"The IRA has made it more likely that plans (particularly HDHPs) will not be creditable coverage in 2025 and future years. Where a plan option loses its creditable status, employees will need to weigh their options and consider whether enrollment in Part D is appropriate. For those not already enrolled in Medicare Part A, it will take weeks to get access to the Medicare card and ID number needed to enroll in Part D, which could jeopardize their ability to enroll during the Part D open enrollment period."  MORE >>

"In 2023, legislatures in five 'Southeastern Conference' states passed statutes creating options for employers to voluntarily provide paid family and medical leave (PFML) through insurance benefits purchased from the private insurance market. Two of those laws took effect on January 1, 2024, and the other three laws are now about a year old. This article discusses the numerous similarities and some differences among the laws of these five states."  MORE >>

"This amendment not only expands the reach of the state's existing paid family leave law but also establishes a benchmark that could potentially motivate other states to implement similar measures. It fills a gap in the current law by identifying prenatal care before the child's birth as a distinct qualifying event for leave."  MORE >>

"The settlement prohibits Unum from denying benefits claims under an ERISA-governed group life insurance policy solely because of a lack of evidence of insurability when a plan participant has paid premiums for 90 days or more.... [T]he company must [also] take steps to make ... their delayed effective date of coverage for dependents more transparent to participants and policyholders.... Unum ... will voluntarily re-process claim denials based on lack of evidence of insurability from Jan. 1, 2018, to the present and claim denials based on the delayed effective date provision from July 1, 2016, to the present."  MORE >>

"Minnesota Attorney General Keith Ellison is leading a bipartisan group of 32 attorneys general asking the U.S. Supreme Court to review a case that could otherwise limit state regulation of pharmacy benefit managers (PBMs).... Minnesota, Oklahoma and other states say PBM practices, in some cases, have enriched insurance companies, hurt independent pharmacies and made it harder for patients to afford and access their medicines." [PCMA v. Mulready, No. 22-6074 (10th Cir. Aug. 15, 2023; cert pet. filed May 10, 2024, No. 23-1213)]  MORE >>

"Nearly two dozen states ... filed an amicus brief [asking] a federal appeals court ... to reverse its decision holding states liable for denying transgender people with gender-change treatments. Twenty-three attorneys general urged the court to reconsider its decision that allows health insurance providers to be held liable under Title VII of the Civil Rights Act of 1964, which prohibits discrimination based on sex." [Lange v. Houston County, Georgia., No. 22-13626 (11th Cir. May 13, 2024)]  MORE >>

"Inflated health and pharma costs and an erratic medical industry leave plan sponsors with nowhere to hide.... [1] Specialty drug costs ... [2] General healthcare inflation ... [3] [Provider] contract negotiations ... [4] Doctor and nursing shortage."  MORE >>

"Success comes through creating a communications strategy that meets employees where they are and helps guide and support them through their benefits experience, from enrollment to care selections, to keep them engaged when it matters most. When evaluated through this lens, it's likely that most employers can find opportunities to improve their employee benefits communications."  MORE >>

"In late April, the state's new Office of Health Care Affordability set a five-year target for spending growth that starts at 3.5 percent for 2025 and drops to 3 percent by 2029. The goal of the embryonic agency is to make care more affordable and accessible while improving health outcomes and reducing inequity. To do so, California's affordability office must confront high prices, unnecessary medical treatments, overuse of high-cost care like emergency rooms, and administrative waste."  MORE >>

"1557 represents the nation's most ambitious effort to frame health care in a civil rights context.... Consistent with the watershed nature of 1557, the Biden Administration's final rule takes the biggest swing yet at health care and civil rights.... The rule's specific applications encompass the multiple dimensions of the modern health care enterprise.... The rule depends on voluntary compliance efforts and private enforcement; direct government enforcement likely will be limited.... Litigation will continue."  MORE >>