News Archive

"[T]he Proposed Rule would, for the first time, allow employers to offer fertility benefits -- including in vitro fertilization (IVF) -- outside the federal market requirements added by [HIPAA], the [ACA] and related statutes. However, that offer of fertility benefits is also subject to some conditions."  MORE >>

"Recently, the IRS, DOL and HHS released certain annual adjustments for 2027 plan years. The adjustments include the largest one-year increase to the [ACA] out-of-pocket maximum (OOPM) in more than a decade -- a $1,400 jump for self-only coverage. High-deductible health plan (HDHP) thresholds and health savings account (HSA) contribution limits rose modestly, and the excepted benefit health reimbursement arrangement (EBHRA) limit was increased by $50. The current 2026 limits and new 2027 limits are illustrated in the table below."  MORE >>

"These unofficial 2027 limits are determined using the Internal Revenue Code (IRC)'s cost-of-living adjustment methods, the Chained Consumer Price Index for All Urban Consumers (C-CPI-U) values through June, and Mercer's projected C-CPI-U for July and August. While adoption assistance program limits generally use the same indexing formula, they can't be reliably projected due to the small rounding threshold."  MORE >>

"Even when ICHRA isn't the right fit, it creates leverage. Employers may get an ICHRA quote showing six- or seven-figure cost savings -- and, whether they switch or not, that quote puts pressure on the current carrier to negotiate. For smaller businesses, especially, that kind of leverage didn't exist before. This is about power. That leverage disappears if you're pitching ICHRA on the wrong assumptions -- and many brokers are, because the two biggest assumptions they bring to it are outdated."  MORE >>

"In 2027, tax-deductible/tax-free HSA contribution limits, HDHP in-network out-of-pocket maximums, and HDHP minimum annual deductibles will rise from 2026 levels for both self-only and family coverage levels. The aggregate fixed monthly fees for an HSA-compatible direct primary care service arrangement (DPCSA) will remain unchanged.... The 2027 maximum annual employer contribution for an excepted-benefit HRA will increase to $2,250."  MORE >>

"The [IRS] recently announced cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs), high-deductible health plans (HDHPs), and excepted benefit health reimbursement arrangements (HRAs) for 2027. In addition, this year's guidance includes inflation-adjusted limits for the aggregate fees that can be made available under direct primary care service arrangements (DPCSAs), which were first made available under the One Big Beautiful Bill Act (OBBBA). Most of the dollar limits currently in effect for 2026 will change for 2027."  MORE >>

"Starting in 2007, the Tax Relief and Health Care Act of 2006 (TRHCA) requires that the IRS release the upcoming year's new HSA and Excepted Benefit Health Reimbursement Arrangement (EBHRA) limits prior to June 1st. Thus, we now have the 2027 limits[.]"  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 >>

"Based on large-employer survey data, 79% were surprised by rate increases, and 94% have experimented with alternative cost-containment approaches. Brokers have said average savings for clients that switch to ICHRAs are 15.5%, but the cost savings may not be the only argument."  MORE >>

"56% of brokers are now recommending the program as an option. The number of brokers who said they moved at least one client to an ICHRA plan reached 37% in 2026, increasing from 15% in 2024."  MORE >>

"ICHRAs and QSEHRAs both allow employers to reimburse employees tax-free for individual health insurance premiums and qualifying medical expenses. Both are employer-funded (as HRAs are required to be), neither requires a traditional group health plan, and both share a common lineage in the broader HRA regulatory framework. But the similarities largely end there. The two arrangements differ materially in employer eligibility, contribution flexibility, employee coverage requirements, ACA interactions, and reporting obligations. These distinctions are important for employers to consider in evaluating either of these options."  MORE >>

"Direct‑to‑consumer platforms like TrumpRx.gov, Hims, Lilly Direct, and NovoCare now offer [GLP-1s] between $149 and $449 per month, cash pay. The obvious question: can we reimburse employees through an HRA for purchases made through these channels? In most cases, yes. But the compliance advice most employers receive says otherwise, and the reason is worth understanding."  MORE >>

