BENEFITS DIGEST

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A publication of The Inner Firm

Thursday, October 22, 2026

№ 79

40 items · ~17 min read

Congress & Agencies (11)·Retirement Plans (6)·Health & Welfare (3)·Leave & Time Off (5)·Court Decisions & Case Commentary (13)·Also Noteworthy (2)

The One Thing

The pharmacy benefit manager fee disclosure rule is through White House review. The public docket of OIRA, the White House regulatory-review office, shows the Labor Department’s rule concluded review on October 20 with changes made during the review. The cleared text is not yet public, so its substance and timing remain to be confirmed. The January proposal would require pharmacy benefit managers’ direct and indirect compensation to be disclosed to the group health plan fiduciaries who hire them. Publication will reveal the changes made during review and when the requirements take effect.

Congress & Agencies (11)

PBM Fee Disclosure Rule Clears White House Review
OIRA / DOL–EBSA 2026-10-20

OIRA’s docket shows the Labor Department’s rule titled Improving Transparency into Pharmacy Benefit Manager Fee Disclosure concluded review on October 20 and cleared with changes made during the review, which the docket records as consistent with change. The January proposal would require disclosure of the direct and indirect compensation pharmacy benefit managers receive, so that group health plan fiduciaries can judge whether their PBM contracts are reasonable, and the rule’s Unified Agenda entry carries the fuller description. The cleared text is not yet public, so what the rule now says awaits Federal Register publication.

SECURE 2.0 Automatic Enrollment Regs Clear White House Review
NAPA 2026-10-20

NAPA reports that the IRS regulations implementing the SECURE 2.0 automatic enrollment requirements for 401(k) and 403(b) plans have cleared White House review and could be released in the near future. OIRA’s docket confirms the Treasury rule, Automatic Enrollment Requirements Under Section 414A, concluded review on October 16, likewise cleared with changes made during review. Sponsors covered by the mandate have been operating on proposed rules and notices while the final text sat in review.

President Trump Signs ESOP Valuation Bill into Law
NAPA 2026-10-16

President Trump signed the Retire Through Ownership Act on October 15. It allows employee stock ownership plan fiduciaries to rely in good faith on independent appraisals of privately held company stock that follow established IRS valuation principles, and their other fiduciary duties remain unchanged. The valuation question has driven much ESOP litigation because the Labor Department never finalized its own regulation, and the law permits further DOL guidance without expanding the agency’s authority. The bill passed the Senate by unanimous consent and the House 401 to 14.

Last Call at CMS to Weigh In on the Arbiters of Surprise-Billing Disputes
CMS 2026-10-16

The petition window closes October 22 for five organizations seeking recertification as the independent dispute resolution entities that decide federal surprise-billing payment disputes, Maximus Federal Services, ProPeer Resources, C2C Innovative Solutions, Medical Evaluators of Texas, and Federal Hearings and Appeals Services. Plans, providers, and members of the public can challenge an applicant’s qualifications through the CMS petition form with supporting evidence. The process concerns who may serve as arbitrator, not any individual payment award.

No Adjustment to HHS Civil Monetary Penalty Amounts for 2026
HHS 2026-10-21

HHS will retain its 2025 civil monetary penalty amounts for 2026. Last fall’s federal funding lapse prevented the Bureau of Labor Statistics from producing the October inflation figure needed for the annual adjustment. The Office of Management and Budget consequently cancelled the 2026 adjustment in April. HHS’s notice confirms that existing penalties remain enforceable at their 2025 levels.

Departments Issue Final Rules Updating Transparency in Coverage Requirements
2026-10 · Aon

Aon’s compliance bulletin explains the October 6 final rules updating health plans’ machine-readable price files. For employers, a central change is the requirement to certify that the posted files are accurate. Other changes include one in-network file per provider network, aggregated allowed-amounts reporting, and quarterly rather than monthly posting. A plan can delegate the files and the attestation to a third-party administrator by written agreement, but the bulletin’s caution is that a self-insured plan may still answer for the vendor’s noncompliance. The bulletin puts the member-facing tool changes at plan years beginning January 1, 2027, the first quarterly machine-readable files at April 1, 2027, and annual utilization files at July 1, 2028.

