The Labor Department, HHS and Treasury finalized amendments to the Transparency in Coverage rules on Monday, October 5. The 2020 rules made health plans and insurers publish machine-readable files of their negotiated rates, and the files proved so large and duplicative that they were difficult to use. The amendments shrink them. Plans will produce one in-network file per provider network rather than one per plan, drop provider-rate combinations that are unlikely to be paid given the provider’s specialty, move in-network and out-of-network updates from monthly to quarterly, and use a standardized format for the pricing files, findable through a required link in the website footer. Out-of-network reporting expands, with the disclosure threshold dropping from 20 claims to 11. Accountability tightens too. The rules add accuracy attestations and require plans to identify the official responsible for the data, and participants gain the right to request their cost-sharing estimates by phone for plan years beginning on or after January 1, 2027. The long-deferred prescription drug file also gets a timetable, laid out in the agencies’ press release rather than the rule text, with a standardized format targeted for around May 2027 and drug files expected starting in December 2027 and monthly thereafter. The in-network and out-of-network file changes apply five months after the rules publish in the Federal Register, and the new contextual files follow at eleven months.

The Pension Benefit Guaranty Corporation has temporarily waived a year-end report triggered by shrinking active participation in a pension plan. The test generally looks for a drop below 80 percent of the start-of-year count, after adding back departures already reported separately as single-cause events. Morgan Lewis notes the trigger has been tripping most often in frozen plans with few remaining active participants. Technical Update 26-1, issued September 18, covers reporting deadlines on or after that date and lasts until an amended final rule takes effect. Reporting rules for layoffs, shutdowns and other single-cause reductions remain in place, along with their existing exceptions. PBGC says attrition reports rarely flag meaningful risks and cost more to prepare than the information is worth.

Sanyam Parikh and Sterling Perkinson turn the Trump Account rules into an implementation checklist. A contribution program must be a separate written plan; up to $2,500 per employee per year, a cap that applies per employee rather than per dependent, is excluded from income but still subject to FICA and FUTA; and salary-reduction contributions run through the cafeteria plan and can fund only a dependent’s account. Two details matter before launch. Under the September 30 temporary regulations, an automatically created account that hasn’t been claimed can’t receive employer contributions, so payroll needs to verify claiming before routing a dollar, and contributions report on the W-2 under new code TA. Their ERISA tip is to set eligibility at age 21 with a year of service, which keeps working minors, and the thorniest coverage questions, out of the program.

Prudential’s 2026 Retirement Pulse Survey asked 3,023 pre-retirees and retirees age 50 and up about spending their own money, and only 14 percent were comfortable using retirement savings each month on things they enjoy. Forty percent would rather leave money behind than risk running short, 29 percent take pride in a bank balance that never moves, and wealth doesn’t cure it: among respondents with at least $500,000 saved, 61 percent still weren’t comfortable spending on themselves. The reasons given are Social Security uncertainty, inflation and health costs, and a third don’t know how long the money has to last. One Prudential planner summed up the job: “I have to give my clients permission to spend.”

TIAA’s “Retirement in the Age of AI and GLP-1s” survey polled 1,000 adults through KRC Research in late July. On longevity, 53 percent worry more about outliving their savings than about underspending, and 43 percent doubt traditional retirement planning accounts for lives that stretch into the 90s. On what AI will do to their finances, 27 percent expect breakthrough treatments to raise costs, 22 percent expect efficiency to lower them, 20 percent expect little effect, and the rest can’t say. Separately, a third are seriously concerned AI could threaten their earning potential before they retire, a worry that peaks with Generation Z. TIAA’s read is that these are all longevity problems, and its consultants’ advice to employers is to weigh guaranteed lifetime income in plan design on par with fees and the investment menu.

Milliman’s midyear study puts aggregate multiemployer pension funding at 106 percent as of June 30, up from 100 percent a year earlier, with 69 percent of plans fully funded and the system holding roughly $55 billion in surplus. The Special Financial Assistance program is a large part of the story: 161 plans have received nearly $78 billion in grants since 2021, which Milliman credits with 9 percentage points of the aggregate funded level. Co-author Tim Connor points to strong markets and contributions that keep outpacing plan costs.

