BENEFITS DIGEST

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A publication of The Inner Firm

Monday, October 19, 2026

№ 76

28 items · ~15 min read

Congress & Agencies (2)·Retirement Plans (5)·Health & Welfare (6)·Leave & Time Off (1)·Court Decisions & Case Commentary (13)·Also Noteworthy (1)

The One Thing

Congress has given employee stock ownership plan fiduciaries explicit statutory support for relying on an independent valuation. Under the Retire Through Ownership Act, signed into law October 15, they may rely in good faith on an appraisal that follows the IRS’s established valuation principles. That doesn’t make the report a shield against every claim. The law preserves ERISA’s fiduciary duties and the Labor Department’s existing rulemaking authority, and fiduciaries still have to scrutinize the valuation rather than simply accept it. The change gives qualifying reliance an express place in the statute while leaving the duty of prudence intact.

Congress & Agencies (2)

ESOP Valuation Act Signed Into Law
PLANSPONSOR 2026-10-16

Fiduciaries of employee stock ownership plans, the retirement plans that invest primarily in the sponsoring employer’s own stock, may now rely in good faith on an independent appraisal of closely held employer stock when the appraiser follows the IRS’s established valuation principles. President Trump signed the Retire Through Ownership Act on October 15, and congress.gov records it as Public Law 119-124. The two-page enrolled text expressly preserves the fiduciary duties ERISA already imposes and the Labor Department’s rulemaking authority, and the change applies to determinations made on or after enactment. The House passed the bill 401 to 14 on September 16 after unanimous Senate passage.

Submit a Petition for the Denial of an IDR Entity’s Certification or Recertification Application
CMS 2026-10-16

CMS has opened a five-business-day window, October 16 through October 23, for petitions opposing certification or recertification of named federal surprise-billing dispute-resolution entities. The listed applicants include Maximus Federal Services, ProPeer Resources, C2C Innovative Solutions, Medical Evaluators of Texas ASO and Federal Hearings and Appeals Services. A petition needs supporting information rather than a general objection, CMS acknowledges petitions within 10 days, and applicants get a chance to respond. The entities are at the application stage, so this is an opportunity to be heard, not an announcement that anyone has been recertified.

Retirement Plans (5)

IRS Clarifies Amendment Deadlines for SECURE and SECURE 2.0 Plan Amendments
Mayer Brown 2026-10-16

Mayer Brown unpacks a September 18 IRS Employee Plans newsletter correcting the widespread assumption that every SECURE and SECURE 2.0 amendment is due December 31, 2026. Under the newsletter as the firm reads it, discretionary changes a plan has already put into operation generally do need amendments by the end of 2026, while many required amendments come due only after the relevant provision lands on an IRS Required Amendments List, with later dates generally applying to collectively bargained and governmental plans. A separate Notice 2026-33 extends the deadline for optional qualified long-term-care distribution amendments to December 31, 2027. The firm’s practical point is to track the document deadline and the operational compliance date separately.

Trump Accounts: What Employers Need to Know
Haynes Boone · via JD Supra 2026-10-15

Haynes Boone walks employers through contributing to Trump Accounts, which the firm describes as traditional IRAs for children under 18 that took effect earlier this year. Ordinary contributions, including qualifying employer contributions, share a $5,000 annual limit per child, with certain government, qualified general and rollover contributions excluded, and an employer program may contribute up to $2,500 per employee, counted within that shared limit rather than on top of it. Qualifying employer contributions are exempt from federal income tax but not from the employer’s Social Security and unemployment payroll taxes, and the firm describes the written-program and nondiscrimination requirements along with open administrative questions. These are accounts for employees’ children, not a new retirement account every adult employee can open, and the analysis is the firm’s reading of the underlying guidance.

When AI Joins a Fiduciary Discussion: Rethinking Leadership, Stewardship, and Governance
401(k) Specialist 2026-10-16

Don Trone argues that AI can sharpen a fiduciary committee’s analysis without displacing the committee’s responsibility for judgment. His leadership, stewardship and governance framework treats generated answers as inputs that still need human oversight, relevant evidence and accountability for consequences. The piece is a practitioner’s opinion about sound process, not a Labor Department requirement or a litigation safe harbor, and the framework is Trone’s own.

