February 4, 2026
The U.S. Department of Labor’s new proposal to require pharmacy benefit managers to give employer-provided health plans detailed information on fees and compensation is a welcome development, benefits attorneys on both sides of the bar say.
The DOL’s Employee Benefits Security Administration on Friday proposed a rule on fee disclosure targeting PBMs — which are intermediaries between drugmakers, insurers and pharmacies — as well as other affiliated providers of brokerage and consulting services that recommend their services.
If finalized, PBMs would be required to give comprehensive disclosures to managers of self-insured employer-provided group health plans regulated by the Employee Retirement Income Security Act. PBMs would also have to update that information twice a year and upon plan sponsors’ request, and submit to plan audits.
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The proposed rule earned praise from both sides of the employee benefits bar, including attorneys representing workers who point out how retirement plans have benefited from greater sunlight into their service providers’ fees for more than a decade.
“It looks like a positive development, and frankly, one that’s long overdue,” said Kai Richter, a plaintiff-side benefits attorney and of counsel at Cohen Milstein Sellers & Toll PLLC.
Richter said the proposed rule, if finalized, could help fiduciaries of employer-provided health plans monitor the fees they pay health plan service providers.
Even without any policy changes, ERISA plan fiduciaries could ask for some of the information subject to the proposed disclosure requirements contemplated by EBSA’s proposal in contract negotiations, Richter said, including requiring that a PBM must submit to an audit.
“Even under existing law, even before the regulations, it’s abundantly clear that plan fiduciaries have a duty to monitor their PBMs and the compensation they receive, and are subject to liability under ERISA if they fail to do that,” he said.
Even still, the proposal contains some significant exemptions, including by carving out fully insured group health plans, where employers buy coverage through a commercial insurer that pays the claims. The DOL noted in its proposal that they were reserving disclosure obligations for those plans for future action.