"Notices 2024-71 and 2024-75 ... mark significant changes in how preventive care is defined and covered under High Deductible Health Plans (HDHPs) and other health benefit accounts under Section 223 of the Internal Revenue Code.... For employers and HR managers, these updates necessitate a review and potential adjustment of current benefits offerings."  MORE >>

"Although most provisions apply only to internal PBM operations and their interactions with pharmacies, there is impact on employer-sponsored prescription drug benefits, including: [1] A minimum pharmacy reimbursement mandate ... [2] A plan cannot require or incentivize a participant to use mail order delivery of prescription drugs.... [3] Pharmacy networks must include an adequate number of non-mail order pharmacies within 30 miles from each participant's residence ... [4] PBMs and insurers are required to submit annual reporting[.]"  MORE >>

"The amendment includes a new subsection that, beginning on Nov. 21, 2024, requires employers to allow employees to use accrued time to: address the employee's own physical and mental health needs, and those of their spouse, if the employee or the employee's spouse experiences pregnancy loss or a failed assisted reproduction, adoption or surrogacy."  MORE >>

"Health-care premiums in workplace benefits plans are expected to rise 7% to 8%, on average, for 2025. Many workers will pay more next year for health insurance and other benefits given inflation, wider adoption of GLP-1 drugs and an increase in catastrophic medical claims. The rate increases make it important for employees to closely review insurance plans during open enrollment and consider high deductible options as one way to potentially lower costs."  MORE >>

"[H]igher use of biosimilars since 2018 in the ESI population is associated with lowered total spending in the same period. Among the six product classes ... studied, total spending on the administered drugs decreased by 28% from 2018 to 2022. The reduction in spending corresponds to more than $3B in savings in 2022.... [T]he decrease in spending appears to be driven primarily by substitution of lower-priced biosimilars for higher-priced biologics."  MORE >>

"Although this research shows that inertia plays a role for employees in making benefits changes, it also found that nearly half of eligible employed Americans spend less than 20 minutes reviewing information related to their workplace benefits during open enrollment period. The good news is that nearly 80% of employees 'strongly agree' or 'agree' they will spend more time reviewing their employee benefits options and coverage this year than they did during the last enrollment period."  MORE >>

"The settlement involved a South Dakota-based provider of plastic surgery services (and HIPAA covered entity (CE)). The provider must pay $500,000 to HHS and comply with a two-year corrective action plan (CAP) that HHS will monitor. On the same day, HHS also announced a $90,000 HIPAA settlement with an Oklahoma-based emergency services provider (and HIPAA CE). Both settlements stemmed from ransomware attacks that encrypted the protected health information (PHI) of thousands of individuals."  MORE >>

"[T]he 225th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as the ERISA Advisory Council) will be held on December 12-13, 2024.... at the U.S. [DOL].... [in] Washington, DC ... The meeting will also be accessible via videoconference ... The purpose of the open meeting is for Advisory Council members to finalize their observations and recommendations on the issues they studied in 2024, present their observations and recommendations to the [DOL], and receive an update from leadership of the Employee Benefits Security Administration (EBSA)."  MORE >>

"In Rev. Proc. 2018-58, the IRS stated that '[t]axpayers who are unable on a timely basis to obtain information necessary for completing the forms from a bank, insurance company, or any other service provider because such service provider's operations are located in a covered disaster area will be treated as 'affected taxpayers.' ' "  MORE >>