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BenefitsPRO.com is the leading source of employee benefits news, trends, opinions, and sales tips for benefit brokers, managers, and retirement advisors.
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News
NAIC guide navigates shifting ERISA preemption battle over state PBM rules
5+ mon, 4+ day ago (460+ words) Stay up to date on the latest in voluntary benefits, group health care solutions, business best practices and more. Many state lawmakers and regulators want to set new rules for the pharmacy benefit managers, health plan provider networks, dental plans…...
Aetna pulls back the curtain on prior authorization data
5+ mon, 4+ week ago (62+ words) BenefitsPRO Aetna pulls back the curtain on prior authorization data What You Need To Know - The head of a key Trump administration health agency has made prior authorization simplification a focus. - A majority of insured adults told KFF that prior…...
Will DOL create a new pharmacy benefit manager language?
6+ mon, 1+ week ago (361+ words) To make the new draft pharmacy benefit manager transparency regulations useful to employers and benefits advisors, federal regulators need to develop a standard PBM transparency language. Benefits advisors at Butler Benefits & Consulting gave that advice in a comment on the…...
Health, voluntary benefits face surging ERISA litigation
6+ mon, 2+ day ago (225+ words) While 401(k) plans remain the primary target of ERISA fiduciary litigation, health plans and voluntary benefits programs are facing growing legal scrutiny, according to a new report from Encore Fiduciary. In 2025, plaintiffs' law firms filed 155 class actions alleging fiduciary breaches, approaching…...
Why smart benefits brokers are reframing PEO as a business strategy
4+ mon, 15+ hour ago (671+ words) For years, many benefits brokers viewed professional employer organizations (PEO) as competitors to their core offerings. In today's ecosystem, that perception is changing. Small and mid-sized businesses (SMBs) are facing pressures that extend far beyond health care costs. Talent shortages,…...
Federal regulators start to gather detailed PBM pay information
2+ mon, 3+ week ago (38+ words) BenefitsPRO Federal regulators start to gather detailed PBM pay information What You Need To Know - Congress put two sets of PBM rules in the Consolidated Appropriations Act, 2026 package....
No Surprises Act dispute resolution services award $1K for $81 ER visits
3+ mon, 3+ week ago (733+ words) The services' medan award for an hour of hospital observation services is 327.9 times the usual market rates. The independent dispute resolution services that handle fights over No Surprises Act claims decided 225,795 cases involving physicians who billed for "emergency department visits…...
Health claim experts eye the new No Surprises Act boxing rings
2+ mon, 3+ week ago (1233+ words) Experts predict that making doctors and hospitals give more details will help employers. Health insurance claim experts have had about two weeks to think about the new Trump administration interim final regulations for No Surprises Act claim fights. Providers and…...
State subject health plan TPAs and PBMs to new licensing requirements
8+ mon, 1+ week ago (81+ words) BenefitsPRO Get expert insights and real-world perspectives from leading voices in the industry to help you make more informed decisions. The Broker Innovation Lab celebrates brokers and other benefits stakeholders who have embraced the changing marketplace to position themselves and…...
Bipartisan House bill aims to free some state benefits laws from ERISA leash
5+ mon, 4+ week ago (70+ words) BenefitsPRO Bipartisan House bill aims to free some state benefits laws from ERISA leash What You Need To Know - ERISA normally keeps states from imposing local rules on self-funded employer benefit plans. - Employer groups say ERISA preemption makes benefits simpler…...