CMS proposes requiring Medicare Advantage plans to verify provider directories every 90 days, to hold enrollees to in-network cost sharing when an inaccurate listing misleads them, and to report accuracy information that would later become public. On the drug side, the proposal would restrict Part D PBM compensation to flat fair-market-value service fees, require rebate pass-through and disclosures, and eliminate certain generic copayments for low-income dual-eligible enrollees starting in 2028. The fact sheet carries the details, and different provisions carry different dates. For plan sponsors the direct reach is employer-group Medicare arrangements rather than commercial self-funded plans, and comments on the proposed rule, published in the October 20 Federal Register, are due December 15.

The IRS republished its annual special per diem rates in this week’s Internal Revenue Bulletin. The high-low substantiation method uses $329 for high-cost localities and $230 for other localities within the continental United States, with separate transportation-industry and incidental-expenses-only rates and a revised high-cost locality list. The rates have applied since October 1 for employers that use this optional substantiation method, and the applicable rate turns on the travel location and seasonal period rather than the headline numbers. Employers using the method should check their reimbursement tables against the new rates and locality dates.

Treasury asked OMB to renew its approval of Form 15397, the application a filer uses to request more time to furnish recipient statements such as Forms 1099. The notice is an extension of an existing information collection without change, meant to standardize requests that once arrived by letter. It grants no one an extension by itself, and comments on the renewal are due November 19.

Seyfarth’s benefits blog reads the Retire Through Ownership Act as a long-sought answer to the valuation uncertainty that has dogged employee stock ownership plan transactions, with fiduciaries now expressly permitted to rely in good faith on an independent appraisal that follows the valuation principles of Revenue Ruling 59-60. The authors argue the change should reduce litigation pressure on good-faith reliance. The statute itself preserves ERISA’s fiduciary duties and the Labor Department’s rulemaking authority, so the reliance the firm describes still sits inside the duty of prudence rather than outside it.

Bradley’s B. David Joffe examines what the new valuation statute for employee stock ownership plans changes in practice for transaction committees. Good-faith reliance on an independent appraisal now has an express statutory footing, but independence, engagement process, and the handling of disputed valuation questions remain the ground where claims are won and lost, and the Labor Department keeps its authority to regulate. The piece treats the act as a process framework rather than immunity, which matches the statute’s own preservation of fiduciary duties.

Phelps Dunbar adds a transactional perspective on the new law for employee stock ownership plans, framing good-faith appraisal reliance as a process improvement for fiduciaries who still must understand the appraiser’s assumptions and exercise oversight. The firm is explicit that the statute is not immunity from imprudence claims. The firm’s advice is to treat the appraisal as a document to interrogate rather than a document to file.

Kaufman & Canoles’ fall update covers employee stock ownership plan valuations, retirement-plan amendments, written cafeteria-plan terms, educational assistance, and Trump accounts. The firm urges employers to check that their written cafeteria-plan documents match how payroll handles pretax premiums and that educational-assistance documents can accommodate inflation adjustments rather than hard-coding the existing $5,250 limit. It also advises documenting an independent appraisal process when relying on the new ESOP valuation law.

Retirement Learning Center walks through curing a failed ADP test, the test comparing higher-paid employees’ salary deferrals with everyone else’s, by amending the plan into a nonelective safe harbor, an employer contribution paid regardless of whether employees defer anything themselves. Per the article, a calendar-year plan can adopt the 3% version for 2026 by November 30, 2026, while the 4% version remains available into the following year and still covers all of 2026. Eligibility conditions and vesting still matter, other testing requirements may still apply, and sponsors staring at a failed test should price the fix against refunds rather than treat it as an escape hatch.

Fred Reish continues his series on the Labor Department’s proposed framework for alternative assets in defined contribution plans, reaching the liquidity factor. His point is structural. Participants can trade daily while many alternative vehicles cannot, so a fiduciary has to investigate how a fund bridges that mismatch, and reliance on managers or other fiduciaries must be informed reliance that does not look past contrary information or conflicts. The framework is a proposal, not final law, and the critique is the author’s.

Leaders of the American Retirement Association and ASPPA told their annual meeting they expect the next Congress to take a serious run at broad retirement-coverage legislation, describing bipartisan interest alongside concern that any mandate preserve the plans employers already sponsor. The predictions are tied to election outcomes nobody knows yet, so this is a forecast from advocates with a stake, useful mainly as a signal of where the trade groups will spend their lobbying effort.

