A 401(h) account is a separate account inside a pension plan that pays medical benefits, ordinarily for retirees and their families. In this ruling the IRS holds that employees who are still working count as retired for that purpose once they reach age 59½ and become eligible to take their pension while working, because the governing regulation treats employees who are eligible to retire and receive benefits as retired. The ruling addresses a specific set of circumstances. The medical account is overfunded, the plan hasn’t moved pension surplus into it under the special transfer rules, and key employees are excluded. The ruling doesn’t address whether these employees count as retired for other tax purposes, and nothing in it lets a plan spend general pension assets on medical benefits. For sponsors whose pension plans carry well-funded retiree medical accounts, the ruling opens a real design question. Employees old enough to retire who keep working could have medical benefits paid from the account, and that’s worth a conversation with counsel.

The Labor Department is expected to announce its final pharmacy benefit manager compensation-disclosure rule today, PLANSPONSOR reports. According to the National Community Pharmacists Association, an announcement event is scheduled for 10:30 a.m. ET. PBMs administer prescription-drug benefits for employer health plans. DOL’s January proposal would require more information about their compensation and give plan fiduciaries rights to audit those disclosures. The final text will determine which requirements take effect and when. For employers with self-insured health plans, the rule could provide better information for comparing PBM contracts and evaluating what they’re paying. An announcement and Federal Register publication may occur at different times.

Kilpatrick’s Sarah Michelle Campbell and R. Sterling Perkinson walk through the IRS’s overhaul of its retirement-plan correction program, covering correction deadlines, missed-deferral relief, overpayment treatment and determination-letter interactions. The operative releases are Revenue Procedure 2026-34, which replaced the 2021 version of the program and took effect October 22, and Revenue Procedure 2026-33, which creates a separate correction system for IRAs. The plan-side changes expand self-correction now, though only for eligible inadvertent failures, corrected on time, by sponsors with established compliance procedures. The IRA system opens May 1, 2027 as a voluntary filing program covering four specified failure categories. The new program does not offer self-correction. For plan administrators, the changes affect which mistakes can be corrected and how. IRA custodians and owners face a separate program with its own opening date and limits.

The Coalition Against Surprise Medical Billing and the ERISA Industry Committee are asking CMS to pause recertification of No Surprises Act arbiters and give the public more time to comment. Jill Hughes of Healthcare Dive reports that eight arbiters are seeking recertification. The arbiters decide payment disputes between health plans and out-of-network providers under the surprise-billing law. The objecting groups, which represent employer and payer purchasers, argue the current roster has produced provider-friendly outcomes at costs plans ultimately bear. They support the argument with federal data and separate research, and the conclusion they draw is the purchasers’ side of the dispute. Self-funded plans encounter this system through their administrators, and who will be deciding those awards next year is the practical stake.

Brownstein’s benefits team explains a Labor Department proposal on electronic delivery of required communications for group health plans, an optional alternative to the existing delivery routes. As proposed, a plan could furnish covered documents electronically after an initial paper notice, using an electronic address for the participant, with portal access available outside employer systems, notices of availability when documents post, and paper copies on request. The rule is proposed, not final. Not every participant notice necessarily falls within it, and posting periods and retention duties differ by document. Health plans that have wanted the electronic default long available on the retirement side now have a concrete draft to evaluate and comment on.

Hall Benefits Law reports that employer and industry groups have filed comments urging the Labor Department to adopt its proposal permitting electronic delivery of required communications for health plans. The commenters cite cost savings and faster participant access, figures that are their own advocacy numbers rather than the proposal’s impact estimates. For health-plan administrators, the proposal could change how required notices reach participants. Existing delivery requirements continue to apply while the proposal remains pending.

Stephanie Grant of Warner Norcross + Judd analyzes the September guidance in which the Labor Department named its mental health parity enforcement priorities. Federal parity law requires group health plans to cover mental health and substance-use care no more restrictively than medical and surgical care, and a 2021 statute requires plans to keep written comparative analyses showing how their limits compare. The named priorities are benefit exclusions, medical-necessity standards and network access. Her emphasis lands on what the priorities don’t do. They don’t erase the comparative-analysis obligations, and they don’t confine investigations to the three named areas, since other treatment-limitation theories remain available to the agency. Her practical point is that the comparative analyses need to be current and producible before anyone asks for them.

