"The HSA telehealth relief will be extended for another two years. ACA reporting has become easier by removing the need to distribute the Forms 1095-C to full-time employees except upon request. ACA employer mandate penalty assessments are now subject to an extended 90-day review period and a six-year statute of limitations."  MORE >>

"Over the past year, ... [because of] the increased cost of living due to inflation ... the benefits elected by highly compensated participants (HCPs) have remained steady or increased, while those chosen by non-highly compensated participants (NHCPs) have decreased.... [N]ow is the time to test your cafeteria plan and make the necessary adjustments through payroll by year-end if the plan fails this nondiscrimination test. After year-end, it is too late to make any plan corrections[.]"  MORE >>

"While the changes to the 2021 guidance were few, they clarify that the DOL's guidance applies not only to ERISA-governed retirement plans but also to ERISA-governed health and welfare plans. The updated guidance also offers new advice about analyzing health and welfare vendor cybersecurity practices, vendor insurance coverage, multi-factor authentication, and the importance of swift participant breach notification."  MORE >>

"The Michigan Supreme Court ruled that the legislature's 'adopt-and-amend' approach in enacting and subsequently amending voter-initiated proposals within the same legislative session was unconstitutional.... The original versions of the Wage Act and Earned Sick Time Act will go into effect 205 days after the Supreme Court's opinion issued on July 31, 2024. This means that the laws will be effective on February 21, 2025." [Mothering Justice v. Attorney General, No. 165325 (Mich. Jul. 31, 2024)]  MORE >>

"Absent a court order vacating the rule or enjoining OCR from enforcing it, OCR must modify or repeal the rule through administrative rulemaking in compliance with the APA. Therefore, regulated entities should be prepared to comply with the rule, despite the ongoing Texas lawsuit and transition between Administrations."  MORE >>

"[T]he appeals court stated that the 'operative time for determining whether a particular condition qualifies as a serious health condition is the time that leave is requested or taken.' With some exceptions that are not relevant to this case, 'A patient does not have a 'serious health condition'… if he waits to see a healthcare provider until after the relevant absences.' " [Rodriquez v. SEPTA, No. 23-3074 (3d Cir. Oct. 11, 2024)]  MORE >>

"The notice was intended to protect consumers from mistakenly believing a fixed indemnity policy was comprehensive health insurance.... [A] Texas court [has] invalidated the notice requirement.... [T]he court found that the notice requirement exceeded the statutory authority of the agencies and did not see the notice as logically following from the notice requirement identified in the proposed rules." [Manhattan Life Ins. Co. v. HHS, No. 24-0178 (E.D. Tex. Dec. 4, 2024)]  MORE >>

"With annual open enrollment periods recently closed for many organizations, now is an ideal time to gain feedback and insights into how your employees felt about their overall enrollment experience and the benefits being offered to them for 2025. By conducting employee surveys, organizations can gain valuable data on how their organization feels about the overall benefits plan offerings and provide a reasonable business case for any potential future changes based on survey findings."  MORE >>

"Biosimilars are lower-cost options for FDA-approved brand name drugs that reduce the price per prescription , on average, by more than 40%. This article will provide you with a deeper understanding of the current biosimilar market, what’s ahead, and the actions you can take now to reduce your pharmacy costs."  MORE >>

"Employers and their providers must attest to the government that their plans are not subject to any gag clauses ... [C]onfirm elections before the end of the plan year  ... Don't forget to nondiscrimination test any applicable plans.... [W]ork with vendors to collect information needed for ACA reporting ... Make sure elections have been properly fed into the payroll system.... [E]mployers offering telehealth pre-deductible (whether under the plan or as part of a separate policy) will need to end that practice in the new year.... [E]mployers with self-funded plans should consider preparing now, and early in the new year, to complete their non-quantitative treatment analysis[.]"  MORE >>

"[In] 2023, health care spending in the United States reached $4.9 trillion and increased 7.5% ... The health sector's share of the economy in 2023 was 17.6%, which was similar to its share of 17.4% in 2022, but lower than in 2020 and 2021 during the height of the COVID-19 pandemic."  MORE >>

"Unfunded retirement health care obligations for public employees now exceed unfunded pension liabilities, representing a larger share of the long-term fiscal debt held by U.S. states and municipalities. In 2022, the most recent year available with full data, net OPEB liabilities for the largest governments reached $789 billion, surpassing $753 billion in unfunded pension liabilities. This marks a critical shift in the debt composition of American states and local governments"  MORE >>

"What's New ... The social security tax rate is 6.2% each for the employee and employer. The social security wage base limit is $176,100. The Medicare tax rate is 1.45% each for the employee and employer, unchanged from 2024. There is no wage base limit for Medicare tax.... Reminders ... Form W-4P, Withholding Certificate for Periodic Pension or Annuity Payments, was redesigned for 2022.... Electronic submission of Forms W-4 and W-4P.... Electronic submission of Forms W-4R ... Sick Pay Reporting."  MORE >>

"[Health plans] must attest annually that their contracts do not contain a gag clause.... The deadline to submit the gag clause attestation [to CMS] is December 31, 2024.... By December 23, 2024, group health plans must revise their HIPAA privacy policies ... Starting January 1, 2025, LTPT employees who work at least 500 hours, but less than 1,000 hours, in two consecutive plan years must be eligible to make salary deferrals to a 401(k) Plan.... New 401(k) (and 403(b)) plans established on or after December 29, 2022, must satisfy automatic enrollment and deduction requirements for plan years beginning after December 31, 2024."  MORE >>