Buried Treasure or Buried Trouble? New Mandatory Disclosure Requirements Just Enacted for ERISA Health Plan Fiduciaries Under CAA 2026

Buried in the new federal law governing Pharmacy Benefit Managers, (which is generally effective beginning in 2028) is a broad expansion of the group of “covered service providers” who are required to provide written fee disclosures to health plan fiduciaries and a mandate that health plan fiduciaries collect such disclosures. Although the effective date of the new provision is not clear, it could be effective as early as the date the new law went into effect—February 3, 2026. See Section 6702(c) of the Consolidated Appropriations Act of 2026.

By way of background, ERISA Section 408(b)(2) already mandates disclosure of fees and certain other obligations for brokers and consultants who provide services to ERISA covered health plans. Plan fiduciaries must obtain (and review) such disclosures and confirm compliance with ERISA’s requirements. Failure to do so could result in payment to a service provider being a “prohibited transaction” under ERISA. Under current law, plan fiduciaries are required to avoid non-compliant contracts and may need to report recalcitrant vendors to the U.S. Department of Labor (“DOL”).

CAA 2026 expands the group of covered service providers to include virtually all service providers (not just brokers and consultants) for both insured and self-insured health plans. For example, covered service providers include third-party administrators for self-insured plans and COBRA administrators for fully insured plans.

Note—the changes under CAA 2026 were made after the DOL promulgated proposed regulations governing PBMs in January of 2026. Those proposed rules will now likely be updated to reflect the new law. See: Department Of Labor Proposed Pharmacy Benefit Manager Fee Disclosure Rule.

As a result, and quite apart from the new rules governing PBMs (more on that to follow), plan fiduciaries will need to promptly take the following steps:

1. Create an inventory of existing service providers and vendors to their ERISA covered health plans to determine who are considered “covered service providers” (we suspect most will be);

2. Determine if appropriate fee disclosures have been obtained from such vendors/service providers;

   
   

3. If appropriate fee disclosures have not been obtained, request them from the vendors/service providers;

   
   

4. Once obtained, review the fee disclosures and service relationships to make sure they meet the statute’s requirements for reasonableness and necessity;

   
   

5. If a vendor/service provider does not respond to requests for fee required disclosures, consider next steps, which could involve terminating the relationship and reporting the vendor to the DOL; and

   
   

6. Keep a record of fulfilling these fiduciary functions.

Note: in our view, it would also be prudent to require the provision of such notices under the terms of the applicable service agreement with the vendor. See 10 Questions to Ask Before Signing That New Service Agreement. 

Please contact us if you would like more information regarding this new requirement.

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