Barry Salkin, Andrew Oringer and Dannae Delano of Wagner analyze the Retire Through Ownership Act, signed October 15, which addresses how employee stock ownership plans value company shares. An ESOP is a retirement plan that holds employer stock for employees, and valuing closely held stock is where ESOP fiduciaries most often get sued. The statute lets fiduciaries rely in good faith on an independent valuation expert applying the factors of Revenue Ruling 59-60, the IRS’s longstanding valuation framework, and the firm works through those factors and what reliance requires in practice. The limits get equal billing. Good-faith reliance isn’t immunity, the statute guarantees no particular valuation, and ERISA’s duties of prudence and loyalty remain fully in place. For fiduciaries and the advisers documenting their transactions, the path is to engage a genuinely independent expert, document the engagement and the reliance, and treat the statute as a framework for diligence rather than a shield.

KFF’s tracker catalogs 64 federal mental-health and substance-use policy actions under the current administration, spanning enacted rules, proposals, rescissions, reversals and litigation. Its publication date isn’t the date of any particular action, later entries supersede earlier ones, and proposed budget cuts recorded there were not enacted as proposed. For benefits professionals, the tracker is a way to check whether a policy a vendor or an employee mentions is actually in force, still proposed or being litigated before the plan responds to it.

Andy Stonehouse summarizes Transamerica’s survey of workers across generations, which finds cost of living, debt and caregiving constraining retirement contributions for every age cohort, not just the youngest. Worker doubts about Social Security’s future appear in the survey as perceptions, not projections of the program’s finances. For plan sponsors, the pressure shows up as suppressed deferrals among employees who are already eligible and enrolled. That’s a problem plan design and financial-wellness communications can reach even when household budgets are tight.

Ted Godbout reports a TIAA survey, conducted online by KRC Research among 1,000 adults ages 18 to 65 in late July, in which 43% of respondents say they have reduced or stopped retirement contributions to cover everyday expenses and 12% report withdrawing retirement money for daily costs. The piece carries TIAA’s framing on Social Security shortfalls and its recommendation of annuity-style defaults, which readers should weigh as the survey sponsor’s perspective. For sponsors, contributions that quietly stop are lost savings that enrollment statistics alone won’t reveal.

Brian Anderson surveys where target-date fund design is heading, with managers adding retirement-income features and, increasingly, sleeves of private assets. The distinctions matter more than the direction. Much of the income innovation is withdrawal guidance without a guarantee, meaning the fund suggests a sustainable spending rate rather than insuring income for life. Income-oriented assets remain a small share of target-date portfolios, and private assets are appearing in a handful of products rather than everywhere. For investment committees, each addition brings its own monitoring questions, from liquidity and valuation practices to layered fees and participant suitability. The time to settle how the committee will evaluate them is before participants are transferred into the new fund.

Ron Surz argues that target-date funds carry too much investment risk at the retirement date itself. He compares the industry’s average allocation near retirement, which he classifies as about 85% risky assets, with a more conservative benchmark he developed and markets. Surz distinguishes a retiree’s tolerance for risk from their capacity to absorb losses, questions whether age alone can personalize an allocation, and draws on historical valuation charts to argue the stakes. For committees selecting default investments, the comparison highlights the importance of assessing how losses near retirement could affect participants who are about to draw on their savings.

Milliman’s monthly index estimates that the 100 largest U.S. public pension plans ended September with assets covering 87.4% of the value of promised benefits, down from 89.0% in August, as a −1.4% aggregate monthly investment return widened the estimated deficit to $877 billion. The figures are roll-forward estimates built on the firm’s 2025 study rather than fresh valuations of each plan, and individual plans’ September returns ranged from −3.4% to −0.5%. Public plans sit outside ERISA. For readers who advise governmental employers or watch the funding environment, the index is the monthly gauge of how market swings translate into funded status.

Andy Stonehouse covers the second annual Longevity Preparedness Index, created by John Hancock with MIT’s AgeLab, which scores Americans’ readiness for longer lives at 60 out of 100, unchanged from last year. The weakest areas are planning for care, scored at 43, and health and housing, at 56 each, against stronger showings for community and social connection. Households working with advisers score better, an association the index reports without establishing cause, and its sponsors promote their own planning tools alongside it. The gap it measures is practical. Retirement readiness increasingly means plans for care, housing and health, not only an account balance.

