On Thursday, October 29^th, the Department of Labor (DOL) finalized regulations requiring any entity providing “pharmacy benefit management services” to a self-insured group health plan to disclose specified compensation streams this entity receives to the plan’s fiduciary.  

Important Things To Know About These Final Regulations

This Final Reg Is Not Just for PBMs

Importantly, these final regulations do not just apply to PBMs.  These new compensation disclosure requirements apply to any entity providing “pharmacy benefit management services” to a self-insured group health plan.  This includes TPAs that contract with a plan to provide “pharmacy benefit management services.”  This also includes TPAs that contract with a plan to provide a whole host of services, one of which is “pharmacy benefit management services.”  TPAs remain subject to these compensation disclosure requirements even if the TPA subcontracts with another entity that actually provides the “pharmacy benefit management services” to the plan.  These compensation disclosure requirements also apply to consultants, brokers, and other plan service providers (like MEWA operators and operators of level-funded plans) who in practice typically provide, among other services, “pharmacy benefit management services” to a self-insured plan.

Two Compensation Disclosure Requirements Under the Law, Not Just One         

It is important to understand that these final regulations are in addition to the existing compensation disclosure requirement set forth under ERISA.  Why is this important?  Because many plan service providers may read these final regulations and determine that they are not subject to these compensation disclosure requirements because they do not provide “pharmacy benefit management services.”  But, that does not mean that this service provider is exempt from ERISA’s general compensation disclosure requirement (which is currently set forth under ERISA section 408(b)(2)(B) and now applicable to all plan service providers).  This means that if you are a TPA, a broker, a consultant, an entity building transparency tools, an entity providing cost-containment services, and even, in some cases, an entity providing services related to stop-loss insurance, you are subject to ERISA’s general compensation disclosure requirement, and therefore, must disclose direct and indirect compensation received for providing services to a self-insured plan.

The DOL has yet to issue detailed guidance on the specificity of the types of compensation disclosures that entities providing the above stated services must furnish.  These final “pharmacy benefit management services” regulations are the first foray into providing some level of specificity.  Specificity around “third-party administrative services” – and what types of compensation streams must be disclosed by TPAs and entities providing “third-party administrative services” – is next on the DOL’s rulemaking agenda (as noted by the DOL in the preamble of these “pharmacy benefit management services” regs).  Specificity on other types of services may come in the form of subregulatory guidance (as also noted by the DOL in the preamble).

Audit Rights

The final regulations confirm that a self-insured plan must be permitted to audit the entity providing “pharmacy benefit management services” at least once per year to verify the accuracy of the disclosure and to ensure that this entity’s compensation disclosure complies with these regulatory requirements.  In addition, this entity cannot limit the period of the plan’s audit, the location of the audit, or the number of records, data, or information to be provided for the audit.  The plan must also be able to select their own auditor, and the plan shall bear all expenses related to the auditor, while the entity providing “pharmacy benefit management services” must pay for the costs of providing the auditor with the records, data, and information needed to perform the audit.  

The final regulations also make a very important clarification:  The auditor may request – and the entity providing “pharmacy benefit management services” must provide to the auditor – the plan’s health claims and transaction-level data.  The DOL explained that plan fiduciaries need access to material information to assess the quality and accuracy of the entity’s disclosures. 

Also just as important, the DOL explicitly stated that if an entity providing “pharmacy benefit management services” fails to provide information in compliance with this audit provision, such failure would result in a violation of ERISA.  The DOL went on to say that the Department may choose to impose monetary penalties on those entities that are not compliant.

Sharing the Disclosed Compensation Information With Other Plan Service Providers

These final regulations confirm that the plan is permitted to share the disclosed information with other third-party service providers (such as consultants, attorneys, and other service providers like data analytics and cost-containment firms), which is good news.  

However, an entity providing “pharmacy benefit management services” may prohibit these third parties from sharing this information with fourth parties (i.e., this entity can require the plan to enter into confidentiality agreements with their third-party service providers to prohibit re-disclosures).

It also appears that the DOL agreed with arguments that compensation and payment-related agreements (like rebate agreements) are proprietary by adding to the final reg the following requirement:  The plan may share the disclosed information with another third-party, but that third-party can only use the information to perform the services this third-party is contracted to perform for the plan.  In other words, the entity providing “pharmacy benefit management services” can prohibit the use of the shared information for purposes unrelated to the services this third-party is contracted to perform for the plan.  

***

We will be preparing a more detailed summary of the requirements set forth in these final “pharmacy benefit management services” regulations, so stay tuned.

In the meantime, you may access our write-up of the proposed regulations (which you can findhere). These final regulations track much of what you see in this write-up.

In addition, if you have any questions regarding these final regulations or ERISA’s general compensation disclosure requirement, please contact Chris Condeluci atccondeluci@siia.org or Anthony Murrello at amurrello@siia.org. 

