"The RxDC report is a series of data files containing plan information, employer information, financial information (such as premiums, fees, drug costs, cost-sharing, and rebates), and aggregated claim information (such as number of claims, number of unique members, and dosage units). Plans are required to submit the RxDC report through CMS's Health Insurance Oversight System (HIOS)."  MORE >>

"CMS adopted additional protections for inpatient care, codified examples of non-allowable special supplemental benefits for the chronically ill (SSBCI), and finalized proposals to implement specific mandates of the Inflation Reduction Act of 2022 (IRA) ... Part D will continue to exclude weight loss drugs from coverage[.]"  MORE >>

"Updated Health Resources and Services Administration [HRSA] guidelines for women recommend no-cost-sharing coverage of imaging in addition to mammograms and pathology when indicated, as well as special navigation services.... HRSA's authority includes additional preventive services and screenings not described in the USPSTF A or B recommendations.... In addition to the expanded breast cancer screening coverage requirement, in 2026 plans must provide patient navigation services for breast and cervical cancer screening and follow up."  MORE >>

"Although seasonal workers must be included when determining whether your workforce exceeds 50 full-time employees (including full-time equivalents), you will not be considered an ALE if you passed that threshold for 120 days or fewer during a calendar year and the employees in excess of 50 who were employed during that period were seasonal workers."  MORE >>

"Designing benefits packages that employees will actually use requires a modern approach rooted in personalization, accessibility, and data-driven decision-making. By leveraging technology, communicating year-round, and aligning offerings with evolving employee needs, HR leaders can reduce friction, improve engagement, and deliver measurable value."  MORE >>

"This settlement highlights the critical importance of adhering to HIPAA's rules, including conducting thorough risk analyses, implementing robust security measures, and ensuring timely notifications of data breaches. It is also a reminder that ongoing vigilance is required to protect ePHI in an increasingly digital health care environment."  MORE >>

"In the U.S., drug companies determine what to charge for their products with few restraints.... One possible solution to bring down costs: tie American prices to what drugmakers charge in other wealthy countries. The Congressional Budget Office found last year that this would have the biggest impact on reducing costs of seven proposals it studied. It's an idea with bipartisan support."  MORE >>

"Cybercriminals exploit weaknesses in systems, software, or human behavior to find opportunities for easy access (like compromised credentials) and steal information.... The digital nature of plan administration and the reliance on third-party service providers create ample access given the broad attack surface."  MORE >>

"Healthcare remains a top concern for employers. But rather than expanding access and coverage, companies are prioritizing cost control and sustainability, especially in high-cost areas like specialty pharmacy and weight loss drugs.... The post-pandemic surge in wellbeing programs is leveling out.... When it comes to leave, employers are focused on streamlining policies, staying compliant, and mitigating risk.... more employers are enhancing retirement support as part of a mature, future-focused benefits strategy."  MORE >>