"The adjusted amount penalty for purposes of Section 4980H(a) of the Code is $2,900 (a $70 decrease from 2024). The adjusted amount penalty for purposes of Section 4980H(b) of the Code is $4,350 (a $110 decrease from 2024)."  MORE >>

"[T]he IRS uses Letter 226-J to inform ALEs of their potential liability under Code Section 4980H. A response form (Form 14764), generally due within 30 days, is included with Letter 226-J so that an ALE can inform the IRS whether it agrees with the proposed penalty. Employers and their advisors should be on the lookout for this letter so that they are prepared to promptly review and respond[.]"  MORE >>

"At the start of 2023, 14 states ... already had paid sick leave mandates in place.... Maine and Nevada require employers to provide paid leave for any reason. During the year, Minnesota and Illinois both passed paid leave laws, which take effect Jan. 1, 2024.... California expanded the amount of paid sick leave employers must provide workers from three days per year to five, effective Jan. 1, 2024."  MORE >>

"The new guidance does not change the underlying preventive services mandate applied to contraceptive coverage. Rather, the new FAQs outline a 'therapeutic equivalence' medical management technique that can be used by group health plans (along with an exceptions process) to administer required contraceptive coverage."  MORE >>

"New York expanded its existing efforts at monitoring and understanding prescription drug prices by enacting legislation addressing prescription drug price transparency. Effective June 19, 2024, S.599-A/A.1707 amends the New York Insurance Law to require prescription drug manufacturers to report certain price increases before they occur."  MORE >>

"This lawsuit is an example of the recent uptick in impending lawsuits regarding compliance with recent transparency rules, reinforcing the need for ERISA fiduciary governance.... Action steps include considering the formation of a health and welfare benefits committee to monitor ERISA benefits, including the selection of service providers, reviewing contract terms, ensuring appropriate value for the price, and monitoring service providers and aggregate costs." [Lewandowski v. Johnson & Johnson, No. 23-0671 (D.N.J. complaint filed Feb. 5, 2024)]  MORE >>

"In its ruling, the court acknowledged that prior case law established that criminal theft by an employee indisputably qualified as gross misconduct. However, in this case, the former employees denied committing any theft, and the city offered no admissible evidence proving that the theft had occurred. The court remained 'unconvinced' that the city's allegations against the employees rose to the level of gross misconduct as a matter of law." [Johnson v. City of Kewanee, No. 21-4051 (C.D. Ill. Nov. 21, 2023)]  MORE >>

"Financial well-being and family-forming support, such as parental leave, are paramount when considering wellbeing benefits for millennials.... Studies have shown that Gen Z employees tend to be financially practical and view physical fitness, nutrition and mental health support as imperative. Gen Z has high expectations of their employers and is willing to leave if their needs are unmet."  MORE >>

"[E]mployers saved an average of $462 in annual medical claims costs per engaged member. This translates to a total direct savings of $39.8 million -- a 4% reduction in claims costs -- across the study group of approximately 40,000 lives from five employers over five years."  MORE >>

"Long-term care insurance can help provide a valuable financial safety net and invaluable peace of mind for your team members. Clear communication and employee education are vital in helping employees know how long-term care insurance can best benefit them. It's also best to introduce LTC insurance off-cycle (not during open enrollment) to ensure it doesn't get lost among other offerings -- this usually results in higher participation."  MORE >>

"The intent of this brief is to share trends on the financial health of markets and issuers over time, how issuer participation, market size, and plan offerings have evolved, the driver of revenue changes due to these external forces, and what those trends could mean for future years."  MORE >>

"Hospitals and insurance carriers, in a dance of complicity and undue complexity, have set a stage where costs are obscured, care is commodified, and the middle class pays the price.... [Reference-based pricing (RBP)] not only introduces a much-needed dose of transparency into healthcare billing but also ensures that payments reflect the actual value of services rendered rather than the whims of a profit-driven market.... RBP encourages patients and providers to engage in more meaningful conversations about the cost and value of healthcare services."  MORE >>

"Two current ERISA hot topics ... are the proposed Retirement Security Rule (the fiduciary rule) and the Prudence and Loyalty in Selecting Plan Investments and Exercising Shareholder Rights rule (ESG rule). If the Court abandons or curtails the Chevron deference, ERISA regulations adopted by the [DOL] may be more heavily scrutinized, modified, or vacated by federal courts."  MORE >>