Benefits Catch-Up - Q2 2025

Eversheds Sutherland (US) LLP

With so much happening in the employee benefits world over the last few months, we bring you Benefits Catch-Up, our catch-up contribution to help you keep up with recent developments.

Eversheds Sutherland’s US Employee Benefits and Executive Compensation team – equipped with a deep knowledge of the nuances of retirement plans, health and welfare benefits, and executive compensation issues – actively monitors industry trends, regulatory changes, and best practices to provide the updates you need to know for your business.

If you missed our last catch-up for Q1 of 2025, it’s available here.

Retirement plans

Anderson v. Intel Corporation Investment Policy Committee 

On May 22, 2025, the Ninth Circuit upheld the dismissal of a lawsuit challenging Intel’s allocation of hedge funds and private equity funds within an investment option offered in its 401(k) plan. The Ninth Circuit reaffirmed that fiduciaries may include hedge funds and private equity investments when the decision is supported by a well-documented and reasoned process. The Ninth Circuit noted that ERISA requires fiduciaries to act prudently, and that simply alleging that hedge funds and private equity funds inherently result in higher fees and greater risks is insufficient to show that the plan fiduciaries breached their duty of prudence. This case has spanned a decade, and it is possible that plaintiffs could appeal to the Supreme Court. 

Cryptocurrency guidance rescinded

On May 28, 2025, the US Department of Labor (DOL) rescinded its 2022 guidance that discouraged offering cryptocurrency and other digital assets as investment options in 401(k) plans. Under the 2022 guidance, fiduciaries were advised to exercise “extreme care” when considering cryptocurrency for plan menus or brokerage windows. 

DOL opinion letter program 

The DOL announced on June 2, 2025 that it is (re)launching an opinion letter program that spans five agencies within the DOL, including the Employee Benefits Security Administration (EBSA). EBSA will issue advisory opinions and information letters, which will provide official written interpretations from EBSA explaining how laws apply to specific factual circumstances. The DOL has established a website at dol.gov/opinion-letters to provide a way for users to submit requests for opinion letters. It appears that DOL intends to issue more frequent guidance in the form of opinion and information letters. 

House Committee approves bill to revoke ESG investment rule

On June 25, 2025, the Education and Workforce Committee of the House of Representatives approved H.R. 2988, the Protecting Prudent Investment of Retirement Savings Act. The intent of the bill is to make it more challenging for retirement plans to utilize ESG factors when selecting investments, seeking to reverse the Biden administration’s 2022 rule. In general, this bill requires ERISA retirement plan fiduciaries to prioritize financial factors over non-pecuniary factors when making investment decisions for clients and would allow investment options to use non-pecuniary factors in a brokerage window, if specific conditions are met, including disclosure requirements to participants. 

Health and welfare benefits 

Kennedy v. Braidwood Management, Inc.

On June 27, 2025, the Supreme Court upheld the preventive care mandates under the Affordable Care Act in Kennedy v. Braidwood Management, Inc., by ruling that the federal appointment of members of the US Preventive Services Task Force (USPSTF) was constitutional, pursuant to the appointments clause. USPSTF members recommend which services are included under “preventive care” under the ACA. Since the Supreme Court upheld the constitutionality of the appointment of USPSTF members, their recommendations of preventive care services remain in effect, and group health plans must continue to cover preventive care without participant cost-sharing. 

MHPAEA tri-agency nonenforcement guidance 

On May 15, 2025, the DOL, HHS, and the Treasury (collectively, the Departments) released a statement announcing that they are re-considering the final Mental Health Parity and Addiction Equity Act (MHPAEA) regulations the Departments released in 2024 (2024 Regulations), and won’t enforce the 2024 Regulations until at least 18 months after litigation challenging the 2024 Regulations is resolved. 

This enforcement relief applies only to the portions of the 2024 Regulations that are new compared to the 2013 final rule. The Departments also stated that the statutory obligations under the 2021 Consolidated Appropriations Act remain in effect, including the requirement to prepare a nonquantitative treatment limitations analysis. The statement noted that MHPAEA provides critical protections for individuals, and during the period of nonenforcement, the Departments will ensure that individuals receive legal protections in ways that are not overly burdensome for plans and insurers. 

Prescription drug pricing executive order

On May 12, 2025, President Trump signed an executive order which stated that Americans should not subsidize low-cost prescription drugs in other developed countries and pay higher prices for the same products in the United States. The executive order directs the Secretary of HHS to facilitate consumer purchasing programs for pharmaceutical manufacturers to sell products to American patients at the “most-favored-nation price.” 

Tiara Yachts, Inc. v. Blue Cross Blue Shield of Michigan

Tiara Yachts, Inc. hired Blue Cross Blue Shield of Michigan (BCBSM) to administer its self-funded healthcare benefits plan. Tiara Yachts alleged that BCBSM, as the third-party administrator (TPA), breached its ERISA fiduciary duties by systematically overpaying out-of-state providers and then collecting fees for recovering its own overpayments. The district court dismissed Tiara Yachts’ claim on the basis that it had not plausibly alleged that BCBSM was an ERISA fiduciary. On May 21, 2025, the Sixth Circuit overturned the dismissal, reasoning that BCBSM had control over plan assets, such that it may have had ERISA fiduciary duties with respect to those assets. 

ESsentials: There are two points that are important for plan sponsors to note. First, when negotiating service agreements, sponsors should require an ERISA fiduciary standard of care for activities taken by their service providers that are fiduciary in nature. Second, overpayment recovery programs, often with commissions of around 30%, should only apply to claims originally decided in accordance with ERISA fiduciary duties. 

PCMA v. Mulready 

In PCMA v. Mulready the 10th Circuit ruled that ERISA preempts certain provisions of Oklahoma law that would restrict pharmacy benefit managers (PBMs) and health plans from designing cost-reducing pharmacy networks. On June 30, 2025, the Supreme Court declined to review the case, and as a result, the 10th Circuit’s ruling on the scope of ERISA preemption stands. 

Legislation

One Big Beautiful Bill Act

The One Big Beautiful Bill Act was signed into law on July 4, 2025 and contains a number of provisions that will impact employee compensation and benefits, including the telehealth extension, other HSA updates, and the new “Trump Accounts.” For more on the One Big Beautiful Bill Act and how it may impact employers, please see our legal alert.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations. Attorney Advertising.

© Eversheds Sutherland (US) LLP

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