Benefits Counselor - July 2025

RETIREMENT PLAN UPDATES

DOL Issues Guidance Clarifying Trump Accounts Generally Not Employee Benefit Plans

On June 18, 2026, the U.S. Department of Labor (DOL) published Technical Release 2026-02, confirming that Trump Accounts generally will not constitute “employee pension benefit plans” and not be subject to Title I of the Employee Retirement Income Security Act (ERISA). Provided specific conditions are met, the guidance also permits a safe harbor for employer contributions to Trump Accounts if the minor beneficiary is an employee. As a result, Trump Accounts will not be subject to the same reporting obligations and fiduciary duties applicable to ERISA-governed plans.

Third Circuit Reaffirms ERISA Requires Prudence, Not Perfection for Fund Performance

On June 22, 2026, the U.S. Court of Appeals for the Third Circuit issued an opinion in In re Quest Diagnostics ERISA Litigation, affirming that a plan fiduciary did not violate its duty of prudence under ERISA by continuing to offer two alleged underperforming investment options in its 401(k) plan. Plan participants alleged the retirement plan sponsor breached their duty of prudence by offering alleged underperforming funds and the retirement plan investment committee’s policy statements obligated removal. The Third Circuit emphasized that ERISA fiduciary duties are primarily concerned with process rather than outcomes, prudence does not mean perfection, and short-term underperformance does not equate to long-term imprudence. As a result, the Third Circuit confirmed that because the plan fiduciary acted prudently with investment decisions, it did not violate its ERISA duties.

PBGC Proposes Modifications to Special Finance Assistance Rules

On June 15, 2026, the Pension Benefit Guaranty Corporation (PBGC) issued a proposed rule to correct regulations governing restrictions and conditions for multiemployer defined benefit plans that receive special finance assistance (SFA). If enacted, the rule would clarify which fixed-income investments qualify as permissible SFA investments, the rules for withdrawal liability settlement approval, and repeal the exception for reallocation of contributions to health plans. Comments on the proposed rule are due by August 17, 2026.

HEALTH AND WELFARE PLAN UPDATES

Agencies Finalize No Surprises Act IDR Regulations

On June 4, 2026, the Departments of Labor, Health and Human Services and Treasury (the Departments) released final regulations addressing the federal independent dispute resolution process (IDR) under the No Surprises Act (NSA). The final rules are intended to improve communication between plans, insurers and providers, and clarify timelines and processes. Highlights of the final rules include requiring health insurers and plans to provide additional information on initial explanations of benefits, reducing administrative fees to $15 per party per dispute, implementing procedural changes to the IDR initiation and negotiation processes, and expanding batching requirements. The final rules will become effective August 4, 2026, but select provisions will be implemented throughout 2026.

HHS Vacates Gender Identity Provisions of ACA Nondiscrimination Rules

On June 2, 2026, the U.S. Department of Health and Human Services (HHS) released a Notice of Vacatur (the Notice), informing covered entities that a federal court vacated specific sex discrimination provisions of HHS’ 2024 regulations implementing nondiscrimination rules under section 1557 of the Affordable Care Act (ACA). The Notice confirms that vacated provisions are void to the extent the provisions expand Title IX’s definition of sex discrimination to include gender-identity discrimination, and HHS will not investigate or enforce compliance with those provisions. The Notice does not affect the remaining provisions of the 2024 regulations, which remain in force.

Third Circuit Finds Plan Administrator Improper Defendant for Denial Claim

On June 18, 2026, the U.S. Court of Appeals for the Third Circuit issued an opinion in Justman v. Accenture LLP, affirming a district court decision. The plaintiff alleged that Accenture, the plan administrator, wrongfully denied his benefits claim and alleged Accenture breached its fiduciary duty under ERISA for failure to timely provide plan documents. The Third Circuit found that plan documents instructed parties to bring benefit denial claims against the claims administrator, which controlled benefit determinations, and the plan administrator had limited decision‑making authority. Further, the plaintiff failed to demonstrate that the delayed receipt of plan documents deprived him of material information required to dispute the claim. As a result, the plaintiff had no claims against the plan administrator, and the plan administrator did not breach their fiduciary duties.

