News Archive

"[1] HSAs are not use-it-or-lose it ... [2] HSAs can provide more tax breaks than 401(k)s ... [3] You can invest the HSA money in mutual funds ... [4] You can open an HSA even if it isn't offered by your employer ... [5] HSA money can be used for even more expenses after retirement ... [6] You can use the HSA money for family members' medical expenses ... [7] You have an unlimited amount of time after you pay for medical expenses to reimburse yourself."  MORE >>

"Most federal employees and retirees will pay much more for health coverage next year; the enrollee share of premium is going up 12.3% on average.... [This article will] go through premium changes in popular plans, discuss which ones saw their costs go up above and below the average, provide enrollment advice for two-person families, explain the government premium contribution, and cover what to expect from FEDVIP options."  MORE >>

"As open enrollment begins, employers should be strategic and consistent about communicating these changes to employees."  MORE >>

"Employer sponsored health insurance plans are about to see the biggest increases in cost in 15 years ... The cost spike has become a 'call to action,' prompting 59% of employers to implement cost-cutting measures for 2026, up from 48% last year. Here's why prices are expected to increase, how employers and employees are responding, and how to prepare for a pricier year."  MORE >>

"With family health insurance premiums ... now averaging more than $25,000 per year, and deductibles climbing nearly 50% in the last decade, many households are feeling the pinch.... Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are valuable tools that not only help manage day-to-day medical costs but can also play a strategic role in your broader financial plan."  MORE >>

"Courts often require disclosure of how much insurers pay doctors and consultants.... Personnel reviews can show whether adjusters or consultants are rewarded for denials.... Statistical patterns can reveal systemic bias.... Insurers rely heavily on outside vendors to supply medical reviewers. Courts scrutinize those ties.... Courts allow probing where insurers repeatedly seek favorable opinions.... Insurers sometimes argue they've walled off claims from financial pressures. Courts want proof.... Courts typically reject overbroad or irrelevant requests."  MORE >>

"[This] Q&A explains how employer-sponsored health insurance affects a family's eligibility for a premium tax credit, and when employees and their family members can forgo an offer of employer coverage and purchase coverage in the health insurance marketplace with the help of a premium tax credit."  MORE >>

"Benefits jargon leaves many employees feeling lost, which can lead to missed opportunities and underused perks. This employee-friendly glossary breaks down 52 of the most commonly misunderstood terms in plain English, helping HR teams and employees alike navigate benefits with confidence. From deductibles to COBRA, this guide makes sure no one gets tripped up by confusing fine print."  MORE >>

"For disabled employees, RTO policies don't just represent a change in environment, they can become a tipping point that insurers use to challenge or deny disability claims. Understanding the interplay between workplace demands, disability accommodations, and the definition of disability in ERISA policies is essential to protecting your rights."  MORE >>

"You may also be able to successfully appeal denials from employer health insurance plans or traditional Medicare -- whether for prior authorization or for a service you already received -- although few people know their appeal rights.... Here's what you need to know to appeal a health insurance denial, whether it involves a prior authorization request or a big bill following a procedure or treatment that you believe your insurance should cover."  MORE >>

"What plans does ERISA cover (and exclude)? ... Key legal differences in ERISA vs. Non-ERISA plans ... Special considerations applied to different types of benefits (health, disability, and retirement) ... Determining ERISA plan status: how to know if ERISA applies ... Recent legal developments and impact ... When to seek legal guidance for an ERISA or non-ERISA claim."  MORE >>

"Part I: HSA Contributions and Deduction.... Part II: HSA Distributions.... Part III: Income and Additional Tax for Failure To Maintain HDHP Coverage."  MORE >>

"Counterforce Health [is] a free artificial intelligence system that helps patients fight insurance claim denials. One AI writes appeal letters disputing the denials, and another calls the insurance companies to continue pursuing the appeal. 'The end game is reducing the patient burden fully,' [CEO Neal Shah] said. 'Because both letter writing and phone calling are just time-wasting."  MORE >>

"[ERISA's] broad venue provision gives plaintiffs multiple options for where to file suit. Participants and beneficiaries gain flexibility to choose locations that offer convenience or strategic advantages.... ERISA's statutory venue provision offers breadth. However, forum-selection clauses can limit where participants may file by requiring a specific court or location to hear the case."  MORE >>