Leading Employers Back Expansion of Electronic Prior Authorization to Self-Funded Health Plans
CMS 2026-10-21

CMS and the Labor Department announced that five employers (Amazon, Axon, Google, Meta, and Oracle) signed a statement of support for bringing electronic prior authorization to the self-funded health plans they sponsor, building on the 2025 pledge by major insurers. The commitment is voluntary, not a new mandate on self-funded plans, and the aim is to replace fax-and-phone authorization workflows with electronic exchanges regardless of how a patient’s coverage is funded. A separate CMS rule already requires certain payers to implement electronic prior authorization beginning January 1, 2027, and the employer statement extends the push into the self-funded market.

No More Counting Zeros: IRS Proposed Rules Make Dependent Care FSA Testing Easier and May Open the Door to the $7,500 Limit
Foley & Lardner · via National Law Review 2026-10-21

Proposed IRS regulations would exclude employees who receive no benefits from the dependent care assistance program’s 55% average benefits test, a participant-only approach that should cut testing failures and the need to cap highly compensated employees’ elections. The firm reads the change as opening a practical path to the $7,500 annual limit, already in effect for 2026, for employers that held at $5,000 over testing concerns, and notes that employers may rely on the proposed rules now. The program’s other nondiscrimination tests still apply.

IRS Proposes New Forms and Procedures to Simplify Rollovers
Marsh / Mercer 2026-10-15

Mercer’s Brian Kearney and Margaret Berger walk through the IRS’s four proposed sample forms and five-step process for plan-to-plan rollovers, a workflow that today runs on plan-by-plan paperwork and phone trees. The proposed process starts with the participant contacting the receiving plan and encourages the two plans to communicate directly and move the money electronically. The forms are optional, and using them does not itself provide special protection against a finding of noncompliance. Existing spousal-consent and rollover-notice requirements still apply.

PBGC Announces Multiemployer Pension Premiums for 2027
Morgan Lewis · via JD Supra 2026-10-21

Morgan Lewis notes the PBGC’s October 14 announcement that 2027 premiums for multiemployer pension plans will be a flat $42 per participant, a $2 increase from 2026 and 40% above the level of a decade ago. The firm’s practical points are keeping participant records accurate and identifying deceased participants, which help prevent inflated premium counts, while permissible small-balance cash-outs can reduce the number of participants counted.

PBGC Updates 2027 Maximum Monthly Guarantee Tables, Premiums
PLANSPONSOR 2026-10-21

On the single-employer side, PLANSPONSOR reports the PBGC’s 2027 guarantee limits rising 4.16%, putting the maximum guaranteed benefit for a 65-year-old retiree at $8,113.64 per month for a benefit paid over the retiree’s lifetime with no survivor payments. The flat-rate premium rises to $116 per participant, the variable rate stays at $52 per $1,000 of unfunded vested benefits under its statutory freeze, and the variable-rate cap reaches $783 per participant. The multiemployer guarantee is not indexed and does not change.

Retirement Plans (6)

Marsh Projects 2027 Retirement Plan Limits
Marsh / Mercer 2026-10-15

Marsh projects a $25,500 employee contribution limit for 401(k), 403(b), and eligible 457 plans in 2027. It estimates an $8,500 catch-up limit for most eligible workers ages 50 and older and $11,750 for those ages 60 through 63. The estimates incorporate September’s inflation reading and remain provisional until the IRS announces the official limits, which usually arrive in late October or early November.

Employees Exhibit Low Confidence in Retirement Preparedness
PLANSPONSOR 2026-10-21

The US portion of State Street’s retirement survey, covering 4,040 adults ages 45 and older, finds only 24% of pre-retirees reporting high confidence in fully retiring, and 21% feeling optimistic about their financial preparedness. The findings point toward practical transition and income-planning help at the moment of retirement rather than product pitches. The pre-retiree and retiree samples answer different questions, so their figures describe different groups.

