On November 8, 2024, the DOL issued Advisory Opinion FMLA2024-01-A, which addresses whether an employee can take leave under FMLA for treatment of a serious health condition provided as part of a clinical trial.

On November 7, 2024, the IRS issued a reminder to employees with access to health flexible spending arrangements (FSAs) through their employer on the advantages of using these arrangements to pay for medical expenses with tax-free dollars.

On November 5, 2024, the United States Court of Appeals for the Ninth Circuit (Ninth Circuit) affirmed a district court’s summary judgment ruling that a legal separation agreement (LSA) met the necessary requirements for a qualified domestic relations order (QDRO) under ERISA.

On November 7, 2024, the DOL and IRS (the agencies) issued joint guidance providing an extension of various compliance deadlines for employee benefit plans, participants, beneficiaries, qualified beneficiaries, and claimants directly affected by Hurricane Helene, Tropical Storm Helene, or Hurricane Milton. In a separate announcement, Disaster Relief Notice 2024-01, the DOL provided additional relief for such plans and individuals.

On October 21, 2024, the DOL, HHS, and IRS (the departments) issued proposed rules that would, among other items, expand ACA preventive service coverage requirements to include over-the-counter (OTC) contraceptive items. 

On October 21, 2024, the DOL updated its FAQs for the ACA and the Women’s Health and Cancer Rights Act (WHCRA) by adding FAQ Part 68. These new FAQs concern issues relating to preventive services, including coverage of Pre-Exposure Prophylaxis (PrEP) and insurance coding practices, as well as coverage for a specific breast reconstruction technique. 

On October 30, 2024, the Fifth Circuit Court of Appeals (Fifth Circuit) reversed a district court’s decision to vacate certain regulations promulgated by three federal agencies: the DOL, HHS, and IRS (the agencies).

On October 8, 2024, CMS released the proposed Notice of Benefit and Payment Parameters Rule for 2026. This notice is issued annually preceding the applicable benefit year and, once final, adopts certain changes. Additionally, CMS issued Premium Adjustment Percentage and related guidance to inform the payment parameters for the 2026 benefit year.

On October 17, 2024, the IRS published two notices (Notice 2024-71 and Notice 2024-75) to expand and clarify the list of preventive care benefits that are permitted under an HDHP without a deductible or with a deductible below the applicable minimum deductible for the HDHP.

On October 1, 2024, in M.S., et al v. Premera Blue Cross, et al, the United States Court of Appeals for the Tenth Circuit (the Tenth Circuit) vacated a lower court’s MHPAEA violation judgment because the plaintiffs lacked standing to bring a MHPAEA claim against the defendants in federal court.