Preparing for the 2024-25 Flu Season - Experts predict that the United States may have another early start to the influenza (flu) season this year. When colder weather arrives, flu rates typically increase, peaking...

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Deadline for Submitting Gag Clause Attestation Is Dec. 31, 2024 - Effective in 2020, the Consolidated Appropriations Act, 2021 (CAA) prohibits health plans and health insurance issuers from entering into contracts with...

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Deadline for Employers to Receive MLR Rebates Is Approaching - Employers with insured group health plans may soon receive a medical loss ratio (MLR) rebate from their health insurance issuers. Issuers who did not meet...

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Report Finds Weight Loss Drugs Key Driver of 2025 Health Care Cost Increase - A recent Business Group on Health (BGH) survey found that heightened interest and spending on glucagon-like peptide-1 (GLP-1) drugs is a...

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Final Rule Makes Extensive Changes to Mental Health Parity Requirements - On Sept. 9, 2024, the Departments of Labor, Health and Human Services, and the Treasury (Departments) released a final rule to strengthen the...

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CMS has provided two model notices for employers to use: Medicare Part D Notices Are Due Before Oct. 15, 2024 - Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible...

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Report: Health Care Costs 254% Higher for Privately Insured Patients Than Those With Medicare - A new RAND report revealed that in 2022, private insurers paid hospitals an average of 254% more than what Medicare would...

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DOL Updates Model Employer CHIP Notice - The U.S. Department of Labor (DOL), through its Employee Benefits Security Administration (EBSA), has released a new model Employer CHIP Notice with information current as of ...

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Deadline for Employers to Receive MLR Rebates Is Approaching - Employers with insured group health plans may soon receive a medical loss ratio (MLR) rebate from their health insurance issuers. Issuers who did not meet...

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Open Enrollment 2025- Health Savings Account (HSAs) - Employers who sponsor high deductible health plans (HDHPs) that are compatible with health savings accounts (HSAs) should prepare for open enrollment by: Ensuring...

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Federal Courts Block Enforcement of Certain Section 1557 Nondiscrimination Provisions - On April 26, 2024, the U.S. Department of Health and Human Services’ (HHS) Office of Civil Rights (OCR) issued a final rule under...

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Using HSAs, Health FSAs and HRAs for Over-the-Counter Items - Health savings accounts (HSAs), health flexible spending accounts (FSAs) and health reimbursement arrangements (HRAs) may provide tax-free reimbursements of...

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Coverage of Gender-affirming Care: Employer Considerations - In Lange v. Houston County, the 11th Circuit Court of Appeals ruled that it was a violation of Title VII of the Civil Rights Act of 1964 (Title VII) for an...

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DOL Issues Gag Clause Attestation Resources for 2024 - On May 24, 2024, the U.S. Department of Labor (DOL) issued various resources to assist health plans and health insurance issuers in annually submitting their...

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DOJ Releases Proposed Rule to Ease Federal Restrictions on Marijuana - On May 16, 2024, the U.S. Department of Justice (DOJ) announced a proposed rule that would reschedule marijuana from a Schedule I to a Schedule III...

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PCORI Fees Due July 31, 2024 - The Affordable Care Act (ACA) requires health insurance issuers and self-insured plan sponsors to pay Patient-Centered Outcomes Research Institute fees (PCORI fees). The fees are reported...

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HHS Finalizes Rule to Strengthen Reproductive Health Care Privacy - The U.S. Department of Health and Human Services (HHS) has issued a final rule that strengthens the HIPAA Privacy Rule by prohibiting the disclosure of...

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Group Health Plan Fiduciary Litigation on the Rise - Enforcement of the strict standards of fiduciary conduct set forth in the Employee Retirement Income Security Act (ERISA) has traditionally been reserved for...

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DOL Rescinds 2018 Final Rule on Association Health Plans - On April 29, 2024, the U.S. Department of Labor (DOL) released a final rule that rescinds in its entirety a prior 2018 final rule on association health plans (...

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Study Shows 40% of Insured Workers Delay Health Care Due to Cost - A study by employee health payment platform Paytient revealed the challenges Americans face with employer-sponsored insurance. Notably, 40% of workers...

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Health Care Costs and Your Employee Health Plan - Health care costs, and consequently employee health benefits costs, have been increasing at an alarming rate for nearly a decade. Avoiding rising health care costs is...

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EEOC Releases Final Rule Implementing Pregnant Workers Fairness Act - On April 15, 2024, the U.S. Equal Employment Opportunity Commission (EEOC) released a final rule to implement the Pregnant Workers Fairness Act (PWFA)...

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What Are Specialty Drug Benefits? - Specialty drugs, also known as specialty pharmaceuticals, are some of the most expensive prescriptions you can buy-costing up to $2,000 or more per month. Unfortunately, they may also...

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- Health Care Industry Trends to Watch in 2024 - In recent years, the health care industry has been navigating a landscape fraught with volatility. Shifting market demands, supply chain struggles and medical inflation...

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- Compliance Overview: Top Health Plan Compliance Issues for 2024 - Employers should be aware of the top compliance issues that impact their health plan coverage for 2024. Some of these compliance issues are established...

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- 7 Key Employee Benefits Trends in 2024 - Attracting and retaining employees has challenged employers since the onset of the COVID-19 pandemic. In 2024, the labor market is expected to cool slightly; however,...

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- House Passes Bipartisan Act to Lower Health Care Costs and Increase Price Transparency - On Dec. 11, 2023, the U.S. House of Representatives passed landmark bipartisan legislation to lower the cost of health care and...

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- Benefits Breakdown - January 2024 - 4 Key Trends Driving Employer Health Care Costs in 2024 - Amid ongoing inflation pressures, employees and employers alike can expect their health care costs to increase in 2024....

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Do Your Part to Keep Our Workplace Safe - Preventing injury and illness on the job is something all employees should take seriously-nothing less than your future is at stake. An on-the-job accident, infection or serious...

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