PBGC Proposes Reporting Requirements for Multiemployer Plans With SFA Funds
PLANSPONSOR 2026-10-16

PLANSPONSOR reports PBGC’s proposal to expand what multiemployer plans that received special financial assistance file with their annual statements of compliance, adding plan investment policies, allocation information, committee documents and relevant meeting records. Segal’s Susan Boyle discusses the practical burden for funds that already file extensively. Comments on the information-collection proposal are due December 15, and the annual statements run through 2051. It is a comment request, not a new investment rule.

Employers Shift Focus to Better Participant Outcomes: Gallagher
401(k) Specialist 2026-10-16

Gallagher’s newly released 2026 U.S. Financial Benchmarks Report, built on a survey of 3,717 U.S. organizations fielded January through March, finds 85% offering retirement benefits but the supporting features uneven. 57% use automatic enrollment and only 5% provide an emergency-savings benefit. The argument is to judge a benefits program by participant outcomes rather than by what is merely offered.

Health & Welfare (6)

Know Before You Owe: New Rules Expand Health Plan Price Transparency Requirements
Seyfarth Shaw · via JD Supra 2026-10-16

Seyfarth lays out the new price-transparency package’s staggered calendar. The rule is effective December 7, 2026, the price-comparison phone tool changes apply for plan years beginning on or after January 1, 2027, specified machine-readable file changes land March 6, 2027, new context files follow September 6, 2027, and the first annual provider-utilization file is due July 1, 2028. The allowed-amount reporting threshold drops from 20 claims to 11, and a plan may limit telephone requests so long as a caller can still get cost information for at least 20 providers per day, a permitted floor rather than a duty to refuse more. The firm also separates an insured plan’s written allocation of responsibility to its issuer from a self-funded plan’s arrangement with its administrator, where responsibility stays with the plan.

2027 Healthcare Cost Trends: What Employers Need to Know
Employee Benefit News 2026-10-16

Aon’s 2026 Human Capital Trends Study projects the North American gross medical trend easing to 9.2% in 2027, the first time in five years the region’s forecast has come in below the prior year’s, and finds 87% of responding organizations planning to use well-being initiatives next year. Aon’s Kathryn Davis cautions in an accompanying interview that moderation is not relief, since costs keep rising from an elevated base while aging populations, chronic conditions and new treatments push the other way. She frames GLP-1 coverage as a question of access, clinical appropriateness and the whole employee health journey rather than a standalone pharmacy decision, and urges targeted, data-driven cost management over across-the-board cuts.

3 Tips to Manage Soaring Health Costs
Healthcare Dive 2026-10-16

Marsh McLennan benefits consultant Marybeth Gray told a CFO conference on October 13 that employers should start planning far earlier, identify the chronic conditions driving their spend, and consider targeted clinical tools. Her timing example is to begin a 2028 benefits strategy in January 2027 rather than the following June. The article cites a 76% rise in costs over the past decade, attributed to the Business Group on Health, and floats genomic and pharmacogenomic testing as options. This is conference advice from a consultant, options to evaluate rather than promised savings.

Proposed New ‘Notice-and-Access’ Safe Harbor for Electronic Group Health Plan Disclosures
Boutwell Fay 2026-10-16

Boutwell Fay walks through the Labor Department’s July 23 proposal to add a notice-and-access electronic-delivery safe harbor for group health plan disclosures, a proposal whose comment period closed September 21. The design would permit a notice linking directly to documents without a login barrier, with an initial paper notice, a paper-copy right, an opt-out, combined annual notices at intervals no longer than 14 months, and documents kept available for at least a year or until replaced. The department’s own estimate puts annual savings at $402 million across 2.8 million plans, and the proposed effective date is the January 1 after a final rule publishes. The firm’s emphasis is implementation, vendor arrangements and data security, and nothing is final yet.

Trade Association Sues Trump Administration Over ACA Broker, Agent Freeze
Healthcare Dive 2026-10-16

Employers that rely on brokers to help workers obtain individual-market coverage have a stake in the federal freeze on registering and training new Marketplace agents and brokers, which runs through February 1, 2027 and overlaps the November 1 to January 15 enrollment window. The National Association of Benefits and Insurance Professionals is suing HHS over the freeze, which Healthcare Dive reports affects roughly 19,000 agents. The association’s complaint says HHS acted without adequate authority or required procedure, while the government points to enrollment misconduct. No court has ruled on the freeze’s lawfulness.

