News Archive

"The FEHB Protection Act of 2025 (FPA) requires OPM to issue regulations and implement a process to verify: [1] the veracity of any qualifying life event (QLE) through which a health benefits plan enrollee seeks to add a member of family to their enrollment and [2] that when an enrollee adds a family member to the health benefits plan, including during any open season, the individual is a qualified member of family. This final rule also clarifies responsibilities for initial family member eligibility determinations for the Postal Service Health Benefits (PSHB) Program."  MORE >>

"This is to inform the public that, on October 22, 2025, the United States District Court for the Southern District of Mississippi issued an order ... vacating portions of the final rule titled 'Nondiscrimination in Health Programs and Activities,' published May 6, 2024. Specifically, the court vacated certain provisions of the regulation to the extent they expand Title IX's definition of sex discrimination to include gender-identity discrimination. Pursuant to the court's order, the vacated provisions are legally void. The other provisions of the Section 1557 Rule remain in force." [Tennessee v. Kennedy, No. 24-0161 (S.D. Miss. Oct. 22, 2025)]  MORE >>

"For calendar year 2027, the annual limitation on deductions under section 223(b)(2)(A) for an individual with self-only coverage under a high deductible health plan is $4,500. For calendar year 2027, the annual limitation on deductions under Section 223(b)(2)(B) for an individual with family coverage under a high deductible health plan is $9,000.

"For calendar year 2027, a DPCSA is not treated as a health plan with respect to an otherwise eligible individual if the aggregate monthly fees for all DPCSAs with respect to the individual do not exceed $150 or, if the individual is covered by a DPCSA that covers more than one individual, $300.

"For calendar year 2027, a 'high deductible health plan' is defined under section 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,750 for self-only coverage or $3,500 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $8,700 for self-only coverage or $17,400 for family coverage.

"For plan years beginning in 2027, the maximum amount that may be made newly available for the plan year for an excepted benefit HRA under Section 54.9831-1(c)(3)(viii) is $2,250."  MORE >>

607 pages. "This document sets forth these final rules related to certain provisions of the No Surprises Act regarding the Federal independent dispute resolution (IDR) process, which was established as part of the Consolidated Appropriations Act, 2021 (CAA). These rules finalize new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act. These final rules also require plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice (ERA) to an entity that does not have a contractual relationship with the plan or issuer. This document also finalizes amendments to certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review process, and the payment and collection of administrative fees and certified IDR entity fees. This document also finalizes the definition of bundled payment arrangements, amends requirements related to batched items and services and amends the rules for extensions of timeframes due to extenuating circumstances. Additionally, this document finalizes provisions that require plans and issuers to register in the Federal IDR portal."  MORE >>

38 pages. "This 2027 Final Letter provides updates on operational and technical guidance for the 2027 plan year for issuers seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Exchanges (FFEs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs). It also describes how parts of this 2027 Final Letter apply to issuers in State-based Exchanges on the Federal Platform (SBE-FPs).... The 2027 Final Letter focuses on guidance that has been updated for the 2027 plan year[.]"  MORE >>

"You are receiving this Form 1095-C because your employer is an Applicable Large Employer subject to the employer shared responsibility provisions in the [ACA]. This Form 1095-C includes information about the health insurance coverage offered to you by your employer." [Also available: Draft of 2026 IRS Form 1094-C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns]  MORE >>

"As required by statute, the [DOL] annually publishes a final rule updating the civil monetary penalties it assesses. The Bureau of Labor Statistics (BLS) did not publish its October 2025 Consumer Price Index for All Urban Consumers (CPI-U) data due to a lapse in funding. Because the relevant law requires that annual penalty adjustments be based specifically on October CPI-U data -- with no alternative calculation allowed -- the 2026 adjustment is cancelled entirely."  MORE >>

May 21, 2026. "Attach to Form 1040, 1040-SR, 1040-NR, or 1041.... If you only owe the additional 10% tax on the full amount of the early distributions, you may be able to report this tax directly on Schedule 2 (Form 1040), line 5, without filing Form 5329."  MORE >>

