BENEFITS DIGEST

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A publication of The Inner Firm

Wednesday, October 28, 2026

№ 83

31 items · ~18 min read

Congress & Agencies (7)·Retirement Plans (9)·Health & Welfare (5)·Leave & Time Off (3)·Court Decisions & Case Commentary (6)·Executive Compensation (1)

The One Thing

When a benefits plan evaluates a claim, who checks the assumptions buried inside the evaluation itself? The NFL players’ disability litigation puts that question in sharp relief. Cognitive evaluations supporting claims used race-based scoring adjustments. On October 27, a federal court approved a settlement that permanently continues the plans’ June 2021 prohibition on those adjustments and provides race-neutral reconsideration of eligible earlier claims dating back to 2012. Players who qualify for previously denied or higher benefits receive back benefits in a lump sum with 6% simple annual interest. Rescoring cannot reduce an existing award. The plans deny wrongdoing, and reconsideration does not guarantee payment. For other plan sponsors, the practical question reaches beyond these particular tests. Scoring norms, review criteria and decision rules can shape a benefit determination before anyone reaches the final approval or denial. Oversight means understanding those methods as well as the resulting decisions. When did your plan last examine the assumptions its claims process relies on?

Congress & Agencies (7)

A New Era for Plan Corrections: IRS Unveils Long-Awaited Updates to EPCRS
Miller Canfield · via JD Supra 2026-10-28

Miller Canfield works through the IRS’s overhaul of EPCRS, its program for correcting retirement-plan errors. The revenue procedure is dated October 22 and is generally effective as of that date. Self-correction now extends to “eligible inadvertent failures” including certain plan-document, nondiscrimination-testing, employer-eligibility and plan-loan errors that previously required a formal IRS filing and user fee. A correction is generally treated as timely if completed by the later of the end of the third plan year after the error occurred or 18 months after it is discovered. Many inadvertent benefit overpayments no longer have to be recovered from participants or restored to the plan, though sponsors who do seek repayment face restrictions the firm says still need DOL guidance. The relief for certain automatic-enrollment errors is now permanent and extends to terminated employees. It waives the corrective contribution for the missed deferral opportunity; missed matching contributions, adjusted for earnings, are still owed. Sponsors still need established compliance procedures that were in place and routinely followed.

Patient Protection and Affordable Care Act; Exchange Pre-Eligibility Verification
Federal Register 2026-10-27

The published text of CMS’s marketplace verification proposal supplies the mechanics. Subsidized enrollees would have to actively confirm their eligibility information every year. Automatic re-enrollment in a plan could continue, but premium tax credits and cost-sharing reductions would generally be withheld until specified information is verified, with exceptions for family-change special enrollments and information already verified midyear, and full-price coverage remaining available in the meantime. Verification would begin ahead of open enrollment on August 1, 2027, generally for the 2028 plan year, and comments are due November 27, 2026. CMS’s own estimates are projections rather than observed effects. The agency projects roughly 332,500 fewer properly enrolled consumers a year from the added administrative steps, a $7.6 billion annual reduction in premium tax credits, and a 0.4% premium increase starting in 2028. Benefits teams explaining coverage options to departing employees should distinguish continued marketplace enrollment from continued eligibility for financial assistance.

New Proposed IRS Regulations Expand Benefits Available to Highly Compensated Employees Under Dependent Care Assistance Plans
Daniel L. Morgan (Blank Rome) · via National Law Review 2026-10-27

Daniel L. Morgan of Blank Rome works through the dependent-care piece of the IRS’s proposed regulations from August, and the change that matters for plan design. The 55% test asks whether the average dependent-care benefit provided to non-highly-compensated employees is at least 55% of the average provided to the highly compensated. Under the proposal, that comparison would count only employees who actually receive benefits, which may help some plans pass a test that today’s broader headcount makes difficult wherever lower-paid employees rarely elect dependent-care accounts. The proposal’s preamble states that taxpayers may rely on the proposed rules for plan years beginning before final regulations are published. Nondiscrimination testing does not disappear and passage is not guaranteed, but for employers whose highly compensated employees have been effectively shut out of the benefit by failed testing, this is an option to evaluate with counsel against the proposal’s terms.