SOURCE: Self-Insurance Institute of America, Inc. personal communication, October 30, 2026

The Health & Voluntary Benefits Association® (HVBA) brought together brokers, consultants, industry leaders, innovators and strategic partners in Tampa for the 2026 HVBA Innovation Summit, delivering two days filled with meaningful conversations, timely education, relationship-building and plenty of fun.

The experience began Wednesday evening with an exclusive VIP Dinner for HVBA Board Members and invited guests, creating an intimate setting for industry leaders to connect before the Summit officially began. The private event was held by invitation from HVBA Chairman & CEO Robert S. Shestack and gave attendees an opportunity to strengthen existing relationships, welcome new faces and begin conversations that continued throughout the following day.

That spirit of connection carried directly into Thursday’s Innovation Summit at Hotel Alba Tampa, where attendees heard from an impressive lineup of speakers addressing some of the most important issues affecting employers, brokers and the benefits industry today.

Mike Hirshberg, Division Sales Manager with MassMutual, welcomed attendees and moderated the afternoon’s educational programming.

Chris McLellan, PMP, Vice President of Operations at MedWatch, opened the educational content with “Transforming GLP-1 Coverage Through a Sustainable Carve-Out Model: A MedWatch Employee Population Case Study,” bringing a real-world perspective to one of the most pressing cost and coverage issues facing employer-sponsored health plans.

Cambria Smith, CEO of Aevitas, and Rick Solofsky, President and published author with Solofsky Financial Group, LLC, tackled “The Retirement-Medicare Crossroads: Helping Employers and Employees Navigate What Comes Next.” Their conversation focused on the growing challenges employers face as more employees work beyond age 65, including Medicare eligibility, compliance, workforce transitions and the need for stronger employee education.

David Sherman, Director of Channel and Partnerships at PTO Exchange, showed attendees how employers can rethink a benefit they already fund by transforming unused paid time off into greater financial flexibility for employees. His session demonstrated how innovation does not always require adding another benefit—it can also mean finding more value in the benefits already available.

Lee Stokes, CEO of Fidelity Enrollment Services, addressed “The Use of AI During the Enrollment Process for a Multi-generational Workforce,” exploring how technology and artificial intelligence can help improve communication and enrollment experiences across generations.

The afternoon continued with Jon O’Toole, Chief Revenue Officer of Recuro Health, sharing “Recuro Health Built Intentionally to Serve — A Success Story,” highlighting the importance of intentionally designing healthcare solutions around service, partnerships and measurable value.

One of the day’s most spirited conversations came during “What the Health?? Rx Costs Shouldn’t Be Hell,” featuring Jake Velie, Vice Chair & President of HVBA and Chairman & CEO of National Integrative Health; Rachel Strauss, Founder & CEO of PBM Princess; and Chris McLellan of MedWatch. The discussion brought together different perspectives on the rising cost and complexity of prescription drugs and challenged attendees to continue asking harder questions about how healthcare dollars are being spent.

Bill Viszt, Consultant with Smart Scan, also introduced attendees to “Smart Scan: Prevent Heart Attacks and Detect Cancer Before It Spreads,” highlighting another example of innovation focused on earlier identification and better health outcomes.

But the HVBA Innovation Summit was never intended to be an event where attendees simply listened to presentations and went home.

At 4:00 p.m., the educational sessions transitioned immediately into an upscale Casino Night Networking Reception, complete with a premium open bar, heavy butlered hors d’oeuvres, casino gaming, giveaways and raffle prizes.

The ballroom came alive as attendees moved from table to table, played casino games, laughed, competed and—most importantly—continued the conversations that had started during the Summit. The casino format was intentionally designed to keep people circulating throughout the room, helping brokers, solution providers and industry professionals connect with people they might not otherwise have had the opportunity to meet.

For HVBA, that is what makes the Innovation Summit experience different.

The goal is not simply to collect business cards. It is to create an environment where meaningful introductions can become partnerships, partnerships can become business, and new ideas can ultimately help brokers and employers better serve the people depending on their benefit programs.

“The energy in Tampa was incredible,” said Robert S. Shestack, Chairman & CEO of HVBA. “From our private VIP Dinner Wednesday night to the educational sessions and then Casino Night, people were talking, laughing, learning and doing business. That is exactly what we want an HVBA event to accomplish. We want people to leave with new ideas, new relationships and real opportunities—not simply another stack of business cards.”

The Tampa Innovation Summit continued HVBA’s longstanding mission of bringing together leaders from across the health and voluntary benefits industry to exchange practical insights, discover emerging solutions and build relationships capable of moving the industry forward.

And if the laughter, conversations and packed casino tables were any indication, Tampa delivered.

About the Health & Voluntary Benefits Association®

The Health & Voluntary Benefits Association® (HVBA) is an industry organization focused on education, innovation, networking and professional development throughout the health and voluntary benefits marketplace. Since 2008, HVBA events have helped brokers, consultants, carriers, TPAs, solution providers and HR professionals better understand the evolving benefits landscape while connecting with organizations and leaders capable of helping their businesses grow.