Employer Compliance Guide to 2027 Open Enrollment for Health and Welfare Benefits
Fisher Phillips · via JD Supra 2026-10-15

Fisher Phillips assembles an open-enrollment checklist that runs from eligibility and the ACA offer requirement through prospective section 125 elections, required disclosures, and enrollment access for employees on FMLA leave or COBRA. The guide collects the 2027 dollar limits announced so far, including HSA figures the article sources to Rev. Proc. 2026-24, and flags the figures still awaiting announcement. The guide’s process reminder is that plan terms, cafeteria-plan rules and enrollment communications have to agree, and that the carrier does not handle compliance by default.

Leave & Time Off (1)

FMLA Leave and RIF Decisions: Why the Record Matters
Littler 2026-10-16

Littler examines Donald v. Toppan, where a Georgia federal court let FMLA interference and retaliation claims proceed past summary judgment after a 15-person reduction in force swept in a production supervisor on intermittent FMLA leave to care for his wife. In her September 28 order, Chief Judge Leigh Martin May cited emails suggesting that leave influenced the decision and the company’s failure to explain why it retained another employee in a senior-operator job Donald was qualified to perform. The disability-association, race and sex claims were dismissed, and surviving summary judgment is not a finding that the layoff was retaliatory. Littler’s lesson is to document selection criteria and apply them consistently, because approving leave for years does not inoculate the termination decision.

Court Decisions & Case Commentary (13)

HP 401(k) Suit Targets CIT Performance, Prohibited Transactions
NAPA 2026-10-14

Three former HP employees filed a would-be class action in the Northern District of California on October 7 over two collective investment trusts holding about $2.53 billion, 23.3% of the $10.85 billion 401(k) plan. The complaint alleges the large-cap fund trailed its Russell 1000 benchmark in 9 of 11 calendar years from 2015 through 2025 and the small and mid-cap fund in eight, and estimates roughly $313 million in foregone returns for 2021 through 2025 against comparator averages, an illustration by the plaintiffs rather than money removed from accounts or an adjudicated loss. Both funds also sat inside all 12 of the plan’s default Birth Date funds. Separate counts invoke Cunningham v. Cornell to challenge recordkeeping, revenue-sharing and plan-administration payments, though Fidelity, SEI and Callan are not defendants, and the complaint itself says late contributions were corrected with lost earnings in 2024. Every figure above is the plaintiffs’ account.

FedEx Pilots’ Pension Recalculation Claims Survive a Renewed Motion to Dismiss
U.S. District Court for the Western District of Tennessee 2026-10-15

Retired FedEx pilots allege that their pension plan still uses life-expectancy assumptions published in 1984, and that the outdated tables shrink the pensions that keep paying a surviving spouse after the retiree dies, with claimed monthly shortfalls of $685.94 for one named pilot and $393.99 for another. On October 15, on remand from the Sixth Circuit, Judge Thomas Parker denied FedEx’s renewed motion to dismiss. The court declined to confine the required comparison to the plan’s normal retirement age of 60 or to read an optional 100% survivor annuity out of the statutory protection, and it let related fiduciary and monitoring theories proceed. Nothing is decided on liability, and the alleged shortfalls are not adjudicated damages.

Fourth Circuit Upholds Title VII Judgment Over Denial of Same-Sex Spousal Health Benefits
U.S. Court of Appeals for the Fourth Circuit 2026-10-16

The Fourth Circuit on October 16 affirmed judgments under Title VII and Maryland law for a Catholic Relief Services data analyst whose husband was denied the spousal health coverage other employees’ spouses received. The majority held that a religious motivation did not displace the prohibition on sex discrimination for an employee in a nonministerial role, and that the Religious Freedom Restoration Act, the federal religious-liberty statute, supplied no defense in a suit between private parties. The parties had stipulated to $60,000 in damages if liability stood on any claim, so the court dismissed the separate Equal Pay Act appeal as moot rather than deciding it. A long dissent would have given the religious employer far broader protection, and the decision does not disturb the ministerial exception, which CRS did not press for this employee.

