This comes on the heels of proposed regulations issued by the Department of Labor’s Employee Benefits Security Administration (EBSA) that, if finalized as written, would significantly expand ERISA disclosure requirements for PBMs and affiliated brokerage/consulting providers. This alert includes a brief discussion of the similarities and differences between the CAA 2026 reform provisions and the proposed regulations. For more information on the specifics of the DOL’s proposed regulations, refer to Lockton’s Compliance Insights guide (opens a new window). We also encourage employer plan sponsors to submit comments to the proposed regulations as noted later in this alert. With the skyrocketing costs of health care and increased pharmacy spending, the implementation of new PBM reforms was expected. No immediate action is required, but employers should be prepared for res…

LOCKTON COMMENT: CAA 2026 also includes PBM transparency requirements for PBMs contracting with Medicare Part D prescription drug plans, including reporting obligations and compensation disclosures. This alert will not detail these requirements. While the Medicare Part D (Rx) transparency rules do not directly regulate employer group health plans, there are concerns that PBMs may shift lost revenue into the commercial market. While the risk exists, the internal changes needed by the PBMs will likely provide better visibility into pricing and rebates, offering new leverage to plan sponsors and increasing fiduciary expectations. Contract terms may not restrict or delay disclosure of compensation, fees, or information tied to manufacturer and pharmacy payments. For plan years beginning on or after 30 months of Feb. 1, 2029 for calendar year plans), plans and insurance ca…