"The 2024 cost-of-living adjustments (and the changes from 2023) for these plans, from Rev. Proc. 2023-23 and Rev. Proc. 2023-34 are summarized in [a] table."  MORE >>

"The Proposed Rule previews potential substantive and technical changes to MA and Part D including coverage for expanded access to behavioral health provider types, changes to the risk adjustment data validation (RADV) appeals process, ... and stricter controls around agent and broker compensation. The Proposed Rule continues this Administration's focus on health equity[.]"  MORE >>

"[T]he Ordinance provides that unless 'obligated' by a city, state, or federal law, employees may 'choose' whether to use Paid Leave or Paid Sick Leave prior to using any other leave the employer provides ... which raises significant questions about an employee's ability to use paid time off under the Ordinance to extend the time period for other paid or unpaid absences available to them under applicable laws."  MORE >>

"The leading driver of medical costs, according to insurers, continues to be overuse of care (59%) due to medical professionals recommending too many services or overprescribing. Nearly half of insurers (49%) also indicate that insured members' poor health habits are among the top factors. The underuse or lack of preventive services (47%) is also a significant cost driver."  MORE >>

"Treating members with digestive health conditions can reduce overall population healthcare costs for employers.... One in four employees live with chronic, debilitating digestive issues ... Digestive issues drive significant costs, year over year  ... Traditional healthcare is complex for patients and employers ... Virtual digestive care gives employees convenience, confidentiality, and hope ... Stress, anxiety, and GI symptoms have a cyclical relationship; gut-brain interventions can help."  MORE >>

"In 2021, [HHS] proposed changes to the [HIPAA] Privacy Rule  ... that would significantly alter the current regulations. The Proposed Rules are supposed to be finalized in 2023.... The proposed changes to the Privacy Rule that should most concern group health plan sponsors fall into two general categories: [1] changes that increase the right of individuals to access their PHI, and [2] changes that allow covered entities and business associates to share PHI more easily while safeguarding against a breach."  MORE >>

"U.S. health insurer Cigna is in talks to merge with peer Humana  ... a deal that could exceed $60 billion in value and would be certain to attract fierce antitrust scrutiny.... Cigna and Humana, which have market values of $77 billion and $59 billion, respectively, currently have limited business overlap, concentrated in Medicare plans for older Americans. Humana's Medicare business is much bigger and more profitable than Cigna's."  MORE >>

"The final rule affirms the requirement that contractors annualize contributions to fringe benefit plans and also provides a safe harbor for defined contribution pension plans (DCPPs) from the annualization requirement without the need to request and have the exception approved by the DOL's Wage and Hour Division (WHD). The final rule also details specific examples of circumstances under which a contractor may take credit for costs directly related to the administration of a fringe benefit plan.... The final rule updating the DBRA took effect on October 23, 2023."  MORE >>

"The Supreme Court appears open to reversing federal agencies' longstanding capacity to adjudicate and enforce certain federal laws, potentially dealing the latest in a series of blows to the executive branch's administrative powers. The conservative majority on the court consistently expressed skepticism toward the Biden administration's argument that existing precedent protected agencies as they adjudicated laws written by Congress, instead suggesting individuals and private entities had a right to defend themselves from civil penalties before a jury." [SEC v. Jarkesy, No. 22-859 (S.Ct. oral argument transcript and audio Nov. 29, 2023)]  MORE >>

"To help you assess your organization's readiness to adjust its employee benefit program to better serve your people, Segal has developed a short self-assessment that you can complete in a couple of minutes. You'll receive immediate recommendations on preliminary areas you can explore to begin improving the appeal of your benefits to individuals."  MORE >>