TAMPA, FL — August 19, 2026 — The Health & Voluntary Benefits Association® (HVBA) will bring benefits professionals, brokers, consultants, healthcare innovators and industry leaders together at the 2026 HVBA Innovation Summit – Tampa on Thursday, August 20, 2026, at Hotel Alba Tampa.

Designed to be more than a traditional industry conference, the HVBA Innovation Summit combines timely education with intentional networking opportunities created to help attendees discover new solutions, develop meaningful partnerships and leave with opportunities to grow their businesses.

The Innovation Summit will take place from 1:00 PM to 4:00 PM ET and will be moderated by Mike Hirshberg, Division Sales Manager, MassMutual.

“This event is about bringing the right people into the room and creating conversations that can lead to real business,” said Robert Shestack, Chairman & CEO of HVBA. “Our Innovation Summits give brokers and industry professionals an opportunity to hear what is changing in healthcare and benefits while connecting directly with organizations developing solutions to some of employers’ biggest challenges.”

Timely Sessions Addressing Today’s Benefits Challenges

The Tampa program will feature a series of concise, thought-provoking sessions focused on issues impacting employers, employees, brokers and benefit advisors.

Topics include:

Transforming GLP-1 Coverage Through a Sustainable Carve-Out Model: A MedWatch Employee Population Case Study
Presented by Chris McLellan, PMP, Vice President, Operations, MedWatch, the session will explore an alternative approach to managing the growing financial impact of GLP-1 medications.

The Retirement-Medicare Crossroads: Helping Employers and Employees Navigate What Comes Next
Cambria Smith, CEO of Aevitas, and Rick Solofsky, President and Published Author, Solofsky Financial Group, LLC, will discuss the increasingly important intersection between retirement planning, Medicare and employer benefits.

How PTO Exchange Turns Unused Time into Financial Flexibility
David Sherman, Director of Channel and Partnerships, PTO Exchange, will examine how unused paid time off can be transformed into meaningful financial benefits for employees.

The Use of AI During the Enrollment Process for a Multi-Generational Workforce
Lee Stokes, CEO, Fidelity Enrollment Services, will discuss how artificial intelligence is changing benefits enrollment and helping employers communicate with an increasingly diverse, multi-generational workforce.

VCRx Update
Robert Shestack, Chairman & CEO, HVBA, will provide an industry update on VCRx.

Recuro Health Built Intentionally to Serve – A Success Story
Jon O’Toole, Chief Revenue Officer, Recuro Health, will share insights into Recuro Health’s growth, strategy and approach to serving clients in today’s evolving healthcare environment.

The educational program culminates with the provocative fireside discussion:

“What the Health?? Rx Costs Shouldn’t Be Hell”

The conversation will feature Jake Velie, Vice Chair & President, HVBA and Chairman & CEO, National Integrative Health; Rachel Strauss, Founder & CEO, Rachel Strauss PBM Princess; and Chris McLellan, PMP, Vice President, Operations, MedWatch.

The panel will examine the rising cost and complexity of prescription drugs, PBM strategy, high-cost pharmacy and other areas where brokers and employers can challenge traditional approaches and identify new opportunities for savings.

From Education to an Upscale Casino Night Experience

Immediately following the Innovation Summit, attendees will transition into an upscale Casino-Themed Networking Reception from 4:00 PM to 7:00 PM ET in the Westshore Ballroom.

The reception will feature a premium open bar, heavy butler-passed hors d’oeuvres, casino gaming, networking and premium giveaways, creating a lively environment designed specifically to encourage attendees to move around the room, meet new people and develop meaningful business relationships.

Casino games begin at 4:00 PM, followed by heavy passed hors d’oeuvres beginning at 4:30 PM. Attendees will have opportunities throughout the evening to earn entries for premium giveaways, with winning tickets pulled between 6:30 PM and 7:00 PM. Attendees must be present to win.

Rather than relying on traditional exhibit booths, HVBA events are designed around interaction and relationship-building — giving solution providers, brokers and industry leaders more opportunities to have substantive conversations.

More Than Business Cards

The philosophy behind HVBA’s Innovation Summits is simple: attendees should leave with more than a stack of business cards.

Through focused education, curated introductions and experiential networking, HVBA creates an environment where brokers can discover solutions to help retain and gain clients, while healthcare and benefits companies can develop partnerships with professionals actively looking for innovation.

The Tampa event also includes the HVBA Board Meeting on Thursday morning, open to board members and invited guests, as well as a private, invitation-only dinner on Wednesday, August 19, sponsored by Juice Financial.

The private dinner will bring invited guests together for an intimate evening of introductions, conversation and relationship-building before the Summit officially begins.

The 2026 HVBA Innovation Summit – Tampa will be held Thursday, August 20, at Hotel Alba Tampa.

Attendance is limited, and qualified brokers may attend the Innovation Summit at no cost.

For registration information and additional details, visit the Health & Voluntary Benefits Association® website.

