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"The first quarter's $14.5 billion in transacted revenue was the highest Q1 figure we have seen in recent years," the report said.

Affordability challenges are leading to reduced security for millions of workers, Dayforce research finds.

The Center for American Progress also wants to limit what TPAs can earn from running employers' self-insured plans.

This is only the latest disagreement involving the independent dispute resolution process since it took effect more than three years ago.

Nineteen states and the District of Columbia allege that the restructuring violates the Administrative Procedure Act and the Constitution because the agency has no authority to restructure itself and fire its employees.

A Paragon Institute analyst calls the idea of "cost-shifting" from government plans to employer plans a myth.