How Does the IRS Deadline for SECURE 2.0 Amendments Work?
PLANSPONSOR 2026-10-27

PLANSPONSOR’s Q&A, drawing on specialists from Groom and CAPTRUST, answers the question sponsors keep deferring. The baseline deadline for adopting SECURE 2.0 plan amendments, in the 403(b) context the question poses, is December 31, 2026, while some amendments have later deadlines tied to the Required Amendments List the IRS publishes for changes in qualification requirements. That is not a blanket extension, and plans using preapproved 403(b) documents still live on their separate restatement cycle. A plan must operate in accordance with the applicable requirements even while its document-amendment deadline sits in the future, so the review the experts describe is checking that operations meet the rules and calendaring the amendments, with an amendment still inside its permitted deadline being ordinary housekeeping rather than a problem.

PBGC Announces Maximum Guarantee for 2027
Groom Law Group 2026-10-27

Groom reports the 2027 maximum guarantee for single-employer pension plans covered by PBGC, the federal agency that insures private pensions. It works out to $8,113.64 a month for a straight-life annuity at age 65, with adjustments for age and payment form. The guarantee, subject to its statutory limits, caps what PBGC pays a participant when a covered underfunded plan terminates, which makes it the practical measure of the federal insurance behind those plans’ benefits. It does not apply to multiemployer plans, whose separate guarantee is far lower.

Red Flags: Mental Health Parity Guidance Provides Practical Tips for Plan Sponsors
Proskauer · via National Law Review 2026-10-21

Proskauer reads EBSA’s September 8 mental health parity enforcement guidance together with the companion checklist the agency issued the same day. The checklist lists plan provisions and operational patterns that should make a sponsor “think twice” about mental health parity compliance, from autism-therapy exclusions and prior-authorization asymmetries to network-admission standards that are harsher for behavioral providers. The firm treats the agency’s three enforcement priorities as a starting point rather than a safe harbor. It reads the checklist as a self-audit tool, with the plan’s comparative analyses, the written comparisons of how it restricts mental-health benefits versus medical benefits, kept current and producible on short notice, vendors asked for the operational data behind their conclusions, and monitoring and corrections documented. The guidance states enforcement policy rather than new binding rules, and the firm’s prediction of outcomes-focused rulemaking to come is its own inference. Running the checklist against plan documents and actual claims practice is a concrete exercise a sponsor can schedule now.

SEC’s 2027 Examination Priorities Focus on Emerging Technology, Cybersecurity, and Investor Protection
Troutman Pepper Locke 2026-10-27

The SEC’s examination priorities for 2027 put registered advisers’ and broker-dealers’ use of artificial intelligence and their cybersecurity practices near the top of the exam program, and Troutman Pepper Locke walks through what examiners say they will look for. Exam priorities are neither new regulations nor an exhaustive checklist; they are a statement of where the staff intends to spend its time. For committees selecting or monitoring investment advisers, the priorities identify AI-use and cybersecurity questions to raise with those providers.

Retirement Plans (9)

Self-Certification of 401(k) and 403(b) Plan Distributions
Verrill · via JD Supra 2026-10-28

Verrill maps where a participant’s own certification can carry a 401(k) or 403(b) withdrawal, and the rules differ by distribution type. For birth-or-adoption and disaster-recovery distributions, the administrator may rely on a reasonable representation unless it has actual knowledge to the contrary. For hardship and emergency-expense distributions, the administrator may rely on a written certification, with IRS rules on misrepresentation still unwritten. For domestic-abuse distributions the statute goes further and says the certification shall be treated as meeting the requirements. The firm’s practical advice is a written oversight policy, forms that state the eligibility rules and get a real signature, review of distribution patterns over time, and clear warnings to participants about the tax and repayment consequences of a false certification. Verrill notes that one administrator defaults to two self-certified distributions annually. That administrative limit is separate from the eligibility and other restrictions governing each withdrawal type.