"[Rev. Rul. 2025-4] aims to clarify the federal tax treatment of state paid leave programs that help pay employees who cannot work because of non-occupational injuries to themselves or family members as well as sickness and disabilities. Under the guidance, employers may generally deduct contributions to mandatory PFML programs as a payment of excise tax. Likewise, employees may deduct contributions as income tax payments if they itemize their deductions. Payments to employees from a state PFML program must be included in the employees' gross income."  MORE >>

"What's New: [1] Preventive care for purposes of qualifying as a high deductible health plan under section 223.... [2] Expenses treated as amounts paid for medical care." [Also see: 2024 IRS Form 8889, draft dated May 30, 2024]  MORE >>

"[1] You must use HSA money by year-end ... [2] You can only get an HSA through your employer ... [3] You can't use money in the HSA after you sign up for Medicare ... [4] You can't contribute to an HSA after you turn 65 ... [5] You must use HSA funds within a certain time period after you incur medical bills ... [6] Your spouse and kids can only use HSA money if covered by your health plan ... [7] You can't use the HSA after you leave your job[.]"  MORE >>

"Lowering your MAGI is the best way to avoid (or reduce) IRMAA charges. [1] [I]ncrease your 401(k) or other tax-deferred account contributions. [2] Donate appreciated assets directly to charity from your taxable accounts.... [3] Make qualified charitable distributions (QCDs).... [4] Distributions from Roth accounts do not count toward your MAGI.... [5] Roth conversions reduce future RMDs from your retirement accounts ... [6] Look for losses in your taxable accounts that could help offset any capital gains. [7] Appeal If you experience a life-changing event[.]"  MORE >>

"[E]mployees must incur eligible expenses before the plan year's end or soon thereafter, to avoid forfeiting any remaining money in the account.... Understanding the provisions for the carry-over and grace period is essential for employees in maximizing healthcare FSA benefits.... Employees should stay aware of the deadlines for submitting FSA reimbursement claims ... Employees should be cautious about using their FSA debit cards in the new plan year (2025) to pay for expenses from the previous year (2024), as this can lead to complications and potential denial of claims."  MORE >>

"The answer depends on a variety of factors, including company policies, the nature of the disability, state laws, and federal regulations like the [FMLA]. [This post explores] the complexities of job protection during short-term disability, what employees can expect, and the key factors influencing job security during a medical leave."  MORE >>

"If you're part of a married couple or family working your way through open enrollment in 2024, here are some of the key issues to keep in mind as you decide whether to choose employee-only, employee-plus-one, or family coverage. [1] Compare the costs of health insurance coverage under different plans: is a traditional PPO or HDHP right for you? ... [2] Understand your healthcare needs and insurance policy usage ... [3] Does dual health insurance coverage make sense?"  MORE >>

"About 165 million Americans get their health insurance through work, and yet ... employees only spent about 45 minutes a year, on average, deciding which benefit options suit them best ... Open enrollment season, which typically runs through early December, is an opportunity to take a closer look at what's at stake. And, for starters, costs are going way up."  MORE >>

"The premium tax credit is only available to people without another offer of affordable and adequate coverage; in most cases, this will mean that people with an offer of employer-sponsored coverage will not be eligible for the premium tax credit. [This] Q&A explains how employer-sponsored health insurance affects a family’s eligibility for a premium tax credit, and when employees and their family members can forgo an offer of employer coverage and purchase coverage in the health insurance marketplace with the help of a premium tax credit."  MORE >>

"After a comprehensive cost-benefit analysis, you can make an informed decision.... There are some who will decide that facing the Part D penalty is a less bad option than paying the monthly premiums and IRMAA, and losing HSA contributions.... Those who are already enrolled in Part A can add a standalone Part D drug plan during the Open Enrollment Period, October 15-December 7."  MORE >>

"The defendant utilized proprietary guidelines ... to adjudicate claims involving both mental health treatment as well as for medical and surgical treatment. The plaintiffs requested that the plan provide copies of both sets of guidelines, but their request was ignored.... Although the court determined that the benefit denial was warranted, the court nonetheless deemed the penalty appropriate for non-compliance with required disclosures." [W.H. v. Allegiance Ben. Plan Mgmt., No. 22-0166 (D. Mont., June 4, 2024)]  MORE >>