"For Plan Year 2026, chemical and surgical modification of an individual's sex traits through medical interventions (to include 'gender transition' services) will no longer be covered under the FEHB or PSHB Programs. This exclusion expands upon Carrier Letter 2025-01a and applies regardless of age.... [C]ounseling services for possible or diagnosed gender dysphoria must still be covered. Covered counseling services must be provided by a licensed mental health provider and may include those who provide faith-based counseling."  MORE >>

53 pages. "The budget reconciliation law commonly known as the One Big Beautiful Bill Act (PL 119-21) ... includes a number of health provisions that impact Medicaid, the State Children's Health Insurance Program (CHIP), Medicare, private health insurance, and rural hospitals and providers.... This report provides descriptions of [those] provisions ... These descriptions are followed by abbreviated summaries of the health provisions ... details about implementation funding ... and a list of the abbreviations used throughout the report[.]" [R48633 Aug. 18, 2025]  MORE >>

"After three consecutive years of lower ACA affordability percentages, 2026 will see a return to higher percentages that were common prior to 2023. In fact, 9.96% will be the highest percentage ever. Employers will appreciate this increase as it allows them to pass along a greater portion of their total premium to employees."  MORE >>

"San Francisco announced an approximate 7% increase for the 2026 Health Care Expenditure (HCE) rates under the Health Care Security Ordinance (HCSO) rules. The HCSO applies to all employers that must obtain a San Francisco business registration certificate and that have at least 20 employees in any location if at least one works in the city and county of San Francisco."  MORE >>

11 pages. "This preliminary observational study of real-world data suggests that increased GLP-1 adherence may lower the medical cost of care for an expanding number of chronic conditions; however, this does not offset the cost of the GLP-1 medications.... Although it may be too early to determine the true impacts of GLP-1 and GLP-1/GIP medications on the overall total cost of care, creating the analytic framework to monitor emerging trends can identify potentially actionable opportunities to re-evaluate care intensity for conditions influenced by GLP-1 drugs."  MORE >>

"While previous research showed Part B increased launch prices, [the authors] estimate its effect on later prices (net of rebates). Drugs more exposed to Medicare have lower price growth. A drug with above median Part B exposure has a 10% lower price after 3 years than a below median exposure drug that launched at the same price, with a larger effect for newly approved molecules."  MORE >>

"For two consecutive years, actual health care costs outpaced employers' anticipated costs. Employers predicted health costs would increase by 6.6% in 2023, while costs actually increased by 0.2 percentage points more (6.8%). In 2024, a 7.1% prediction was outpaced by the actual increase of 7.5%. The predicted cost increase in 2025 was 8.0%, and actual costs remain to be seen. Looking ahead to 2026, the prediction is one full percentage point higher than it was last year. On a compounded basis, costs in 2026 are likely to be 62% higher than 2017 levels."  MORE >>

"Rising costs and the struggles during the pandemic brought the realization that developing federal and provincial programs wasn't just long overdue but a necessary economic strategy to increase workforce participation and invest in the future. By capitalizing on government programs, employers can foster greater employee loyalty and reduce burnout -- which affects workforce productivity -- through employee-sponsored benefits that support child care."  MORE >>

"These final regulations remove the physical presence requirement for formal continuing professional education programs required for active (printed page 40232) enrolled actuaries and the physical location requirement from course certifications. These final regulations also modify the continuing professional education requirement for certain actuaries who seek to return to active enrollment from inactive status due to their failure to timely satisfy the renewal requirements in the first enrollment cycle after their initial enrollment. Finally, the final regulations add a requirement that certificates of instruction for continuing professional education courses must reflect the hours credited toward the formal program requirement."  MORE >>

"When an employee passes away, employers are suddenly faced with a tangle of legal, tax, and benefits questions that don’t come up in your average HR handbook. Who gets the final wages? What about that bonus they were about to earn? Can we offer extra support to the family without triggering a tax nightmare? ... What happens to PTO, health insurance, retirement plans, and other benefits? ... The generous employer’s dilemma."  MORE >>