"To help employers determine whether an ICHRA offer is considered affordable for purposes of validating they are making affordable offers of coverage to their employees and avoiding the employer responsibility payment, CMS is publishing the ICHRA Employer LCSP Premium Look-up Table [XLSM]. The table allows users in states participating in the Federally-facilitated Exchange (FFEs) and State-based Exchanges on the Federal Platform (SBE-FPs) to access individual market Qualified Health Plans (QHP) lowest cost silver plan (LCSP) data by geographic location." [Also available: Plan Year 2026 ICHRA Employer Lowest Cost Silver Plan Premium Look-up Table Data Dictionary (PDF)]  MORE >>

160 pages; Dec. 2025. "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."  MORE >>

18 pages; Rev. Nov. 2025. "The purpose of this publication is to set forth the tax year 2025 requirements for: [1] Using official [IRS] forms to file information returns with the IRS, [2] Preparing acceptable substitutes of the official IRS forms to file information returns with the IRS, and [3] Using official or acceptable substitute forms to furnish information to recipients."  MORE >>

101 pages; rev. Dec. 2025. "[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 Years 2015 through 2025] in PY2026: [1] Form 1094-B ... [2] Form 1095-B ... [3] Form 1094-C ... [4] Form 1095-C[.]"  MORE >>

"IRS guidance permits employers to post a website notice of availability of Forms 1095-B and 1095-C with respect to those ACA forms rather than distribute the forms to every individual. But some states now have their own reporting requirements that may still require the ACA forms or similar state-issued forms to be automatically provided to individuals."  MORE >>

"Because exhaustion is not required for a true fiduciary-duty claim, the court concluded that Bechtel was not obligated to pursue a second plan appeal. It therefore denied Wexford's motion as to the Section 1132(a)(3) claim. The court granted summary judgment to Wexford on the Section 1132(a)(1)(B) denial-of-benefits claim and denied summary judgment on the Section 1132(a)(3) fiduciary-breach claim." [Bechtel v. Wexford Health Sources Inc., No. 25-8006 (D. Ariz. Dec. 10, 2025)]  MORE >>

"The Connecticut Supreme Court reversed a lower court and held that the Town of Groton is not required to extend employer health savings account (HSA) contributions to retired police officers.... [R]etirees argued that a 2008 pension agreement promising the 'nature and scope of coverages, including but not limited to deductibles' in effect for active officers entitled them to the same HSA contributions the town provides to active officers under a later collective bargaining agreement." [Duso v. Groton, No. SC 21082 (Conn. Dec. 9, 2025)]  MORE >>

"Preventive care is one of the most valuable yet misunderstood benefits employees have access to. This guide breaks down what preventive care really includes, what's free under most health plans, and why early detection matters for both employee well-being and employer costs. HR leaders play a critical role in helping employees use these benefits confidently, reducing confusion, strengthening trust, and improving overall health outcomes."  MORE >>

"Health plan prescription drug formularies continue to increase in complexity, and changes to those formularies are especially challenging for consumers to navigate.... Formularies are divided into anywhere from four to six tiers to manage costs and encourage the use of clinically effective, lower-cost medications. Each tier corresponds to a different level of cost-sharing for the patient. The lower the tier, the less the patient pays out of pocket."  MORE >>

"A study led by Brown University researchers found that Oregon's cap on hospital prices for its public employees, established by 2017 legislation that limits payments to 200% of Medicare rates for in-network services and 185% for out-of-network, has so far produced little disruption in hospital finances or the quality of patient care."  MORE >>

"Generally, for-profit health insurers operate in their local jurisdiction with a lower capital and surplus level, reporting lower RBC ratios, while their increased leverage leads to higher returns on equity. This management approach usually entails larger and more frequent contributions of capital to the insurer by its ultimate owners, as well as more frequent dividends being paid out by the insurer. In contrast, nonprofit or not-for-profit insurers have less access to outside capital and therefore must effectively manage business requirements and risk by holding more capital and surplus on their own balance sheet."  MORE >>

"77% of Americans who have reviewed their 2026 plan choices felt good about their coverage options, with the highest satisfaction among Medicare beneficiaries (86%) and people with employer-sponsored plans (81%). 57% of Americans enrolled in ACA plans remain hopeful that enhanced subsidies will be extended by Congress. 51% of Americans who have reviewed their coverage options were surprised by the high cost of monthly premiums, including 79% of ACA enrollees."  MORE >>

"Employers interested in offering a [Trump Account Contribution Program (TACP)] benefit now have scaffolding upon which to start building out their programs. For example, employers will want to consider whether to allow funding through cafeteria plan salary reductions, as well as the processes for tracking contributions and communicating the new benefit to employees. Meanwhile, the federal government has established a new website with information about TAs and has issued drafts of IRS Form 4547 (Trump Account Election(s)) and related instructions."  MORE >>

25 pages. "This GRIST details the 2026 COLAs for retirement, health and fringe benefit plans, as well as Medicare and Social Security. Although IRS has not issued 2026 covered compensation tables for retirement plans, Mercer has projected those amounts."  MORE >>

14 pages. "The AI in HR benefits ecosystem includes developers, deployers, HR professionals, and compliance experts, all of whom impact how AI tools are built and used responsibly. The report distills AI-driven HR benefits use cases into a three-factor framework -- each functioning as a dial, adjustable to the specific application and context. [1] Core Employee Lifecycle Stages ('when'); [2] Key Benefit Categories ('what'); [3] Users and Roles ('who')."  MORE >>