Consultants at October Three, J.P. Morgan Asset Management and Russell Investments describe the same change in client conversations. With average corporate pension funding at 99 percent this year, up from 77 percent in 2008 by Russell’s tally of public filings, employers with fully funded pension plans are asking how to use them rather than how to wind them down. The options include reopening frozen plans, improving benefits, and applying surplus to shore up an acquired company’s pension, and some employers are watching for legislation that would let surplus move into the 401(k) plan. For a decade the standard endgames were keeping a frozen plan quietly invested in bonds or terminating it by buying annuities. Neither is the automatic answer anymore.

What does an employer do when its pension no longer needs contributions? Advisers from Gallagher, Cerulli, Alight and Milliman walk through two different pools of money. Company cash freed up by a contribution holiday can go to debt, buybacks or deals. Assets already inside the plan are plan assets, and the choices there run from maintaining a funding cushion to help absorb market losses (the advisers quoted suggest 105 to 110 percent) to applying surplus to retiree cost-of-living increases or a qualified replacement plan, or continuing to de-risk through liability transfers and cash balance conversions. The thread running through the interviews is that the right answer turns on company-specific risk tolerance, not an industry default.

A retirement plan can run smoothly and still fall short for the workforce it serves, writes T. Katuri Kaye. In her example, 90 percent participation looks strong until you ask whether first-year employees are in, whether lower-paid workers contribute enough to collect the full match, and whether anyone ever moves off the auto-enrollment default rate. The four steps use data employers already receive from recordkeepers and payroll. She closes on governance. Choosing the matching formula is a business decision about plan design, while investigating why employees miss the match is fiduciary work governed by ERISA, and committee minutes should make clear which kind of decision was being made.

A new ICI and ISS Market Intelligence profile of large ERISA 403(b) plans, built from Form 5500 filings for 5,332 plans with at least 100 participants, finds employer contributions reached $13 billion in 2023, two and a half times the 2009 figure. Costs moved the other way. The average participant was in a plan costing 0.45 percent of assets in 2023, down from 0.68 percent in 2009. The share of large plans offering an employer contribution rose from 71 percent to 87 percent, target-date funds spread from about half of plan menus to 90 percent, and index funds now hold 42 percent of plan assets. For 403(b) sponsors wondering how their plan compares, the benchmarks just got a refresh.

In the only benefits entry in the IRS’s Friday, October 2 batch of private letter rulings, the agency approved a single-employer pension sponsor’s request to use substitute mortality tables, tables built from the plan’s own participant experience rather than the standard government tables, in its minimum funding calculations under Code section 430. The approval runs up to 10 years starting with the plan year beginning November 1, 2026, and follows a new experience study. The same sponsor received a similar ruling in 2021. These approvals are routine, but they’re a reminder that a large plan whose population differs from the standard tables can ask to fund based on its own data. The approval carries annual reporting conditions, and the standard tables snap back if the sponsor stops supplying the data. A private letter ruling binds the IRS only as to the taxpayer who requested it.

Fred Reish continues his series on the Labor Department’s proposed rule for selecting investments in participant-directed plans, this time on liquidity at the plan level rather than the participant level. The proposal’s example asks fiduciaries weighing a fund that holds private assets to think about what happens when the plan itself needs to exit the investment, say in a recordkeeper change or a corporate merger, and whether redemptions by other investors could knock the fund off its target allocations. The proposal would treat fiduciaries as prudent if they evaluate the fund’s maximum illiquid allocation, how long a sale would take without giving up value, and the required exit notice. Reish’s caution is that weighing other plans’ redemptions isn’t common practice today and most committees aren’t equipped for it, which points toward delegating the analysis to an investment manager with authority to make the decision.

Fred Barstein catalogs what stands between the retirement industry and its favorite growth story, advisers turning plan participants into wealth management clients. The hurdles are practical. Most participants don’t hold enough assets to interest advisers under traditional service models, engagement is famously hard, recordkeeper technology in some shops dates to the 1990s, and there’s no standard format for plan or participant data. He also notes that recent litigation means sharing participant data may now require plan sponsor permission, and that some providers would rather keep participant relationships for themselves. His bottom line is that convergence is real but will take longer and cost more than the pitch decks suggest. Sponsors fielding wealth-service offers from their plan providers can borrow his checklist.

Proposed IRS rules published August 11 would clarify how employers test whether dependent care benefits favor higher-paid employees. The change that matters most involves the average-benefits test, which requires that benefits for lower-paid employees average at least 55 percent of those for higher-paid employees. The test would count only employees actually receiving benefits, rather than treating every non-participant as a zero. A plan designed to offer the same benefits to everyone eligible satisfies the same-terms requirement even when use differs by pay level, though the average-benefits test still applies. No more than 25 percent of benefits can go to owners holding more than 5 percent of the business. There’s also a correction path for two of the four tests. A failed average-benefits or owner-concentration test can be fixed after year end by moving the excess into the affected employees’ income by the deadline for furnishing W-2s, and failing any test makes benefits taxable only for highly compensated employees. These programs let workers exclude up to $7,500 a year of dependent care assistance, and employers can rely on the proposed rules before they’re final.