Industry Demonstrates Need for Better Retirement Savings Rollover Support for Job Changers
PLANSPONSOR 2026-10-27

PLANSPONSOR assembles the evidence that retirement savings leak when workers change jobs, and the pieces differ in kind. Empower’s survey of 2,005 adults reports what savers say. In it, 39% hold savings scattered across former employers’ accounts, and roughly half of Generation Z say they may have lost track of old savings. PensionBee’s analysis of automatic rollover IRAs, the parking place for left-behind accounts under $7,000, finds 87% of the accounts still sitting there a year later. About 68% lose value in that first year, which the firm attributes to fees and cash investments. Vanguard’s researchers analyzed plans that adopted the Portability Services Network and observed automatic portability cutting cash-out rates for sub-$1,000 balances from about 50% to roughly 9%. Even so, 94% of moved accounts had not yet matched to a new employer’s plan, which they tie to low employer adoption. The IRS’s proposed five-step rollover standardization under Notice 2026-49 closed its comment window October 23. For sponsors, the findings put small-account transfer practices and rollover help for departing employees on the agenda, including whether an automatic transfer actually reaches the worker’s next plan.

Hardship Withdrawals Are Rising. The Answer Isn’t Making Them Harder.
The Rosenbaum Law Firm · via JD Supra 2026-10-28

Ary Rosenbaum’s opinion piece takes rising hardship-withdrawal numbers as a symptom rather than a compliance problem, and argues the response should be emergency-savings features and financial wellness rather than tighter gates on the money. For sponsors, Rosenbaum’s piece raises whether emergency-savings and financial-wellness benefits could address the pressures behind hardship withdrawals, while the plan’s withdrawal eligibility rules still apply.

Goldman Sachs: Insurers Bet on In-Plan Income Adoption
PLANSPONSOR 2026-10-27

Goldman Sachs’s survey of insurers finds them positioning for in-plan retirement income to grow, with 15% expecting meaningful adoption over the next three years against 5% expecting it in the next year. Those are supplier expectations, not measured uptake, and insurers have an obvious interest in the market developing. A committee weighing lifetime-income options can take the supply side organizing itself as a signal worth noting, while the fiduciary questions about cost, portability and guarantees remain exactly where they were.

US Adults Appear Underprepared for Longer Lives
PLANSPONSOR 2026-10-27

The John Hancock and MIT AgeLab Longevity Preparedness Index, built from NORC surveys of 1,340 adults in May, holds at an average of 60 out of 100 for the second straight year, with the weakest scores in caregiving at 43 and health and home at 56 each, against stronger showings in community and social connection. Respondents who work with a financial professional average 67 against 58 for those who never have, a correlation the sponsors read favorably but not proof that advice causes preparedness. The domain detail is the usable part for benefits teams, since caregiving and health are exactly where employer programs beyond the 401(k) operate, and those are the areas where respondents report feeling least prepared. Findings like these can inform benefit priorities; they do not prove any particular program is needed.

Rethinking Compensation for DC Lifetime Income Programs
Business of Benefits (Bob Toth) 2026-10-27

Bob Toth argues that the compensation structures built for picking mutual funds fit poorly when a plan adds lifetime-income guarantees, because guarantees carry manufacturing and servicing costs that basic investments do not. His piece is an opinion about how compensation ought to be rethought, not a fee safe harbor or a DOL rule. For committees comparing income products, Toth’s argument is that a mutual-fund fee comparison alone may miss the costs of guarantees and ongoing services.

Long-Awaited Guidance on ESOP Valuation Standards
Arnold & Porter 2026-10-27

Arnold & Porter walks through the Retire Through Ownership Act, signed October 15. The new ERISA provision lets a fiduciary of an employee stock ownership plan, or ESOP, rely in good faith on a valuation of privately held company stock by an independent valuation expert or business appraiser who applied the principles and methodologies of Revenue Ruling 59-60, and it applies to determinations made on or after enactment. The statute does not modify a fiduciary’s general duties of prudence and loyalty, and it preserves the Labor Department’s authority to issue interpretive regulations. The change gives fiduciaries an express basis for good-faith reliance on an independent valuation, while preserving their duties in selecting and monitoring the expert.

Software Without Structure: AI and Retirement Providers
Fred Reish 2026-10-27

Fred Reish’s newsletter turns the AI conversation toward supervision. Retirement providers adopting AI tools need structure around them, meaning defined processes, human checkpoints and accountability for what the software produces. He draws on sanctions episodes from outside ERISA as cautionary background rather than as precedent. When a retirement provider uses AI to deliver plan services, sponsors can ask what it does, who checks its output and who is accountable for errors.

