"As subsidies shrink or disappear, many people are seeing their exchange premiums increase dramatically ... The cafeteria plan rules do allow for election changes if an employee (or spouse or eligible dependent) who is currently enrolled in employer sponsored coverage seeks to change their election in order to enroll in exchange coverage. This, however, is a one-way street ... It does not allow individuals to move from exchange coverage onto group plans."  MORE >>

"[Notice 2026-5] affirmed a permanent safe harbor provision allowing HSA holders to receive telehealth and other remote care services before meeting their deductible, while remaining eligible to contribute to an HSA, effective for plan years beginning on or after January 1, 2025. The notice also clarified that, as of January 1, 2026, bronze and catastrophic plans available through a health care exchange are considered HSA-compatible, regardless of whether the plans satisfy the general definition of a high-deductible health plan. The plans do not have to be purchased through an exchange to qualify for the relief."  MORE >>

"[It] is important to understand the tax issues affected by your administration of group health plan benefits for employees on leave, particularly for leaves that cross calendar years. If you provide group health benefits and an employee takes approved leave, it is likely that such employee has benefit continuation rights under federal or state law.... Employers have options for collecting premium payments, and each option comes with its own advantages and risks.... IRS guidance has made it clear that an employee cannot make pre-tax payments for premium payments for benefits to be received in a subsequent tax year."  MORE >>

"The court found no evidence that any employer created, sponsored, or administered an ERISA plan. Instead, the record showed four individual life insurance policies purchased by individuals associated with a business, each naming the business as beneficiary. Under either version of ownership advanced by the plaintiff -- sole ownership or equal co-ownership -- the arrangement failed to satisfy ERISA's requirement that an employer establish or maintain a plan for the purpose of providing benefits to employees." [Aikens v. Colonial Life & Accident Ins. Co., No. 24-0580 (W.D. La. Dec. 11, 2025)]  MORE >>

"Implementing a value-based contract that ties payments to quality metrics or population health outcomes creates several fiduciary questions. Does shifting risk to a provider expose plan participants to narrower networks or limited access that may conflict with fiduciary obligations? How should fiduciaries evaluate whether the incentive structures truly benefit plan participants rather than merely reduce employer costs? ... Using standardized CMS data sets minimizes ambiguity and improves objective benchmarking. From a legal point of view, incorporating CMS data sets requires careful implementation. "  MORE >>

"Private health insurers play a central role in determining the cost and quantity of health care in the United States. Despite this centrality, there has been limited empirical work studying how insurers differentially affect spending and consumption, especially for expensive and pervasive chronic conditions. [The authors] use hundreds of natural experiments involving employers switching their primary health insurer, together with a movers design, to estimate these causal effects."  MORE >>

"For the second consecutive quarter, workplace life insurance premium rose year over year, overcoming a shaky start in the first quarter. In the third quarter of 2025, workplace life insurance new premium increased 9% to $691 million. In the first nine months of 2025, workplace life insurance new premium was $3.38 billion, down just 3% from last year's results. Despite the decline, a majority of carriers reported gains,with the top 10 companies generating 64% of the sales."  MORE >>