Neuromonitoring Providers Sue Anthem to Enforce Unpaid Surprise-Billing Awards
U.S. District Court for the Eastern District of Virginia 2026-10-16

SpecialtyCare and two physician groups sued Anthem Health Plans of Virginia and HealthKeepers on October 16 over federal surprise-billing arbitration awards for out-of-network intraoperative neuromonitoring, the tracking of a patient’s nerve function during surgery, that the insurers allegedly never paid. The providers allege that $2,501,372 remains unpaid, and the complaint pleads several alternative routes to enforcement under the No Surprises Act, the Federal Arbitration Act and ERISA, with the ERISA counts limited to awards involving self-funded plans. For plan sponsors, the case tests what happens when the surprise-billing arbitration system produces awards that go unpaid. Whether any of the enforcement theories holds up is now the court’s question.

Class Action Challenges a $20 Fee on One-Time Online COBRA Payments
U.S. District Court for the Northern District of California 2026-10-14

A former employee sued Optum Financial and ConnectYourCare on October 14 over a $20 processing charge he says was added to one-time online COBRA premium payments and inadequately disclosed, paying $944.59 on one occasion where $924.59 was due and $120 extra across six payments. The theory is that the charge pushed payments past the premium ceiling COBRA permits, but the complaint pleads four state-law claims, California unfair-competition and consumer-remedies counts, unjust enrichment and Minnesota consumer fraud, and no ERISA count. The focus is one-time online payments and the disclosure of alternatives, not a claim that every payment method carried a fee. Nationwide and California classes are proposed, and the allegations are untested.

Engineering Firm Ramboll Agrees to Pay $750,000 to Settle 401(k) Stable-Value Suit
U.S. District Court for the Northern District of New York 2026-10-16

Ramboll’s U.S. units and their plan committees have agreed to pay $750,000 to settle a class action over the stable-value option in the Ramboll US Retirement & Savings Plan, a plan with more than 3,000 participants. The February complaint alleged the fiduciaries kept the Prudential Guaranteed Income Fund while comparable guaranteed investment contracts credited more interest, and the parties settled in July with a dismissal motion pending and before any ruling on the merits. Plaintiffs’ October 16 preliminary-approval papers put potential class damages at $3 million to $4 million against conservative comparators, making the deal 19% to 25% of their own best case before fees and expenses. Requested fees run up to a third of the fund, and the settlement allocates the net amount according to participants’ holdings in the disputed investment, with deposits to active accounts and checks to former participants. Ramboll denies wrongdoing, and the proposal is before Judge Brenda Sannes.

Class Action Challenges Tenet’s Tobacco Surcharge Under ERISA’s Wellness Rules
U.S. District Court for the Northern District of Texas 2026-10-16

A former Tenet hospital employee filed a would-be class action in Dallas on October 16 over the $25 per pay period tobacco surcharge, roughly $650 a year, in the company’s self-funded health plan, which the complaint says covered more than 55,000 active participants in 2024. The suit contends the surcharge is premium discrimination based on a health factor that cannot claim the wellness-program exception. The complaint alleges that earlier versions of the program offered no compliant way to earn back the full surcharge. It acknowledges that the 2026 guide introduced cessation-program refunds for the current plan year, but challenges the remaining notice language and says discovery is needed to establish how those refunds work in practice. Fiduciary counts allege Tenet kept the collected surcharges for its own benefit, another point the complaint concedes needs discovery. The proposed class is surcharge payers since October 2020, not the whole plan, and the claims follow a wave of similar surcharge suits.

Florida Auto Dealer Agrees to Pay $209,000 Over a 401(k) Recordkeeper Transition
U.S. District Court for the Southern District of Florida 2026-10-14

Rick Case Enterprises and its plan fiduciaries have agreed to pay $209,000 to settle claims that a December 2022 recordkeeper move from Empower to Principal triggered a market value adjustment charged against participants invested in the 401(k) plan’s MassMutual stable-value fund. The unopposed preliminary-approval motion, filed October 14, puts the class at about 111 participants and the aggregate adjustment at $263,279. The proposed $209,000 fund equals about 80% of that alleged loss before deductions; after the requested fees and expenses, the motion estimates about $145,929, or 55%, would reach participants, with no claim forms required, current participants paid by deposit into their plan accounts and former participants by check. The complaint alleged a prudent fiduciary would have timed or structured the transition to avoid the charge; the defendants say the adjustment was a disclosed contractual feature driven by 2022’s interest-rate spike and deny any breach. For any sponsor contemplating a recordkeeper change, the case is a reminder to model stable-value exit charges before the move. The motion is before Judge Anuraag Singhal.