An ASPPA Annual panel turned Cycle 4 plan restatements into a project plan. Identify which plans need restating, chase down missing or unsigned prior documents, decide up front whether clients may request design changes during the cycle, and run one status-tracking system with clear internal ownership. The panel’s sharpest advice is to carry current provisions forward accurately and put experienced document reviewers on the output, because restatement software and AI drafting do not replace human review. Batching the work beats a year-end scramble.

This commentary argues that state auto-IRA mandates are expanding the private small-plan market rather than displacing it, as employers nudged into action by a mandate graduate into their own 401(k) plans. It sketches the opportunity for advisers, TPAs, pooled plans, and plan technology, and forecasts more of the same as additional states come online. The forecasts and the mandate-causation claim are the author’s projections rather than measured results.

Advisers quoted here treat the Social Security cost-of-living announcement as an opening for retirement-income conversations rather than news that changes anyone’s plan. Fidelity models what a hypothetical future benefit reduction would mean for savings targets, and CAPTRUST connects the moment to participant education. The hypothetical is only a hypothetical, since no benefit cut is enacted or scheduled, and sponsors fielding participant questions can use the same distinction.

Ary Rosenbaum’s reminder is simple and regularly ignored. The handbook is not the plan, so eligibility, matching, and benefit descriptions in employee-facing materials have to track the operative plan document and its amendments, because conflicting summaries breed administration mistakes and disputes.

This is the sponsor-side read of the premium tax credit proposed regulations. The firm separates the schedules, with repayment changes effective for 2026, immigration-related eligibility changes for 2027, and verification changes for 2028, and notes that employer reporting on Forms 1095-B and 1095-C continues unchanged. Effects on marketplace enrollment and employer penalty exposure are possibilities the firm flags rather than assured outcomes. Comments are due November 30 with a hearing set for December 8.

Segal’s walkthrough of the transparency final rule is organized the way administrators actually have to implement it, separating machine-readable file changes from reporting, attestations, and the phone-access requirement. The dates deserve care because applicability and first-disclosure deadlines differ. Segal places schema changes at March 6, 2027 with first disclosures that April, new contextual files at September 6 with first files that October, the first provider-utilization file in July 2028, and price-comparison tool changes for plan years beginning in 2027. The firm also stresses that a self-funded plan keeps responsibility when vendors do the work.

Sidecar Health’s founder argues that the new transparency files will matter only if plans put prices and quality in front of patients before they choose care and give them a financial reason to use the information. He illustrates with his own MRI shopping and Sidecar’s cash-pay model. The savings figures are company claims.

Devenir’s midyear survey counts nearly $192 billion across 42.6 million health savings accounts at June 30, with just over half of the assets invested. The majority-of-assets figure can mislead, since only 11% of accounts hold any investments and just over half of accounts sit under $500 including zero balances. Employer-affiliated accounts hold 65% of the assets, which is why the numbers matter to sponsors. The industry’s growth projections in the report are forecasts, and the research is provider-reported.

New Horizon Academy describes four benefits it credits for retention in a high-turnover field, education assistance, visible career paths, affordable health coverage with a childcare discount of nearly 65% for employees, and retirement saving with a match of one third of contributions up to 6% of pay, an effective maximum of 2%. The company says it is helping 468 of its roughly 3,000 educators obtain degrees, and reports five-year average teacher tenure with about 90% retirement-plan participation. The results are employer-reported.

Transamerica’s survey of 100 healthcare organizations finds automatic enrollment at 77% of responding employers. Among those employers, 64% set the default below the contribution needed for the full match, so employees who stay at that rate can miss part of the match. Respondents say living costs and healthcare costs are what their employees feel most, and personalized financial support is where they are putting attention. It is an employer-reported survey rather than an employee survey, and the figures describe the responding organizations, not the industry.

Bhargav Raman, cofounder of the primary-care firm Ten Ten Ten, argues that fee-for-service medicine and intermediary compensation reward higher spending, and that employers should move toward fixed payments agreed in advance, tied to responsibility for patients’ care and costs. He warns against shoving unprepared practices straight into full risk, recommending graduated arrangements, independent benchmarks, disclosed flat fees, audit rights, and workable exit terms. The headline and the cost claims are the argument of a vendor with a model to sell.

