Health and Welfare

Sponsors of self-insured health plans should take note of a recent Seventh Circuit case addressing when states can regulate their plans.

On August 26, 2026, the Seventh Circuit upheld the lower court’s ruling in Central States, Southeast and Southwest Areas Health and Welfare Fund and Charles A. Whobrey v. McClain.

The case deals with the way in which states may regulate pharmacy benefit managers (PBMs) and, by extension, self-insured health plan sponsors.

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On September 8, 2026, the Department of Labor issued new enforcement guidance regarding the Mental Health Parity and Addiction Equity Act (MHPAEA) and its nonquantitative treatment limitation (NQTL) requirements.

Under MHPAEA, group health plans must ensure that any nonquantitative treatment limitations (NQTLs) affecting mental health and substance use disorder (MH/SUD) benefits are designed and applied in a manner comparable to, and no more restrictive than, those applied to medical/surgical benefits.…

The City of Philadelphia has amended its Fair Practices Ordinance to specifically protect employees from discrimination on the basis of menstruation, perimenopause and menopause.

This includes discrimination on the basis of reproductive health autonomy, whether based on pregnancy, childbirth and related medical conditions, or menstruation, perimenopause or menopause. The law further requires an employer to provide reasonable accommodation to an employee for needs related to menstruation, perimenopause or menopause if related symptoms substantially interfere with an employee’s ability to perform one or more job functions, absent undue hardship.…

A multinational technology and consumer-services company that is one of the largest employers in the world is facing a class action lawsuit in the Southern District of New York for alleged failure to comply with the Pregnant Workers Fairness Act (PWFA), a federal law.

The complaint, filed on September 8, alleges that the employer had an improper blanket policy requiring employees to submit medical documentation with all accommodation requests. However, EEOC regulations state that it is not reasonable or necessary for an employer to require supporting documentation from a pregnant employee seeking one of the following modifications due to their pregnancy: 

  1. carrying or keeping water near for drinking;
  2. taking additional restroom breaks;
  3. sitting, for those whose work requires standing, and standing, for those whose work requires sitting, as needed;
  4. taking breaks to eat and drink.
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The U.S. Department of Health and Human Services has pushed back final action on its proposed overhaul of the HIPAA Security Rule from May 2026 to July 2027, giving covered entities and business associates additional time to prepare for what would be the first major update to the Security Rule since 2013. Employers that sponsor self-insured health plans should take note of the delay and consult with ERISA counsel on next steps to ensure their plans are in compliance.

The proposed rule, published in the Federal Register on January 6, 2025, would eliminate the distinction between “required” and “addressable” implementation specifications, mandate multi-factor authentication, expand encryption requirements, require comprehensive technology asset inventories and network mapping, extend documentation requirements, and impose detailed incident response and disaster recovery planning obligations, among other significant changes.…

OSHA has proposed a new rule, OAR 437-002-0150, to implement the workplace violence prevention requirements of Senate Bill 537, enacted in 2025.

The proposal would create a dedicated OSHA standard for healthcare employers, placing Oregon alongside California, Washington, Minnesota, Virginia, and New Jersey in the growing list of states with healthcare-specific workplace violence prevention mandates.…

Virginia Employers:

Employment law developments continue to be red hot. In the last month, we have updated our followers on significant updates relating to non-competes, pay transparency, and paid family leave.

Since these updates, Virginia has enacted a statewide paid sick leave mandate, joining the continuously growing list of states and localities requiring employers to…

NYC employers: Sick leave law obligations have been expanded once again.

Under existing law, New York City employers were already required to provide paid sick leave, specifically 56 hours for employers with 100+ employees and 40 hours for employers with fewer than 100 employees.

Under a recently enacted bill, which takes effect February 22, 2026…

Rhode Island employers take note: Rhode Island is now the first state to expressly protect employees’ menopause and related conditions. This comes on the heels or women’s specific health benefits emerging as a strategic tool to attract and retain talent.

The Rhode Island Fair Employment Practices Act already required employers with at least four employees…