An Aon health benefits specialist predicts that employers will have to work harder to monitor their pharmacy benefit managers.

The former employees argue that the company was involved in self-dealing and prohibited transactions under ERISA because it designed its own funds, picked the managers, decided how assets were allocated and then collected related fees.

"Employers have an opportunity to strengthen engagement by pairing competitive benefits with greater flexibility and support that helps people feel more secure," said Jake Spiegel, senior research associate at EBRI.

The shifts from the Biden to Trump administrations have been stark: the suspension of a green card lottery, the revoking of 8,000 student visas, last week's ban on visa issuances to the citizens of more than 75 countries, the hiking of fees for investor visas to $1 million and — most resonant for employers — a $100,000 fee attached to H1-B work visas.