By February 16, 2026, all HIPAA covered entities must update their HIPAA Notice of Privacy Practices (NPPs) pertaining to the confidentiality of substance use disorder (SUD) treatment records in accordance with the February 16, 2024 final regulation under 42 CFR Part 2 (the “Final Rule”). While the U.S. District Court for the Northern District of Texas vacated (invalidated) the Final Rule’s provisions pertaining to increased privacy protections for the confidentiality and disclosure of PHI related to reproductive healthcare (see our eAlert here), the ruling did not vacate requirements pertaining to SUD treatment records. The ruling also does not prohibit covered entities from retaining language in their NPPs providing increased protections for reproductive healthcare records if they so choose. Employers and plan sponsors should consult with their trusted advisors to ensure that all required updates to the NPPs are completed by the February 16, 2026 deadline. This should include making a determination as to whether to retain language in the NPPs regarding reproductive healthcare.

On January 15, 2026, President Trump announced the Great Healthcare Plan, a broad healthcare initiative that promises to lower drug prices and insurance premiums, hold large insurance companies accountable, and maximize price transparency. The Plan proposes to lower drug prices by codifying the administration’s Most-Favored-Nation deals and making more drugs available over the counter. It calls for sending subsidy payments directly to eligible Americans to allow them to purchase insurance of their choice, funding a cost-sharing reduction program, and ending kickbacks to lower insurance premiums. It aims to hold insurance companies accountable by requiring them to publish rate and coverage comparisons, costs of overhead vs. claim payments, claim denial rates, and wait times. Finally, the Plan calls for maximum transparency and seeks to require any provider or insurer who accepts Medicare or Medicaid to post their pricing and fees to avoid surprise billing. It will now be up to Congress to pass this framework into law.

On December 23, 2025, a series of lawsuits were filed in U.S district courts in Illinois and New York against several national employers and their benefits brokers, including United Airlines, Laboratory Corp. of America Holdings, Gallagher Benefit Services Inc., Mercer Health and Benefits Administration LLC, Lockton Companies LLC, and Willis Towers Watson US LLC. The lawsuits allege that the employers and their brokers are plan fiduciaries and that they breached their fiduciary duties by failing to negotiate prices and ensure prudent processes by monitoring broker commissions and loss ratios for voluntary benefits, such as accident and critical illness insurance, causing the plaintiffs to pay higher premiums for these benefits. Further, the suits allege that the plan sponsors engaged in self-dealing with their benefit brokers which resulted in higher premiums. While these voluntary benefits are not traditionally subject to ERISA, as they fall under the “voluntary plan safe harbor” (an ERISA exemption), the suits argue that certain actions by the employer removed these benefits from the safe harbor protection, and thus, subjected them to ERISA. Specifically, the suits allege many actions taken by the plan sponsors constitute “endorsing the plan,” as defined under ERISA, but argue that the action that cements these voluntary plans as subject to ERISA is the inclusion of these benefits on their Form 5500s.

Copies of these Complaints:
Brewer v. CHS/Community Health Systems, Inc.
Braham v. Laboratory Corp of America Holdings
Fellows v. Universal Services of America, LP
Pimm v. United Airlines, Inc.
Article in PSCA: New Wave of ERISA Litigation Targets Voluntary Benefits

Effective December 19, 2025, the U.S. Department of Labor (DOL) modified its Delinquent Filer Voluntary Compliance Program (DFVCP), which allows plan administrators to voluntarily submit overdue annual Form 5500 reports while paying lower civil penalties. This modification expanded penalty relief to multiple employer welfare arrangements (MEWAs) and Entities Claiming Exemption (ECEs) who are required to file the Form M-1. Eligible MEWAs and ECEs who wish to participate in the DFVCP must file a complete Form M-1 for the most recent filing year via the DOL’s EFAST site and pay the $750 penalty amount by submitting electronic payment via the gov.pay link on the DOL’s website.

On January 1, 2026, Minnesota will begin its Paid Family and Medical Leave (“PFML”) program. The Minnesota PFML program will provide employees with the ability to take up to 12 weeks of job-protected paid medical leave for their own health conditions and up to 12 weeks of paid family leave for parental bonding, caring for family members with serious health conditions, military family leave, and safety leave for victims of domestic violence. Employees in Minnesota will be able to take a combined maximum of 20 weeks of leave per year through the PFML program. Employees will receive between 55% and 90% of their regular wages while on leave, with a maximum amount set at the state’s average wage, which is currently $1,423 per week.

As the January 1 effective date nears, employers should:

Choose a plan: State plan or equivalent private plan (requires annual renewal, $500 fee, and surety bond).

Set contributions: The 2026 contribution rate is 0.88% of taxable wages.. Employers will pay at least 0.44%; employees may pay up to 0.44%. (Minnesota law caps the premium rate at 1.2% of taxable wages.).

Communicate clearly: Post multilingual notices, provide written/electronic details in employees’ primary language, and obtain acknowledgment.

Prepare for reporting: Quarterly wage reporting will occur via the state’s existing Unemployment Information (UI) system, which will convert to joint UI-Paid Leave accounts automatically.

