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August 31, 2026Health & Welfare

The Daily Brief for Benefits Professionals

BenefitsWire

Health & Welfare Plans

August 31, 2026

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7 items · ~3 min read

In this issue

Regulatory Action and Guidance (1)  ·  Health & Welfare Plans (1)  ·  Litigation (3)  ·  General Benefits (2)

Regulatory Action and Guidance

1 item
Federal agencies give employers enforcement relief on tobacco surcharge timing | Insurance Business

“FAQ Part 74 answers by exercising enforcement discretion. The departments say they will not take action against a plan that provides the reward only from the point the employee satisfies the alternative standard going forward, rather than back to the start of the plan year. The regulatory text did not clearly require retroactive payment, the guidance acknowledges, and the departments are declining to enforce the preamble's stricter reading while rulemaking is assessed. Plans that choose to continue paying retroactively remain free to do so.” MORE >>

Source: insurancebusinessmag.com

Health & Welfare Plans

1 item
The absence conversation advisers can't afford to outsource

“Middle-market and enterprise employers seek outsourced and co-sourced leave administration because HR is overburdened, compliance is messy and the employee experience is harder to hold together. FMLA, ADA, PFML, disability, accommodations and growing in-house leave complexity now overlap in ways that are hard for the best HR teams to administer consistently. For decentralized employers, absence management has shifted from a side process to a core business function. When benefit advisers stay uninvolved, they leave room for someone else to frame the problem, define the value and own the strategy.” MORE >>

Source: Employee Benefit News

Litigation

3 items
ERISA Long-Term Disability Denial Upheld: Eighth Circuit Affirms Unum Termination Where Treating Doctor’s Own Records Supported Sedentary Work

“The court held that Plaintiff had not proven he was unable to perform any gainful occupation once his group disability policy’s definition of disability changed at the 24-month mark. For anyone whose ERISA-governed group disability insurance claim has been denied at the two-year point, the decision is a clear illustration of how much weight a court gives to a treating physician’s own contemporaneous records, and how difficult those records are to overcome once they are in the file.” MORE >>

Source: Roberts Disability Law

Fifth Circuit Affirms Summary Judgment for MetLife on De Novo Review, Holding LTD Claimant Was Not Totally Disabled and Declining to Resolve Choice-of-Law Dispute Over Dueling State Bans on Delegation Clauses

“Plaintiff received short-term disability benefits through his Google plan during this period. Although Dr. Ebert initially confirmed that Plaintiff could return to full-time work without restrictions on July 20, Plaintiff did not return, and Dr. Ebert later submitted a form extending the return-to-work date to September 23 while still listing that date as unrestricted. Plaintiff filed a claim for long-term disability benefits from MetLife.” MORE >>

Source: Roberts Disability Law

Eleventh Circuit Affirms Termination of Long-Term Disability Benefits Where Plan Vested Discretion and Insurer Relied on Multiple Medical and Vocational Reviews

“LINA initially approved the claim, but after twenty-four months, when the definition of disability shifted from regular occupation to any occupation, LINA terminated benefits based on Plaintiff’s surgeon’s opinion that she could perform a sedentary job, an independent medical assessment by Dr. Kornfield reaching the same conclusion, and a vocational assessment identifying two alternative occupations available in her area, information clerk and gate guard.” MORE >>

Source: Roberts Disability Law

General Benefits

2 items
Your employees completed compliance training. Can they apply it when it matters?

“Almost 90% of compliance, legal and risk leaders are confident employees can apply compliance policies in real-world situations. Among HR and L&D leaders, confidence rises to almost 96%. Recently trained employees, meanwhile, averaged 64.5% on assessments designed to test how they apply compliance knowledge in realistic workplace scenarios. Employees performed strongly when expectations were relatively clear. Among those who had completed harassment prevention training, 90% recognized that an employer has a responsibility to address third-party harassment and 90% recognized that same-sex harassment is covered under federal law. Performance became more uneven when employees needed to interpre” MORE >>

Source: HR Dive

DOL Proposes E-Delivery as Default Option for Employers

“The U.S. Department of Labor (DOL) has drafted a regulation designed to facilitate employers’ use of electronic delivery systems as the default option when dealing with the Employee Benefits Security Administration (EBSA) and other federal agencies.” MORE >>

Source: Hall Benefits Law

BenefitsWire · A digest for ERISA attorneys, third-party administrators, actuaries, recordkeepers, and benefits consultants.
An informational digest, not legal advice.
BDK2, LLC, 2503D N Harrison St PMB 2091, Arlington, VA 22207-1640

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