"The Ninth Circuit emphasized that when a court is conducting a de novo review of a benefit denial, 'it evaluates the plan administrator's reasons for denying benefits without giving deference to its conclusions or opinions.' ...Ultimately, the Ninth Circuit concluded that '[t]he district court's task is to determine whether the plan administrator's decision is supported by the record, not to engage in a new determination of whether the claimant is disabled." [ Collier v. Lincoln Life Assurance Company of Boston , No. 21-55465 (9th Cir. Nov. 21, 2022)]   MORE >>

"Pharmacy Benefit Manager (PBM) reform ... remains at the forefront of the healthcare pricing debate ... Specific drug pricing/PBM-related legislation [likely to] either receive consideration in the lame duck or be reintroduced in the 118th Congress includes: [1] the Lower Costs, More Cures Act of 2021 ( HR 19 ) ( S 2164 ), [2] the Pharmacy Benefit Manager Transparency Act of 2022 ( S 4293 ), [3] the Shaheen-Collins INSULIN bill [not yet filed], and [4] Rep. Harshbarger's PBM Transparency, Accountability, and Reform Act [not yet filed]."   MORE >>

"Optimizing the integration process of health and welfare plans can make a significant impact on the cost and efficiencies of the plan, reduce employee attrition, increase the perceived value, and limit the burden on HR leadership.... Health and welfare/employee benefits due diligence ... Synergies/dis-synergies associated with health plan integration ... Integration timeline ... Compliance."   MORE >>

"Companies are already starting to increase their spend on non-cash incentives due to recent trends and findings in employee retention, so there's some great synergy here in rewarding employee's efforts in a way that will drive joy, motivation, and well-being.... [T]here's been an emerging trend in the use of gift cards for improving well-being in corporate, state, and even city programs."   MORE >>

"two out of three U.S. employers (67%) plan to make employee mental health and emotional wellbeing programs and solutions one of their top three health priorities over the next three years.... Eight out of ten employers said that their top approach to addressing employee mental health issues was expanding telehealth and tele-behavioral health."   MORE >>

"As the world's largest self-insurance event, SIIA drew a diverse audience from within the self-insurance marketplace. These perspectives provided insights and key takeaways. [1] The Independent Dispute Resolution (IDR) process is ineffective ... [2] The process is occurring piecemeal ... [3] No reporting yet of any decisions."   MORE >>

"Paid parental leave insurance is a new financial product, but it could be a game-changing employee benefit and an untapped opportunity for brokers, agents, and advisors."   MORE >>

"$7 is the average monthly premium for Medicare Advantage plans selected by Medicare beneficiaries in the first half of the Annual Enrollment Period for 2023 coverage ... $31 is the average monthly premium for Part D plans ... up from $21 the year before ... 8% of Medicare Advantage enrollees express satisfaction with their coverage, and most say they could not afford more costly alternatives like Medicare Supplement."   MORE >>

"EBSA is proposing numerous changes to the VFCP in an effort to streamline the program and encourage plan fiduciaries to correct breaches and reimburse plan losses.... EBSA reiterated that all welfare and pension plans may use the VFCP if they have a fiduciary breach for which there is an eligible transaction. The proposals would make only minor changes to the eligible transactions for welfare plans -- one of which involves delinquent participant contributions to an insured health plan."   MORE >>