10 pages; rev Dec. 2024. "An eligible employer (defined later) uses Form 8994 to figure the employer credit for paid family and medical leave. The credit ranges from 12.5% to 25% of certain wages paid to a qualifying employee while the employee is on family and medical leave."  MORE >>

"The drugs will have a lowered Part B coinsurance rate from January 1, 2025 - March 31, 2025, since drug companies raised prices for each of these 64 drugs faster than the rate of inflation." [Also available: Fact Sheet on the 64 Part B drugs with a coinsurance reduction for the quarter January 1, 2025 - March 31, 2025]  MORE >>

"None of the changes significantly alter existing employer reporting requirements, but the changes will provide employers with a little relief. The changes ... are effective for the current 2024 reporting year (for returns due early in 2025).... [1] Flexibility in reporting TINs/SSNs for covered individuals of a self-funded plan ... [2] Section 4980H enforcement timelines adjusted/established ... [3] Easier distribution of form 1095s."  MORE >>

"HSA and FSA limits increase in 2025 ... Relief for areas impacted by hurricanes ... Expected extension for first-dollar telehealth cost-sharing relief ... IRS guidance on expanded male reproductive coverage ... New indexed PCORI fees issued ... Understanding nondiscrimination testing ... Updated 2025 San Francisco healthcare expenditure rates."  MORE >>

"The ACA requires that employers who issue at least 250 W-2s reflect the applicable premium for health coverage on Box 12 of Form W-2. Reporting health care costs is optional for employers issuing fewer than 250 W-2s.... Employers offering health coverage must include the fair market value cost of the coverage provided for domestic partners and other non-dependents as imputed income to an employee[.]"  MORE >>

"[This article explores] the most egregious error the IRS continually makes when assessing ESRP penalties. The egregious error involves penalizing employers for employees who are clearly not even eligible for a premium tax credit based on the amount the employer inserted on line 15 of the Form 1095-C. Fortunately, a simple computer program can exponentially improve the accuracy of the IRS ESRP process."  MORE >>

"The relevant data evaluation requirement has proven especially challenging for self-funded group health plans of every size, as third-party administrators fail, refuse, or are otherwise unable to provide the information necessary to comply.... Some large carriers have shared the NQTL analysis that they previously prepared for their fully insured groups with the self-funded group to whom they provide administrative services. Presumably, this will give their self-funded groups a starting point."  MORE >>

"The FAQ which is geared more toward employee use, added a section to clarify the difference between accrual, carryover, and use.... The FAQ now clarifies the difference between employees who are fully exempt from paid sick leave requirements and employees who are partially exempt."  MORE >>

"Since subjective symptom complaints comprise an important component of many disability benefit claims and are typically the main concern in claims based on behavioral health, the guidance offered by the court in Macalou is of great value both to the courts and to the parties. The checklist of points enumerated by the court on how to evaluate disability claims where the medical evidence is in conflict and the guidance on the weight to be given to the competing opinions will undoubtedly help decide future cases." [Macalou v. First Unum Life Ins. Co., No. 22-10439 (S.D. N.Y., Nov. 22, 2024)]  MORE >>

"AI’s ability to process vast amounts of data quickly and accurately can be very beneficial for group health plan administration. However, while there are clear benefits of using AI, there are also risks, including litigation risk. Several lawsuits have recently been filed against large insurers that use AI for claims administration, arguing that its use leads to an increase in claim denials."  MORE >>

"[1] Health plans are overdue for redesigns ... [2] AI has a steep learning curve ... [3] Mental health isn't leaving the benefits conversation ... [4] RTO policies aren't set in stone."  MORE >>

"In 2023, 46 percent of employers provided health benefits to their employees, down from 56.4 percent in 2008.... HDHPs have gained popularity, with a noticeable increase in the percentage of enrollees in a single plan from 24.6 percent in 2010 to 54.6 percent in 2023 ... and with the percentage of those in a family plan increasing from 23.7 percent in 2010 to 56 percent in 2023[.]"  MORE >>

"The letter requests a ruling on the impact of amending a pension plan document to expand employee eligibility for benefits under the plan's section 401(h) retiree medical accounts to include ... certain employees eligible to commence retirement benefits under the plan upon attainment of age 59½.... [IRS concludes] that the payment of medical benefits from the Pension Plan's 401(h) Accounts for Pension Plan participants who are eligible to take pension distributions in accordance with section 401(a)(36) does not violate section 401(h) or Section 1.401-14 or otherwise cause the Pension Plan to lose its tax-qualified status under section 401(a)."  MORE >>

"The standard mileage rate for transportation or travel expenses for 2025 is 70 cents per mile for all miles of business use (business standard mileage rate) ... The standard mileage rate is 14 cents per mile for use of an automobile in rendering gratuitous services to a charitable organization under Section 170.... The standard mileage rate for 2025 is unchanged from 2024 at 21 cents per mile for use of an automobile: [1] for medical care described in Section 213; or [2] as part of a move for which the expenses are deductible under Section 217(g)."  MORE >>

An explanatory list of common acronyms primarily used in discussions of Health Care Reform or 401(k) Plans.  MORE >>