"[E]mployers and plan sponsors with ACA reporting responsibilities should consider taking the following steps: [1] Draft and post your notice of availability of Form 1095-C (or Forms 1095-B, where applicable).... [2] Establish a process for timely responding to requests to obtain a copy of the form and, if you want to be able to provide the form electronically, draft a valid consent form.... [2] Continue to prepare and file Forms 1095-C and 1095-B with the IRS.... [as] you still have an obligation to file these statements with the IRS ... [3] If you sponsor a self-insured plan and anticipate that you may have covered individuals who do not have a SNN or TIN, adopt procedures to obtain full names and dates of birth."  MORE >>

"The year-over-year inflation increase for 2025 is 2.598%.... [T]he adjustment reflects the percent change in the October CPI-U from 2023 to 2024. The following chart shows the 2025 and 2024 maximum (and in some cases, minimum) penalties for certain health and welfare plan violations assessed after Jan. 15."  MORE >>

"Michigan's Earned Sick Time Act (ESTA) will become effective on February 21, 2025. Last minute bills have been introduced by both the House and Senate, designed to address serious issues ESTA presents to Michigan employers."  MORE >>

"The Supreme Court on [January 10] agreed to review a challenge to the [ACA's] requirement that insurers cover certain recommended preventive services at no cost.... The case takes up whether the coverage requirement, based on the recommendations of the U.S. Preventive Services Task Force, is invalid because the panel lacked authority since its members weren't Senate-confirmed." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024; cert. pet. granted Jan. 10, 2025)]  MORE >>

"New ERISA rulings hold that health plans breach their duties by sending denial letters that lack specific references to medical records, detailed explanations and particularized evaluations of the member's needs and by ignoring materials sent by providers during claims appeals By evaluating and addressing potential deficiencies now, health plans may be able to buttress their defenses to bad faith actions"  MORE >>

"[1] Make it easier for employees to address the links between health, savings and financial stress.... [2] Leverage health care claims data analytics to help drive strategic, cost-conscious benefits decisions.... [3] Promote voluntary and supplemental benefits to help minimize potential costs.... [4] Guide employees to their next best care decisions.... [5] Support and engage employees with their benefits during the 'great stay.' "  MORE >>

"The clinical superiority of Zepbound, alongside expanding indications for both drugs, has the potential to drive increased consumer demand, intensify competition for rebates, and prompt changes to existing coverage. These shifts could significantly impact health plans and pharmacy benefits, influencing both pricing and availability for both Zepbound and Wegovy. It's crucial for employers to understand these changes and assess their effects on the overall benefits strategy and employee experience."  MORE >>

"Medicare Advantage benchmark payments are poised to increase by 2.23%, [CMS proposed] ... The rate hike represents a significant increase year-over-year from the federal government to MA health plans, compared to the previous year's 0.16% dip. Payments from the federal government to MA plans will increase by $21 billion, or 4.33% on average."  MORE >>

"[I]ndividuals and businesses in parts of California affected by wildfires and straight-line winds that began on Jan. 7, 2025 ... now have until Oct. 15, 2025, to file various federal individual and business tax returns and make tax payments. ... [I]ndividuals and households that reside or have a business in Los Angeles County, qualify for tax relief."  MORE >>

"[A] table reflects the DOL's 2025 annual inflation adjustments to the civil money penalties for violations of certain requirements under ERISA, effective January 15, 2025.... [A second] table reflects the DOL's 2025 annual inflation adjustments to the civil money penalties for violations of certain requirements under WHD enforcement authority, effective January 15, 2025."  MORE >>