"In the wake of a federally declared disaster, employees may face issues with their benefit plans.... The [DOL] has guidance to assist health plan fiduciaries in preventing the loss of coverage following a disaster. The [IRS] may waive certain filing and payment deadlines for taxpayers affected by disasters. Employers may assist employees in helping coworkers during disasters through leave donation programs."  MORE >>

"The safe harbor list in Notice 2004-23 only included mammograms and no other types of breast cancer screenings. So, Notice 2024-75 adds other types of breast cancer screenings to that list.... Notice 2024-71 provides a safe harbor under Code section 213(d) for amounts paid for condoms."  MORE >>

"The new law requires that California health and disability insurers using artificial intelligence (AI), algorithms ... may not supplant healthcare provider decision making for those functions.... [T]he new law mandates that all ultimate medical necessity determinations under their plans must be made by a licensed physician or other licensed healthcare professional competent to evaluate the specific clinical issues involved in the healthcare services requested by the provider."  MORE >>

"OPM's requirement that FEHB plans expand their coverage of infertility services was one of the major benefit updates in 2024. This included all methods of artificial insemination and the fertility drugs associated with IVF, for up to three cycles annually.... Federal employees will have even more options for plans offering IVF coverage, including another national PPO plan."  MORE >>

"We analyzed public IDR data from 2023 for the most common disputed professional service: evaluation and management of a moderate to severe emergency medicine visit. Providers won 86% of cases, with mean decisions 2.7 times the QPA. Private equity-backed providers won more often and higher monetary awards than other providers. The mean QPA was 2.4 times Medicare payments."  MORE >>

"[E]mployers are adopting various strategies to ensure the affordability of their healthcare programs for both their companies and employees. They are concentrating on more competitive and cost-effective plan designs to manage expenses while also prioritizing employee wellbeing."  MORE >>

"A combined approach to managing a HCFSA and DCFSA can help the accounts work together to provide comprehensive financial support for employees managing both healthcare and dependent care expenses. By allowing pre-tax contributions, these accounts help reduce taxable income, thereby increasing take-home pay."  MORE >>