"In the ACA Section 1557 space, for example, the order likely means the end of certain Biden administration interpretive and regulatory policies ... [If] recent history and the new executive order are a guide, the [May 2024 final regulations that implemented Section 1557] will likely be replaced with a version that is significantly more limited in scope[.]"  MORE >>

"[S]some states have adopted so-called individual mandates requiring individuals to purchase health insurance or pay a penalty. To support these mandates, states have implemented health coverage reporting requirements ... [which] dictate that employers and/or carriers report the health coverage offered to individuals in those states. [This article provides] a summary of some of these requirements."  MORE >>

"[HHS] updated guidelines, effective Jan. 15, 2025, set the 2025 federal poverty level (FPL) at $15,650 (up from $15,060 in 2024) for a person working in the mainland US, but $19,550 (up from $18,810 in 2024) for a person working in Alaska, and $17,990 (up from $17,310 in 2024) for a person working in Hawaii.... The updated FPL figures will apply for 2026 calendar-year plans and noncalendar-year plans beginning in 2025.... 2025 calendar-year plan sponsors must use the 2024 FPL amounts."  MORE >>

"If finalized in its current form, the Proposed Rule would require covered entities — health plans, health care clearinghouses and health care providers who transmit information electronically in connection with a transaction for which HHS has adopted a standard — to take significantly more responsibility in establishing and maintaining robust defenses against security risks."  MORE >>

"[T]he list of preventive services that most plans need to cover at $0.00 cost to participants under the ACA is more narrow than the list of care that QHDHPs may cover pre-deductible at no/reduced participant cost without risking participants' ability to contribute to an HSA.... Beyond what is required to be covered as preventive services under the ACA, the plan has flexibility to cover additional preventive care with no cost/reduced cost, but is not required to do so."  MORE >>

"To be HSA-eligible, individuals must a) be enrolled in a HDHP, b) have no disqualifying coverage, c) not be enrolled Medicare, and d) not be able to be claimed as a dependent on someone else's current year tax return."  MORE >>

"Under IRS Section 125 current regulations, a cafeteria plan may be drafted to permit a participant to change elections midyear on account of a change in status.... The change in residence event allows for a change in the place of residence of an employee, spouse or dependent where the change affects their eligibility for coverage. Typically, an employee moving three blocks away will not trigger a change in status."  MORE >>

"Employees that elect to enroll in a commuter benefit program can save FICA, federal income taxes, and, in some places, state income taxes on qualified expenses.... A growing number of cities and regional areas (including the state of New Jersey) have passed laws or ordinances requiring certain employers to provide an avenue for employees to receive pre-tax commuter benefits."  MORE >>

"[O]ne possibility is that the Supreme Court will conclude that the USPSTF members are officers of the United States, were not properly appointed, and therefore, any updates to the USPSTF recommendations after March 10, 2010 do not have the force of law.  But, the recommendations pre-March 10, 2010 continue in effect, because Congress adopted them in the statutory text." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024; cert. pet. granted Jan. 10, 2025)]   MORE >>

"In each case, OCR's investigation determined the company failed to conduct an accurate and thorough risk analysis to determine the potential risks and vulnerabilities to ePHI in its systems.... These enforcement actions, and OCR's pursuit of the new Risk Analysis Initiative, teach some important lessons about risk analysis for covered entities and business associates looking to avoid falling within OCR's enforcement crosshairs."  MORE >>

"The directives ... provide a possible road map that health researchers say could increase the number of uninsured Americans and weaken safety net protections for low-income people.... The drug order Trump rescinded called on [CMS] to test ways to lower drug costs ... and having states try to get better prices by banding together to buy certain expensive cell and gene therapies. That might indicate Trump expects to do less on drug pricing this term or even roll back drug price negotiation in Medicare."  MORE >>

"The leadership of the Senate Committee on Health, Education, Labor and Pensions (HELP) listed some key retirement and health priorities for the Committee for this session of Congress ... [including] benefits portability, the definition of independent contractor, funding of the [PBGC], pharmacy benefit manager (PBM) reform, and the cost of prescription drugs."  MORE >>