Talking Points: What Should Scare Plan Fiduciaries?
NAPA (Nevin Adams) 2026-10-27

Nevin Adams’s Halloween-timed list of what should actually frighten plan fiduciaries skips the headlines and lands on governance. He points to target-date glidepaths, the schedules by which a fund’s investment mix shifts as retirement approaches, that nobody has re-examined, personalization claims for managed accounts that outrun their evidence, vendor cybersecurity taken on faith, and the difference between a fidelity bond, which protects the plan against theft, and fiduciary liability insurance, which covers specified claims against the fiduciary personally, subject to its terms. Nothing in it is a new rule or holding, and every entry on the list is a question a plan committee can put on its own agenda.

Health & Welfare (5)

Why Employers Are Reconsidering Their Pharmacy Benefit Managers
Employee Benefit News 2026-10-27

Employee Benefit News reports on an RxBenefits-sponsored survey in which 87% of responding employers said they were likely to consider switching pharmacy benefit managers, the companies that administer prescription-drug benefits, at renewal, a striking number that arrives without the survey’s sample or method, so it describes the vendor’s respondents rather than the market. The piece also explains how rebate cash-flow timing obscures true costs, and how claims-data access decides whether a sponsor can compare pricing models at all. The GLP-1 utilization-review ideas are the vendor’s suggestions, not clinical guidance. Free registration required.

HR Focus with Christina Nechiporchik: Three Common Mistakes Employers Make During Open Enrollment
Bodman · via JD Supra 2026-10-27

Bodman’s short open-enrollment video names three recurring mistakes, which are benefit changes communicated late or unclearly, required notices that never go out, and eligible people the enrollment campaign never reaches. The delivery pitfalls are the useful part. A glossy enrollment guide handed to employees may not count as delivering the continuation-coverage notice a covered spouse is entitled to, and the people most often missed are those on leave or furlough and former employees still on continuation coverage, so the firm’s advice is to start communications early, use more than one channel, and keep records of what was sent to whom. In enrollment season, this is a checklist against the mistakes that generate claims later.

The Healthcare Plan Questions Employers Should Be Asking
Employee Benefit News 2026-10-27

A survey of 124 brokers and advisers, not employers, gives this EBN piece its numbers. In it, 22% say fiduciary oversight is now the leading question from clients, 12% are very confident in their clients’ processes, 78% report no visibility into the outcomes of their clients’ surprise-billing arbitrations, and 62% say the plan lacks data on subrogation, the recoveries a plan pursues when someone else is legally responsible for a claim it paid. Those are intermediaries describing their clients, with the limits that implies. For sponsors, the gaps raise a practical oversight question. What information will the administrator actually provide about claim recoveries and dispute outcomes? Reference-based pricing, which benchmarks payments to a stated reference point such as Medicare rates instead of negotiated network discounts, and captive insurance arrangements appear as alternatives some clients weigh, not as recommendations. Free registration required.

Roundtable: An Orrick Conversation on Health Data Privacy
Orrick · via JD Supra 2026-10-27

Orrick’s roundtable transcript starts from a clarifying point. HIPAA does not govern most consumer health apps, so the wellness and point-solution vendors in an employer’s ecosystem may sit outside it entirely, governed instead by state privacy laws and FTC rules, because the absence of HIPAA is not the absence of law. The discussion’s useful core is the vendor-diligence questions, covering what health data is retained, whether it trains models, and how deletion actually works.

How Employers Can Balance Oncology Costs and Quality
Employee Benefit News (WTW) 2026-10-27

Three WTW health-management leads lay out the oncology playbook for plans watching cancer become a top driver of spend. The levers include steering infusions to lower-cost sites of care, letting clinicians round doses where clinically acceptable to avoid wasting part of a vial, second opinions and centers of excellence, and screening and palliative support. The authors also flag the treatment costs that push members to delay or skip care, and the leave, disability and return-to-work pieces that sit outside the medical plan. The authors are candid that net savings are hard to bank, and the design levers rather than any quoted percentage are the takeaway. The approaches emphasize clinical judgment and patient choice while giving plans options for improving access and managing costs. Free registration required.

