"When at least one spouse has family coverage and both spouses are HSA-eligible, a special rule for married individuals requires the spouses to share the higher limit -- either spouse's HSA may receive contributions up to the family maximum, but their combined contributions cannot exceed the family maximum. "  MORE >>

"Mehmet Oz, M.D., ... has been approved by the Senate to serve as administrator of [CMS]. Senators voted 53-45 along party lines in favor of the nomination, which would place the thoracic surgeon at the head of more than 160 million Americans' health coverage.... He enters the role at a time of major upheaval. Congressional Republicans and the administration have outlined major reductions to federal health through, respectively, major spending cut targets within the ongoing budget reconciliation process and a slew of layoffs at [HHS]."  MORE >>

"The plan explicitly excludes coverage for care from out-of-network providers. However, the plan document does allow for exceptions to this general rule where the plan's in-network options are inadequate.... The court determined the plan's claim denial letter ... merely stated that the claim was denied because the services were provided by an out-of-network provider. Even construing the plan's denial letter to have included a rejection of the exception request, the court ruled that the plan failed to explain the criteria it used in reaching this decision." [Doe v. Deloitte LLP Grp. Ins. Plan, No. 23-4743 (S.D.N.Y. Feb. 24, 2025)]  MORE >>

"HR professionals are facing increased scrutiny regarding fiduciary responsibilities, as class action lawsuits targeting employer-sponsored health plans continue to rise.... Taking proactive steps today can help HR leaders safeguard their organizations and mitigate potential liabilities."  MORE >>

"Counterforce Health [is] a free artificial intelligence system that helps patients fight insurance claim denials. One AI writes appeal letters disputing the denials, and another calls the insurance companies to continue pursuing the appeal. 'The end game is reducing the patient burden fully,' [CEO Neal Shah] said. 'Because both letter writing and phone calling are just time-wasting."  MORE >>

"[1] To understand how well their mental health benefit is working, employers must ask fundamental questions ... [2] Engage employees and get their feedback ... [3] Meet growing need with diverse, expanded resources ... [4] Strengthen health plan oversight to prevent access obstacles ... [5] Treat mental health supports as a moral and business imperative."  MORE >>

"[1] Periodically reminding employees to update or confirm beneficiary designation forms ... [2] Reviewing equity award agreements to determine whether awards vest upon an employee's death ... [3] Periodically reminding employees to keep the employer apprised of any changes to the employee's marital status ... [4] Reviewing all benefit plans to understand what benefits are payable upon an employee's death, including the effect, if any, on such benefits if the employee is on a leave of absence at the time of death ... [5] Reviewing insurance policies to understand whether the employer or the insurer is responsible for providing any conversion notice to an employee upon their loss of coverage[.]"  MORE >>

"[T]he SOA is launching a new report series -- the Quarterly Mortality Monitoring Report (QMMR) -- to be released every three months.... This report is the first of the QMMR series, focusing on mortality data through July 2024.... The estimated death rate for January through December 2024 ... was 1.1% below the level observed in 2019. Thus, for the U.S. population in the aggregate, the death rate is now about equal to its pre-pandemic level."  MORE >>