The Departments' first official acknowledgment of this week's Fifth Circuit decision in the long-running Texas Medical Association litigation over the No Surprises Act's qualifying payment amount methodology, posted to CMS's No Surprises Act notices page. The statement is brief; the ruling it responds to is not. See The First Thing above.
Friday, August 14, 2026
№ 31Regulatory & Guidance (1)·Court Decisions (2)·Retirement Plans (16)·Health & Welfare (2)·Case Commentary (2)·Leave & Time Off (2)·Executive Compensation (1)·Also Noteworthy (1)
The Two Things
The First Thing: The Fifth Circuit this week struck down core pieces of the No Surprises Act's payment methodology in the latest Texas Medical Association decision, holding that the rules let insurers calculate artificially low qualifying payment amounts. Out: so-called ghost rates for services a provider rarely performs, out-of-specialty rates, and the exclusion of bonus and incentive compensation from the calculation. For group health plans, especially self-insured plans relying on TPA-calculated QPAs, the practical consequence is recalculated and generally higher QPAs, with ripple effects through every out-of-network payment dispute. Ask your TPA two questions: how it calculates QPAs today, and when it will have recalculated ones.
The Second Thing: The Ninth Circuit affirmed an arbitrator's finding that a multiemployer pension actuary violated ERISA by using PBGC-published interest rates to calculate withdrawal liability rather than the actuary's own best estimate of anticipated experience. The fund's 7 percent funding assumption applied instead, which means a smaller bill for the withdrawing employer. Contributing employers facing a withdrawal liability assessment should read this one before paying: the assumptions behind the number are challengeable, and the challenges are winning.
Regulatory & Guidance (1)
Court Decisions (2)
In an unpublished memorandum, the Ninth Circuit affirmed an arbitration award holding that a multiemployer plan actuary's use of PBGC-published interest rate assumptions to calculate withdrawal liability violated ERISA's requirement that assumptions represent the actuary's best estimate of anticipated experience. The plan's 7 percent minimum funding rate applied instead. See The Second Thing above.
another data point on where provider state-law claims survive plan-administration preemption.
Retirement Plans (16)
PLANADVISER's take on Wednesday's rollover guidance, which led yesterday's Digest: electronic transfers and standardized forms for moving retirement savings between plans would be encouraged under the proposed procedures.
A second read on the SECURE 2.0 section 324 rollover package, with attention to the four sample forms and what recordkeepers will need to change to support direct electronic transfers.
NAPA's advisor-facing angle on the same guidance: what standardized rollover procedures would mean for plan-to-plan transfers and the participants who currently abandon rollovers midway.
Mayer Brown's analysis of Monday's proposed regulations: the up-to-$2,500 tax-free employer contribution to Trump Accounts, the workplace-program nondiscrimination and reporting requirements, and the first formal guidance on the 55 percent average-benefits test for dependent care assistance programs.
A pilot becomes policy: employers considering a defined benefit plan can now ask PBGC for a coverage determination before establishing the plan, removing a source of uncertainty for church-affiliated, professional-service, and Puerto Rico plan sponsors.
Principal's latest financial-health index finds employers and employees converging on two trends: workers postponing retirement dates and both sides leaning on AI tools for planning.
the mid-year checkpoint for sponsors budgeting next year's contribution and compensation limits.
PLANSPONSOR digs into the Boston College CRR small-business study the Digest featured Wednesday: the barriers to plan adoption reflect misperceptions and information gaps rather than insurmountable economics.
Financial Finesse research suggests employees approaching retirement who engage with virtual financial wellness programs are significantly more likely to take key planning actions and improve retirement readiness.
relevant context for rollover conversations.
If a pooled employer plan absorbs the lion's share of fiduciary and administrative responsibility, what role remains for the advisor? NAPA argues the answer is a redefinition, not a reduction.
and why plan sponsors should treat cross-selling as a fiduciary-oversight item.
Technology, participant expectations, and advisor demand are pulling 401(k)s out of their traditional silos toward holistic planning that connects workplace accounts to broader wealth management.
a workforce-planning number as much as a benefits one.
The Slott team untangles a perennial confusion: how the five-year holding period actually applies when a saver has made multiple Roth conversions in different years.
the gap to watch as alts push toward DC menus.
Health & Welfare (2)
which participant communications could move to e-delivery, and the notice-and-access mechanics sponsors would need to build.
the second consecutive year of double-digit projected trend, and the number that will anchor this fall's renewal conversations.
Case Commentary (2)
Another voice joins the post-Genworth chorus the Digest has been tracking: Holland & Hart on why the era of stipulated or rubber-stamped class certification in 401(k) fiduciary litigation is ending, and how sponsors should adjust their defense posture.
one of the largest 401(k) fee settlements on record, and a checklist of the oversight practices that were alleged to be missing.
Leave & Time Off (2)
a payroll and policy update for any employer with San Francisco headcount.
CBIZ's monthly compliance calendar: state vaccine-assessment filings due August 15 in New Hampshire and Maine, Washington PAL program payments due September 1, and Connecticut's health and welfare fee assessment due September 30.
Executive Compensation (1)
Part four of the firm's executive-pay series reaches section 280G: how golden-parachute payments trigger the excise tax, the shareholder-approval escape hatch for private companies, and the planning that has to happen before a deal is on the table.
Also Noteworthy (1)
a useful one-stop review for anyone catching up after a summer vacation.