Bricker Graydon Wyatt explains how a policy that lets employees choose between cashing out PTO and keeping it can trigger constructive receipt, taxing employees on leave they retained because they could have taken cash. The firm points to IRS rulings allowing employees to make an irrevocable cash-out election before the year they earn the leave. Those rulings apply only to the taxpayers who requested them, so they do not give every employer blanket approval for that approach. State law also constrains some designs. The distinction that matters is between elective cash-outs, which raise the issue, and automatic ones, which generally do not.

Epstein Becker Green surveys the laws beginning to treat menopause as a protected characteristic or an accommodation trigger. Rhode Island went first, enacting workplace menopause protections in June 2025, and two more arrive on January 1, 2027, when Illinois’s Menopause Equity and Care Act will require employers with four or more employees to provide reasonable accommodations and post notices of employees’ rights, and Philadelphia’s ordinance will make menstruation, perimenopause, and menopause protected classes with an accommodation duty. Separate New York and federal proposals remain proposals. For multistate employers the near-term work is accommodation processes plus handbook and notice updates.

Judge Stephen Bough granted the certified classes summary judgment on liability on all six counts over the $24-per-week tobacco surcharge in Compass Group’s self-funded health plan, and denied the company’s cross-motion. The order holds that the statutory full reward required refunding the whole plan year’s surcharge once a participant completed the tobacco-cessation alternative, without having to quit successfully. The court also found at least one required disclosure missing from plan materials in each year from 2016 through 2026, and it held that the separately coded surcharge deductions were plan assets Compass commingled with its general assets. The Labor Department’s August FAQ, which reads the regulation more forgivingly, received no deference. The parties agree $47,960,937.87 in surcharges was collected over the decade, and the court has not determined how much must be repaid, ordering damages briefs within 14 days. Different claims also carry different recovery periods. Liability is decided; the number is not.

Three participants sued Citizens Financial Group and its plan fiduciaries over the CFG Retirement Savings Plan, which the complaint says held $3.22 billion for 23,881 participants with balances at the end of 2024. The investment claims challenge the retention of Fidelity Freedom Index target-date funds and Vanguard index funds, with the comparisons collected in an appendix. Separate claims target administrative fees and the use of forfeitures, the employer contributions workers leave behind before vesting, to reduce company contributions rather than participant expenses, plus monitoring and prohibited-transaction theories. The forfeiture-allocation claim is aimed at the discretionary period before a January 2025 plan amendment reprioritized how forfeitures are used. These are allegations in a newly filed complaint, and no class has been certified.

Two participants allege SAP America kept a PPO option whose higher premiums and lack of an employer-funded health savings account left employees paying more than they would have under the company’s Consumer Choice 90 option for the same Aetna network and services, and that fiduciaries should have noticed. The complaint pleads prudence, loyalty, and monitoring claims and asks for repayment and changes to the menu or its disclosures. The court must first determine whether the challenged conduct was subject to ERISA’s fiduciary duties at all, and the complaint’s own charts show some out-of-network spending levels where the PPO costs less, so the everywhere-and-always framing is the plaintiffs’ characterization.

In Estay v. Ochsner Clinic Foundation, the appeal from the dismissal of a forfeiture-reallocation suit against Ochsner’s 401(k) plan, the U.S. Chamber and the ERISA Industry Committee filed a friend-of-the-court brief defending the practice of using forfeited, unvested employer contributions to fund contributions for remaining participants. The brief argues that longstanding Treasury guidance supports the practice, that ERISA does not compel benefits beyond what the plan promises, and that a menu of permitted uses should not become a duty to pay participant expenses first. ERIC’s announcement frames the stakes for sponsors. The groups are advocating for the employer side, not reporting a ruling, and the Fifth Circuit has not decided the appeal.

Judge Christine Van Aken granted Wells Fargo summary judgment against Timothy Sloan, whose 2023 complaint sought roughly $34 million in canceled stock awards and withheld pay. What the public record shows is unusual. The merits order itself is sealed because it discusses material the court had already sealed as confidential business and employee information, some of it claimed protected by federal banking regulation in an omnibus sealing order supported by a letter from the Comptroller’s office. The court has directed the parties to prepare a public version of the ruling, so the reasoning should eventually surface. Until it does, the outcome is public and the why is not.