"Section 401(a)(39)(E) of the Internal Revenue Code permits distributions from a defined contribution plan for the payment of certified long-term care insurance premiums if certain disclosure requirements are met, including that the issuer of the certified long-term care insurance must file an 'Issuer Disclosure' with the IRS. IRC Section 401(a)(39)(E)(iii) provides that a long-term care premium statement will be accepted by a defined contribution plan only if you (the issuer) file an Issuer Disclosure with the IRS describing the specific coverage life insurance product that is the subject of the long-term care premium statement. Use the procedures on this webpage to make an Issuer Disclosure only if you plan on filing a long-term care premium statement with a defined contribution plan with respect to a policyholder's request for qualified long-term care distributions."  MORE >>

22 pages. "This notice provides guidance on qualified long-term care distributions, as permitted under section 401(a)(39) of the Internal Revenue Code. In particular, the notice provides guidance to providers of certified long-term care insurance  relating to the disclosure and reporting requirements under sections 401(a)(39) and 6050Z. In addition, the notice provides guidance under sections 72(t)(2)(N) and 401(a)(39) to plan administrators making and individuals receiving qualified long-term care distributions, including setting forth safe harbors for plan administrators in making qualified long-term care distributions. This notice also extends the deadline for a plan sponsor of a defined contribution plan that is not a governmental plan (within the meaning of section 414(d)), a section 403(b) plan maintained by a public school, or an applicable collectively bargained plan, to amend its eligible retirement plan to permit qualified long-term care distributions."  MORE >>

"Use a separate Form 7206 for each trade or business under which an insurance plan is established."  MORE >>

Rev. May 19, 2026. "Table 1 lists key PY2027 dates for QHP certification applications and related data submissions.... As in prior years, issuers will submit a complete QHP application for all plans they intend to have certified in a state in which an FFE is operating. Through an iterative process ... CMS will review QHP applications for current and new issuers applying for QHP certification in an FFE."  MORE >>

1121 pages. "This final rule contains provisions to improve implementation of the [ACA], including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This final rule also includes [1] provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; [2] standards governing agents, brokers, and web-brokers; [3] the expansion and codification of hardship exemption eligibility; [4] implementation of the State Exchange Improper Payment Measurement (SEIPM); [5] provider access standards and essential community provider standards for QHP certification; [6] QHP certification of non-network plans; [7] a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); [8] requirements related to defrayal for the cost of any State-required benefits in addition to the EHB; [9] cost-sharing flexibilities for catastrophic and individual market bronze plans; [10] establishment of catastrophic plans with plan terms of up to 10 consecutive plan years; [11] QHP issuer quality improvement strategies (QISs); and [12] revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States. This final rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation."  MORE >>

"This notice provides guidance on the corporate bond monthly yield curve, the corresponding spot segment rates ... and the 24-month average segment rates ... [as well as] the interest rate on 30-year Treasury securities ... as in effect for plan years beginning before 2008 and the 30-year Treasury weighted average rate[.]"  MORE >>

11 pages. "This notice sets forth the 2026 Cumulative List of Changes in Plan Qualification Requirements for Defined Benefit Qualified Pre-approved Plans. The 2026 Cumulative List will assist providers applying to the [IRS] for opinion letters for the fourth remedial amendment cycle for defined benefit qualified pre-approved plans (Cycle 4) under the IRS's pre-approved plan program. Cycle 4 began on April 1, 2025. The Cycle 4 submission period begins on August 1, 2026, and ends on July 31, 2027. The 2026 Cumulative List identifies recent changes in the qualification requirements of the Internal Revenue Code that were not taken into account during the first three remedial amendment cycles for defined benefit qualified pre-approved plans and that will be taken into account by the IRS with respect to the form of a plan submitted to the IRS for Cycle 4."  MORE >>

"Criteria for Mergers Involving Plans that Received SFA

• What are the eligibility requirements for a merger involving a plan that received SFA?
• What conditions apply after the merger?
• May plans request a waiver of any conditions beyond those permitted in § 4262.16(f)(4)?

"Request for Approval

• Where should a plan representative file a request for approval?
• When should a request for waiver of one or more conditions be submitted?
• May plans confer with PBGC before submitting a request for approval?
• When must a plan request approval of a merger involving a plan that received SFA?
• If plans want to adopt an alternative allocation method for the merged plan, when should that request be submitted?
• What withdrawal liability methods may a merged plan use to comply with § 4261.16(1)(3)(iv) and (v)?
• How does the example of a compliant alternative allocation method work?
• How does the example alternative allocation method satisfy the requirements of § 4262.16(f)(3)(iv) and (v)?
• Will adoption of the example alternative allocation method satisfy the risk of loss standard?
• May plans propose a different alternative allocation method?"

