October is Employee Ownership Month, and McAfee & Taft’s Judy Burdg uses it to walk business owners through the ESOP as a succession tool. An employee stock ownership plan, or ESOP, is a retirement plan funded with company stock, which gives a retiring owner a built-in buyer, potential deferral of capital gains on the sale, and significant tax advantages when the company becomes wholly ESOP-owned. The obligations run alongside the benefits. An ESOP company must pay for annual valuations, maintain fiduciary oversight, repurchase shares when employees retire or take distributions, and keep enough cash flow to fund those repurchase obligations on top of normal operations.

Survey quantifies a tradeoff benefits teams have sensed. Among current GLP-1 users, nearly half worry the drugs’ cost is eroding their retirement savings. Fifty-four percent have changed financial behavior to afford the medications, including 17 percent taking on debt and 14 percent each withdrawing from savings or trimming retirement contributions. Out-of-pocket costs average $203 a month for users whose insurance does not fully cover the drugs. Among surveyed GLP-1 users, 88 percent feel better about their long-term health, and 64 percent say they may retire later because of it. But 59 percent doubt they can afford the medications in retirement.

Milliman’s Vanessa Vaag works through whether a cash balance plan should let participants who reach age 59½ move their money out while still working, an option the Bipartisan American Miners Act opened in 2019. Despite the name, that law’s distribution provision is not limited to miners. It lowered the minimum in-service distribution age from 62 to 59½ for every employer’s pension plan, cash balance plans included, and a sponsor adopts the feature by amending its plan. The appeal is control. A participant who cannot direct the pooled plan’s investments can roll a vested benefit to an IRA or the employer’s 401(k) without leaving the job. Employers may reduce future pension obligations and federal pension-insurance premiums, but they need enough cash to pay departing balances and must weigh the accounting effects, especially if many participants move money out at once. Employees give up the plan’s federal pension protection and lifetime payment option for the money they withdraw. The decision facing a sponsor is whether the added flexibility solves a real workforce problem, and Vaag recommends starting with an estimate of how many employees would actually use the option.

CBIZ’s October update flags three dates for employers. Medicare Part D creditable coverage notices, which tell employees whether their drug coverage is at least as good as standard Medicare coverage, are due before October 15. Extended Form 5500s for calendar-year plans are due October 15, and Massachusetts HIRD filings open November 15. The Labor Department’s benefits agency, in new Field Assistance Bulletin 2026-03, is focusing mental health parity enforcement on blanket exclusions of mental health treatment, the review practices plans use to decide whether care is necessary, and inadequate provider networks. Its updated red-flags checklist helps plans spot potential problems in their own designs while new regulations are drafted. The issue also covers the Trump Accounts temporary regulations, with IRS automatic enrollment reaching more than 60 million children and comments open through November 29, San Francisco’s 2027 health care expenditure rates, New York and New Jersey paid leave figures for 2027, and the District of Columbia’s October 1 reductions in paid family leave durations and maximum benefits.

Employees need help understanding their benefits before open enrollment begins. Employee Benefit News highlights employers that provide education throughout the year, giving workers more time to weigh their choices. The need is substantial. Alera Group reports that 84 percent of employers saw premium increases, while Prudential found that only 38 percent of employees feel confident navigating enrollment. Solidarity Health Network’s CEO projects per-employee premium increases above 8 percent for 2027, with increases of 15 to 22 percent in some markets.

Bricker Graydon Wyatt’s Michaela Sheppard explains what employers must do under the new health plan price-transparency rules. The headline obligation is a certification, for each pricing file designed for computer analysis, that the information is accurate and complete, tied to the sponsor’s CEO, president or a designated senior official, though a written agreement can shift that duty to an outside administrator. Plans must also deliver estimates of what members would pay for care by telephone, with requests limited to 20 providers per day, and maintain a standardized text file disclosing where those pricing files live along with a monitored email address. The rule takes effect December 7, with most consumer-facing changes applying for plan years beginning on or after January 1, 2027. Sponsors who have left transparency compliance entirely to their outside administrators now need to know what those vendors actually do and whether the services agreement assigns responsibility for the new certification.