Fred Barstein’s weekly industry roundup covers five threads, spanning retirement-income product design, how workplace plan benefits are evolving, recordkeeper economics, financial wellness and what plan sponsors say they need from providers. Where the discussion leans on polling, surveys of sponsors and surveys of employees measure different things, and the withdrawal-guidance features in newer income products are not guarantees. It’s a quick orientation for readers who want the industry conversation in one place.

Andy Stonehouse reports BlackRock’s survey of more than 300 retirement plan advisers on what the fastest-growing practices report doing, including heavier use of artificial intelligence and selling additional services to existing clients. The survey records what growing practices say they do rather than establishing what causes growth. Advisers can read it as a benchmark against the competition, and sponsors get a view of where the adviser market is spending its energy.

Michael Stoyanovich of Segal recounts a phishing campaign against a benefit-fund office that impersonated Microsoft branding and infrastructure. By Segal’s account, trained employees recognized the messages and reported them, and the fund experienced no clicks, no exposure and no compromise. It’s the consultant’s story about an unnamed client, and impersonating Microsoft doesn’t mean Microsoft was breached. The exposure it illustrates is specific to the plan world. Fund offices concentrate personal data, money movement and small staffs, and the habit of reporting suspicious messages instead of opening them is trainable.

Employee Benefit News reports that 53% of employers responding to WTW’s survey cover GLP-1 drugs for weight loss, compared with 57% in its 2025 survey. The survey, reported by Jimmy Nesbitt, reached more than 470 U.S. employers with at least 100 employees, covering some 7 million workers, from late June through early August. Weight-loss coverage is a separate question from diabetes coverage, which remains broadly in place. Employers are also considering steps short of exclusion, from clinical-program requirements, cost sharing and purchasing channels to stop-loss adjustments, and WTW cautions that aggressive weight-based eligibility limits can jeopardize rebate arrangements. The firm pegs 2026 pharmacy cost trend at 11.5%. These are survey findings as reported, and the surveys do not necessarily track the same employers year to year. Employers heading into renewals need to weigh net cost after rebates alongside access and clinical outcomes before excluding coverage.

KFF’s updated explainer lays out health-marketplace subsidy mechanics for 2027 coverage. Premium tax credits cap what a household must pay for benchmark coverage on a sliding scale, from 2.15% of income near the poverty line to 10.22% of income in the 300% to 400% bracket. With the enhanced credits lapsed, there is no cap on premiums for households above 400% of the poverty line. Eligibility also turns on household income, family size and access to other coverage. Cost-sharing reductions, which lower deductibles and copays, still require choosing a silver plan, and premium credits can’t be used for catastrophic coverage. The explainer also notes the removal of repayment caps on excess advance credits for 2026. None of this governs employer plans directly, but benefits teams fielding exit conversations need the current figures, and older departing employees comparing COBRA with marketplace coverage particularly need to know where the subsidy stops.

Kate Reinaker and Sarah Klein of Lockton explain a coordination problem inside self-funded plans’ pharmacy arrangements. Stop-loss insurance reimburses a plan for catastrophic claims, and it typically keys to gross claim amounts, while the plan’s real cost is net of rebates, credits and contractual refunds. As pharmacy contracts grow more complex, the gap between those two figures widens. Their advice is contractual. Reconcile how the stop-loss policy defines eligible claims with how the pharmacy contract actually moves money, before renewal locks a mismatch in for another year. The piece ties coming federal disclosure requirements to plan years beginning after August 3, 2028.

KFF counts 4.3 million Medicare beneficiaries whose Medicare Advantage or stand-alone prescription drug plan terminates at the end of 2026, most of them in individual Medicare Advantage drug plans, against 42 million whose plans renew and 1.4 million whose plans are consolidated into other plans. The analysis excludes employer-sponsored and union-sponsored coverage, so it isn’t a statement about retiree plans that sponsors run. Terminated enrollees who default into traditional Medicare may need separate drug coverage, and termination carries rights to buy a Medigap supplemental policy that consolidation doesn’t. Benefits teams can use the findings to prompt retirees to review termination notices and their replacement medical and drug coverage.

Hall Benefits Law describes arrangements in which promoters nominally make workers limited partners in a partnership in order to sell them thin health coverage pitched as beyond regulators’ reach. The concern isn’t hypothetical. Montana’s insurance commissioner issued a consumer warning about self-funded limited-partner health plans in September, following a May enforcement action against arrangements marketed in the state, and citing entities identified by regulators in other states. Whether any particular arrangement is an ERISA plan, whether it is genuinely self-funded and which regulator reaches it are three separate questions. Employers should independently verify those claims before offering the coverage. Coverage marketed primarily on its claimed exemption from oversight is coverage to examine carefully before anyone’s employees are in it.