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"[U]ntil after the Department issues a final regulation or other applicable administrative guidance, the Department, as an enforcement policy, will not take enforcement action against plan administrators that comply in good faith with a reasonable interpretation of the provisions set forth in the NPRM. Likewise, the Department will not take enforcement action against plan administrators that comply in good faith with a reasonable interpretation of section 105(a)(2)(E) of ERISA pending the adoption of a final rule (for example, plan administrators may furnish the pension benefit statement described in section 105(a)(2)(E) of ERISA in accordance with the current regulation under 29 CFR Section 2520.104b-1(c))."  MORE >>

PBGC has launched a new webpage designed specifically to support the practitioner community. It is intended to streamline the user’s experience and make it easier to find information. PBGC’s statute and regulations require the submission of various notices, forms, applications and payments. This new page brings those requirements together in one place by providing an overview, clear guidance, and direct links to relevant information. Practitioners can now easily access details on what must be filed, when it must be filed, and how to submit required materials.  MORE >>

"Attach to Form 1040 or Form 1040NR.... You cannot take the PTC if your filing status is married filing separately unless you qualify for an exception."  MORE >>

"Instructions for Recipient: This Form 1095-B provides information about the individuals in your tax family (yourself, spouse, and dependents) who had certain health coverage (referred to as 'minimum essential coverage') for some or all months during the year. " [Also available: Draft of 2026 IRS Form 1094-B: Transmittal of Health Coverage Information Returns]  MORE >>

"This Carrier Letter includes the 2027 Community Rating Guidelines and Proposal Instructions for Federal Employees Health Benefits (FEHB) Program and Postal Service Health Benefits (PSHB) Program Carriers. FEHB and PSHB plans must be rated separately based on the population covered." [Also available: MLR Threshold; Proposal Tables (XLSX)]  MORE >>

"The [PBGC] is notifying the public that its civil monetary penalty amounts will not increase for the 2026 calendar year.... In accordance with guidance from the Office of Management and Budget (OMB), PBGC will continue to use the 2025 civil monetary penalty levels because there will be no cost-of-living adjustment for 2026."  MORE >>

121 pages. "These proposed rules are generally intended to provide employers and health insurance issuers with flexibility to cover a broad spectrum of treatments and interventions for fertility- related and pre-conception care as part of the excepted fertility benefit. The Departments believe allowing employers and health insurance issuers this flexibility creates the opportunity for fertility benefits to help individuals address their specific fertility needs, regardless of whether they need pre-conception care related to the underlying cause of infertility or more invasive treatments and procedures, like IVF.... In addition to the proposed limitation on the scope of coverage, the Departments are also proposing to establish a lifetime dollar limit for the proposed excepted fertility benefits....

"[W]hile the plan sponsor would be required to offer a traditional group health plan to all individuals offered the fertility benefit, participants in the fertility benefit (and beneficiaries, if eligible for the fertility benefit) would not be required to enroll in that traditional group health plan in order for the fertility benefit to qualify as a limited excepted benefit....

"[T]he Departments propose ... to require that plans and issuers provide written notice to plan participants and beneficiaries  ... for fertility benefits to qualify as limited excepted benefits....

"This proposal to create an excepted fertility benefit as a new category of limited excepted benefits would apply to group health plans and health insurance issuers offering group health insurance coverage for plan years beginning on or after January 1, 2027."  MORE >>

"As part of the Corporation's compliance assistance efforts, this program establishes a process for private parties to request that the agency file an amicus brief in cases with potential implications for PBGC or the broader private pension system.... Instructions for submitting an amicus curiae request can be found on PBGC's website. Upon receiving a request, PBGC will move expeditiously to evaluate it. Still, PBGC recommends early submission to facilitate thorough review. PBGC may ultimately decline to file an amicus brief. It may also elect to file one on its own initiative."  MORE >>

"File Form 5498-TA, Trump Account Contribution Information, with the IRS and furnish it to the account beneficiary for each Trump account you maintained during the calendar year shown on the form for any calendar year during the growth period of the account beneficiary. For any calendar year after the growth period of the account beneficiary, file Form 5498, IRA Contribution Information, with the IRS and furnish it to the account beneficiary."  MORE >>