KFF’s annual explainer lands ahead of Medicare open enrollment, which runs October 15 through December 7. Beneficiaries with employer or union retiree coverage can lose it permanently by switching between traditional Medicare and Medicare Advantage, because many employers offer retiree benefits exclusively through one or the other. Sixty-five percent of beneficiaries did not compare options during the last enrollment period. For 2027, the average beneficiary will have 35 Medicare Advantage plans to choose from. On the drug side, the Part D out-of-pocket cap reaches $2,400, and the new GLP-1 Bridge Program offers $50 monthly copays for weight-loss coverage outside Part D. The brief also notes that roughly 32,000 current beneficiaries are set to lose eligibility starting in 2027 under the reconciliation law’s immigration provisions.

A former Macy’s employee alleges that the company allowed excessive broker compensation to be built into the premiums workers paid for supplemental insurance, the accident, critical illness and hospital indemnity policies offered alongside its health plan. Munson v. Macy’s Inc. names Macy’s, Aon Consulting, Aon Insurance Agency and Hewitt Insurance Brokerage as defendants, and it is built almost entirely on commission data from the plan’s public Form 5500 filings. The suit claims Macy’s breached its fiduciary duties by never market-testing Aon’s compensation and by telling employees the products came at discounted group rates, and it asks the court to make the Aon entities give up compensation allegedly received through the breaches. It also alleges the 2022 carrier switch increased commissions without genuine competition, pointing to an allegedly near-identical commission pattern at BlueTriton Brands, placed by the same Aon entity through the same Aflac subsidiary in the same years. The case is assigned to Judge John Cronan, and no defendant has responded yet.

After a six-day trial, a Massachusetts federal judge ruled in Stephan v. Trader Joe’s Co. that the grocer’s 401(k) fiduciaries breached their duties on recordkeeping fees. The committee had never sought competitive bids or negotiated fees with its recordkeeper of more than fifteen years. The defendants prevailed on the investment claims and on claims involving forfeitures, employer contributions that departing workers hadn’t earned the right to keep. The award is $715,264, an overpayment the court measured from the recordkeeper’s own unprompted fee cut, plus prejudgment interest that brings the total near $1.2 million, and the court rejected the plaintiffs’ $9.2 million damages theory. Wagner Law Group’s Andrew Oringer calls the outcome sobering. The committee had checked the market, but the court found its efforts insufficient. PLANSPONSOR places the ruling in the forfeiture wave, 48 such complaints filed in 2025 against 29 the year before, with courts dismissing similar claims against AT&T, Home Depot and JPMorganChase.

Air ambulance operator PHI Health filed at least six additional suits in early October seeking payment of surprise-billing arbitration awards, against Cigna Healthcare in the Western District of Virginia, Highmark West Virginia, CareFirst of Maryland, Presbyterian Health Plan in New Mexico, UMR in Kentucky and the outside administrator 90 Degree Benefits in Ohio. They join PHI’s pending suits against Anthem affiliates in Kentucky and Missouri and an Indiana case filed in September that named roughly 70 employer and union plans as defendants. The complaints follow a common template, seeking court enforcement of arbitration awards the payors allegedly ignored, and PHI alleges Anthem alone owes nearly $30 million on more than 1,200 awards nationwide. According to the Maryland complaint, the arbitrator ruled for PHI after CareFirst failed to submit an offer or pay its arbitration fees. PHI says $19,492.87 remains unpaid months after the award became binding. In the Kentucky and Indiana cases, PHI also names employer plan sponsors as defendants in their fiduciary capacity for keeping an administrator that allegedly failed to pay binding awards. These are allegations no court has tested. Any self-funded sponsor whose administrator handles surprise-billing disputes now has a reason to ask how many awards involving the plan remain unpaid.

