"Plan sponsors and issuers are advised to make good faith efforts to comply with the comparative analysis requirements under the CAA and all other applicable requirements under MHPAEA. Failure to conduct the comparative analysis in accordance with the 2024 Final Rule will not, at this point, result in adverse action from the Departments."  MORE >>

"Data centers may provide space, cooling, power, physical wiring and connectivity to customers that store hardware in the centers. If this hardware is used to store protected health information (PHI) subject to federal [HIPAA] privacy and security rules, data center operators may have HIPAA responsibilities.... If a data center meets HIPAA's definition of a business associate, it must implement an effective HIPAA compliance program."  MORE >>

"In November 2024, Alaskan voters passed Ballot Measure 1 ...[which] requires employers to provide an additional paid benefit to employees in the form of paid sick leave ... Employees must accrue at least one hour of paid sick leave for every 30 hours worked ... [T]he law does not designate a balance or carry-over cap."  MORE >>

"When it comes to safeguarding health data, the Health Insurance Portability and Accountability Act (HIPAA) is paramount. HIPAA's extensive reach encompasses nearly all healthcare providers and all health plans, affecting just about every American. However, its coverage is not complete. States are stepping in to address the gaps and tackle specific areas of concern, such as reproductive health information."  MORE >>

"On the merits of the fiduciary status issue, the Sixth Circuit noted that 'if a contract grants a plan administrator discretion as to its compensation, using that discretion is a fiduciary act.' The Court then found it clear under the facts alleged 'that BCBSM exercised discretion in setting its compensation for the SSP' ... [T]he Sixth Circuit disagreed with the district court that Tiara Yachts could not recover under either ERISA Section 502(a)(2) or under Section 502(a)(3). To the contrary, the appellate court held that both offered appropriate channels of relief."  MORE >>

"[1] The modern PBM system ... [2] The rise of transparent and alternative PBMs ... [3] A comparison of PBM models ... [4] How to select the right PBM partner ... [5] Common pitfalls to avoid ... [6] Final decision and transition tips."  MORE >>

"[T]he Florida Office of Insurance Regulation has brought PBM laws and preemption back into the spotlight with its somewhat stringent audit protocols aimed at increasing transparency and accountability within the pharmaceutical supply chain, a trend in state oversight of PBMs that may seem attractive to an increasing number of states."  MORE >>

"[T]he treatment of unused funds from health flexible spending accounts (FSAs), dependent care assistance programs (DCAPs), and health savings accounts (HSAs) varies significantly ... [This article provides] a breakdown of how each program and any distributions should be treated upon a participant's death[.]"  MORE >>

"In the context of medical coverage, the terms 'Preventive Services' and 'Preventive Care' are often used interchangeably. The two terms, however, have very different meanings. Understanding the difference can have significant implications for plan sponsors and participants alike."  MORE >>

"[If] fully executed, the EO could present both opportunities and challenges for employer-sponsored group health plans: [1] Lower prescription drug costs ... [2] Increased prescription drug utilization ... [3] Plan design changes."  MORE >>

"The national average satisfaction score for commercial health plans is 563 (on a 1,000-point scale) ... 20% of employers cite low employee satisfaction as a top reason for switching health plans.... [A]mong members who say they do not completely understand their out-of-network benefits, 48% had a claim denied and 56% said their choice of network doctors was not available.... Many high-impact digital tools remain underutilized: ... The average deductible paid by commercial health plan members working for small employers ... is 8% more than for those working for midsized employers and 10% more than those working for large employers."  MORE >>

"Achieving value-based care requires the capability to transmit all the determinative details of each patient's health status and healthcare received, currently available in modern electronic health records (EHRs), to support modern data analytics. [This] article discusses how our current healthcare data extraction system prevents us from doing this and describes two pathways to achieve significant improvements."  MORE >>

"Employers rely on 4.4 different communication methods on average; however, the majority of employers use only three. By far the most popular method of communication is email, used by 87% of respondents. Discussion during in-person meetings and text messages are also widely used marketing techniques."  MORE >>