About the Health & Voluntary Benefits Association®

The Health & Voluntary Benefits Association® (HVBA) brings together brokers, consultants, employers, carriers, solution providers and benefits innovators to advance meaningful conversations and partnerships throughout the healthcare and employee benefits ecosystem. Through Innovation Summits, industry education, research, media and curated networking opportunities, HVBA works to connect professionals with the ideas, technologies and relationships that can help improve benefits strategies and business outcomes.

Media Contact:
Health & Voluntary Benefits Association®
Jenny Jenkins
jjenkins@vbassociation.com

Client Snapshot: The Illinois Plan Sponsor Top 25 Reprice

An Illinois Plan Sponsor was facing a growing challenge with high-cost pharmacy claims. A small group of prescriptions was driving significant plan spend, and the company needed a clearer way to identify savings without disrupting employees who depended on these medications.

NIH analyzed 1,677 claims of The Illinois Plan Sponsor’s Top 25 high-cost prescriptions using the NIH MSO Network  and clinical cost-containment strategies, including:

·       Manufacturer Direct Contracting

·      Formulary Optimization 340B opportunities

·      Clinical Trials

·      503B options

·      Biosimilars

·      Therapeutic equivalence

·      Site of Care Optimization

·      The analysis also included a 20% rebate weight to reflect plan economics more realistically.

The Problem: High-Cost Pharmacy Spend with Limited Transparency

Like many employers and plan sponsors, The Illinois Plan Sponsor was dealing with rising pharmacy costs and limited transparency into whether prescriptions were being filled at the lowest possible net cost.

The client’s concern was not only cost. They also wanted to understand what would happen to members already taking high-cost medications.

Would members lose access?

Would they experience disruption?

How would they transition into a new pharmacy strategy without confusion or delays?

The core question was simple:

How do we bring costs down while making sure employees still receive the medications they need?

The Solution: NIH Technology, Repricing, and manufacturer direct contracting

NIH stepped in and provided a transparent repricing analysis to show the client where savings could be achieved immediately.

Through NIH’s technology-driven pharmacy solution, the client was able to see how high-cost drug spend could be reduced by identifying the lowest net cost of acquisition and applying smarter pharmacy management strategies.

NIH reviewed every member, every transaction, and every opportunity for savings. The solution included manufacturer direct contracting options, biosimilar strategies, and therapeutic equivalents where clinically appropriate.

This included:

·      Auditing claims for the lowest net cost of acquisition

·      Reviewing high-cost medications for generic, biosimilar, or therapeutic equivalent alternatives

·      Leveraging manufacturer direct, 340B, and 503B sourcing opportunities

·      Running a biosimilar and generic strategy where appropriate

·      Working directly with physicians when a lower-cost equivalent was available

·      Proactively communicating with members before disruption occurred

·      Managing the transition so employees continued receiving the medications they needed

The Savings: Lower Plan Spend and More Money Back to Members

The NIH reprice showed immediate and meaningful savings potential.

By analyzing 1,677 prescriptions across the Top 25 high-cost drugs, NIH identified that The Illinois Plan Sponsor could save:

$742,226.23 in plan savings

That represents a:

35.40% reduction in spend

In addition, NIH’s strategy would put:

$331,049.31 back into members’ pockets

This means the solution did more than reduce employer and plan costs. It also created meaningful savings for employees and their families.

The Member Experience: Seamless, Proactive, and Protected

One of The Illinois Plan Sponsor’s biggest concerns was the member experience.

NIH’s process was designed to be seamless. Members already taking high-cost medications were not left to figure things out on their own. Instead, they received proactive communication and support throughout the transition.

When a lower-cost generic, biosimilar, or therapeutic equivalent option was available, NIH worked with the doctor to help make the change in a clinically appropriate way. When a member needed to remain on a medication, the focus stayed on ensuring access while still managing cost intelligently.

The goal was never to take medications away from employees.

The goal was to make sure the plan was not overpaying for those medications.

The Result: High-Cost Drug Spend Came Down While Employees Stayed Protected

Using NIH’s technology, repricing tools, manufacturer direct contracting, and high-cost claim management strategy, The Illinois Plan Sponsor was able to identify substantial savings while maintaining access to critical medications.

The client gained:

·      Immediate visibility into potential savings

·      A projected $742,226.23 in plan savings

·      A 35.40% reduction in pharmacy spend

·      A projected $331,049.31 returned to members

·      A clearer understanding of where high-cost pharmacy spend was concentrated

·      A seamless implementation strategy

·      Better oversight of every pharmacy transaction

·      A smarter approach to biosimilars, therapeutic equivalents, and manufacturer direct contracting

·      Lower drug spend without unnecessary member disruption

The Takeaway

High-cost pharmacy spend does not have to remain unpredictable or uncontrollable.

With NIH, The Illinois Plan Sponsor moved from limited transparency and rising costs to a smarter, technology-driven pharmacy strategy that showed measurable savings from day one.

NIH did not just tell the client they could save money.

NIH showed the savings, identified the opportunities, and created a seamless path to bring high-cost drug spend down while ensuring employees continued to receive the medications they needed.