If no action is taken, the enhanced Affordable Care Act (“ACA”) premium tax credits (“PTCs”) that were created in response to the COVID-19 pandemic will expire at the end of 2025. As background, the ACA created and implemented PTCs, which are subsidies offered to individuals to help lower the cost of their premiums for healthcare on ACA Exchange plans. During the COVID-19 pandemic, the PTCs were enhanced by Congress through the elimination of an income cap that had been used to disqualify higher-earners from receiving the PTCs, and through an increase in the subsidy amount available for all income brackets. These enhancements are set to expire at the end of 2025, impacting the qualification criteria for receiving the PTC subsidy and lowering the amount of PTC subsidy that is available to those who still qualify. Reverting to these unenhanced PTCs will significantly increase the premium cost for Exchange plans, which may push many employees back into employer-sponsored health plans if such plans are available to them. Additionally, since fewer employees will qualify for PTCs, this could decrease the risk of penalties for employers under the Employer Shared Responsibility Provisions (“Employer Mandate”) of the ACA since qualifying for PTCs is a necessary precursor for assessment of Employer Mandate penalties.

On December 19, 2025, the Centers for Medicare & Medicaid Services, Department of Labor and Treasury (“Agencies”) issued new proposed regulations (“Proposed Rules”) updating the transparency requirements issued under the Consolidated Appropriations Act of 2021 (“CAA”) in response to President Trump’s Executive Order 14221, entitled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information.” The Proposed Rules aim to update the CAA’s machine readable file (“MRF”) disclosure requirement by consolidating the MRF’s required files, cleaning the form and number of files and ensuring that the MRF is easy to find by specifying where the MRF should be housed on the plan sponsor’s website. Specifically, the Proposed Rules propose that group health plans and health insurance issuers will need to add a link in the footer of the home page of the plan’s or issuer’s website entitled “Price Transparency” or “Transparency in Coverage” that routes to the web page that hosts the MRF to allow for a simple and consistent path for users to find the MRF. Further, the Proposed Rules would require that the price transparency information that was previously available through both phone and the internet self-service tool would only need to be available over the phone upon request. If finalized as proposed, these Proposed Rules would take effect 12 months after the final regulation is published.

On December 5, 2025, the Internal Revenue Service (“IRS”) issued IRS Notice 2026-05 which contains guidance that clarifies the changes put in place by the One Big Beautiful Bill Act (“OBBBA”) on Health Savings Accounts (“HSAs”). The OBBBA allowed for high-deductible health plans (“HDHPs”) to cover telehealth or remote care prior to the annual deductible being fulfilled, for bronze and catastrophic individual plans to qualify as HDHPs for HSA eligibility and for direct primary care arrangements to be utilized without impacting HSA eligibility.

On December 2, 2025, the Department of the Treasury and the IRS issued guidance in Notice 2025-68 (“Notice”) to clarify rules relating to Trump Accounts. Trump Accounts, created under the One Big Beautiful Bill Act (OBBBA), and scheduled to be released to the public in 2026, are investment vehicles similar to individual retirement accounts for children under age 18. The Notice sets out initial general requirements for creating, funding and administering Trump Accounts, including the option for employers to set up a contribution program for Trump Accounts via salary reductions under a Section 125 cafeteria plan. Specifically, the Notice permits an employer to establish a Trump Account contribution program via salary reduction under a cafeteria plan to allow employees to contribute to Trump Accounts for their dependents. However, to avoid deferred compensation, the Notice explicitly prohibits using a cafeteria plan to fund contributions to an employee’s Trump Account. The Treasury Department and the IRS are expected to issue additional guidance related to the coordination of Trump Account contribution programs with Section 125 cafeteria plans in the near future.

On November 28, 2025, the Centers for Medicare and Medicaid Services (CMS) issued a proposed regulation (“Proposed Rule”) that would exempt health reimbursement arrangements (“HRAs”), including individual coverage HRAs (“ICHRAs”), from the Medicare Part D creditable coverage disclosure requirements. As background, plan sponsors providing prescription drug coverage are required to disclose whether the coverage is creditable, which generally means that the value of the prescription drug coverage provided is as good or better than the actuarial value of the prescription drug coverage under Medicare Part D. Currently, account-based plans, such as HRAs, are included in this disclosure requirement, but as explained in the Proposed Rule, account-based plans are often designed to supplement other coverage, rather than offering prescription drug coverage. Additionally, the design of account-based plans makes the disclosure of creditable coverage burdensome.  Further, because these account-based designs are often supplemental to primary coverage, participants receiving two different notices (one from the plan and one from the HRA) are often confused regarding the creditability of the coverage offered. The comment period for the Proposed Rule will be open until January 26, 2026.

On November 26, 2025, Judge Ouraishi of the U.S. District Court for the District of New Jersey ruled in favor of the defendant, Johnson & Johnson, in dismissing Lewandowski v. Johnson and Johnson, a lawsuit where the plaintiff alleged that mismanagement of the Johnson & Johnson health plan led to increased costs for the participants (see our eAlert, here). In his order, Judge Ouraishi wrote that it was too speculative to conclude that Johnson & Johnson’s alleged mishandling of plan funds and overpaying of certain plan vendors directly impacted the costs to the plan participants, and found the plaintiff’s attempts at establishing a direct connection unconvincing. He also found that the claims for damages were too speculative, and dismissed the case. It should be noted that Judge Ouraishi’s ruling was based on the plaintiff’s failure to demonstrate that they had suffered an injury that would give them standing to sue. However, the judge allowed the plaintiffs 30 days to file an amended complaint. Additionally, even though this case was dismissed, there are other similar cases (Navarro v. Wells Fargo and Stern v. JPMorgan Chase) that are still pending and could still have an impact on ERISA fiduciary compliance for health and welfare plan sponsors.