Lee Hafner’s data piece treats menopause as a retention problem, not a wellness perk, arguing that support is what keeps mid-career women from scaling back at work. The number that frames it comes from a Stanford study, which found women’s earnings drop 10 percent in the four years after they first seek menopause-related care. The article collects current statistics, accommodation ideas and employer examples for benefit teams building support that goes beyond simply referring employees to an employee assistance program.

Will Prest’s test for a financial wellness program is whether it helps an employee choose, not just learn. His composite employee juggles a 401(k), an HSA, credit card debt and a parent she helps support, and every tool she’s offered addresses one slice without ranking her priorities. EBRI’s 2025 employer survey found more than three quarters of firms ran cost-benefit analyses on their wellness offerings, and connecting standalone benefits remains one of the sticking points employers name. He’d ask any vendor three questions. Can employees compare options against the benefits they actually have? How do they reach a qualified human when they’re stuck? And what turns a decision into action? Measure follow-through, he argues, not logins.

Trevor Colhoun, who runs the behavioral health network TPN.health, argues that coverage only counts when an employee actually reaches an appropriate provider instead of getting lost in disconnected directories and referrals. Brokers and advisers write the RFPs, evaluate the networks, negotiate the pricing and review vendor performance, so he’d point the incentives at them: tie part of vendor compensation to measurable standards such as response times and the rate at which members accept their first provider match.

Ben Conner, who leads the benefits brokerage Conner Insurance, argues that rebates and changes to drug coverage don’t address the underlying conditions driving pharmacy spending. Conner says his diabetes playbook, standalone clinics, home-delivered medications and incentives for working with health coaches, held per-patient costs steady and cut emergency visits and admissions. Mental health is his next target, and the obstacle is measurement. Some newer specialty psychiatric medications run $15,000 to $20,000 or more per member a year, utilization keeps climbing, and unlike diabetes there’s no A1C, no lab value that shows a drug is working. Conner argues that continued prescription use can become a substitute for measuring whether treatment helps, and that the incentives point the wrong way, since pharmacy benefit managers and manufacturers are paid when prescriptions keep filling. He is explicit that the answer isn’t denying care. He wants employers to ask what evidence shows that expensive medications, together with clinical support, are actually improving patients’ lives.

California has revised its restrictions on stay-or-pay provisions, the contract terms that make a departing worker repay a bonus, tuition, training, relocation help or advanced leave. Governor Newsom signed AB 1697 on September 30, postponing compliance until January 1, 2027 and softening several edges of last year’s AB 692. Retention and relocation bonuses no longer have to be agreed at the start of employment to qualify for an exception, employers may recoup advanced paid time off up to 40 hours, and the exceptions for grant-funded bonuses and for tuition agreements covering transferable credentials both got wider. Jackson Lewis’s Susan Groff and Rachel Szela walk through the details. Employers with California workers should inventory every agreement that conditions money on staying, and complete the review before January 1, 2027.

The order list issued Monday, October 5, on the opening day of the term, denied review in four cases benefits lawyers were watching. Zavislak v. Netflix leaves standing a Ninth Circuit ruling that the service contracts between Netflix’s health plan and its administrators aren’t plan documents a participant can demand under ERISA’s disclosure rules. McLean v. Delta Air Lines ends former pilots’ effort to revive a suit claiming Delta pushed them out over military leave, leaving the Eleventh Circuit’s dismissal in place. Gasper v. EIDP closes a retiree’s challenge to a reduction of his monthly annuity, with Justice Alito recused. And in United Airlines v. Kincannon, the Court declined to review the class certification United challenged in a suit by employees placed on unpaid leave after receiving religious exemptions from its COVID-19 vaccine policy, over a noted vote by Justice Kavanaugh to grant review. The case traveled below as Sambrano v. United Airlines, where the panel affirmed certification of a 2,221-member class over a partial concurrence by Judge Willett questioning whether religious sincerity can ever be a common question. A denial isn’t a ruling on the merits. It leaves each lower court decision in place without endorsing its reasoning.

