"The Medicare Part A inpatient hospital deductible ... will be $1,736 in 2026, an increase of $60 from $1,676 in 2025.... The standard monthly premium for Medicare Part B enrollees will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025. The annual deductible for all Medicare Part B beneficiaries will be $283 in 2026, an increase of $26 from the annual deductible of $257 in 2025. "  MORE >>

"Plan eligibility and the annual enrollment process becomes of utmost importance when an employer becomes an [ALE] ... For employers that hover around a 50-employee threshold, ALE status can fluctuate from year to year. [This article discusses] the important aspects of an ALE status and how to mitigate potential penalties."  MORE >>

"In September, the Advisory Committee on Immunization Practices (ACIP) ... changed its recommendations regarding several vaccines ... Although the updated recommendations have not been published in the ACIP Morbidity and Mortality Weekly Report (MMWR), the CDC immunization schedules for both COVID-19 vaccination and MMRV were updated October 7, 2025 with adopted changes to recommendations. Plan years beginning on or after October 7, 2026, must comply with the new recommendations ... (January 1, 2027 for calendar year plans)."  MORE >>

"The decision provides a helpful reminder that, in ERISA cases involving conflicting medical opinions and evolving rationales, courts may permit targeted discovery to assess whether the insurer's structural conflict influenced its claim decision." [Kramer v. Metropolitan Life Ins. Co., No. 25-00327 (D. Utah Nov. 13, 2025)]  MORE >>

"An employee told supervisors that his pregnant spouse's condition was high risk, that she could not drive, and that he needed to get home after his shift to care for her. He twice refused overtime for this reason. No one informed him of his rights under the Family and Medical Leave Act of 1993 (FMLA). The Eleventh Circuit held that a jury could find he was entitled to intermittent FMLA leave, that the employer failed to provide required notices, and that this failure may have led to his termination. The FMLA interference claim survives." [James v. FedEx Freight, Inc., No. 24-12907 (11th Cir. Nov. 7, 2025)]  MORE >>

"For fiscal year 2023, the federal government and six selected states -- California, Georgia, New York, Pennsylvania, Tennessee, and Texas -- paid health insurance entities at least $1.6 billion in potential overpayments or fraud for duplicate health care coverage or benefits. The payments were made on behalf of approximately 500,000 individuals who were simultaneously enrolled across multiple states in Medicaid or the Children's Health Insurance Program (CHIP) or receiving an advance premium tax credit (APTC) across multiple states." [GAO-25-106976, pub. Sep 25, 2025. rel. Nov 17, 2025]  MORE >>

"While most Americans get their insurance through work, many families rely on alternatives, and these options can offer relief when employer coverage becomes unaffordable."  MORE >>

"Our member needed high-stakes surgery. The hospital knew it. The family knew it. Surgery was on the calendar; pre-op scans and imaging needed to be done. The message from the hospital was essentially: pay our inflated price, or the whole thing is at risk. When our repricer hit their bill with the 140%-of-Medicare logic, we weren't even in the same galaxy as their demand. They wanted ten times that amount. They wanted something no rational fiduciary could sign off on under ERISA's command to guard plan assets prudently."  MORE >>

"[I]ndividuals and businesses in parts of Missouri affected by severe storms, straight-line winds, tornadoes, and flooding that began on March 30, 2025 ... now have until March 30, 2026, to file various federal individual and business tax returns and make tax payments.... [I]ndividuals and households that reside or have a business in Bollinger, Butler, Cape Girardeau, Carter, Cooper, Douglas, Dunklin, Howell, Iron, Madison, Maries, Mississippi, New Madrid, Oregon, Ozark, Pemiscot, Reynolds, Ripley, Scott, Shannon, Ste. Genevieve, Stoddard, Texas, Vernon, Washington, Wayne, and Webster Counties qualify for tax relief."  MORE >>

2-page chart includes 2026 limits for qualified retirement plans, IRAs, PBGC, Social Security, and health and fringe benefit plans, along with corresponding limits for 2025 and 2024.  MORE >>

"Benefit plans operate in a world where every rule matters, every exception counts and every decision touches someone’s livelihood. ... [F]ull automation isn’t achievable today with the tools currently on the market. And even if it were, it might not be the right move. The smarter, and safer path forward is to use AI as a collaborator, not a replacement."  MORE >>