That is the power of one in-house team delivering a fully integrated managed care model.
Contact Information:

National Integrative Health
Jenny Jenkinsl, Global Brand Ambassador
jjenkins@nationalintegrativehealth.com
www.nationalintegrativehealth.com

San Antonio, TX — May 2026 — The Health & Voluntary Benefits Association (HVBA) officially kicked off its 2026 Innovation Summit in San Antonio with a full strategic board meeting, setting the tone for a high-impact event focused on leadership, innovation, meaningful networking, and partnership development across the health and voluntary benefits industry.

The San Antonio Innovation Summit brought together HVBA board members, sponsors, brokers, carriers, solution providers, and industry leaders for a curated experience designed to move beyond traditional conference networking. The event created an environment where attendees could engage in real conversations, explore case studies, ask thoughtful questions, and identify new opportunities to bring innovative benefit solutions to employers and their employees.

“HVBA events are intentionally designed to bring the right people into the room,” said Rob Shestack, President and CEO of HVBA. “Our goal is not just attendance. Our goal is connection, collaboration, and business outcomes. In San Antonio, we saw exactly that — meaningful introductions, strategic discussions, and partnerships already taking shape.”

Throughout the event, attendees participated in focused conversations around industry trends, benefit innovation, broker differentiation, and solutions that can be bundled, expanded, or offered as stand-alone opportunities. The summit highlighted how important it is for benefits professionals to hear real case studies, review data, and understand offerings in a way that supports stronger strategic decisions for brokers and their employer clients.

A key highlight of the event was the strength of the networking experience. Attendees left with more than business cards — they left with actionable next steps, new connections, and opportunities for future collaboration. HVBA’s curated format once again proved that smaller, high-value events can generate powerful results for attendees and sponsors alike.

The event also featured strong sponsor and speaker engagement, giving attendees direct access to companies and leaders bringing new ideas to the voluntary benefits and health benefits marketplace. The energy in the room reflected HVBA’s core mission: to create space where education, innovation, and relationship-building lead to real business growth.

With the success of San Antonio, excitement is already building for the next HVBA Innovation Summit, taking place Thursday, August 20, 2026, in Tampa, Florida. Attendees, sponsors, and partners from San Antonio are already looking ahead to continuing the conversations, expanding the partnerships, and building on the momentum created at this powerful event.

“Everyone left San Antonio energized,” Shestack added. “The conversations were strong, the connections were meaningful, and the business opportunities were real. We are thrilled that so many of our attendees and partners will be joining us again in Tampa.”

The HVBA Innovation Summit series continues to serve as a premier gathering place for professionals across the health, voluntary benefits, employee benefits, broker, carrier, and solution provider communities. Through strategic networking, education, sponsorship visibility, and curated access to decision-makers, HVBA remains committed to helping its members and partners grow, differentiate, and succeed.

About HVBA
The Health & Voluntary Benefits Association is dedicated to advancing education, innovation, networking, and strategic collaboration within the health and voluntary benefits industry. Through curated events, research, thought leadership, certification, and partnership opportunities, HVBA connects industry professionals with the insights and relationships needed to drive meaningful business growth.

Media Contact:
Jenny Jenkins
Health & Voluntary Benefits Association
jjenkins@vbassociation.com
www.vbassociation.com

Overland Park, KS – May 6, 2026: Allied National, one of the original pioneers in level-funded and reference-based pricing (RBP) healthcare plans, proudly announces the launch of Freedom Open Access, an end-to-end network alternative solution and bold reimagining of its decades-long commitment to affordable, transparent, and member-centric healthcare.

Background

Controlling ever-rising healthcare costs remains a challenge for many employers. The continued cost surge driven by a combination of rising prices for medical services and increased utilization raise affordability concerns for many small employers.

At the same time, navigating healthcare continues to be highly complex and fragmented for consumers who often feel lost and alone in that process.

Consumer focused innovation

Fortunately, solutions exist for employers to offer best-in-class benefits without the inflated costs. Allied National’s Freedom Open Access will be effective Aug. 1 and is data-driven, open-access solution powered by strategic direct contracts and pricing benchmarks above Medicare levels. It also features personalized member advocacy services supporting consumers to assist them in better navigating the complexities of healthcare.

The result: care that puts people first, meaningful cost savings and an enhanced healthcare experience.

Key Benefits of Freedom Open Access:

• Smarter Spending – Transparent pricing and strategic contracting deliver real value.
• Member Support – Personalized guidance and advocacy throughout the healthcare journey.
• Balance Bill Protection – Robust safeguards for members against unexpected costs.
• True Freedom of Choice – See any provider, anywhere. No more “in-network” vs. “out-of-network” confusion.
• Flexible Plan Designs – Tailored to meet today’s evolving healthcare needs.
• Market Differentiation – A forward-thinking solution for brokers and clients.

Media Contact: Contact Allied National at marketing@alliednational.com for an interview to learn more about the place of reference-based pricing plans like Freedom Open Access in a level-funded plan or visit www.alliednational.com/agentedge to see a copy of our Broker Guide for more information about the company’s enhancements to Freedom Open Access.