The Sixth Circuit has overturned an order that let roughly 800 plaintiffs in the national opioid litigation add claims against pharmacy benefit managers affiliated with OptumRx and Express Scripts nearly two years after the deadline to amend their complaints. In an October 2 order in In re OptumRx, the appeals court said the judge who manages the litigation, Dan Polster, clearly abused his discretion by finding good cause for the delay across the board instead of examining each plaintiff’s explanation, and it noted the PBMs’ point that some plaintiffs had sued them as early as 2018. The court granted the PBMs’ petition for a writ of mandamus, the rarely used order that corrects a trial court midstream, vacated the amendment order, and directed the district court to look at diligence plaintiff by plaintiff. The claims aren’t dead. Amendments backed by actual diligence can still go forward.

Amro Naddy ran the 360 Reviews division at U.S. News & World Report and says the company owed him roughly $1.9 million under two long-term incentive plans and a 2024 bonus plan when cash ran short. He alleges the CFO offered him a choice between taking less and being fired for cause, and that the termination email arrived two hours later. In a September 28 opinion, Judge Dabney Friedrich let Naddy’s contract and D.C. wage claims on the incentive plans proceed. The 2020 plan was never signed, but under D.C. law continued employment can supply both acceptance and consideration, and clauses making the company’s calculations ‘final’ don’t amount to discretion to pay nothing at all. The severance claim failed because the employee handbook summarizing the severance plan disclaims being a contract and promises only that employees ‘may be eligible’ for severance. The court expressly left open whether claims under the separate severance plan document itself would be preempted by ERISA. The handbook disclaimers did exactly the job they were drafted to do.

Patrick Hawkins sued Wells Fargo and its short-term disability plan over denied benefits, and separately claims he was fired for pursuing those benefits and for providing information to the Labor Department. Wells Fargo’s arbitration agreement covers employment claims broadly but carves out ‘claims for benefits under the Employee Retirement Income Security Act.’ In a September 28 opinion, Magistrate Judge Andrew Edison in Galveston read the carve-out narrowly. The claim seeking the unpaid disability benefits stays in court, and both sides agreed it should. The claim that Wells Fargo fired him for pursuing those benefits, brought under ERISA section 510, goes to arbitration along with his disability discrimination claims, because it attacks the termination rather than seeking benefits. The opinion collects decisions from other courts reading similar language the same way. Anyone who assumed an ERISA carve-out keeps every ERISA claim in court should reread their arbitration agreement with that distinction in mind.

Hall Benefits Law recaps PHI Health’s suit against Anthem, the air-ambulance operator’s claim that the insurer and the plans it administers haven’t paid about $30 million in final awards from the No Surprises Act’s independent dispute resolution process, plus more than $1.3 million in interest. IDR determinations are binding and payment is generally due within 30 days, yet it remains unsettled whether a court can actually compel payment of an unpaid award, which is what this Indiana federal case may answer. PHI also alleges Anthem delayed and underpaid awards to pressure providers into below-market network deals. The roughly 70 employer plans named alongside Anthem, and every self-funded sponsor it administers, have a direct stake in the answer.

Michelle Roberts breaks down Macpeak v. Unum, a September 28 decision of the Eastern District of Pennsylvania. The plan’s own words decided the case. For attorneys, this Unum plan defined ‘regular occupation’ as the lawyer’s specialty in practice, yet Unum’s vocational review and all three of its reviewing physicians measured the claimant, a securities lawyer with migraines and cyclical vomiting syndrome, against the generic duties of an attorney from a national database, trial work and patent applications included. Even under deferential review an administrator can’t read the plan’s language away, and the court leaned on Third Circuit precedent about diluting a specialty with generalized occupational data. The remedy followed from the history. Because Unum had paid benefits for six years before cutting them off, the court ordered those benefits restored retroactively rather than sending the claim back to Unum for another review.

Northwestern Mutual’s 2026 Planning and Progress Study, a Harris Poll survey of 4,375 adults fielded in January, finds 61 percent of adults expect to need long-term care and 73 percent would rather receive it at home, yet 54 percent have made no financial plan for it. The study prices a home health aide working eight hours a day at $99,280 a year in 2025, citing illumifin’s cost of care data. Caregiving is already reshaping younger workers’ finances. About a fifth of Gen Z and Millennial respondents are currently providing care, and 10 percent of current and former caregivers report reallocating retirement funds to cover it, per the study. For sponsors, the study reads as a case for pairing retirement education with long-term care planning before the costs arrive.