An associate at AmeriBen, the company administering the plaintiffs’ employer health plan, emailed a spreadsheet of members’ claims data, names, providers, dates of service and amounts billed, to other plan members. The district court dismissed the resulting class action, finding no concrete injury. The Ninth Circuit reversed in a published opinion, holding that unauthorized disclosure of sensitive health information entrusted to a company is itself the injury. Congress’s judgment in HIPAA reinforced the point, since even mundane-looking line items can reveal a psychiatrist visit or a fertility clinic. The ruling allows the patients’ suit to proceed without requiring them to show that the disclosure caused financial loss, and it matters to sponsors because the defendant administers employer health plans across the country.

The Fifth Circuit affirmed summary judgment for the Labor Department against Coastal Bridge and its sole owner, who kept withholding employees’ health premiums from paychecks while the company stopped forwarding them to its insurers and quit reimbursing Blue Cross for claims under its self-funded plan. At least 78 participants were left with $172,351 in unpaid medical bills, coverage lapsed while deductions continued, and the owner was ordered to pay $209,466 plus interest and permanently barred from serving as a plan fiduciary. The panel swept aside the defenses distressed sponsors reach for. Delegating plan tasks did not shed fiduciary status, the company’s role as named fiduciary did not shield the man who decided not to pay, and a surety’s control of receivables was no excuse. Financial trouble doesn’t excuse using employees’ health-plan contributions to cover the company’s other expenses.

Roberts Disability walks through Krambeck v. Unum, a September 30 Florida federal ruling that sends a long COVID disability claim to a bench trial and strips the insurer of two advantages it usually counts on. The policy’s discretionary clause did not require the judge to give the insurer’s decision the benefit of the doubt, because a 2020 restatement reset the policy’s effective date and placed it under Washington state’s prohibition on such clauses. And Unum’s counterclaim to recover $24,000 in benefits after the claimant received a retroactive Social Security award failed, because the money had been spent, leaving no identifiable funds for Unum to recover through that claim. The court also refused to weigh dueling physician opinions on paper, holding that a genuine dispute over how long the claimant can speak in a day belongs at trial. Plan documents age, state insurance regulation moves, and a routine restatement can quietly change which rules govern.

Callbeck v. Wellington Management Company, filed October 9 in Massachusetts federal court, asks whether an investment manager prudently ran its own $3.16 billion retirement plan. More than 40 percent of the plan’s assets sit in investment funds managed by Wellington itself, and three of the four challenged funds are Wellington’s own products, holding roughly $267 million of participant money at the end of 2024, alongside $90 million in the also-challenged Vanguard U.S. Growth Fund. The complaint cites other public retirement plans that placed the challenged funds under closer review or removed them, including a Connecticut utility district that moved its Wellington large-cap money to an index fund for greater returns and lower costs. It argues that Wellington’s own committee had access to the same warning signs but kept every one of the funds. The suit estimates plan losses exceed $50 million. It was filed by Almeida Law Group, the firm behind the Rockland Trust complaint days earlier, and the Supreme Court’s pending Intel decision could affect what the plaintiffs must allege to keep the case moving.

Three former employees sued HP and its plan committee on October 7 in San Jose federal court over two custom funds in the company’s $10.85 billion 401(k) plan, the U.S. Large Cap Equity Fund and the U.S. Small/Mid Cap Equity Fund. The complaint alleges the large-cap fund trailed the Russell 1000 index in nine of the eleven calendar years from 2015 through 2025 and the small/mid-cap fund trailed the Russell 2500 in eight of eleven, underperformance it says was visible on the funds’ own fact sheets and the Fidelity screens shown to participants. The two funds held about 23 percent of plan assets and sit inside all twelve of the plan’s Birth Date Funds, the investments used for participants who don’t make their own selections. The complaint therefore also seeks compensation for losses suffered by participants who never selected either fund directly, and it estimates plan losses above $300 million. The suit brings distinct prohibited transaction claims as well, over the plan’s recordkeeping and revenue-sharing payments to Fidelity, its payments to HP itself for administrative services, and employee contributions deposited late in seven straight years, delays the plan’s own filings classify as nonexempt prohibited transactions. The plaintiffs argue that their chosen comparisons meet the standard the Supreme Court is considering in the Intel case.

