The lawsuit, filed in U.S. District Court for the Middle District of Georgia, said this surcharge violates a provision of the Employee Retirement Income Security Act.

"The No Surprises Act was designed to protect patients from unexpected medical bills, not to increase healthcare costs," Catherine Gaffigan, president of health solutions at Elevance Health, said in a statement.

Individual and small group health plans faced losses in 2025 as medical claims continued to climb, accelerating a shift toward alternative benefit models.

Navigating global payroll compliance is increasingly complex for multinational companies, with varying tax rules and evolving regulations across jurisdictions.