Learn about Allied National at www.alliednational.com.

New COO brings senior and benefits industry expertise to NIH’s leadership team

April 6th, 2026 – DES MOINES, IOWA. NIH is a fast‑growing consulting firm specializing in healthcare design, data, pharmacy, and analytics, helping employers better manage healthcare costs while improving care quality and access to personalized services for their employees.

NIH has named Joshua Ridgeway as its Chief Operating Officer. Prior to joining NIH, Mr. Ridgeway was Co-Founder and Chief Operating Officer for Rx-Precision, a genetics-based healthcare company pioneering one of the first Genetic Benefit Management platforms with groundbreaking innovation bringing personalized medicine into the self-insured space. Mr. Ridgeway was Founder & Managing Partner of National Health Advisors, leading a team dedicated to helping employers design self-insured health plans that lower costs, strengthen retention, and simplify benefit management. He will be responsible for leading NIH’s operational strategy and growth efforts in the healthcare market as NIH continues to scale its industry-leading solutions.

With NIH’s exponential growth in health plan management across the country, Robert S. Shestack has been promoted to Chief Enterprise Actuary while maintaining the role as NIH’s President. 

“We are pleased to have Josh join our executive team and leading the strategic operations of NIH,” said Jake Velie, Chairman & CEO. “Josh’s experience and knowledge speak for themself. His extensive experience and operational leadership make him an important part of our future growth. His insights and industry innovations will be a key addition in support of our continued success.” Jake Velie continues, “Having Rob lead our actuarial analytics division is an important step for NIH to provide our clients, stop loss carriers, and brokers the data they need to make important decisions while reducing stop loss premium renewals.”

Mr. Ridgeway has over 15 years of experience in strategic leadership roles in the healthcare space, across organizations such as Northwestern Mutual, Rx-Precision and National Health Advisors. He holds undergraduate degree in Communications and Business from Florida State University.

“I am excited to join the NIH team,” said Ridgeway. “I’ve been fortunate to join NIH and begin to collaborate with an exceptional team, build strong partnerships, and help create real impacts for clients and employees alike. What drives me most is helping people solve meaningful problems and see possibilities they didn’t know existed.”

About National Integrative Health

Since 2013, NIH has specialized in delivering innovative, highly effective clinical strategies directly to employers and their employees. Unlike traditional partners, NIH can integrate seamlessly into existing initiatives to expand impact and scope or design a program entirely from the ground up. In addition to its clinical strategies, NIH provides one‑stop healthcare delivery, provider case management, clinical consulting and engineering, 360° secure healthcare data solutions, and net‑zero funding. By doing so, NIH has helped clients save tens of millions in healthcare spend and serves Employers, Brokers, Pharmacy Benefits Managers, Population Health companies, Third‑Party Administrators, Healthcare Delivery Organizations, and Unions & Associations.

Contact Information:

National Integrative Health
Isabella Walles, Executive Assistant to the CEO
iwalles@nationalintegrativehealth.com
www.nationalintegrativehealth.com

San Antonio, Texas – HVBA today announced the upcoming HVBA Innovation Summit, taking place Thursday, May 21, at the renowned Hilton Palacio del Rio in San Antonio. Designed as a highly curated gathering of industry leaders, the Summit is redefining how the benefits community connects, collaborates, and drives innovation.

Unlike traditional conferences filled with massive expo halls and transactional booth visits, the HVBA Innovation Summit is intentionally structured to foster meaningful dialogue, strategic partnerships, and actionable outcomes.

A Different Kind of Industry Event

The Summit brings together the leaders shaping the future of benefits:

• Strategists delivering focus and clarity in a complex marketplace
• Innovators solving real employer challenges with forward-thinking solutions
• Connectors turning high-value conversations into lasting business relationships
• Visionaries defining what benefits will look like next year—not last year

Attendees can expect an environment free from the distractions of conventional trade shows. There are no endless exhibit aisles and no surface-level networking. Instead, participants will experience:

• Curated rooms designed for productive engagement
• Substantive “real talk” panels focused on industry realities
• Data-driven insights that provide a measurable competitive advantage
• Conversations that don’t just begin partnerships—they move them forward

Where Business Happens

HVBA’s approach is simple: every conversation matters. The Summit is built for leaders who are serious about innovation, collaboration, and measurable progress within the benefits space.

“Deals don’t start here—they happen here,” said an HVBA Brand Ambassador, Jenny Jenkins. “We’re creating an environment where the right people are in the right rooms, having the right conversations.”

Event Details

HVBA Innovation Summit
Thursday, May 21
Hilton Palacio del Rio
San Antonio, Texas

The 2026 Summit marks the beginning of a broader expansion of HVBA Innovation events, with additional programming and markets planned in the future.

Professionals interested in leadership, strategic growth, and meaningful partnership development within the benefits industry are encouraged to attend.