Leave & Time Off (3)

Evolving Legal Protections and Benefits for Employees Experiencing Menopause
Ogletree Deakins 2026-10-27

Ogletree’s overview sorts what is actually law on menopause in the workplace from what is pending, and the two tracks differ. On coverage, Illinois and Louisiana have enacted mandates requiring health plans to cover menopause treatments, which reach insured policies rather than self-funded plans. On workplace rules, Rhode Island and Philadelphia prohibit discrimination based on menopause, New Jersey’s civil-rights agency has issued accommodation guidance, and the governors of California and Virginia recently vetoed similar antidiscrimination bills; a federal accommodation bill is pending in the House. Under the Americans with Disabilities Act, accommodation turns on whether symptoms rise to a disability, and the historical cases the piece collects are background rather than fresh rulings. Employers should assess requests under existing accommodation requirements while monitoring new legislation.

Employers to Comply With New Paid Parental Leave Law in Allegheny County, PA in 2027
Ogletree Deakins 2026-10-27

Ogletree summarizes Allegheny County’s employer-funded paid parental leave mandate, the 12-week benefit with a $4,200 weekly cap, alongside the county’s expanded sick-leave rules. On timing, the county’s regulation sets two stages. The rules take effect at least 180 days after passage, and employers then have up to another 180 days to comply, which is why the firm frames compliance as arriving in 2027. The county has not yet confirmed the specific calendar dates, so employers in the county should build their policy, payroll and recordkeeping calendars from the ordinance’s stages and watch for the confirmed dates.

The Accommodation Mistake Employers Keep Making
HR Dive 2026-10-27

HR Dive’s piece on accommodation practice names the recurring failure, which is treating the interactive process as paperwork rather than an actual back-and-forth and letting requests stall without a decision. What a process breakdown costs an employer varies by jurisdiction. Under the federal Americans with Disabilities Act, courts generally also ask whether a reasonable accommodation was actually available, while some state and city laws, New York’s among them, can penalize the failure to engage itself. For teams handling leave or requests for a modified schedule, the practical issue is keeping the accommodation discussion moving and recording the options considered.

Court Decisions & Case Commentary (6)

Landmark Settlement Approved in NFL Players’ Disability Benefits Class Case
Beasley Allen 2026-10-21

The settlement over race-norming, the use of race-based adjustments in scoring the cognitive tests behind disability claims, in Bailey v. The NFL Player Disability & Survivor Benefit Plan has final approval. The court’s signed order, entered October 27, certifies a settlement class of former players whose claims reach back to 2012, one whose members cannot opt out, permanently continues the plans’ June 2021 prohibition on race-based adjustments and requires eligible earlier claims to be reconsidered without them. Under the settlement agreement, a player whose race-neutral rescore qualifies him for a benefit he was denied, or for a higher level than he was awarded, is reclassified and paid the back benefits he would have received, in a lump sum with 6% simple annual interest, and no one’s existing award can be reduced by the rescoring. A rescore is an opportunity for review, not an automatic award. For plan administrators, the caution is about what sits inside inherited claims-administration methodology, since the plans here agreed to unwind a scoring practice used for years in their own claims evaluations.

FMLA Interference Claim Survives Dismissal Over Withheld Leave Paperwork
U.S. District Court, N.D. Illinois 2026-10-21

A machine operator alleges that he asked human resources for medical-leave paperwork shortly before being fired, that the promised forms never arrived, and that the company knew about his medical problems. In its October 21 opinion, the court allowed his claim under the Family and Medical Leave Act to proceed, because those allegations plausibly show that the missing information deprived him of an opportunity to use protected leave. The ruling does not establish employer liability. Separate accommodation and sex-discrimination claims were dismissed for administrative-charge and pleading defects, with an opportunity to amend. For leave administrators, the case illustrates how failing to explain available leave after receiving notice of a possible need can become an interference claim when the employee alleges resulting harm.