CMS Solicits Input on PBM Compensation and Data Restrictions

On June 18, 2026, the Centers for Medicare and Medicaid Services (CMS) released a request for information related to pharmacy benefit managers (PBMs) to inform implementation of new legislative requirements. CMS is specifically seeking information about remuneration PBMs and affiliates may receive for services related to Medicare Part D drugs and data reporting requirements. Comments are due by July 20, 2026.

OCR Settles Enforcement Action Related to Group Health Plan HIPAA Violations

The HHS Office for Civil Rights (OCR) recently entered into a settlement agreement with an employer-sponsored group health plan to resolve alleged violations of the HIPAA Privacy and Security Rules. OCR began its investigation after the health plan reported a ransomware incident in 2022, which resulted in unauthorized access to participant names, health insurance and plan-related information, and Social Security numbers. OCR’s investigation revealed that the plan failed to conduct an accurate and thorough risk analysis of potential risks and vulnerabilities to the electronic protected health information, and implement appropriate policies to comply with the HIPAA Privacy and Security Rules. As a result, the plan agreed to pay $450,000 to OCR and agreed to a two-year corrective action plan monitored by OCR.

COMPLIANCE DEADLINES AND REMINDERS

General Deadlines

• Form 5500 for Calendar Year Plans: Generally, plan administrators must file Form 5500 within seven months after the end of the plan year, including applicable schedules and attachments. For plan years ending on December 31, 2025, the Form 5500 filing deadline is July 31, 2026. Plan administrators may apply for a deadline extension by filing Form 5588 (Application for Extension of Time) on or before July 31, 2026.
• Summary of Material Modifications for Calendar Year Plans: Summaries of material modifications (SMMs) must be distributed within 210 days after the end of the plan year in which the significant modification was adopted. For calendar year plans, all SMMs for amendments adopted during the 2025 plan year must be distributed by July 29, 2026.

Health and Welfare Plans

• PCORI Fee Due July 31, 2026: Plan sponsors of self-insured group health plans must report and pay the annual Patient-Centered Outcomes Research Institute (PCORI) fee to the IRS by filing IRS Form 720 (Quarterly Federal Excise Return) for the second quarter by July 31, 2026. For plan years ending on or after October 1, 2024, and before October 1, 2025, the applicable fee is $3.47 per covered life. For plan years ending on or after October 1, 2025, and before October 1, 2026, the applicable fee is $3.84 per covered life.

Retirement Plans

• Form 8955 SSA: Plan administrators must file form 8955 SSA within seven months after the end of the plan year (i.e., July 31, 2026 for calendar year plans). A plan administrator may receive the same extension for Form 8955 SSA that is available for Form 5500 by filing Form 5588 on or before July 31, 2026. Plan administrators must also provide individual statements to separate participant identified on Form 8955 SSA prior to the applicable deadline.
• Multiemployer Plan Summary Report: Plan administrators of multiemployer retirement plans must provide participating unions and contributing employers with a report containing specified plan information, which includes contribution schedules, the numbers of employers and participants and contribution schedules. Plan administrators must furnish this information within 30 days after the Form 5500 deadline, including extensions.

Defined Benefit Plans

• Annual Funding Notice: Plan administrators of defined benefit plans with 100 or fewer participants on each day during the prior plan year generally must provide the annual funding notice to required recipients by the Form 5500 filing deadline, including extensions.

Defined Contribution Plans

• Periodic Pension Benefit Statements: For calendar year defined contribution plans with participant directed investments, pension benefit statements must be provided by August 14, 2026. Calendar year plans without participant-directed investments must provide pension benefit statements on or before the date the Form 5500 is filed, but no later than July 31, 2026 (unless the Form 5500 deadline is extended).