Sponsorship Opportunities Available

HVBA is offering multiple sponsorship tiers and branding opportunities, including:

• Summit Title Sponsor – $12,500
• Special VIP Dinner Sponsor – $7,500
• Networking Cocktail Reception Sponsor – $5,000
• Board Meeting Sponsor – $5,000
• Innovation Summit Presentation Slots (3 available) – $3,500
• Additional sponsorships ranging from $1,200–$4,000

For more information or to register, please contact events@vbassociation.com or visit https://www.eventbrite.com/e/2026-hvba-innovation-summit-san-antonio-tx-tickets-1982362073325?aff=oddtdtcreator.

About HVBA
HVBA is dedicated to advancing innovation, leadership, and partnership within the benefits industry through curated events and strategic collaboration platforms designed to create measurable business impact.

Mount Laurel, NJ — Tuesday, February 9, 2026 — The Health & Voluntary Benefits Association® (HVBA) today announced the appointment of Robert Lashley, President and Chief Executive Officer of ClickEnroll, to its Advisory Board. Lashley brings more than 30 years of leadership experience across insurance, benefits technology, artificial intelligence, and enterprise software development, further strengthening HVBA’s mission to advance innovation, collaboration, and best practices across the voluntary benefits ecosystem. 

A recognized industry architect, Lashley has built a career transforming complex, fragmented enrollment processes into scalable, data-driven platforms that improve engagement for employers, brokers, carriers, and employees alike. As founder and CEO of ClickEnroll, he has led the development of a next-generation benefits engagement and enrollment ecosystem designed to simplify decision-making, increase participation, and deliver personalized digital experiences through intelligent automation and modern architecture.

“Rob’s depth of experience and forward-thinking approach to benefits technology make him an invaluable addition to the HVBA Advisory Board,” said Robert Shestack, Chairman & CEO of the HVBA. “His leadership at the intersection of enrollment innovation, data standards, and human-centered design aligns closely with HVBA’s commitment to helping the industry evolve responsibly and effectively.”

Prior to founding ClickEnroll, Lashley held senior leadership roles at Manhattan Life and Humana, where he led enterprise enrollment transformation initiatives, electronic data interchange (EDI) architecture, and strategic integration partnerships within voluntary and group benefits divisions. Earlier in his career, he served as Chief Technology Officer of Falcon Technologies and as Vice President and Partner at TopLink Systems, architecting enterprise-grade platforms supporting enrollment, billing, claims, and administration for carriers nationwide. 

In addition to his executive leadership, Lashley is a founding member of the LIMRA Data Exchange (LDEx) standards committee and has played a formative role in shaping data integration frameworks that continue to influence interoperability and enrollment modernization across the industry. He is a frequent international speaker and trusted advisor to organizations spanning carrier, broker, union, and employer ecosystems. 

“I’m honored to join the HVBA Advisory Board,” said Lashley. “HVBA plays a critical role in fostering collaboration and thoughtful innovation across the voluntary benefits community. I look forward to contributing my experience and perspective to help advance solutions that benefit the entire ecosystem.”

Beyond his professional work, Lashley has supported numerous nonprofit and mission-driven organizations through technology consulting and strategic advisory roles, reflecting a longstanding commitment to community impact and service. 

About the Health & Voluntary Benefits Association® (HVBA)

The Health & Voluntary Benefits Association® is dedicated to advancing the voluntary benefits and healthcare industry through education, collaboration, and advocacy. HVBA brings together carriers, brokers, technology providers, and industry leaders to promote innovation, best practices, and sustainable growth across the health and voluntary benefits landscape.

Media Contact

Sarah M. Hunt
Senior Vice President, Administration
Health & Voluntary Benefits Association®
shunt@vbassociation.com
www.vbassociation.com

Last Week the DOL, Today Congress: PBM Transparency and Compensation Disclosure Requirements

As we told you on Friday, the DOL released proposed regulations requiring PBMs to disclose up to 8 “types” of compensation streams to a self-insured group health plan in accordance with ERISA’s section 408(b)(2)(B) Compensation Disclosure requirements (which you can read here, along with a 2-page summary of these proposed regs here).

And today, in a “1-2 punch” for PBM transparency, Congress enacted legislative language that would require a PBM to disclose to a group health plan, among other things, PBM payment practices including the receipt of rebates, price concessions, and “spread pricing,” along with the gross and net costs of prescription drugs in the PBM’s drug formulary, and other information like whether the PBM is dispensing covered drugs through PBM-owned pharmacies, mail-order, or specialty programs.  Below is a bullet-pointed list of information that PBMs must now disclose to the plan.

And to pile on, this legislative language also amended ERISA section 408(b)(2)(B) to delete the references to “Brokerage Services” and “Consulting,” and instead, clarified that any plan service provider that furnishes the “types of services” included in the statute’s enumerated “list of services” are subject to the 408(b)(2)(B) Compensation Disclosure requirements.  This amendment is intended to confirm that (1) PBMs that perform “pharmacy benefit management services” and (2) TPAs that perform “third-party administrative services” (both of which are “types of services” included in the statute’s enumerated “list of services”) are required to disclose “direct” and “indirect” compensation to a plan’s fiduciary in accordance with ERISA section 408(b)(2)(B).

