Vol.8, February 2026

February Benefits Rundown: pharmacy transparency + health plan oversight

Graphic for Mindy’s Benefits Rundown February 2026 issue with a "Play Now" button.

Like many of you, I caught bits and pieces of the Winter Olympics this month, including the overtime finish of the men’s hockey final (on a tiny airplane TV, no less). The winning goal happened in an instant, but of course it wasn’t really instant at all. It was the product of years of steady practice, discipline, and doing the hard things long before anyone was watching.

It reminded me a lot of benefits work. So much of what you do isn’t visible, yet it’s the consistency and behind-the-scenes effort that ultimately supports employees’ financial security and their families’ well-being. Even if there’s no medal stand, the impact is real.

‘Til next time,

Mindy Zatto, FSA, EA, FCA, MAAA, MSPA
Founding Principal, SBA

This Month at SBA

A quick look at what’s new, noteworthy, or just plain useful from our team.

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Why pharmacy transparency is becoming a C-suite issue

Pharmacy benefits are under unprecedented scrutiny—from Congress, regulators, and now the courts—and many employers are realizing their “transparent” arrangements aren’t as clear as they seem. In this HR Executive article, Andy Clonts explains where transparency actually breaks down, why rebates distort both pricing and participant costs, and how evolving fiduciary expectations are reshaping what HR leaders need to know about their pharmacy benefit strategy.

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The murky waters of healthcare cost transparency

Health plan fiduciary expectations are rising, yet true cost transparency remains elusive. Writing for BenefitsPRO, Jay Schmitt breaks down what recent rules do—and don’t—require, why pricing data often raises more questions than answers, and how plan sponsors can apply retirement-plan-style governance to their health and welfare vendors. The result is a clearer framework for exercising prudent oversight in a system where much remains outside employers’ control.

Ask the Principals

Our leadership team tackles tough questions from plan sponsors like you.

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Could our voluntary benefits be exposing us to ERISA fee risk?

A: Voluntary benefits are often viewed as lower risk because they’re employee-paid and sit alongside core health and welfare plans rather than inside them. That perception can lead to lighter oversight of compensation structures, carrier arrangements, and administrative fees.

The exposure typically arises when compensation is indirect, embedded in premiums, or not clearly documented. As regulatory scrutiny and fee-related litigation continue to expand, voluntary programs are increasingly being examined through the same fiduciary lens applied to other ERISA-covered benefits. That includes how vendors are selected, how compensation is structured, and whether the sponsor has exercised appropriate oversight.

A disciplined review doesn’t mean something is wrong. It means ensuring that fee arrangements are transparent, reasonable, and well-documented. SBA helps plan sponsors evaluate voluntary benefit structures, understand how compensation flows, and confirm that governance practices are aligned with evolving expectations—reducing the likelihood of unpleasant surprises down the road.

Tags: broker commissions/compensation, cost transparency, ERISA, plan management, voluntary benefits

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