"This clarification removes a compliance obligation for employers that sponsor HRAs ... [E]mployers will no longer need to separately evaluate and disclose the creditable coverage status of their account-based plans. For individuals, the change is equally practical: those with both major medical coverage and an account-based plan will no longer need to reconcile potentially conflicting notices to determine whether they truly have creditable coverage."  MORE >>

"Although EBHRAs have fewer compliance obligations as compared to traditional HRAs, employers should not mistake 'excepted benefit' for 'compliance-free.' The EBHRA carries meaningful obligations under ERISA, COBRA, HIPAA privacy and the nondiscrimination rules, and proper plan documentation and administration are essential to maintaining compliance with the applicable regulations."  MORE >>

"PLR 202434006 permitted an election between a defined contribution plan, an HRA, an HSA, and student loan payments under a qualified educational assistance program. The [OPTIONS Act (HR 8314)] goes beyond that and allows an election for any benefits that are excluded under the Code. Presumably, this would include benefits such as a dependent care assistance program and a Trump Account."  MORE >>

"Sponsors of HRAs and other account-based plans, which are typically offered alongside major medical plans, will welcome the relief from providing burdensome and potentially confusing Part D creditable coverage notices. Sponsors of plans that remain subject to the disclosure requirements should use the 2027 parameters when determining whether their plans' prescription drug coverage is creditable for that year."  MORE >>

"The final rule codifies that account-based medical plans, specifically HRAs and ICHRAs, are no longer required to determine, document, or disclose their creditable coverage status to Part D-eligible individuals. CMS concluded that the fundamental design of account-based arrangements -- which provide tax-free reimbursements for medical expenses and individual policy premiums rather than comprehensive prescription drug benefits -- makes actuarial comparisons to the Medicare standard drug benefit inapplicable."  MORE >>

"The trend is being observed most clearly among Michigan employers with workforces ranging from 50 to 500 employees ... What was once considered a niche or experimental approach has matured into a legitimate and well-supported strategy that mid-market HR teams are actively evaluating and, in many cases, implementing."  MORE >>

"Because an EBHRA is classified as an "excepted benefit," it is not subject to many of the requirements applicable to traditional group health plans or traditional group health plan HRAs, including the Affordable Care Act's (ACA) market reform requirements, HIPAA's portability provisions or mental health parity requirements. These features make EBHRAs an attractive supplemental benefit option for employers of all sizes."  MORE >>

"Employers offering or considering an ICHRA must understand how these arrangements interact with Medicare -- both to structure the benefit properly and to avoid exposing their organizations to compliance risk. This article provides a practical overview of how ICHRAs work alongside Medicare, the key regulatory requirements and the compliance pitfalls employers should watch for."  MORE >>

"Mercer projects the 2027 inflation-adjusted amounts for health savings accounts (HSAs), high-deductible health plans (HDHPs), and excepted-benefit health reimbursement arrangements (HRAs) will increase from 2026 levels."  MORE >>

"[T]here are a variety of creative options for employers who want to provide access to GLP-1 drugs prescribed for weight loss but who also want to contain costs. But, as with any benefits program, each employer must carefully consider the associated risks with these options and ensure they can be tailored to suit the employer's individual needs. These options include health reimbursement accounts and health flexible spending accounts."  MORE >>

Seventeen 2026 compliance guides cover common employee health and welfare benefits issues and strategies for employers, including COBRA, HSAs, domestic partner issues, HIPAA, ICHRA, and more.   MORE >>

"OBBBA ... introduced several changes affecting HSAs, including a permanent safe harbor for pre-deductible telehealth and remote care, the designation of [ACA] Exchange bronze and catastrophic plans as HSA-compatible, and clarification that qualifying Direct Primary Care Service Arrangements (DPCSAs) do not disqualify individuals from HSA eligibility."  MORE >>

"CMS explains in the proposal's preamble that account-based plans are designed to provide cost savings through pre-tax contributions and reimbursements, and often supplement other coverage, rather than actually offering prescription drug coverage. Thus, the benefit design of account-based plans makes concepts such as the disclosure of creditable coverage inapplicable and unduly burdensome[.]"  MORE >>