"The FAQs ... clarify the rules surrounding tax-free educational assistance benefits for student loan payments.... Qualified educational assistance benefits include payments for tuition, fees, books, supplies, and equipment.... [T]hey also include payments by an employer for an employee's principal or interest payments on qualified education loans ... Employees may exclude from their gross income up to $5,250 in qualified educational assistance benefits per year."  MORE >>

"Although many plan obligations are tied either to the calendar year or the plan year, there are two [ACA] items that arise annually during the summer months: the Patient-Centered Outcome Research Institute Fee (PCORI) and Medical Loss Ratio (MLR) rebates."  MORE >>

"[T]he Fifth Circuit affirmed a district court's ruling prohibiting the federal administrative agencies from enforcing preventive health mandates based on 'A' or 'B' recommendations from the US Preventive Services Task Force (USPSTF) against specific objecting employers and individuals. However, the Fifth Circuit reversed the district court's vacatur of all administrative agency actions to enforce the preventive health mandates and a nationwide injunction on the agencies' enforcement of these mandates." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024)]   MORE >>

"The U.S. Court of Appeals for the Fifth Circuit upheld a lower-court ruling that preventive-care mandates for ACA health plans are unconstitutional. But the appeals court said the ruling should apply only to the plaintiffs, who had objected on religious grounds to providing coverage of [certain] services ... However, the court also kicked a key question back to the lower court, and that could set the stage for application of a broader ruling." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024)]  MORE >>

"The Eleventh Circuit concluded that because the plaintiff no longer 'holds to desires' to be a firefighter because she voluntarily retired, she lost her right to sue for discrimination -- even though it concerned benefits she earned while employed. The Sixth, Seventh, and Ninth Circuits have reached the same conclusion as the Eleventh Circuit. The split in authority emanates from the Second and Third Circuits." [Stanley v. City of Sanford, Florida, No. 22-10002 (11th Cir. Oct. 11, 2023; cert. pet granted No. 23-997, Jun. 24, 2024)]  MORE >>

"IT resources are scarce, especially when you consider competing priorities within the health plan organization. Health Plans have limited dollars to invest -- and no shortage of ideas of things to do, with siloed business units up against similar challenges. Often these siloed solutions are preventing health plans from maximizing the value of their benefits administration and engagement tools."  MORE >>

"Pharmacy Benefit Managers (PBMs) are supposedly employed to reduce the costs of prescription drugs. However, a comprehensive investigation by the New York Times reveals that these managers frequently achieve the opposite effect. They have been found to direct patients toward more expensive medications, impose substantial markups on otherwise affordable drugs, and amass billions through concealed fees."  MORE >>