Jul. 12, 2024. "Instructions for Recipient: You are receiving this Form 1095-C because your employer is an Applicable Large Employer subject to the employer shared responsibility provisions in the [ACA]. This Form 1095-C includes information about the health insurance coverage offered to you by your employer.." [Also available: Draft of 2024 Form 1094-C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns]  MORE >>

Jul. 12, 2024. "Instructions for Recipient: This Form 1095-B provides information about the individuals in your tax family (yourself, spouse, and dependents) who had certain health coverage (referred to as 'minimum essential coverage') for some or all months during the year. " [Also available: Draft of 2024 IRS Form 1094-B: Transmittal of Health Coverage Information Returns]  MORE >>

"New York State amended its Labor Law to require employers to provide nursing employees with 30-minutes of paid break time to express breast milk at work, enhancing a law that previously permitted reasonable, unpaid break time. This new paid time must be provided each time an employee has a reasonable need to express breast milk and can be extended through existing paid breaks or mealtimes if the employee needs more than 30 minutes to express breast milk."  MORE >>

"The defendant utilized proprietary guidelines ... to adjudicate claims involving both mental health treatment as well as for medical and surgical treatment. The plaintiffs requested that the plan provide copies of both sets of guidelines, but their request was ignored.... Although the court determined that the benefit denial was warranted, the court nonetheless deemed the penalty appropriate for non-compliance with required disclosures." [W.H. v. Allegiance Ben. Plan Mgmt., No. 22-0166 (D. Mont., June 4, 2024)]  MORE >>

"[T]he FTC's interim report makes clear that the FTC has authority to file suit against PBMs for unfair, deceptive or anticompetitive practices. Therefore, as PBMs have been accused by the FTC of structuring agreements with drug manufacturers that are based on profits to the PBMs, rather than what is in the best interests of consumers, complaints by the FTC against such PBMs are all but a certainty."  MORE >>

"[1] Value-based care models: Cut healthcare costs and improve employee wellbeing ... [2] Whole person care: Treating people not conditions ... [3] Employee mental health benefits: Strategies to reduce burnout and stigma ... [4] Financial stress: How financial wellness programs boost ROI."  MORE >>

"The CMS’ first audit of an insurer for compliance with a law preventing surprise bills for consumers found some evidence to support provider allegations that insurers are gaming the system to lower or delay payments for out-of-network medical services."  MORE >>