"Employers sponsoring prescription drug plans that are not applying for the [Retiree Drug Subsidy (RDS)] may choose either the existing or revised simplified method for determining creditability. The revised simplified method requires plans to cover at least 72% of average prescription drug costs, up from the current 60% threshold, and will be the only simplified determination method beginning in 2027."  MORE >>

"Employers should be prepared to turn over an NQTL comparative analysis to the government upon request. Employers with fully insured plans should contact the insurance company (if they have not already done so) to request a copy of the insurance company's NQTL comparative analysis. Employers with self-funded plans who have not yet conducted or arranged for an NQTL comparative analysis should begin the process of locating a vendor and should contact benefits counsel."  MORE >>

"Employers with fully insured plans subject to MHPAEA should continue to communicate with their carriers to ensure the carrier is performing the NQTL analyses Employers with self-insured plans subject to MHPAEA ... should ensure their contract with their third party administrator (TPA) requires that the TPA complete and/or provide all of the data necessary for another party to complete the NQTL analyses ... Employers who have any carved-out coverages subject to MHPAEA should ensure the TPA for those benefits is assisting with and/or completing NQTL analyses relative to the specific benefits involved."  MORE >>

"The definition of a health plan under the HIPAA privacy and security rules is broad enough to include health FSAs, with only one very limited exception. If a health FSA has fewer than 50 participants and is administered by the employer, it is not subject to HIPAA 's privacy or security rules.... Because most health FSAs are not fully insured, ... the privacy rules will apply to your health FSA, and your company will be responsible for compliance"  MORE >>

"The IRS has announced new HSA contribution limits for 2026 ... Key considerations for employers: [1] Encourage employees to maximize HSA contributions for better long-term savings; [2] Review HDHP plan options to ensure compliance with IRS guidelines; [3] Assess the impact on your benefits strategy to optimize costs and employee satisfaction; [4] Update benefit materials and integrated payroll systems as needed to reflect the updated limits."  MORE >>

"In the first five months of 2025, [HHS OCR] announced it had entered into ten [HIPAA] resolution agreements reflecting the settlement of alleged HIPAA violations stemming from data breaches reported to OCR.... Each announcement indicates the resolution agreement was intended to cure defects in basic HIPAA Security Rule compliance, with a common emphasis on each organization's failure to conduct a thorough risk analysis consistent with the HIPAA Security Rule."  MORE >>

"Employer-offered worksite clinics with free or discounted primary care services would now be available to employees on high-deductible health plans (HDHPs), even if they already have an HSA.... [The bill also allows] HSA funds to be spent on gym memberships, increases the HSA contribution limit for some individuals ... and permits one spouse to contribute to an HSA even if the other spouse has a flexible spending account.... Beginning in January, the bill would give small employers a $100 per-month per-member tax credit to offer ICHRA plans. The credit drops to $50 in subsequent years."  MORE >>

"This article aims to dispel some of the most common wellbeing myths and demonstrate how a thoughtfully constructed strategy can directly enhance organizational efficiency, workplace resilience, address employee expectations, and support broader organizational goals."  MORE >>

"[Members] urge the [DOL] to prioritize rulemaking to establish a default electronic delivery (e- delivery) safe harbor for ERISA health and welfare plan disclosures ... Expanding default e-delivery for health and welfare plans ... would benefit ... American employers and workers by ... [1] Reducing a costly regulatory burden for American businesses and health plans.... [2] Enhancing workers' access to information about their health benefits.... [3] Supporting the health of the American workforce.... [4] Reducing need for physical mailings."  MORE >>

"In theory, [ICHRAs] should be an attractive option, since the cheapest individual market plans now cost, on average, 31% less than comparable employer-purchased health-insurance plans. But very few firms currently offer ICHRA funds because federal regulations prohibit giving individual workers a choice between group health insurance and ICHRA.... [E]mployers should be allowed to offer workers a choice between both options, so long as their ICHRA contributions exceed minimum standards and their group plans conform to the same benefit requirements as those for the individual market."  MORE >>

"[T]here is a certain degree of irony that the Committee's proposal would safeguard access to ICHRAs at the same time as it would severely undermine the individual health insurance market.... [E]mployers and employees who currently take advantage of ICHRAs, or would want to do so in the future, would face enrollment barriers and higher out-of-pocket costs thanks to the changes to actuarial value and the premium adjustment percentage.... There is a similar dynamic at play with the changes to HSAs[.]"  MORE >>