News & Analysis as of

Employee Retirement Income Security Act (ERISA) Benefit Plan Sponsors Pharmacy Benefit Manager (PBM)

Hall Benefits Law

PBM Contracts Could Expose Plan Sponsors to Fiduciary Liability

Hall Benefits Law on

A plan sponsor’s fiduciary duty to be transparent in Pharmacy Benefit Manager contracts safeguards plan participants’ interests and mitigates the risk of litigation, regulatory penalties, and reputational harm, say Hall...more

Holland & Knight LLP

Excessive Fee Cases: Not Just for Retirement Plans Anymore

Holland & Knight LLP on

A recent wave of cases has attempted to apply the theory of liability for retirement plan excessive fee cases to health plans – specifically, arrangements with pharmacy benefit managers. Though the cases thus far have...more

Wiley Rein LLP

PBM Contracting and Administration: What Are the Rules of the Road for Self-Insured Employees?

Wiley Rein LLP on

In February 2024, a group representing (among others) the Johnson & Johnson Group Health Plan and its component plans (Plaintiffs) sued Johnson & Johnson and The Pension & Benefits Committee of Johnson and Johnson (J&J) over...more

Jackson Lewis P.C.

Johnson & Johnson Case Sparks Concerns Over Future Excessive Health Fee Litigation

Jackson Lewis P.C. on

Recent scrutiny of pharmacy benefit managers, also known as “PBMs,” has resulted in various lawsuits alleging that the high drug costs they charge violate ERISA. Among the first lawsuits in what appears to be a wave of new...more

Bricker Graydon LLP

Does Your Health Plan Meet the New Kentucky Prescription Drug Rules?

Bricker Graydon LLP on

Effective January 1, 2025, Kentucky has new law regulating pharmacy benefit managers (“PBMs”). Earlier this year, the Governor of Kentucky signed SB 188 into law, making Kentucky the latest state to pass legislation...more

Snell & Wilmer

Perplexed and the Fiduciary Committee – PBM Edition

Snell & Wilmer on

I read the Lewandowski v. Johnson & Johnson class action complaint and couldn’t help but wonder – are plans and participants doomed, or can employers take proactive steps to satisfy their fiduciary duties and potentially...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - February 2024

The February Monthly Minute discusses a class action suit alleging a breach of fiduciary duties in connection with ERISA benefit plan prescription drug pricing and the latest IRS guidance on defined contribution plan...more

Laner Muchin, Ltd.

Lawsuit Against Johnson & Johnson For Mismanagement of Drug Prices Likely a Sign of Things To Come For Many Self-Insured Health...

Laner Muchin, Ltd. on

A novel proposed class action lawsuit was filed against Johnson & Johnson (J&J) earlier this month by a current employee for mismanagement of prescription drug prices. The lawsuit alleges, among other things, that J&J...more

Alston & Bird

Year-End Health Benefits Roundup 2023

Alston & Bird on

It was a lively year for health benefits. Our Employee Benefits & Executive Compensation Group unpacks 2023, from the end of the COVID-19 emergencies to the much-anticipated Mental Health Parity and Addiction Equity Act...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Medical Travel Reimbursement Benefits Under the Supreme Court’s New Dobbs Decision

On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Making a List, Checking It Twice: Year-End Guidance on Drug Cost Reporting

Employers and their benefit administrators have more detail and a more convenient way to submit “top 50” lists and other data - but no more time to comply with - daunting prescription drug cost reporting requirements in the...more

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