The Daily Brief for Benefits Professionals
BenefitsWire
Health & Welfare Plans
June 24, 2026
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11 items · ~3 min read
In this issue
Expert Analysis (6) · Regulatory Action and Guidance (2) · ERISA Litigation (2) · Health & Welfare Plans (1)
Expert Analysis
6 items“The CAA (H.R. 7148) enacted PBM reforms related to transparency and reporting, rebates and compensation, pharmacy participation, and enforcement and remedies. While the reforms do not take effect for more than two and a half years (plan years beginning on or after 30 months after the Act's enactment, or Jan. 1, 2029, for calendar year plans), employers will benefit from early review of their PBM contracts as the CAA requirements prohibit the renewal of contracts that do not meet the requirements imposed by the CAA. Failing to meet the relevant requirements can result in prohibited transactions.” MORE >>
Source: Epstein Becker Green
“Employers are now beginning to receive settlement proceeds from the $2.67 billion class action settlement reached by the Blue Cross Blue Shield Association (BCBSA) and the class plaintiffs.” MORE >>
Source: JD Supra
“According to consulting firm Mercer, the average cost of employer-sponsored health insurance rose about 7% in 2026 from the prior year. ... With the Consolidated Appropriations Act, brokers and advisors need to disclose compensation. HR leaders need to be intentional in reviewing these programs. The disparity can be five to 10 times the cost for the same product from company to company.” MORE >>
Source: Employee Benefit News
“Plan sponsors’ ongoing efforts to manage rapidly rising prescription drug costs should include identifying and mitigating waste and abuse associated with common pharmacy benefit manager (PBM) practices that may have adverse events on costs. Examples include PBM retention of some manufacturer rebates and the use of spread pricing (where plan sponsors are charged more than the amount reimbursed to retail pharmacies)." MORE >>
Source: Segal
“Consolidated Omnibus Budget Reconciliation Act (COBRA) compliance often gets treated as a “set it and forget it” administrative task, particularly when employers outsource to third-party administrators. But the legal obligation to provide compliant COBRA notices ultimately rests with the plan administrator, not the COBRA vendor. That makes periodic reviews of COBRA notices essential. A deficient notice is not just a technical error; it can expose the plan (and employer) to statutory penalties, litigation costs, and participant claims.” MORE >>
Source: Bricker Graydon
“They suggested locking in this emerging alternative to traditional health insurance coverage over a three-to-five-year time horizon to help stabilize soaring health benefit costs. ... one of the biggest value propositions to consider is that individual-market plan renewals have been better than many group health programs, according to Fields.” MORE >>
Source: Employee Benefit News
Regulatory Action and Guidance
2 itemsCMS issued a Request for Information seeking technical input on PBM compensation practices and data reporting to guide implementation of two provisions—effective 2028—that will restrict remuneration PBMs and affiliates may receive for Part D drug services and impose new data reporting mandates, directly affecting how plan sponsors and PBMs structure their contracts. MORE >>
Source: Centers for Medicare & Medicaid Services (CMS)
“Forgot Your Password? If you do not yet have an ERIC Online profile or user name and password, please create one using Create Profile Form. If you need assistance with your user name/password or profile, please contact ERIC at (202) 789-1400.” MORE >>
Source: ERIC
ERISA Litigation
2 items“The Pharmaceutical Care Management Association filed separate federal lawsuits challenging newly enacted pharmacy benefit manager laws in Illinois and Tennessee, arguing the state measures unlawfully interfere with employer-sponsored health plans governed by the Employee Retirement Income Security Act. ... Congress recently enacted sweeping transparency requirements that will require PBMs to disclose pricing, rebates, fees and spread pricing arrangements to employer health plans beginning in 2028, while the Department of Labor has proposed rules requiring PBMs to disclose direct and indirect compensation to ERISA plan fiduciaries.” MORE >>
Source: PLANADVISER
“The Pharmaceutical Care Management Association filed separate federal lawsuits challenging newly enacted pharmacy benefit manager laws in Illinois and Tennessee, arguing the state measures unlawfully interfere with employer-sponsored health plans governed by the Employee Retirement Income Security Act.” MORE >>
Source: PLANSPONSOR
Health & Welfare Plans
1 item[Regulatory Action and Guidance]
Developing CMS Issues 2027 HHS Notice of Benefit and Payment Parameters Final Rule“The 2027 NBPP final rule was published in the Federal Register on May 20 and is effective on July 20, 2026. ... On June 3, 2026, plaintiffs City of Columbus et al. (including municipalities, local governments, and advocacy organizations) filed a complaint alleging that several policies in the 2027 NBPP final rule are unlawful and violate the Administrative Procedure Act. ... A ruling is expected around July 20, 2026.” MORE >>
Source: Groom Law Group