News & Analysis as of

Pharmacy Benefit Manager (PBM) Employer Group Health Plans Benefit Plan Sponsors

Bricker Graydon LLP

Is My Group Health Plan Covered by State PBM Reporting Laws?

Bricker Graydon LLP on

State laws seeking to regulate pharmacy benefit managers (PBMs) have increased significantly over the past few years. As it stands, all 50 states have laws that regulate PBMs in some way, but all are unique. However, most of...more

Lathrop GPM

Call for Additional Regulations for Health Plan Compensation Disclosures

Lathrop GPM on

In an April 15 Executive Order, entitled “Lowering Drug Prices by Once Again Putting Americans First,” the Trump Administration has called attention to an ERISA disclosure required by the Consolidated Appropriations Act of...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.

Health Plan Hygiene Part 4 – Show Me the Money

Jackson Lewis P.C. on

Our “health plan hygiene” series has focused on steps that fiduciaries of employer-sponsored group health plans can take to ensure they meet their fiduciary responsibilities. This issue has been brought to the forefront...more

Mayer Brown

United States: Health and Welfare Hot Topics

Mayer Brown on

At A Glance - In recent months, there have been a number of important developments in the United States relating to health and welfare plans. This list of hot topics identifies the key areas for employers and plan sponsors to...more

McAfee & Taft

Employee benefit rules: The gifts that keep on giving

McAfee & Taft on

As employers look back at 2023 and ahead to 2024, there are so many compliance-related items to consider relating to their employee benefit plans.  The rules employers are supposed to be complying with keep growing and...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

Foley & Lardner LLP

Is an Employer’s Health Plan Required to Count the Value of Drug Manufacturer Coupons Towards an Employee’s Out-of-Pocket Maximum?

Foley & Lardner LLP on

Background. These days, almost all employer-sponsored group health plans require an employee (and any dependents) covered under the plan (each are referred to as a “member”) to pay “out-of-pocket” for covered expenses in the...more

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