BENEFITS DIGEST

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A publication of The Inner Firm

Friday, August 28, 2026

№ 41

22 items · ~5 min read

Regulatory & Guidance (1)·Retirement Plans (9)·Health & Welfare (6)·Case Commentary (5)·Leave & Time Off (1)

The One Thing

When regulators start writing FAQs about a litigation trend, the trend has arrived. The wellness-program enforcement relief the agencies issued Wednesday is a direct response to the tobacco-surcharge class action wave, which by Groom's count now runs to more than 80 putative class actions claiming that premium surcharges for tobacco use violate ERISA. The relief takes two recurring theories off the table going forward, midyear reward timing and notice wording, and leaves the rest to the courts, including the retroactive-refund question sitting in the Sixth Circuit's Progressive appeal. Sponsors running surcharge programs should read the FAQs against their own plan documents now.

Regulatory & Guidance (1)

Walberg, Mackenzie Seek Audit of Additional DOL Agencies Following Inspector General Findings
House Education & Workforce Committee 2026-08-26

House Education and Workforce Committee Chairman Tim Walberg and Workforce Protections Subcommittee Chairman Ryan Mackenzie have asked the DOL Inspector General to expand its information-sharing audit beyond EBSA, the Wage and Hour Division, and the Office of the Solicitor, the three agencies covered by the IG's June 30 report on the Department's common interest agreements with outside litigants. The August 26 letter asks whether the same informal sharing practices extended to other major DOL enforcement agencies.

Retirement Plans (9)

Restating Your 401(k)/Defined Contribution Plan for the Fourth Remedial Amendment Cycle
Boutwell Fay 2026-08-27

Plan sponsors of qualified defined contribution plans such as 401(k) plans must update their pre-approved plans every six years to reflect law changes and to maintain their pre-approved status with the IRS. Boutwell Fay walks through what the fourth remedial amendment cycle requires and the timing sponsors should be planning around.

Benefits Monthly Minute - August 2026
Keating Muething & Klekamp · via JD Supra 2026-08-28

The August Monthly Minute reminds plan sponsors of the upcoming SECURE 2.0 plan amendment deadline and highlights a Fourth Circuit decision reflecting the litigation impact of a delayed ERISA appeal determination.

Health & Welfare (6)

Clearing the Air: Tri-Agencies Issue Enforcement Relief on the Wellness Program “Full Reward” Requirement
Groom Law Group 2026-08-27

Groom situates the new tri-agency FAQ relief against the litigation wave that produced it: by the firm's count, the HIPAA wellness program rules have drawn more than 80 putative class actions claiming that premium surcharges for tobacco use violate ERISA. The relief addresses the midyear reward-timing and notice-disclosure questions; the broader surcharge fights, including the pending Sixth Circuit appeal in the Progressive case, remain in the courts.

“Double Dip” Health Plans Marketed to Employers: Too Good to Be True
Thompson Hine · ERISA Litigation & Compliance 2026-08-27

Thompson Hine warns employers about double dip health plan arrangements marketed as payroll-tax savings vehicles. Treasury and the IRS have said repeatedly that these arrangements do not work under the law, and employers who adopt them risk liability for back taxes, penalties, and costly W-2 corrections.

Case Commentary (5)

Third Circuit Vacates Dismissal of Hospitals’ ERISA Underpayment Claims Under MRC-1 and MRC-2 Plans
Roberts Disability Law 2026-08-27

In Hudson Hospital OPCO v. Cigna Health and Life Insurance Company, No. 24-2830 (3d Cir. Aug. 26, 2026), the Third Circuit vacated the dismissal of three New Jersey hospitals' ERISA claims that Cigna underpaid them under the plans' MRC-1 and MRC-2 reimbursement provisions, while affirming dismissal of their reasonable-and-customary and fiduciary-duty theories. The partial revival sends a long-running provider-payment dispute back for another round on the plan-terms claims.

Sixth Circuit Reinforces Circuit Split Over Preemption of Provider Claims
Your ERISA Watch (Kantor & Kantor) 2026-08-26

Kantor & Kantor's weekly survey leads with Laurel Hill Management Services v. La-Z-Boy, where the Sixth Circuit held a provider's claims preempted, reinforcing the circuit split with the Ninth Circuit's Healthcare Ally decision covered here last week. The same edition rounds up the week's district courts, including Kovacs v. Moradi, holding that restricted stock units are not ERISA plans, and Cregan v. Unum, finding that a voluntary accident plan failed the safe harbor on three of four prongs and is therefore ERISA-governed.

Court Rejects Caremark's Website Arbitration Bid in Zepbound Coverage Class Action
Berger Montague · case page 2026-08-27

In Larkin v. Caremark Rx, No. 1:25-cv-07307 (S.D.N.Y.), participants allege the PBM wrongfully denied coverage for the GLP-1 drug Zepbound on medical-necessity grounds while steering them to Wegovy. According to early reports, the court has now declined to compel arbitration based on an arbitration provision in CVS's website terms of use, letting the ERISA coverage claims proceed. The order itself is not yet publicly posted, and the decision date is unconfirmed.

Leave & Time Off (1)