Judge Sarah F. Russell denied XPO’s motion to keep discovery, the exchange of documents and testimony, on hold in Hill v. XPO, a class action over the $100 monthly tobacco surcharge in the group health plans of XPO and GXO Logistics, its spun-off contract logistics business. A retired operations supervisor who paid the surcharge alleges that the companies cannot claim ERISA’s wellness program exception to the ban on charging tobacco users more, because employees who completed the free cessation program had the surcharge removed only going forward rather than refunded for the full plan year, and the plan materials didn’t explain an alternative way to avoid the surcharge. After most claims survived dismissal in March, XPO asked to keep discovery on hold while the judge considered another request to end the case. The judge refused, saying XPO was raising arguments it could have made earlier and the case was already two years old. The parties now head to a magistrate judge to set deadlines for the next stages of the case.

All Points North, a Colorado addiction and mental health treatment provider, is now pressing its claim-denial fight with Aetna in as many as 29 separate federal cases. In an October 6 order, Judge Nina Y. Wang severed the provider’s 2024 suit over allegedly widespread claim denials into individual benefits cases, one per patient, each pairing Aetna with that patient’s employer health plan, and waived the filing fees. The first new dockets include the Boston Consulting Group and Alaska Electrical plans. Each new case opens with the same 118-page complaint from the original action, which named more than two dozen employer plans, including those of Amazon, Apple and CVS. In it, the provider and eleven named patients allege that since 2022 Aetna denied hundreds of claims for residential and outpatient mental health and addiction treatment using boilerplate requests for records that had already been sent, with representatives conceding the records arrived but were never attached to the claims, and a portal that often offered no way to appeal. The complaint says Aetna placed the provider on a special review status and told it the status would lift only after six months of what Aetna called clean claims, without saying what was wrong with the claims it had. A demand letter from the provider’s counsel put the disputed benefits for the 42 patients above $5.5 million. The mental health parity claims stay behind in the original case, where the eleven patients will press them against Aetna and six employer plans, and the court set an October 21 conference to build a master schedule for all of the severed cases. No defendant has responded to the new cases yet.

The Supreme Court’s Intel argument focused on how similar investments must be before comparing their returns can support a claim that a 401(k) plan was mismanaged. Nevin Adams’ recap works justice by justice. Kagan accused the participants’ counsel of attacking a caricature of the Ninth Circuit opinion, which she read as requiring comparable objectives and risk rather than identical investments. Gorsuch kept pulling the discussion back to the question presented, benchmarks for underperformance claims only, and Kavanaugh pressed the difference between results and prudence, noting a sound strategy can lose money while an imprudent one profits. Barrett asked how to define meaningful without inviting lower courts to demand a twin. Intel’s counsel conceded that comparators need not share asset allocations and that risk-adjusted tools exist, and the government argued plaintiffs can plead imprudence without any comparator when they are not relying on underperformance. Adams reads the argument as receptive to requiring a meaningful comparison, with the real fight over how much content the word carries.

Saul Ewing’s monthly roundup examines how courts evaluate disability evidence. A Massachusetts court rejected every argument a claimant raised against a benefits termination, including his attempt to rely on a physician report submitted nine months after the final appeal decision, which the court would not consider. A California court said an insurer need not take subjective complaints at face value. An Oregon court reinstated benefits for a claimant with young-onset Parkinson’s disease, crediting her personal statements and treating physicians over doctors who reviewed the records without examining her. The Eighth Circuit refused to credit a treating physician who said the claimant could do seated work for two years and changed his opinion only after benefits were terminated. And an Alabama dispute over who should receive life insurance proceeds went to the insured’s daughters, after the court found a telephonic beneficiary designation invalid under the policy and the purported marriage void, noting that federal courts routinely look to state law to identify a spouse under an ERISA plan.