In recent years, there has been a surge in litigation targeting employer plan sponsors over the design and administration of their group health plans. Those cases put forth various theories of liability, but currently fall into three general categories.

On February 25, 2025, President Trump issued an Executive Order which seeks to enhance and expand upon existing price transparency requirements and improve enforcement of these policies to ensure compliance.

In the absence of any meaningful federal regulation, over the past few years, states have been extremely active in regulating pharmacy benefit managers (PBMs) and/or employer sponsored pharmacy plans.

The Affordable Care Act (ACA) created two reporting requirements, one of which is ALE reporting. This reporting requires applicable large employers (ALEs)–those subject to Pay or Play–to identify their full-time employees and report on whether they offer these employees coverage that is affordable and provides minimum value.

A number of large and/or well-known employers are facing lawsuits challenging their wellness programs, almost all of which required tobacco users to pay more for health coverage than non-tobacco users.

In April 2021, the Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA) issued guidance on cybersecurity best practices for plan sponsors, fiduciaries, service providers, and participants to safeguard plan data, personal information and, where applicable, plan assets.

On June 28, 2024, the U.S. Supreme Court issued its opinion in two companion cases, Loper Bright Enters. v. Raimondo, and Relentless, Inc. v. Department of Commerce.

On May 24, 2024, the Departments of Labor (DOL), Health and Human Services (HHS), and Treasury (the Departments) released updated instructions for the Gag Clause Prohibition Compliance Attestation (GCPCA) due December 31, 2024.

The US Department of Health and Human Services (HHS) recently issued new final regulations on Section 1557, the nondiscrimination provision of the Affordable Care Act (ACA).

GLP-1 is a hormone that has several roles, including triggering insulin release from your pancreas, blocking glucagon secretion, slowing digestion in the stomach, and increasing satiety.

Our employee benefits compliance team has put together an overview of key issues to consider and litigation to watch as many group health plans move into strategic planning for the next year.