"[T]he Section 1411 certifications that Marketplaces should be generating are theoretically mandatory.... [T]he Marketplace must notify employers 'within a reasonable timeframe' when a determination is made that one of their employees is eligible for subsidized coverage.... [E]mployers that do receive certifications are permitted to appeal a subsidy determination.... Given how infrequently these Section 1411 certifications are currently issued, employers receiving them may need to be made aware and prepared."  MORE >>

17 pages. "[1] Common features of qualified transportation plans ... [2] Monthly limits ... [3] Taxation ... [4] Special rules ... [5] Documentation, reporting and disclosure ... [6] Penalties ... [7] State and local laws."  MORE >>

"Only time worked in Minnesota will require accrual of sick and safe time. ESST hours accrue only during hours worked. ... Employees need not specifically ask to use 'sick and safe time' to use it. Employees may use accrued ESST in 'the smallest increment of time tracked by the employer's payroll system or four hours, whichever is smaller.' ESST may be used 'at the same time as other protected leave under other state or federal laws.' "  MORE >>

67 pages. "Of the 65 million Medicare beneficiaries in 2022 who were eligible for Part D, 49.8 million (about 77%) were enrolled in a Part D plan and another 1.3 million (about 2%) had prescription drug coverage through a former employer that received a Part D subsidy for a portion of the coverage.... The 2022 IRA phases in a number of significant Part D changes from 2023 to 2025, including an annual out-of-pocket cap on Part D enrollee cost sharing, enhanced low-income subsidies, a $35 monthly cap on insulin cost sharing, and an annual limit on premium increases from 2024 to 2029." [R40611 updated Nov. 14, 2023]  MORE >>

"When offered the opportunity, nearly 60% of eligible employees enrolled in the HSA-qualifying health option. Of those that enrolled, 80.1% made contributions to their account ... More than one-third of employers also reported that less than 25% of employees spent their entire HSA balance in 2022 ... Fewer than 20% of participants invested assets when given the option, and nearly 70% of all HSA assets remain in cash."  MORE >>

"[This paper summarizes] a series of issue briefs [which] explore how employers are using health plan benefit design innovations to advance health equity -- the challenges they face and the ways they overcome these challenges."   MORE >>

"The Biden administration's first major step toward imposing limits on the pharmacy benefit managers who act as the drug industry's price negotiators is backfiring, pharmacists say. Instead, it's adding to the woes of the independent drugstores it was partly designed to help. The so-called PBMs have long clawed back a fee from pharmacies weeks or months after they dispense a drug.... The clawbacks have ballooned from about $9 million in 2010 to $12.6 billion in 2021[.]"  MORE >>

22 pages. "In 2022, average cost of a biological product, $174 per prescription, was 3.7 times greater than average cost of a small molecule drug, $48 per prescription. Among the 1,838 small molecule drugs in 2022, 43 percent (796 drugs) had only one manufacturer ... Between 2017 and 2022, for small molecule drugs, the proportion of drugs with 6+ manufacturers rose while those with a single manufacturer declined over time."  MORE >>

"Both FSAs and HSAs allow you to put aside money for healthcare expenses in a tax-advantaged way. But they also have a few major differences, including who qualifies, how much you can contribute each year, and how long you can wait to spend the money on qualifying medical expenses."  MORE >>

"[A comment letter from the Brookings Institution] expresses concern over the depth of the analysis that is required for each NQTL [and] provides a useful schematic that fleshes out the particulars. The schematic makes the point that a substantial amount of effort is involved in demonstrating compliance for a single NQTL.... [and] all steps must be repeated for each additional NQTL."  MORE >>