"To address the expiration of the telehealth safe harbor, plan sponsors should: [1] Amend plan documents to reflect the changes to cost-sharing requirements. [2] Draft and disburse summaries of material modification describing the changes. [3] Ensure claims administrators are aware of and properly implementing the new requirements. [4] Educate participants on the consequences of contributing to an HSA if the high deductible health plan inadvertently covers telehealth services prior to the deductible."  MORE >>

"The Notice of Proposed Rulemaking (NPRM) is intended to improve the industry's cybersecurity posture but may be administratively challenging and costly for some HIPAA-regulated entities to implement.... [While] a final rule may not be on the immediate horizon, HIPAA-regulated entities should consider whether to weigh in on the changes."  MORE >>

"The Proposed Rule would require health plans, health care clearinghouses, most health care providers, and business associates to strengthen cybersecurity protections for electronic protected health information (ePHI)."  MORE >>

"Now, employers can meet their Form 1095 distribution requirements by posting a notice of availability and then only distributing the forms upon request. ... Employers can now avoid the additional solicitations and use the date of birth when the individual's SSN/TIN is unavailable.... The new legislation increases [Letter 226-J] response times to 90 days. Further, the retroactive period for which the IRS can levy such penalties is now limited to six years."  MORE >>

"Telemedicine and HDHPs ... Legal challenges to regulations ... State pharmacy benefit manager (PBM) regulation ... Over the counter preventive care without a prescription ... Preventive care mandate ... Mental health parity ... Drug coupons ... HIPAA privacy and security ... Transparency ... Surprise billing adjustments ... Pharmacy benefit manager transparency."  MORE >>

"In the other 49 states, long-term disability benefit claims for physical ailments -- cancer, arthritis, stroke -- are assessed differently than mental health issues -- major depressive disorder, anxiety, PTSD and eating disorders. For 99% of group disability plans sold in the United States, long-term disability benefits for a behavioral health condition max out at 24 months, often leaving those with severe and persistent mental health symptoms in dire straits."  MORE >>

"After rising slowly and steadily since the turn of the century and hovering between 25 million and 27 million, the number of disabled among the U.S. population rose nearly 35 percent in the last four years, to an all-time high of 38,844,000 at the end of November ... Reasons behind the stunning increase vary, but many seem connected to the COVID-19 pandemic."  MORE >>

"GLP-1 drugs are adding to general healthcare inflation that is projected to increase employer-sponsored health insurance coverage by 9%, eclipsing $16,000 per employee in 2025. The spike in premiums, which is higher than the 6.4% increase employers faced in 2024 and in 2023, comes before any 'cost savings strategies' are implemented ... But a new report ... indicates Zepbound is poised to overtake other GLP-1 drugs."  MORE >>

"While many patients can shed up to 20% of their body weight using the injectables, the cost of the drugs and side effects like nausea and vomiting lead many to quit.... [W]ithin one year of withdrawal, the participants [in a 2022 study] regained two-thirds of their prior weight loss, with corresponding changes in risks for conditions like heart disease and Type 2 diabetes."  MORE >>

"Making drugs faster and cheaper with quantum computers could solve one of pharma's most vexing problems and simplify a process that now can take decades and cost billions."  MORE >>

"To answer this question, [the author] asked different AIs what the answer would be."  MORE >>

Rev. Jan. 2025. "Form 8868 includes the extension of time to file Form 5330, Return of Excise Taxes Related to Employee Benefit Plans. If approved, you may be granted an extension of up to 6 months after the normal due date for Form 5330." [Also available: IRS Form 8868, rev. Jan. 2025]  MORE >>