The Compliance Download, July Vol. 1

PCORI Fee Amount Adjusted for 2026 Plan Years 

PCORI fees are due by July 31, 2026, for plan years ending in 2025. These fees are reported and paid annually using IRS Form 720 and apply to employers that sponsor self-insured health plans. 

Excluded plans generally include excepted benefits such as standalone dental and vision plans, health FSAs that meet applicable exemption requirements, and certain employee assistance programs. 

Employers should review their PCORI fee calculation and ensure payment is submitted by the July 31, 2026 deadline. If you have questions regarding your covered-life count, filing requirements, or payment process, please contact your Bolton consultant. 

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ERISA Litigation Trends Expand to Health Plans and Voluntary Benefits

Recent litigation involving health and welfare plans, particularly voluntary benefits, highlights increasing scrutiny of employer decision-making, governance practices, and fiduciary oversight. Several employee-driven lawsuits have challenged how voluntary benefits are selected, administered, and communicated, with plaintiffs alleging that employers and advisors failed to ensure that benefits were reasonably priced, appropriately monitored, or adequately disclosed. While the legal theories and outcomes remain unsettled, these cases reflect growing expectations around transparency, value, and accountability in benefit offerings. 

For plan sponsors, these developments serve as an important reminder to evaluate fiduciary governance practices across all health and welfare plans, including voluntary benefits. Employers should be prepared to demonstrate a prudent process for selecting and monitoring carriers, assessing the competitiveness and value of plan offerings, reviewing broker compensation arrangements, and communicating benefits effectively to employees. Organizations may also wish to revisit their reliance on ERISA safe harbor provisions for voluntary benefits and consider whether existing governance structures, such as fiduciary committees and documented review processes, are sufficient to address evolving litigation and regulatory risks. Maintaining clear documentation of benefit-related decisions and regularly reviewing plan oversight procedures can help strengthen fiduciary compliance efforts as this area continues to develop. 

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