement mandates that health benefit plans submit compensation information to the Commissioner, with the specific data to be reported identified in AID Bulletin #18-2024. ... The court concluded that Plaintiff failed to distinguish the Dispe” MORE >>
Source: Roberts Disability Law
General Benefits
1 item[Health & Welfare Plans]
Employers cut GLP-1 coverage as pharmacy costs hit 25% of health spend | Insurance Business“By Mark Rosanes Pharmacy now accounts for a quarter of employer healthcare spending. The employers who are most concerned about it are doing something about it.” MORE >>
Source: insurancebusinessmag.com
Also of Note
- Federal agencies give employers enforcement relief on tobacco surcharge timing | Insurance Business — “FAQ Part 74 answers by exercising enforcement discretion.” (insurancebusinessmag.com)