The Weekly Highlights for Benefits Professionals
BenefitsWire
Health & Welfare Plans
Week of October 30, 2026
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12 items · ~3 min read
In this issue
Regulatory Action and Guidance (9) · Health & Welfare Plans (3)
Regulatory Action and Guidance
9 items“The rule is intended to improve transparency into fees and compensation plan sponsors pay pharmacy benefit managers and their affiliates.” MORE >>
Source: PLANSPONSOR
“On Sept. 8, the U.S. Department of Labor's Employee Benefits Security Administration released two pieces of guidance on the Mental Health Parity and Addiction Equity Act that, when read together, send a more nuanced message than either does on its own.” MORE >>
Source: Milliman
HHS has published a list of approved Medical Review Officer certification entities, aligning with updated Mandatory Guidelines for Federal Workplace Drug Testing Programs that specify MRO qualifications and oversight. MORE >>
Source: Federal Register
“Quick Hits EEOC Chair Andrea Lucas stated that the vote to rescind “reaffirms the agency’s commitment to enforce Title VII consistent with the Constitution and the limits Congress placed on the EEOC’s authority.” MORE >>
Source: PSCA
The Administration for Children and Families is seeking to extend its Child Care and Development Fund Plan Preprint form for FFY 2025-2027 and proposes changes for FFY 2028-2030 to reduce burden and improve program integrity. MORE >>
Source: Federal Register
The ONC is issuing a rule on health data, technology, and interoperability, which may affect how benefits plans manage and exchange health information. MORE >>
Source: Federal Register
“The revenue ruling affects 14 states (and Washington, DC) that have PFML mandates for private employers: California, Colorado, Connecticut, Delaware, Hawaii, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Rhode Island and Washington. California, Hawaii, New Jersey, New York and Rhode Island started with a wage-replacement program for nonwork-related disabilities only. All but Hawaii later added a wage-replacement program for family leave, which typically includes leave for child bonding, caring for a family member with a serious health condition and handling military exigencies.” MORE >>
Source: Mercer
“On October 22, 2026, the Civil Division of the U.S. Department of Justice (DOJ), in partnership with the Department of Health and Human Services (HHS), announced the Healthcare False Claims Act Self-Disclosure Pilot Program (FCA SDPP or Pilot Program). The Pilot Program will run for six months and is intended to provide “a clear and predictable pathway” to resolve potential civil liability under the FCA. It is also designed for issues that arise under HHS administrative authorities, including revocation of enrollment in Medicare, permissive exclusion for false or improper claims, and permissive exclusion based on fraud and kickbacks or other prohibited activities.” MORE >>
Source: Troutman Pepper Locke
The Internal Revenue Service Advisory Council will hold a public meeting to discuss relevant matters. MORE >>
Source: IRS
Health & Welfare Plans
3 items“For the first time in three years, the share of employers covering GLP-1s for weight loss has declined, with rising costs driving some to reconsider the benefit.” MORE >>
Source: Employee Benefit News
“Workers forfeited an average of $404 in 2024, with younger employees particularly likely to lose unused health care dollars About 40% of flexible spending account (FSA) holders forfeited unused funds in 2024, according to new research released today by the Employee Benefit Research Institute (EBRI).” MORE >>
Source: 401(k) Specialist
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Source: 401(k) Specialist