Thompson Hine unpacks a California complaint alleging that Cigna charged a self-funded plan percentage-based shared-savings fees of up to 29% on ground-ambulance bills it simply did not pay in full, in one example paying $386.77 of a $3,644.91 bill while the participant faced collection for the balance the fee treated as savings. The participant pleads fiduciary breach and self-dealing. The firm’s practical advice runs to reviewing fee formulas, payment-in-full assurances, reporting, and audit rights in administrative services agreements, and notes the employer is not a defendant. The allegations are untested, and functional fiduciary status is exactly what the case will contest.

WilmerHale’s treatment of Bolton v. Inland Fresh Seafood situates the full Eleventh Circuit’s overruling of its exhaustion precedent among the other circuits that already declined to require plan-level review before statutory ERISA suits. The firm keeps the two standing limits in view, since benefit claims still go through the plan’s process and the court left open whether an express plan provision requiring exhaustion of statutory claims would hold. The underlying valuation allegations about the company’s employee stock ownership plan remain just allegations on remand.

This preview collects the term’s employment and benefits questions, led by Anderson v. Intel on what a 401(k) plaintiff must plead about comparator benchmarks. It also covers the personal-staff exemption dispute in Younge and the Title IX employment question in Crowther. The benchmark question is the one with daily consequences for plan sponsors, since pleading standards decide which fee and performance suits survive long enough to cost money. (Editor’s note: The case comes from the Ninth Circuit, not the Eleventh, and was argued October 6.)

PLANADVISER picks up Whitlock v. Provident, the California ruling that Lockton’s voluntary supplemental disability arrangement was an ERISA plan because of the employer’s involvement, endorsement, and compensation. The arrangement failed the exemption for voluntary coverage because Lockton endorsed it and received compensation, and Whitlock still lost her benefits claim after the court applied fresh review, per the opinion. The plan-status holding is what matters for employers who facilitate voluntary coverage. (Editor’s note: The article reverses the parties’ positions. Provident argued that ERISA applied; Whitlock argued that it did not.)

NAPA reports the proposed $209,000 settlement in Hebert v. Rick Case, the suit over a market value adjustment, a charge deducted from participants’ stable-value holdings when the plan changed recordkeepers in 2022. The gross recovery is about 80% of the $263,278.78 the class alleges it lost, with an estimated $145,929.34, about 55%, reaching participants after proposed fees, expenses, and administration costs, all subject to court approval. The defendants deny wrongdoing, and the preliminary-approval motion carries the terms.

HR Dive covers the Fourth Circuit’s decision affirming the Title VII judgment against Catholic Relief Services over denied same-sex spousal health coverage. Despite the headline’s must-face wording, the court’s opinion affirmed a judgment already entered against Catholic Relief Services. The holding was that religious motivation did not displace the sex-discrimination prohibition for a nonministerial employee.

Mayer Brown summarizes SEC staff interpretations issued October 15 on Form S-8, the registration statement for employee equity plans, covering fee calculations, awards granted before an initial public offering, acquisition-related awards, former employees, and reuse of unused restricted stock unit registration capacity. One useful nuance is that employer contributions and employee-directed purchases can take different fee treatment. A separate interpretation starts the two-business-day clock for Form 4, the insider transaction report, on the transaction’s local date, which matters for cross-border grants.

Pillsbury explains why UK stock options do not simply carry over when a company reorganizes by placing a new Delaware parent above its UK business. Assumption and exchange are different events, and preserving an option’s economics is not the same as preserving its tax treatment. An option that ends up priced below fair market value after the change can create U.S. deferred-compensation tax problems for employees who relocate to the United States. Board approval and completed grant conditions matter because awards cannot be backdated, and grants above $10 million in a twelve-month period can trigger additional disclosures to the employees receiving them.

A Corporate Synergies account-management director distinguishes posting benefits information from walking an employee through a formulary fight, a claims dispute, or a cost-sharing surprise, and argues the hands-on version is what actually reduces confusion and lost work time. The piece is vendor commentary without measured results, but the distinction it draws is a fair test to put to any advocacy service a sponsor is paying for.

WTW’s global survey of 41,000 employees across 31 markets finds 70% saying their benefits meet their needs while 38% worry about AI harming job security, and reports that financial wellbeing has deteriorated even as other measures improved. The firm argues for more tailored support. The figures are global rather than U.S.-only, and the detailed report sits behind a registration form, so this introduction is what is freely readable.

Lockton relays what employer roundtables are worrying about, which is cost pressure meeting a workforce that understands its benefits better than it used to, and expects communication, flexibility, and visible value in return. The anecdotes about leave usage and performance are illustrations rather than evidence, and the piece is a broker’s view of its clients.