Georgia Appeals Court Reverses Workers’ Compensation Cut for Missing Medical Basis
Georgia Court of Appeals 2026-10-26

Georgia’s appellate court reversed a ruling that had allowed Delta to reduce a worker’s compensation benefits. The medical report attached to the employer’s notice described lifting restrictions but did not release the worker to return to work, and older records did not supply the missing contemporaneous support, so the case returns for further proceedings, including reconsideration of attorney fees. The ruling is specific to these facts and does not require particular words in every medical report, and this is state workers’ compensation rather than ERISA. For employers and administrators handling Georgia workers’ compensation claims, the distinction matters, because a lifting restriction alone did not establish the work release needed to support this reduction.

New Suit Challenges a Bank Plan’s Retention of an Underperforming Growth Fund
U.S. District Court, D.N.J. 2026-10-26

A former employee alleges that M&T’s retirement-plan committee retained the T. Rowe Price Growth Stock Fund despite persistent underperformance, investor withdrawals and a manager change, with more than $446 million of plan assets still in the fund at year-end 2025. The complaint compares the fund’s rolling three-year returns against its benchmark at 26 consecutive quarter-ends and alleges the fund lagged each time. The defendants are the bank, its parent and the plan’s committee, not T. Rowe Price, and the plaintiff acknowledges lacking access to the committee’s internal deliberations. No class has been certified and the allegations remain unproven. The case joins the investment-monitoring litigation and puts a familiar committee question in focus. What analysis supports keeping a fund when the warning signs persist?

Buried Alive? ERISA Claims Exhaustion Isn’t Necessarily Dead After Bolton
Thompson Hine 2026-10-27

Thompson Hine pushes back on broad readings of the Eleventh Circuit’s Bolton decision, which eliminated the judge-made exhaustion requirement, the rule that a participant must finish the plan’s internal claims review before suing, for statutory ERISA claims in that circuit. Ordinary benefit-denial claims still go through the plan’s claims procedures; Bolton is about claims brought under the statute itself, such as fiduciary-breach claims. What the opinion leaves unresolved is whether a plan’s own terms can require exhaustion even for statutory claims, since the plan before the court used permissive rather than mandatory language. The authors propose drafting mandatory exhaustion language and litigation approaches that lean on the distinction, and that strategy is their analysis rather than anything the court held; the opinion is linked for the holding’s exact scope. Whether plan language can still put a participant through internal review before a statutory suit is now a live drafting question in the Eleventh Circuit and worth watching everywhere else.

Your ERISA Watch for the Week of October 28, 2026
Your ERISA Watch · Kantor & Kantor 2026-10-28

Peter Sessions’s weekly survey finds its theme in tobacco-surcharge litigation, the class actions challenging the fees employers’ wellness programs add to tobacco users’ health premiums. As the roundup reports them, three cases span the field this week. In Mehlberg v. Compass Group, a Missouri federal court handed plaintiffs what the roundup calls the first summary-judgment win in the wave, reading the full-reward requirement to reach surcharges already paid, finding the required disclosures were not provided, and holding equitable relief available as a remedy. A Goodyear ruling let an inadequate-notice claim proceed while dismissing the fiduciary theories, and a $450,000 class settlement with Nordstrom won preliminary approval. The roundup’s other entries run from the EssilorLuxottica stable-value dismissal to a fiduciary-exception privilege ruling and a dozen more decisions across disability benefits, discovery, pension claims and subrogation. For sponsors with tobacco surcharges, the cases put both participant notices and the opportunity to earn back the full surcharge under scrutiny.

Executive Compensation (1)

Form S-8 Simplified: SEC Staff Delivers Long-Awaited Equity Compensation Relief
Latham & Watkins · via JD Supra 2026-10-28

Latham & Watkins works through the new and revised interpretations the SEC’s Division of Corporation Finance issued October 15 on Form S-8, the streamlined registration statement for employee equity. Companies may now register shares underlying equity awards granted before their initial public offerings, including restricted stock and restricted stock units. Separately, companies already eligible to use Form S-8 when they grant restricted stock or restricted stock units may register those awards before vesting, which ends the practice of rushing a registration ahead of every off-cycle award. And a public acquirer may use the form for target-company awards it assumes, including awards held by the target’s former employees, which makes assuming those awards practical instead of cashing them out. The firm’s extensions beyond that, including profits-interest conversions and not counting forfeited awards against the registered reserve, are its own inferences from the staff’s principles, and the piece says so. These are staff interpretations rather than Commission rules, which is the status to keep in mind when acting on them.