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Recent Court Decisions Favor Employers in Tobacco Surcharge Litigation

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Summary

Warner Norcross + Judd summarizes three recent federal district court decisions (Plesha v. Ascension Health Alliance, E.D. Mo.; Greene v. Progressive Corp., N.D. Ohio; Noel v. PepsiCo, Inc., S.D.N.Y.) dismissing ERISA class action claims challenging employer tobacco surcharge wellness programs. Courts held that employers need not provide retroactive refunds of tobacco surcharges, that disclosure language substantially similar to DOL model notice satisfies requirements, and that tobacco surcharge design is a settlor function rather than a fiduciary duty. The analysis signals a trend generally favorable to employers while noting dozens of similar lawsuits remain pending nationwide.

Published by Warner Norcross + Judd on jdsupra.com . Detected and summarized by GovPing. Review our methodology and editorial standards .

What changed

Three federal district courts (E.D. Mo., N.D. Ohio, S.D.N.Y.) dismissed ERISA class action claims challenging employer tobacco surcharge wellness programs, ruling that employers need not provide retroactive refunds of surcharges once employees satisfy reasonable alternative standards, that disclosure language substantially similar to DOL model notice satisfies regulatory requirements, and that tobacco surcharge design is a settlor function outside ERISA fiduciary duties.

Employers sponsoring wellness programs with tobacco surcharges benefit from substantive judicial guidance favorable to plan design flexibility. While these rulings signal a trend supporting employer programs, dozens of similar lawsuits remain pending nationwide, and employers should ensure compliance with existing wellness program disclosure requirements to minimize litigation exposure.

What to do next

  1. Monitor ongoing tobacco surcharge ERISA litigation developments
  2. Ensure wellness program disclosures use language substantially similar to DOL model notice
  3. Continue compliance with ACA and HIPAA wellness program regulations

Archived snapshot

Apr 15, 2026

GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.

April 14, 2026

Tobacco Surcharge Programs: Recent Decisions Favor Employers, But Risk Remains

Stephanie Grant, De'Andre Robbins Warner Norcross + Judd + Follow Contact LinkedIn Facebook X Send Embed

Employers sponsoring wellness programs including tobacco surcharges have faced a growing wave of ERISA class action litigation over the past several years. These lawsuits primarily challenge whether such programs comply with ACA and HIPAA wellness program regulations, particularly the requirement to provide a “full reward” and properly disclose a reasonable alternative standard.

Until recently, these cases largely remained at the pleading stage without meaningful judicial guidance on the merits. However, several recent federal district court decisions now provide the first substantive rulings on these issues. Notably, each court dismissed the plaintiffs’ claims in full, signaling a trend that is generally favorable to employers. That said, this remains an actively litigated area, with dozens of similar lawsuits pending nationwide. Employers should continue to monitor developments and ensure compliance with applicable wellness program rules.

(For additional background on wellness program requirements, see our prior e-Alert: Holy Smokes: Is Your Tobacco Surcharge Program Compliant?)

Recent District Court Decisions

Three recent cases, Plesha v. Ascension Health Alliance (E.D. Mo.), Greene v. Progressive Corp. (N.D. Ohio) and Noel v. PepsiCo, Inc. (S.D.N.Y.), addressed nearly identical claims and reached consistent outcomes. Across all three decisions, courts rejected plaintiffs’ core theories and dismissed the cases for failure to state a claim.

“Full Reward” Does Not Require Retroactive Refunds

Plaintiffs consistently argued that ERISA requires employers to retroactively reimburse tobacco surcharges once a tobacco user satisfies a reasonable alternative standard such as completing a smoking cessation program. All three courts rejected this interpretation. Instead, the courts held that:

  • The “reward” in these programs is typically the avoidance of a surcharge, not a rebate.
  • Providing the reward on a prospective basis, by removing the surcharge going forward, satisfies legal requirements.
  • Neither the statute nor the regulations clearly require retroactive reimbursement of previously paid surcharges.

Disclosure Claims Fail Where Summary Plan Description Language is Sufficient

Plaintiffs also alleged that employers failed to adequately disclose the availability of a reasonable alternative standard, as required under wellness program regulations. These claims were uniformly dismissed. The courts found that:

  • Use of disclosure language substantially similar to the Department of Labor’s model notice is sufficient.
  • Where the SPD includes the required disclosure, generalized allegations that other plan materials are deficient are too vague to state a claim.
  • In some cases, disclosure claims failed entirely because they were derivative of the failed “full reward” theory. Additionally, courts reinforced that the regulations do not require disclosure of every detail of the alternative standard in all materials, particularly where materials do not describe the program’s terms in detail.

Tobacco Surcharge Design is a Settlor Function (Not Fiduciary)

Plaintiffs in all three cases asserted that employers breached ERISA fiduciary duties by imposing and retaining tobacco surcharges. Again, all courts rejected these claims. The courts consistently held that:

  • Designing and adopting a wellness program, including surcharge structures, is a settlor function, not a fiduciary act.
  • Implementing the plan in accordance with its terms does not convert settlor decisions into fiduciary conduct.
  • Plaintiffs failed to allege harm to the plan itself, which is required for fiduciary breach claims.

Practical Takeaways for Employers

While these recent court decisions represent a meaningful shift toward employer-favorable outcomes, this area remains unsettled. Many similar lawsuits are still pending, and additional appellate guidance may further shape the legal landscape. For now, however, these decisions provide persuasive authority (and binding authority in their respective jurisdictions) to defend tobacco surcharge programs that:

  • Provide a reasonable alternative standard,
  • Include appropriate disclosures, and
  • Apply surcharges in a prospective (rather than retroactive) manner. Despite these favorable rulings, Warner Norcross + Judd currently recommends that employers not located within the applicable jurisdictions of these decisions consider providing retroactive reimbursement of tobacco surcharges upon completion of a cessation program until more uniform guidance (e.g., appellate-level decisions) is established. This approach may help reduce exposure to ongoing and future litigation in this area.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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Named provisions

Full Reward Requirement Reasonable Alternative Standard Disclosure ERISA Fiduciary Duty Summary Plan Description Requirements

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Last updated

Classification

Agency
Warner Norcross + Judd
Published
April 14th, 2026
Instrument
Notice
Legal weight
Non-binding
Stage
Final
Change scope
Minor

Who this affects

Applies to
Employers Healthcare providers
Industry sector
6211 Healthcare Providers 5112 Software & Technology
Activity scope
Employee wellness programs Health benefit plan design ERISA compliance
Geographic scope
United States US

Taxonomy

Primary area
Employment & Labor
Operational domain
Legal
Compliance frameworks
HIPAA
Topics
Healthcare Consumer Finance

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