On January 22, the U.S. House of Representatives passed on a bipartisan basis HR 7148, the Consolidated Appropriations Act, 2026 (HR 7148). If it also wins passage in the Senate, the bill would, among other Trump administration priorities, impose new rules and requirements for pharmacy benefit managers (PBMs) and pharmacy benefit administration more generally. As with prior federal legislative proposals, HR 7148 attempts to bring more transparency to the administration of pharmacy benefits for both fully insured and self-funded groups and would impose enhanced transparency requirements for PBMs contracting with Medicare Part D prescription drug plans PDP sponsors. Specifically, among other requirements, HR 7148 proposes the following new rules and regulations impacting PBM arrangements:
Top Five Health and Welfare Updates
Join Lydia Parker and Laura Ferguson, partners in Troutman Pepper Locke’s Employee Benefits + Executive Compensation Practice, as they discuss the top five health and welfare updates from 2025 to prepare you for 2026, from significant legislative changes to emerging litigation trends that are reshaping the landscape for plan sponsors.
IRS Issues Proposed Regulations on the Expanded Definition of “Covered Employee” Under Code Section 162(m)
On January 16, the Internal Revenue Service (IRS) published proposed regulations (90 FR 4691) under Section 162(m) of the Internal Revenue Code. Section 162(m) generally limits the deductibility of compensation paid in any tax year to covered employees of a publicly held corporation to $1 million.
UPDATE – Form 5330 E-Filing Requirement Headache Relieved for 2024
In a blog post dated May 10, 2024, we discussed the Form 5330, an excise tax return used by certain employers and individuals to pay penalty taxes with respect to employee benefit plans, must be filed electronically for taxable years ending on or after December 31, 2023 if the filer is required to file at least 10 returns of any type. As described further in that blog post, this electronic filing requirement had the potential to create issues for sponsors of qualified retirement plans because there was not an Authorized e-file Provider (“AEP”) with the capability of electronically filing Forms 5330. Without relief from the Internal Revenue Service (“IRS”), employers would not have the option of filing the Forms 5330 by paper even with the lack of AEPs.
Form 5330 E-Filing Requirement Headache
The Form 5330, an excise tax return used by certain employers and individuals to pay penalty taxes, must be filed electronically for taxable years ending on or after December 31, 2023. As described below, this may create issues for sponsors of qualified retirement plans.
SECURE 2.0: Two-Year Transition Relief Announced for Roth Catch-Up Contributions
Long-awaited guidance was received from the IRS on Friday related to the SECURE 2.0 requirement that catch-up contributions for high-income participants in 401(k), 403(b), and governmental 457(b) plans be made as Roth contributions. Notice 2023-62 provides for a 2-year administrative transition period that will be welcome relief to retirement plan sponsors and record keepers alike.
IRS Expands Determination Letter Program to Include Individually-Designed 403(b) Plans
In Revenue Procedure 2022-40, the IRS recently expanded the determination letter program to allow applications by individually-designed 403(b) plans. This expansion will allow 403(b) plan sponsors to request a determination letter that expresses the IRS’ opinion that the plan’s terms (as stated in the plan document) meet the requirements
SEC Adopts Final Clawback Rules
The SEC adopted long-awaited final rules that require the recovery of erroneously awarded incentive-based compensation of executive officers, as required by the Dodd-Frank Act. Under Rule 10D-1, each exchange must adopt listing standards that will apply to all listed issuers, with limited exceptions. Each issuer must adopt a clawback policy
US Dept. of Labor Announces Cybersecurity Guidance for Plan Sponsors, Plan Fiduciaries, Record-Keepers and Plan Participants
The U.S. Department of Labor (“DOL”) recently issued guidance on best practices for maintaining cybersecurity directed to plan sponsors, fiduciaries, record-keepers and participants of employee benefit plans governed by the Employee Retirement Income Security Act of 1974, as amended (“ERISA”). While some prior cybersecurity guidance has been issued for certain
DOL, HHS, and Treasury Jointly Issue FAQs on the CAA’s Mental Health and Substance Use Disorder Parity Provisions
On April 2, 2021, the Departments of Labor, Health and Human Services, and Treasury (the “Departments”) issued Frequently Asked Questions (“FAQs”) related to the implementation of the mental health and substance use disorder parity provisions under the Consolidated Appropriations Act, 2021 (“CAA”) and the Mental Health Parity and Addictions Equity