Capital Group Unveils Retirement Withdrawal Guidelines for TDFs
401(k) Specialist 2026-10-21

Decumulation, the spend-down phase after retirement, is where target-date competition has moved, and sponsors field the how-much-can-I-withdraw question whether or not their lineup has an answer. Capital Group’s new withdrawal guidelines are one vendor’s answer, a fixed approach starting around 4% to 4.5% of the initial balance and adjusting for inflation, and a variable approach taking around 5% to 5.5% of the prior year-end balance. The guidance comes from the firm’s modeling of 100,000 market paths over 30 years, and modeled sustainability is not a promise. The firm is also adding retirement-income wording to the names of its 2010 through 2025 in-retirement funds, not the entire target-date series.

AI in Retirement Plans: Where Humans Still Matter
NAPA 2026-10-20

NAPA reports a practitioner panel with Jordan Cross, Amanda Iverson, and Joey Santos Jones. The panelists describe artificial intelligence already at work in preparing employee data for plan administration, drafting participant communications, and building training materials, and they map where human judgment still has to do the work. Their cautions are confidentiality, unreliable answers, and the slow loss of the skills needed to check a tool’s output, so they recommend written policies and human review. It is practitioner conversation rather than regulatory guidance, and delegation to a tool does not delegate the fiduciary duty.

What Employers Need to Know About Trump Accounts
Marsh / Mercer 2026-10-14

Mercer’s 15-page explainer covers the employer side of the new child savings accounts, to which employers have been able to contribute since July 2026. The $2,500 exclusion applies per employee, not per child. Additional employer contributions outside the program are taxable wages, and individual and employer contributions remain subject to the account’s separate aggregate annual limit, while Social Security, Medicare, and federal unemployment taxes still apply under the proposed guidance. Minor employees cannot fund their own accounts pretax, and the linked proposed regulations carry their own open questions.

The $2,500 Question: What Employers Need to Know About Contributing to Trump Accounts
Foley & Lardner · via National Law Review 2026-10-21

Foley & Lardner’s explainer covers the employer-contribution side of the new accounts, up to $2,500 per employee per year, fundable by employer dollars or pre-tax salary reductions for dependents through a cafeteria plan. An employer offering contributions needs a separate written program plus nondiscrimination, notification, reporting, and trustee-notice compliance, and salary-reduction designs require plan amendments. Parts of the framework rest on proposed regulations, so not every mechanic is final.

Health & Welfare (3)

2026 Employer Health Benefits Survey
KFF 2026-10-22

KFF’s annual benchmark survey, published October 22, puts the average family premium at $28,303, up 5% from 2025, with workers contributing $7,471 of it, up 9% or $621. Single coverage averages $9,804 with workers paying $1,672, and among workers whose plans have a general annual deductible, the average for single coverage is $1,955. The announcement highlights the cost shifting behind the worker numbers, with 44% of large employers, those with 200 or more workers, reporting they increased the share of premiums workers pay. Among those large firms, 18% cover GLP-1 drugs for weight loss, essentially flat from last year.

Employees Are Seeking Therapy for Work Stress, but They Often Need a Different Benefit
Employee Benefit News 2026-10-21

Modern Health’s survey of 2,000 current and former therapy users finds 88% saying therapy met their needs, while the company’s leaders argue that much work stress is better addressed by lighter-touch coaching, better-equipped managers, and organizational change alongside clinical care. The respondents are therapy users rather than all employees, and the research and recommendations come from a vendor whose products sit where it points. Nothing in the piece establishes that anyone’s therapy was unnecessary, only that one size of care does not fit every stressor.

