ML BeneBits

For decades, fiduciary litigation under the Employee Retirement Income Security Act of 1974 (ERISA) was largely concentrated on 401(k) and pension plans. That era has ended. In recent years, we have seen class-action lawsuits targeting health and welfare plans. Plaintiffs’ firms have begun applying the excessive fee playbook to health plans, alleging that plan sponsors have failed to monitor pharmacy benefit manager pricing, allowed excessive broker commissions, and ignored opaque indirect compensation structures.

Glucagon-like peptide-1 receptor agonists (GLP-1s) such as Ozempic, Wegovy, Mounjaro, and Zepbound have reshaped the landscape of diabetes and obesity treatment and quickly become one of the most significant cost drivers for employer-sponsored health plans.

In Williams v. Bally Management Group, LLC, the US District Court for the District of Rhode Island became the first court to grant a motion to dismiss in a class action challenging Bally Management Group’s (Bally) tobacco surcharge wellness program. The court dismissed the plaintiff’s challenge in full, rejecting both the ERISA nondiscrimination claim that the tobacco surcharge violated the “full reward” requirement and the fiduciary-breach claim. This decision is a favorable development for plan sponsors amid the recent surge of class actions targeting tobacco surcharge wellness programs, as discussed in our recent blog post.

Annual benefits enrollment, which for many companies will be in the coming months, typically lasts one to two weeks, but the preparation process begins several months in advance. For human resources (HR) and benefits teams, this period often involves a complex blend of strategic planning, system updates, vendor coordination, and employee communications. A well-executed enrollment period ensures that employees understand their options and are equipped to make informed decisions for themselves and their families.

The US administration recently issued an executive order to expand access to alternative investments in ERISA-governed retirement accounts. The order titled Democratizing Access to Alternative Investments for America's Workers aims to modernize retirement plan investment options by including alternative investments, such as private equity, private credit, real estate, and digital assets like cryptocurrency, as designated investment alternatives.

President Donald Trump signed the One Big Beautiful Bill (OBBB) into law on July 4, 2025. The OBBB is a wide-ranging piece of legislation that introduces significant reforms across multiple areas of federal policy, including changes affecting group health plans in the areas of telehealth coverage and dependent care assistance.

The US District Court for the Northern District of Texas on June 18, 2025 vacated portions of the HIPAA Privacy Rule to Support Reproductive Health Care Privacy (2024 Final Rule) related to reproductive healthcare privacy. The ruling in the case of Purl, M.D. v. US Department of Health and Human Services granted judgment in favor of the plaintiffs. Notably, the opinion only addressed reproductive healthcare privacy-related aspects of the 2024 Final Rule, and the court severed the provision of the 2024 Final Rule requiring updates to the HIPAA notice of privacy practices requirements relating to confidentiality of substance use disorder health records. That requirement remains intact and becomes effective February 16, 2026.

President Donald Trump issued an executive order (EO) on May 12, 2025 to address the high cost of prescription drugs in the United States with the goal of ensuring Americans have access to most-favored-nation (MFN) pricing, which aligns drug prices in the United States with those in comparably developed countries.

The US Departments of Health and Human Services, Labor, and the Treasury (together, the Departments) filed a motion to suspend the litigation proceedings in The ERISA Industry Committee vs. HHS et al. on May 9, 2025 while the government reconsiders final regulations implementing the Mental Health Parity and Addiction Equity Act (MHPAEA). On May 12, the US District Court for the District of Columbia granted the stay.

Since taking office, President Donald Trump has issued several executive orders (EOs) and actions that may have an impact on group health plans. These EOs provide insight into the US administration’s policies and outline potential actions that regulatory agencies and Congress may take to implement these policies.