The Challenge: Costs That Keep Climbing A recent survey projects a 9% increase in medical costs next year, or about 7.6% after plan adjustments. Much of this increase stems from the growing use of obesity medications, cancer treatments, chronic condition management, and mental health services. Demand for GLP-1 drugs has surged, with nearly 80% of … Continued
NONDISCRIMINATION TESTING AND NEW DEPENDENT CARE FSA CONTRIBUTION LIMIT Beginning in January 2026, the maximum contribution to a Dependent Care Flexible Spending Account (DCFSA) will increase from $5,000 to $7,500 ($3,750 for married employees filing separately). This expanded limit offers employees greater tax savings for child and adult care expenses, but it also raises the … Continued
UNDERSTANDING AND DISTRIBUTING MLR REBATES Insurance carriers must issue Medical Loss Ratio (MLR) rebates by September 30 when too much of the prior year’s premiums went to administrative costs or profit instead of claims and quality improvements. Employers who received MLR rebate checks will need to determine how much—if any—belongs to the plan and its … Continued
UNDERSTANDING AND DISTRIBUTING MLR REBATES Insurance carriers must issue Medical Loss Ratio (MLR) rebates by September 30 when too much of the prior year’s premiums went to administrative costs or profit instead of claims and quality improvements. Employers who received MLR rebate checks will need to determine how much—if any—belongs to the plan and its … Continued
THE ONE BIG BEAUTIFUL BILL ACT IMPACT ON EMPLOYEE BENEFITS The One Big Beautiful Bill Act of 2025 (OBBBA) introduces permanent changes to a range of employee benefits, creating a more stable and generous framework for employers and employees. HDHPs and HSAs Telehealth Services: High-deductible health plans (HDHPs) can now permanently cover telehealth before deductibles … Continued
SUPREME COURT AFFIRMS PREVENTIVE CARE PROTECTIONS UNDER THE ACA The U.S. Supreme Court has upheld a critical component of the Affordable Care Act (ACA), reinforcing the requirement that health insurers provide coverage for preventive services recommended by a federal expert panel. The decision ensures that Americans will continue to have access to early detection and … Continued
CONSOLIDATED APPROPRIATIONS ACT 2024 RXDC REPORTING DEADLINE The Centers for Medicare & Medicaid Services (CMS) has reaffirmed that the instructions for reporting 2024 Prescription Drug Data Collection (RxDC) remain unchanged from 2023. The deadline for employers and plan sponsors to submit 2024 data is Sunday, June 1, 2025. Overview of RxDC Reporting Requirements Each year, employers sponsoring … Continued
ACA REPORTING Affordable Care Act (ACA) reporting for applicable large employers (those with 50 or more employees) was due for the 2024 plan year in March. Reporting to Employees – due March 3, 2025 Form 1095-C: For Applicable Large Employers (ALEs) to report health coverage offered to full-time employees. Form 1095-B: For employers with self-funded … Continued
RESULTS OF AGENCY ENFORCEMENT OF MHPAEA INVESTIGATIONS The U.S. Departments of Labor (DOL) and Health and Human Services (HHS) recently released their latest enforcement findings on the Mental Health Parity and Addiction Equity Act (MHPAEA), covering investigations completed during the 2023-2024 fiscal year. Their report sheds light on key areas of noncompliance and emphasizes the government’s ongoing … Continued
IRS ISSUES TAX GUIDANCE ON STATE PAID FAMILY AND MEDICAL LEAVE PROGRAMS On January 15, 2025, the Internal Revenue Service (IRS) released Revenue Ruling 2025-4 (providing guidance on the taxation and reporting of contributions and benefits under state paid family and medical leave (SPFML) programs. Key Highlights Employer and Employee Contributions Employee-required SPFML contributions paid by an … Continued
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