The Daily Brief for Benefits Professionals
BenefitsWire
Health & Welfare Plans
September 30, 2026
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10 items · ~3 min read
In this issue
Regulatory Action and Guidance (2) · Litigation (1) · General Benefits (5) · Health & Welfare Plans (2)
Regulatory Action and Guidance
2 items“Earlier this month, the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) issued new guidance, narrowing its enforcement focus under the Mental Health Parity and Addiction Equity Act (MHPAEA).” MORE >>
Source: Husch Blackwell LLP
“The IRS issued draft regulations Tuesday that would allow the Secretary of the Treasury to automatically create an initial Trump Account, or 530A account, for eligible children without requiring a parent, guardian, or other adult to submit an enrollment election.” MORE >>
Source: PLANADVISER
Litigation
1 item“66 Franklin Street, Suite 300 Oakland, CA 94607 In Ioannidis v. Benefit Program for Mass General Brigham and Membership Organization Plan (501), No. 25-12197-FDS, 2026 WL 2874084 (D.” MORE >>
Source: Roberts Disability Law
General Benefits
5 items“In our previous installment, we examined how a comprehensive forensic audit quantifies program performance across seven core operational pillars to solve the health and welfare value equation.” MORE >>
Source: Employee Benefit News
[Regulatory Action and Guidance]
Puerto Rico Department of Labor Launches Desempleo Digital: Key Changes for Employers“This platform replaces the Department’s previous technological infrastructure and modifies how employers, third-party administrators, and accounting professionals access employer accounts, manage documents and communications, process payments, and complete various transactions with the PRDOL. This transition may require employers to follow new access and security procedures, verify their account information and authorized users, and adjust how they file tax and wage reports.” MORE >>
Source: Littler
[Regulatory Action and Guidance]
What Goes Around: IRS Audits of Fixed Indemnity Health/Wellness Benefit Plans that Offer Purported Tax Savings“The Internal Revenue Service (IRS) has begun to audit fixed indemnity health/wellness benefit plans that have been marketed by promising significant payroll tax savings to employers and employees. The IRS has long disagreed with the claimed tax treatment, issuing a steady stream of guidance since 2016 disagreeing with various iterations of such plans. However, the law and guidance in this area is complicated, and promoters offer opinions supporting the legality of these programs that can lead employers to potentially misinterpret the rules on benefits that can be excluded from employee income. These arrangements are marketed as supplemental health or wellness benefits that will result in sig” MORE >>
Source: Morgan Lewis (ML BeneBits)
[Health & Welfare Plans]
Developing D.C. Cuts Paid Family Leave Benefits Beginning October 1, 2026“Effective October 1, 2026, amendments to the D.C. Paid Family Leave Act reduce the maximum duration and weekly amount of certain paid leave benefits available to eligible employees. Employer funding obligations are unchanged, but employers must update their mandatory workplace notice and communicate the revised benefit levels to employees before the effective date. Key Changes Maximum amount of Paid Family Leave: the maximum amount of combined Paid Family Leave available to employees in one 52-workweek period decreases from 12 weeks to 6 weeks. Maximum amount of Paid Medical Leave: the maximum amount of combined Paid Medical Leave available to employees in one 52-workweek period decreases fr” MORE >>
Source: Groom Law Group
[Health & Welfare Plans]
Developing California Expands What Is Covered by Paid Family Leave Benefits“California has passed Assembly Bill (AB) 2054, which expands the definition of “covered active duty” under Section 3302.1 of the Unemployment Insurance Code for purposes of eligibility for Paid Family Leave (PFL) benefits from the state. Under existing law, “covered active duty” includes deployment of a member of the regular Armed Forces of the United States to a foreign country and deployment of reserve components to a foreign country under a federal call or order. Under the amendment, “covered active duty” means: However, implementation of the amendments will not take place until the changes can be incorporated into the EDD’s claims management system or on July 1, 2028, whichever occurs fi” MORE >>
Source: National Law Review
Health & Welfare Plans
2 items[Regulatory Action and Guidance]
Evolving PBM economic models: Implications for cash flow and the time value of money for commercial plan sponsors“The findings reveal three key insights: Overall, among the POS approaches, the emerging net price model produces the most favorable plan results over time because manufacturers—not the plan—fund the TVM component by embedding the rebate directly in the pharmacy-counter price, while also improving transparency, cash accounting, auditability, predictability, and alignment of incentives and avoiding the additional funding cost present in traditional POS rebate arrangements.” MORE >>
Source: Milliman
“Does your company's health plan provide prescription drug coverage? If so, you have until October 15, 2026 to send a notice to individuals who are enrolled in Medicare Part A or Part B and are eligible for the company's health plan. The notice lets recipients know whether the company's prescription drug coverage is "creditable" or "non-creditable.” MORE >>
Source: Venable LLP