Calculating the ROI of Well-Being
Employee Benefit News 2026-10-21

Ray Fabius, cofounder and president of HealthNEXT, argues that employers should measure well-being programs through workplace injuries, absence, disability, retention and productivity as well as medical spending. He recommends adjusting comparisons for workforce size, illness burden, benefit design and inflation. His supporting example comes from a client engagement, rather than a controlled study establishing that the program caused every improvement.

Leave & Time Off (5)

Pennsylvania County Becomes First in Nation to Pass Paid Parental Leave
HR Dive 2026-10-21

Allegheny County’s council passed an ordinance providing 12 weeks of paid parental leave at employers with at least 15 employees, with coverage HR Dive reports as reaching remote employees whose employers are based elsewhere. The ordinance takes effect one year after signing, and at the reporting date it had passed the council but not yet been signed. Full-time and part-time employees face different service requirements, and the first-in-the-nation framing is the source’s characterization.

Paid Family and Medical Leave Snapshots Across the US
Marsh / Mercer 2026-10-19

Mercer’s 25-page state-by-state deck compares paid family and medical leave programs on contributions, eligibility, wage replacement, and job protection, setting 2026 rates beside the 2027 figures states have announced. It flags the upcoming Maryland and Virginia programs, distinguishes programs employees fund from those requiring employer contributions, and covers voluntary insurance options. For multistate employers it is a map of where mandates exist and where they are coming.

State Paid Family and Medical Leave Contributions and Benefits
Marsh / Mercer 2026-10-19

Mercer’s multistate reference covers paid family and medical leave contribution rates, benefits, employer notices and coordination with other leave. It also explains that eligibility for a payment and eligibility for job protection can differ. The guide includes state tables and a federal-tax discussion for employers administering programs across several jurisdictions.

Nearly a Quarter of Fathers Don’t Return to Work After Parental Leave, Study Shows
HR Dive 2026-10-21

Deel’s study finds that nearly a quarter of fathers do not return to the same position after parental leave, with American white-collar fathers taking more leave than fathers in the 12 other countries studied. Across the countries surveyed, not returning to the same position does not necessarily mean leaving the workforce. For employers the figure is a retention question attached to a leave policy.

Court Decisions & Case Commentary (13)

Voluntary Benefits Litigation: How Plaintiff Firms Turned Broker Compensation Into an ERISA Class Action Playbook
Encore Fiduciary and Davis & Harman 2026-10-13

Justin Bove, Robert Davis, and Kent Mason, writing for Encore Fiduciary and Davis & Harman, trace the emerging class actions treating broker commissions on voluntary benefits as an ERISA problem, through excessive-commission allegations, carrier switching, and employers acting as their own brokers. The authors distinguish three questions that decide these cases, whether ERISA covers the arrangement, who acts as a fiduciary, and what counts as participant injury. On the last, they argue that commission comparisons alone do not establish injury. Their advice to sponsors is to document how carriers and brokers are selected, monitor premiums and commissions, and check insurance coverage, and their critique of the pending cases is defense-side advocacy rather than any court’s holding.

Comcast Seeks Dismissal of Tobacco-Surcharge Claims
U.S. District Court for the Eastern District of Pennsylvania 2026-10-19

Comcast is asking a federal court to dismiss claims challenging its health plan’s tobacco surcharge. In Cannon v. Comcast, the company argues that an annual opportunity to enroll in a smoking-cessation program satisfies the applicable requirements, and it disputes the plaintiffs’ demand for retroactive relief. Its brief also says the plan fully reimburses participants who complete the program during the year, whether or not they quit smoking. The filing lays out defenses to the surcharge litigation facing employers. It is not a ruling that Comcast’s program complies with the law.

Court Requires Further Privilege Review of Remanded Disability Claim
U.S. District Court for the Central District of California 2026-10-05

In Collier v. Lincoln, a California federal court rejected the insurer’s argument that starting litigation permanently shields legal advice about administering a disability claim. When a claim returns to the insurer for another decision, some advice about that review may again fall within the fiduciary exception, which can give plan beneficiaries access to otherwise privileged communications. Separate protection for material prepared for litigation may still apply. The court required an expanded privilege log and confidential judicial review, not wholesale disclosure to the claimant. The amended log is due October 30 unless a specified appeal triggers a stay, and the order separately sets November 16 for submission of disputed documents to the judge. Roberts Disability Law has a write-up of the ruling.

