101 pages. "[This publication] outlines the communication procedures, transmission formats, business rules and validation procedures for information returns transmitted electronically through the AIR System.... The procedures in this publication should be used when the following information returns are transmitted electronically for Tax Year (TY) 2015, TY2016, TY2017, TY2018, TY2019, TY2020, TY 2021, TY2022, TY2024, TY2025 in PY2025: [1] Form 1094-B, Transmittal of Health Coverage Information Returns; [2] Form 1095-B, Health Coverage; [3] Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns; [4] Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. This publication does not contain information or procedures for filing Form 1095-A." [Updated Jul. 11, 2025, pub. Sep. 11, 2025]  MORE >>

73 pages. "The purpose of this document is to describe the User Interface (UI) for the AE for ACA Providers Application ... This guide provides instructions on how to enroll and maintain A2A Client Application Systems using the IRS Enterprise Portal (IEP). Its scope is limited to the ACA functionality of the AE Application. However, this guide does not discuss any administrative aspects of the AE Application nor does it discuss how to use the IEP other than the aspects you need to know to access the AE Application." [Updated Jun. 4, 2025; pub. Sep. 11, 2025]  MORE >>

160 pages. "This document covers details on composing and submitting Forms 1094/1095-B and Forms 1094/1095-C by transmitters to IRS. The scope of the document addresses the A2A-application based via SOAP messages exchanged between client and exposed Web Service endpoints and the Web UI-browser-based requiring human initiation." [Rev. Jun. 18, 2025; pub. Sep. 11, 2025]  MORE >>

"[HHS] released an updated version of the Security Risk Assessment Tool (SRA Tool), which is an easy-to-use interactive application that covered entities and business associates can use to create the required security risk assessment.... Employer plan sponsors of group health plans can partner with their internal IT teams to create the required 'security risk assessment' using the SRA Tool -- and significantly reduce their exposure to potential fines and penalties[.]"  MORE >>

"This expansion of the Illinois Insurance Code, which applies to policies issued, amended, delivered, or renewed after January 1, 2026, creates new administrative challenges and compliance obligations for group health plans -- especially since they typically offer dependent benefits only to children and spouses or domestic partners."  MORE >>

"The trial court noted that the employer was aware at the time it mailed the election notice that the address may have been inaccurate and thus held that the employer did not timely provide the notice. Nevertheless, the court exercised its discretion not to impose penalties because, with more than two years of employer-paid coverage, the employee was 'better off' than if she had received a timely notice and paid for the continued coverage herself. On appeal, the Eleventh Circuit agreed[.]" [Thibodeaux v. City of Atlanta, No. 24-12921 (11th Cir. Sep. 2, 2025; unpub.)]  MORE >>

"In yet another case in the continuing trend of ERISA preemption challenges to state laws regulating PBMs, this decision aligns very closely with Rutledge, but the outcome of these cases depends on specifics -- state laws directly affecting ERISA plan design are more likely to be held preempted." [Cent. States, Se. & Sw. Areas Health & Welfare Fund v. McClain, No. 25-3938 (N.D. Ill. Sept. 2, 2025)]  MORE >>

"In concluding that the definition of 'exempt' was not as limited as the DLSE (and plaintiff's counsel) argued, the court observed that 'California courts ... consistently use the phrase 'exempt employees' in the private employment context to mean those not entitled to overtime wages under California wage and hour law.' Considering 'exempt' a 'term of art,' the panel next found that the legislature knew what it was doing when, in the rate of pay context, it did not limit its scope to only [executive, administrative, and professional (EAP)] employees." [Hirdman v. Charter Communications, LLC, No. D084304 (Cal. Ct. App. Aug. 4, 2025)]  MORE >>

"Employers are moving beyond traditional tactics and adopting more targeted clinical strategies: [1] Specialty medications ... [2] Condition-specific programs ... [3] Align care management to risk ... [4] Improve access and navigation ... [5] Expand mental health support ... [6] Earlier risk identification and prevention ... [7] Accountability and value-based care."  MORE >>

"Off-exchange plans -- a less common way to purchase coverage directly from an insurance company or licensed broker -- currently look like they'll see significantly smaller increases than group coverage and plans on the individual exchange.... Typically, the differences between on-exchange and off-exchange plans would be minimal. Some employers default to on-exchange plans due to convenience: Several ICHRA administrators only allow employees to purchase plans on the exchange."  MORE >>

"This white paper provides a framework for building a long-range forecast and can help employers covering these drugs understand how trends associated with these drugs may change over time.... Based on assumptions in the paper, utilization will continue rising from 2025 through 2027, and then stabilize between 2028 and 2030.... [The authors] estimate that 7.9% to 12.7% of the total commercial population may be using GLP-1s for weight loss in the distant future."  MORE >>

"This article examines how the lack of standardized identifiers for provider networks creates many frustrations for consumers and other health care stakeholders. It also reviews the role that standardized identifiers and standards bodies play in developing seamless consumer experiences in other industries and the roles the could play in health care in assisting consumers and other stakeholders."  MORE >>