KFF refreshed its frequently-asked-questions explainer on the ACA marketplace, eight entries covering family coverage, income counting, eligibility and midyear changes. Its introduction notes that the longer FAQ library has been discontinued, making this the maintained set. For benefits teams, it’s a plain-language reference for the basic coverage questions departing employees and their families ask, including the household-eligibility rules that interact with an employer’s own offer of coverage.

Nate Epp of HUB writes for advisers guiding clients from employer coverage into Medicare. Whether active-employment coverage pays before or after Medicare depends on employer size, and the article highlights enrollment timing and the coverage choices retiring workers face. Advisers helping workers make that move also need to coordinate enrollment with health savings account contributions. IRS and Social Security guidance explain that Medicare coverage, including retroactive Part A coverage, affects contribution eligibility. Turning 65 alone does not end that eligibility.

KFF’s election-cycle update on immigrant health policy distinguishes coverage restrictions already in effect, including public-charge rules and eligibility limits that have taken hold, from changes scheduled for 2027 and proposals still pending, among them a proposed H-1B fee that is not an existing requirement. Benefits teams communicating with affected employees need to identify which rules apply now and which remain unsettled, because workforces with visa-holding or mixed-status employees are hearing all of it discussed as if already enacted. Precision about what has changed and what hasn’t is the help an employer can actually offer.

Katherine Koop Irwin and Andrew Beck of FBT Gibbons supply administration-side detail on Allegheny County, Pennsylvania’s new ordinance, the first county-level paid parental leave mandate in the country. As posted, the ordinance covers employers with 15 or more employees in the county, provides up to 12 weeks of paid parental leave at the employee’s base rate capped at $4,200 a week, and separately raises paid sick leave accrual to one hour per 30 worked, up to 72 hours a year, with smaller employers addressed separately in the sick-leave provisions. County Council passed the measure 11 to 4 and County Executive Sara Innamorato signed it October 22, per the county’s announcement, which speaks of an implementation year without publishing official dates. The posted text takes effect no fewer than 180 days after passage, with implementation required no later than 180 days after the effective date, so employers should treat precise dates as pending until the county publishes them. The firm’s practical additions are the employer duties, including written eligibility determinations within ten business days after a claim and its required documentation are received, notices at hire and annually, and an annual compliance certification to the county beginning a year after the effective date.

A consent order addresses unfinished retirement-plan business at McCullough, Campbell & Lane, a defunct Chicago law firm whose former capital partners the Labor Department sued for failing to wind the plan down after a 2019 partnership resolution required it. The August 18 order, announced by the department on October 26, records about $6.26 million in existing plan assets distributed to located participants and another $230,000 transferred to PBGC’s program for missing participants. The department’s release puts the recipients at 40 employees. The order directs recordkeeper Transamerica to allocate roughly $13,861 remaining in employer-level accounts, which it identifies as unallocated forfeitures and an advanced employer account, and to begin administering the plan’s termination after distributions are complete. Four former partners, Paul Turner, John McCullough, F. Dennis Nelson and David Joslyn, are permanently barred from serving as fiduciaries or service providers to ERISA-covered plans. The order resolves the claims by consent rather than adjudication. For employers winding down, closing the business is not the end of plan administration. Residual accounts, missing participants and proof of termination still need attention.

Nancy Thompson sought severance from Command Alkon, a software company, after resigning when the company was acquired. She claimed her resignation was for good reason, the contractual standard under which a departing executive still qualifies for severance. The company denied her request. When she sued, it argued she should have completed the plan’s appeal process before coming to court. On October 28, a federal court in Philadelphia rejected that defense because the denial correspondence did not explain the required review procedures and deadlines. Knowing an appeal existed was not enough when the letters failed to say how and when to take it. The court also declined to decide the case on the release she never signed, reasoning that a wrongfully denied claimant had no obligation to sign it. Both sides lost their requests for judgment without a trial. Her roughly $467,726 demand remains a claim rather than an award, and the court said it will schedule a bench trial on whether she is entitled to severance under the accompanying order. For claims administrators, the denial letter itself has to carry the review procedures and deadlines the regulation requires, for executives as much as anyone.