Supreme Court Declines to Hear Ruby Tuesday Appeal in Equitable Surcharge Case
PLANADVISER 2026-10-15

The Supreme Court has declined to review the suit by 96 former Ruby Tuesday managers and executives against Regions Bank over their top-hat plan, a deferred-compensation arrangement for a select group of managers and executives that sits outside most of ERISA’s protections. The Sixth Circuit had rejected their state-law claims and the money remedy they sought, called a surcharge, in a dispute over accounts informally funded with corporate-owned life insurance. PLANADVISER also describes the government’s argument that the case was a poor vehicle for the broader question about equitable monetary relief under ERISA. The denial leaves the Sixth Circuit’s outcome in place without endorsing its reasoning.

Straight to Court: Eleventh Circuit Eliminates Exhaustion Defense in ERISA Statutory Suits
Proskauer · via JD Supra 2026-10-15

Proskauer analyzes the full Eleventh Circuit’s decision in Bolton v. Inland Fresh Seafood, which overruled the circuit’s longstanding rule that participants must first use a plan’s internal claims and appeals process before suing on statutory ERISA claims such as fiduciary breach, in litigation over an ESOP’s alleged $92 million purchase. The firm keeps two limits in view. The ruling leaves the existing exhaustion rules for claims seeking plan benefits unchanged, and the court left open whether a plan provision expressly requiring exhaustion of statutory claims would be enforced. Predictions about Supreme Court review are the firm’s, not anything the opinion holds.

Eleventh Circuit Overrules Longstanding ERISA Exhaustion Rule for Fiduciary-Breach Claims
Gibson Dunn 2026-10-15

Gibson Dunn concentrates on what the full Eleventh Circuit’s ruling in Bolton v. Inland Fresh Seafood changes for fiduciary-breach litigation now that statutory ERISA claims in that circuit no longer wait for plan-level review, with the case back before the panel. The firm sketches plan-design responses, including express exhaustion provisions, while acknowledging the court did not decide whether such a clause would hold. Benefit claims under plan terms are unaffected, and the suggestions are the firm’s practice advice rather than anything the opinion establishes.

Recordkeeper Contracts Can Be Plan Documents, per Federal Appeals Court
PLANADVISER 2026-10-15

PLANADVISER returns to Kelly v. Altria, the Fourth Circuit’s August 10 ruling that a recordkeeper’s administrative services agreement can be a plan document subject to ERISA’s plan-document disclosure rules when it sets out operational duties such as participant calls, balances and investment information. Practitioners from Haynes Boone and the Wagner Law Group discuss the administrative fallout, including how sponsors should reread service agreements with disclosure requests in mind. The question of what document a participant can demand turns on the document’s function in running the plan, not its label.

When an Employer’s Premium Withholding Can’t Rewrite the Plan: District Court Denies ERISA Life Insurance Benefits and Civil Penalties on a Default Judgment Motion
Roberts Disability Law 2026-10-16

A widower sued his late husband’s employer after discovering that the company had withheld life-insurance premiums matching the $300,000 coverage his husband elected while actually enrolling him for $50,000. In an October 13 opinion Roberts Disability Law examines, Chief Judge Hala Jarbou of the Western District of Michigan denied default judgment for the remaining $250,000 because the plan unambiguously capped his coverage at $240,000 under its salary-based formula and required proof of good health for amounts over $100,000 that was never submitted. Premium withholding could not rewrite those written terms, and the court declined document-request penalties because no prejudice was shown. The takeaway for administrators is that enrollment systems and payroll need to match the plan, because deductions alone do not rewrite it.

Also Noteworthy (1)

How Leaders Can Build Better Workplaces for Neurodivergent Talent
Employee Benefit News 2026-10-16

EBN gathers practitioner advice on making workplaces and benefits more usable for neurodivergent employees. The practical questions for sponsors run to whether mental-health benefits and flexibility are structured so employees will claim them, how enrollment and accommodation processes handle employees who have not disclosed a condition, and whether AI tools in employment practices introduce bias. It draws on earlier reporting and practitioner interviews rather than a new study.