United Rentals Faces Claims Over 401(k) Fees and Forfeitures
U.S. District Court for the District of Connecticut 2026-10-20

A proposed class action accuses United Rentals and its retirement committee of allowing excessive recordkeeping fees and using forfeitures to reduce employer contributions instead of participant expenses. Forfeitures are employer contributions that workers leave behind before earning the right to keep them. The complaint describes a plan with about $2.64 billion and 27,059 participants in 2025 and alleges more than $2.5 million in excessive fees. It also challenges the treatment of roughly $14.37 million in forfeitures generated over six years. These are the plaintiff’s allegations, and the court has not ruled on liability or certified a class.

Ecolab Pension Case Moves Toward Settlement Approval Request
U.S. District Court for the District of Minnesota 2026-10-21

The court overseeing Bennett v. Ecolab has kept pending deadlines on hold and directed the plaintiff to request preliminary settlement approval by December 18. The case concerns the actuarial assumptions used to calculate pension benefits. The order exists only as text on the docket, and the linked record is the Digest’s transcription of that entry, verified against the public docket. It does not disclose financial terms or approve a settlement.

Envision ESOP Order Separates Prohibited-Transaction Proof From Overpayment
U.S. District Court for the District of Colorado 2026-10-02

A Colorado federal judge ruled that participants challenging an employee stock ownership plan transaction do not have to prove overpayment as an additional element of their prohibited-transaction claims before the fiduciary must establish an exemption, the exception that permits an otherwise prohibited transaction. In Harrison v. Envision, the court applied the Supreme Court’s Cunningham decision to the allocation of proof at trial. Participants still must establish the prohibited transaction’s elements, and the court separately found their alleged overpayment injury sufficient for standing. The order sets trial burdens without deciding liability or awarding money.

Wilderness-Therapy Benefits and Parity Claims Survive Dismissal
U.S. District Court for the Northern District of Illinois 2026-10-19

A federal judge in Illinois allowed a family’s benefits and mental-health-parity claims against Blue Cross and Blue Shield of Illinois to proceed over approximately ten weeks of wilderness treatment. The family alleges it paid $48,000 after coverage was denied. Exceptions in the plan’s wilderness-treatment exclusion and conflicting provider definitions made a benefits claim plausible, and the court also found a plausible claim that the plan restricted mental-health treatment without a comparable restriction on medical care. The ruling permits the lawsuit to proceed. It does not order reimbursement or invalidate every wilderness-treatment exclusion.

Novartis Severance Dispute Returns to State Court
U.S. District Court for the District of New Jersey 2026-10-15

A New Jersey federal judge sent a former Novartis executive’s severance suit back to state court after finding the company had not established that ERISA gave the federal court jurisdiction. Andrew Isaacs alleges that an improper misconduct termination cost him a package worth about $1.04 million. The court concluded he had not shown a sufficiently plausible claim to benefits under the plan Novartis supplied, citing its misconduct exclusion and his failure to allege use of its written application process, while Isaacs alleges he was told there was no process to challenge the termination. The ruling decides the forum, not whether he is owed severance.

Court Declines to Reconsider Refusal of Further Amendments in Walgreens Benefits Suit
U.S. District Court for the Southern District of New York 2026-10-15

A New York federal magistrate judge declined to reconsider an order refusing further amendments in a Walgreens employee’s benefits and employment lawsuit. The plaintiff did not identify overlooked authority, evidence, or a correctable omission sufficient to reopen the ruling. Her objections to the earlier order remain for the district judge, and the case continues on surviving claims. The decision does not newly resolve the merits of those claims.