And not to be outdone, this recently enacted legislation also requires a PBM to pass through 100% of the rebates paid to the PBM by a drug manufacturer to the plan itself.

The proposed regulations, and now this legislation, include industry-changing requirements, and only time will tell how transformative they may be.  We will keep you posted…

Bullet-Pointed Summary of Required PBM Transparency Disclosures

• Effective for the first plan year starting 30 months after the date of enactment, an entity providing pharmacy benefit management services (e.g., a PBM) on behalf of a group health plan must furnish to the group health plan every 6 months (or quarterly if requested by the group health plan) a report in a Machine-Readable Format with the following information relating to the prescription drugs covered under the group health plan:

• A list of covered drugs for which a claim was filed and the proprietary name and National Drug Code for each drug.

• The amount of compensation paid by the plan to the PBM for each covered drug.

• The amount of compensation the PBM paid to a pharmacy for each covered drug.

• The difference between the amount of compensation (1) paid by the plan to the PBM and (2) paid by the PBM to the pharmacy for each covered drug.

• The type of dispensing channel used to furnish each covered drug (e.g., retail, mail-order, or specialty).

• With respect to each drug dispensed through any of these channels, disclose (1) the “wholesale acquisition cost” (in the case of a brand-name drug) and (2) the “average wholesale price” (in the case of a generic drug).

• With respect to the brand-name and generic drugs, disclose (1) the original prescription and refill claims, (2) the participants and beneficiaries for whom a claim was filed through any one of the dispensing channels, (3) the dosage units and dosage units per fill, and (4) days supply of such drug per fill.

• The net price, after rebates, fees, or discounts received from a drug manufacturer, per course of treatment or single fill.

• The total amount of participant out-of-pocket spending for each covered drug.

• The total net spending for each covered drug.

• The total amount received, or expected to be received, by the plan from a drug manufacturer in rebates, fees, or discounts.

• The total amount received, or expected to be received, by the PBM from a drug manufacturer in rebates, fees, or discounts (1) for claims incurred and (2) related to utilization of a drug or spending on a drug.

• If applicable, the total amount of copay assistance, copay cards, or other discounts offered by each drug manufacturer to plan participants.

• A list of each “therapeutic class” for which a claim was filed and with respect to each such “therapeutic class” (1) the total gross spending on drugs in such class before rebates, price concessions, or discounts, (2) total net spending in such class after rebates, price concessions, or discounts, (3) total amount received, or expected to be received, by the PBM from a drug manufacturer in rebates, price concessions, or discounts for (a) claims incurred and (b) related to utilization of a drug or spending on a drug.

• The average net spending per 30-day and per 90-day supply by the plan among all drugs within the “therapeutic class” for which a claim was filed.

• The number of participants and beneficiaries who filled a prescription for a drug in such “therapeutic class,” including the National Drug Code for each drug.

• If applicable, a description of the formulary tiers and utilization mechanisms (e.g., prior authorization or step therapy) for the drugs in the “therapeutic class.”

• The total amount of participant out-of-pocket spending for the drugs in the “therapeutic class.”

• With respect to any drug for which gross spending under the plan exceeded $10,000 during the 6-month reporting period OR in the case that gross spending under the plan exceeded $10,000 during the 6-month reporting period with respect to fewer than 50 drugs:

• The highest gross spending for the 50 covered drugs under the plan.

• For the 50 covered drugs with the highest gross spending during the 6-month reporting period, (1) a list of all other drugs in the same “therapeutic class” as these drugs, (2) the rationale for the formulary placement of such drug in that “therapeutic class,” and (3) any change in formulary placement from plan year to plan year

• If the PBM providing services to the plan owns a pharmacy, or owns a mail-order or specialty home delivery program, or owns a retail and mail auto-refill programs, or provides cost-sharing assistance funded by the PBM, this PBM must:

• Provide an explanation of any benefit design parameters that encourage or require participants and beneficiaries to fill prescriptions at the PBM-owned mail-order, specialty, or retail pharmacies.

• Provide the percentage of total prescriptions dispensed by such PBM-owned pharmacies to plan participants.
• Provide a list of all drugs dispensed by such PBM-owned pharmacies to plan participants including (1) the amount charged to the plan per dosage unit or 30-day or 90-day supply, (2) the median amount charged to the plan and the interquartile range of the costs per dosage unit or 30-day or 90-day supply, including amounts paid by plan participants, when the same drug is dispensed by pharmacies NOT owned by the PBM, (3) the lowest cost per dosage unit or 30-day or 90-day supply for each drug, including amounts charged to the plan and participants, that is available from ANY pharmacy in the plan’s network, and (d) the net acquisition cost per dosage unit or 30-day or 90-day supply if such drug is subject to a maximum price discount.

If you have questions or comments, please contact Chris Condeluci at ccondeluci@siia.org or Anthony Murrello at amurrello@siia.org.

Source, Self-Insurance Institute of America, Inc., personal communication, February 3, 2026