Three participants sued Inspira Medical Centers, a New Jersey health system, with its board and administrative committee, on October 27 in a proposed class action over the system’s 403(b) retirement plan, the account-based plan type used by nonprofit employers, which held about $560 million for 9,883 participants at the end of 2023. The 59-page complaint challenges the selection of a stable-value fund whose manager allegedly kept a spread between what it earned and what it credited to participants, a figure the plaintiffs estimate at 1% of assets and concede discovery must establish, along with the plan’s recordkeeping costs and three of its funds. It also contests how the plan used forfeitures, the employer contributions left behind by workers who leave before vesting, and ties allegedly missed plan contributions to wage underpayments asserted in separate litigation. A quoted $600,000 wage settlement is not a recovery in this case. Everything is allegation, in a complaint that itself describes a 2020 bidding process with eight bidders, and the recordkeeper and adviser are discussed but not sued. The plaintiffs argue that understated wages also reduced the retirement contributions calculated from them, giving benefits and payroll teams a concrete reason to compare notes.

In Kolnsberg v. Boehringer Ingelheim, one of the wave of suits challenging how 401(k) plans apply forfeitures, the employer contributions left behind by departing workers, the parties told a Connecticut federal court on October 28 that an October 21 mediation produced a settlement in principle. Financial terms have not been disclosed. The settlement remains subject to final documentation and court approval. The parties asked for a December 7 deadline to file their preliminary-approval papers and requested that the pending class-certification motion and merits proceedings be paused in the meantime. The accompanying proposed order is unsigned. For readers following the forfeiture litigation, this is a procedural development, not a ruling on any forfeiture practice.

The IAM National Pension Fund sued Transport Maintenance Corp., a contributing employer that had fallen $50,156.58 behind on required contributions to the multiemployer pension plan. The employer paid $31,987.97 after the suit was filed and never appeared in court. On October 28, a Washington, D.C. federal court entered a default judgment of $32,904.79, comprising the remaining $18,168.61 in contributions, $9,228.46 in interest, $3,633.72 in liquidated damages and $1,874 in fees and costs, with the interest and damages rates set by the fund’s own trust agreement rather than any universal ERISA rate. Because the employer defaulted, the court accepted the complaint’s well-pleaded allegations without a trial. Catching up most of a delinquency after suit still left interest, damages and fees that together nearly matched the remaining principal.

ArentFox Schiff’s Alison Lima Andersen, Meredith Gillespie and Hannah Shlaferman analyze East Coast Advanced Plastic Surgery v. Cigna, in which the Second Circuit joined the Fifth in holding that the No Surprises Act gives providers no right to sue under that statute to collect unpaid awards from its independent dispute resolution process, the arbitration system that sets payment for out-of-network care. The decision does not erase the underlying payment obligations, and it does not resolve every alternative theory a provider might press under ERISA or state law. For sponsors and payors, the consequence runs through their administrators, since how and where unpaid awards get enforced shapes the leverage in the disputes that follow arbitration.

Edward Rueda of PLANSPONSOR reports on Daniel v. Aon, a proposed class action in Chicago federal court alleging that Aon profited from the voluntary benefits program offered to its own employees. The pleaded theory is a compensation conflict. The complaint alleges that Aon entities collected $14,834,190 in commissions and administration fees from 2020 through 2024 on employee-paid coverages spanning multiple welfare benefits, and that the arrangement put the employer’s broker economics ahead of its participants. The claims and the requested relief are allegations at the complaint stage, and nothing has been adjudicated. The oversight question reaches past this defendant. When an employer or its affiliate earns compensation from benefits sold to its own workforce, someone independent of that revenue should be examining the economics.

Polsinelli analyzes Bolton v. Inland Fresh Seafood, the Eleventh Circuit’s October 13 decision holding that ERISA itself does not require participants to exhaust a plan’s internal review process before bringing statutory claims, meaning suits alleging violations of the law itself rather than claims for benefits under a plan’s terms. The decision reversed a dismissal and sent the case back. It is not a merits ruling, and the underlying allegations about how the employee stock ownership plan priced company shares remain allegations. The boundaries matter. The ruling concerns statutory ERISA claims and does not decide the separate exhaustion rules for claims seeking benefits under a plan’s terms. For committees and counsel in the Eleventh Circuit, ERISA itself no longer supplies an exhaustion defense to statutory claims. Whether the plan’s own terms can require that review remains unresolved.