Eleventh Circuit Jettisons Exhaustion Requirement for Statutory Claims
Your ERISA Watch · Kantor & Kantor 2026-10-21

Peter Sessions’s case-of-the-week treatment of Bolton v. Inland Fresh Seafood in his weekly roundup connects the full Eleventh Circuit’s decision that participants bringing statutory ERISA claims need not first complete the plan’s internal claims and appeals process back to the employee stock ownership transaction that started the case, a $92 million loan-funded purchase of the company’s stock. The same roundup summarizes a dozen other decisions across arbitration, fiduciary claims, discovery, benefits, and severance, including Kraft Heinz, Taylor, Watt, and Hannon. The Bolton ruling concerns statutory claims. The decision leaves the existing rules for benefit-denial claims unchanged, and the court left open whether plan terms demanding the internal process for statutory claims are enforceable.

Eleventh Circuit Eliminates Exhaustion Requirement for Statutory ERISA Claims
Haynes Boone · via JD Supra 2026-10-20

Haynes Boone’s analysis of Bolton emphasizes what the overruling means for defense strategy, since fiduciary-breach and other statutory claims in the Eleventh Circuit no longer require completing the plan’s internal claims and appeals process before suing, while the existing rules for benefit-denial claims are unchanged. The firm recommends that sponsors review their claims-procedure language with counsel. Whether plan terms that purport to require exhaustion of statutory claims remain enforceable is a question the opinion itself expressly left open.

Fiduciaries Seek to Fend Off 401(k) Religious Accommodation Suit
NAPA 2026-10-19

Thermo Fisher is asking a court to dismiss an employee’s claim that its 401(k) plan should offer a fossil-fuel-free investment option to accommodate his Christian beliefs. In its dismissal brief, the company argues that the federal claims were filed too late and that the same investment menu was available to everyone, and it disputes whether the requested menu change qualifies as a religious accommodation at all. The motion remains pending. These are the employer’s arguments, not a ruling on whether the requested investment option is a required accommodation.

All or Nothing? Second Circuit Clarifies Scope of Sexual Harassment Arbitration Law
Squire Patton Boggs · via National Law Review 2026-10-21

Squire Patton Boggs explains the Second Circuit’s September 30 holding in Diaz-Roa v. Hermes Law that when an employee properly invokes the Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act, a pre-dispute arbitration agreement becomes unenforceable as to the entire lawsuit, not just the harassment claims. In the case itself the defendants did not contest proper invocation. The surviving non-harassment claim concerned stock options the employee alleged had been wrongfully taken. Severance, bonus, and equity disputes often travel in the same complaint as harassment allegations, and under this holding a properly invoked sexual-harassment claim takes those compensation claims out of arbitration along with everything else. The court left class actions and cases involving different plaintiffs for another day.

Also Noteworthy (2)

When the Referee Gets the Rulebook Wrong: Concerns About Recent Illinois Department of Labor Prevailing Wage Audits
Amundsen Davis · via JD Supra 2026-10-20

Amundsen Davis reports Illinois contractors receiving prevailing-wage audit findings the firm says depart from the statute, industry practice, and the agency’s own published guidance, with fringe-benefit credits among the flash points. This is advocacy grounded in the firm’s audit experience, not a new regulation or a judicial finding of agency error. Contractors on public work should document fringe-benefit calculations against the published rules.

Ready to Respond: What Employers Should Know About OSHA’s New Opioid Guidance
K&L Gates · via National Law Review 2026-10-20

K&L Gates reviews OSHA’s new guidance on workplace opioid-overdose response, covering naloxone availability, training, and response planning as informational guidance rather than a new standard. The guidance does not impose a new requirement that every employer stock overdose-reversal medication. The practical move is a response plan matched to worksite risk.

Correction. Our October 21 issue incorrectly identified the author of “Meaningful Benchmarks: Clarity May Be Coming; Leadership Cannot Wait” as Gordon Dyson. The author is Eric Dyson. Both web versions have been corrected. We apologize for the error.