NJFLA eligibility and employer coverage thresholds are reduced under Assembly Bill 3451. Beginning July 17, 2026, employers with 15 or more employees must provide job-protected leave to employees with at least 3 months and 250 hours of service.  This is a change from the prior requirement for employers with 30 or more employees to provide leave that was not job protected to employees who had worked for 12 months and 1,000 hours. The updated NJFLA also clarifies that employees cannot use paid sick leave to supplement NJ Temporary Disability Insurance (TDI) or NJFLA benefits. However, employees retain the right to choose how to sequence and coordinate available leave (e.g., whether to use accrued paid leave before or after statutory benefits). Additional state guidance is expected in July 2026 according to the NJFLA website.

On May 14, 2026, the U.S. Supreme Court paused a Fifth Circuit Ruling in the case Louisiana v. FDA, that sought to restrict access to mifepristone by reinstating a prior Food and Drug Administration (FDA) rule that required patients to travel to a health center to obtain the medication, rather than through the mail via telehealth or pharmacy. The case challenges FDA rules currently in place that permit remote access to the medication, which has been approved since 2000 for use in medication abortions and early miscarriage care. The Court did not rule on the merits but allowed access to remain unchanged while the litigation proceeds.

On May 13, 2026, the U.S. Departments of Treasury, Labor and Health and Human Services published a proposed regulation (Proposed Rule) which would allow certain fertility services, including in vitro fertilization (IVF), to qualify as limited excepted benefits if offered separately or not integral to a group health plan. The Proposed Rule would also require written notice of the availability of coverage and impose an individual lifetime benefit cap of $120,000 (indexed for inflation). If finalized, the rule would apply to plan years beginning on or after January 1, 2027.

IRS Revenue Procedure 2026-22 sets 2027 ACA Employer Mandate penalties. Applicable Large Employers (ALEs) that fail to offer minimum essential coverage to at least 95% of full-time employees and their dependent children may face penalties of $3,780 per employee (up from $3,340) should at least one full-time employee receive a premium tax credit on an Exchange. Further, employers failing to offer affordable, minimum value coverage may face penalties of $5,670 per affected employee (up from $5,010) for each employee who receives a premium tax credit on an Exchange.

The IRS recently issued updated FAQs (FS-2026-10) on Section 127 educational assistance programs to address recent changes to the law implemented by the One Big Beautiful Bill Act (OBBA) (see our E-Alert here) and to supersede earlier FAQs. Employers are now required to disclose program availability and applicable terms to employees. The guidance confirms student loan repayment benefits are permanently excludable from income and introduces future inflation adjustments to the $5,250 exclusion limit beginning after 2026. It also clarifies eligibility for loans incurred prior to employment and updates IRS Publication 5993 to include a new model plan document for such programs.

On March 27, 2026, the U.S. Court of Appeals for the First Circuit upheld dismissal of a lawsuit alleging ACA Section 1557 discrimination for excluding GLP-1s and other weight-loss drugs from the health plan’s formulary. While the Court acknowledged that the plaintiff had properly alleged an individual disability, it concluded that the plan’s exclusion applied equally to all participants and was not a proxy for disability discrimination.

The deadline for filing the 2025 annual reporting form (ARF) for the San Francisco Health Care Security Ordinance (HCSO) is May 1, 2026. The HCSO requires, among other items, that covered employers report on their total healthcare expenditures for employees for each quarter in 2025. As background, employers with at least one employee within the city of San Francisco who works more than 8 hours per week for more than 90 days are required to spend a certain amount (called an expenditure) on healthcare for their covered employees. These funds can be used for employer-sponsored medical, dental or vision insurance, paid to the city, or contributed toward programs that reduce employee out-of-pocket healthcare costs.

On March 2, 2026, the U.S. Department of Labor (DOL) announced that it would be extending the public comment period for its proposed rule, Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure, from March 31 to April 15. This proposed rule, published on January 30, 2025, would add new disclosure obligations for pharmacy benefit managers (PBMs), PBM consultants and other advisors providing PBM-related services to self-insured group health plans (see our eAlert here). The DOL press release states that extending the comment period will allow stakeholders the opportunity to address aligning the proposed rule with the PBM requirements set out in the Consolidated Appropriations Act of 2026. 

On March 10, 2026, in the case of DaVita Inc. v. Marietta Memorial Hospital Employee Benefit Plan, et. al., a federal district court for the Southern District of Ohio held that an employer-sponsored, self-insured health plan’s decision to classify all dialysis providers as “out-of-network,” resulting in lower reimbursement, did not constitute disparate treatment based on a health factor, and thus, did not violate HIPAA’s nondiscrimination rules. Although the Supreme Court had already rejected DaVita’s Medicare Secondary Payer claim, the trial court separately considered whether the policy unlawfully discriminated against participants with end-stage renal disease (ESRD). The court concluded that the plan design of keeping dialysis providers out-of-network was, on its face, neutral and that the evidence did not show the employer adopted the dialysis carve‑out with discriminatory intent, but rather as a permissible cost‑containment measure. As a result, the remaining claims made under HIPAA, as well as the claims made under ERISA, were dismissed, reinforcing plan sponsors’ ability to structure benefits for legitimate business reasons when properly documented.

On March 19, 2026, in State of Oregon et. al. v. Kennedy et. al., a federal judge of the United States District Court for the District of Oregon indicated that he would partially grant an order to invalidate a December 2025 declaration issued by the Secretary of the Department of Health and Human Services (HHS), Robert F. Kennedy Jr. Widely known as “the Kennedy Declaration,” it called into question the medical validity and safety of gender affirming care for children and adolescents and threatened to bar hospitals and providers who provide gender affirming care to minors from participating in Medicare, Medicaid and other federal healthcare programs. The judge agreed with the arguments set forth by the plaintiff states and determined that the declaration, which established standards of medical care that superseded existing standards, was unlawful because it exceeded HHS’s statutory authority. Further, he affirmed that the Kennedy Declaration amounted to a substantive modification to the law which could only be adopted following notice-and-comment rulemaking, which had not occurred. A formal written opinion from the Court is expected in the coming weeks. HHS will likely appeal the decision.