24 pages. "What's New:  [1]  Changes to 'coverage month' definition for PTC/APTC ... [2] Reporting entities no longer required to send minimum essential coverage (MEC) forms automatically."  MORE >>

"Employees may take full advantage of both the credit and the exclusion for employer reimbursements but not for the same expenses.... Because employer-provided adoption benefits are subject to FICA, most employees will use the tax credit first.... Lower-income employees may be unable to take full advantage of the credit.... Employer-provided adoption benefits can help employees' cash flow."  MORE >>

"Starting February 22, 2026, employees will be able to use safe/sick leave for additional reasons ... [and] employers must provide all employees and new hires with an additional 32 hours of unpaid sick/safe time.... The expansion of these regulations comes on the heels of the City's amendment to ESSTA regulations that require employers to provide 20 hours of paid prenatal leave to eligible employees."  MORE >>

"Effective January 1, 2026, the Pittsburgh Paid Sick Days Act increased the amount of sick time employers of all sizes must provide to their employees annually. The new ordinance implemented faster accrual rates and increased hour requirements for employees working within the geographic boundaries of the City of Pittsburgh....[T]he Allegheny Paid Sick Days Act has yet to update, making compliance for employers challenging."  MORE >>

"Historically, benefit consultants functioned primarily as intermediaries between employers and insurance carriers and did so under the protection of ERISA's fiduciary exemption. But here plaintiffs allege that consultants exercise discretion in selecting insurance carriers and insurance policies, and also in structuring voluntary benefit plans to gain sizeable commissions -- actions that, plaintiffs argue, make these consultants plan fiduciaries."  MORE >>

"[A]mong other requirements, HR 7148 proposes the following new rules and regulations impacting PBM arrangements: [1] PBM rebate pass-through and compensation disclosures for ERISA fully insured and self-funded plans ... [2] PBM reporting obligations for fully insured and self-funded group health plans.. [3] Compensation disclosures and reporting obligations for Medicare Part D prescription drug program."  MORE >>

"The proposed Great Healthcare Plan is aimed at reducing prescription drug costs, lowering insurance premiums, and expanding transparency in the healthcare system. While the proposal requires congressional action and may evolve significantly, it highlights policy priorities that could shape future legislation and regulatory initiatives impacting employer-sponsored health and welfare plans."  MORE >>

"Make sure health and welfare plan documentation and delegation is current, accurate, and understood.... Set a proactive annual calendar for welfare plan governance and vendor oversight.... Keep detailed records of welfare plan decisions, especially exceptions, claims escalations, and vendor direction."  MORE >>

"Selecting a carrier with strong financial backing may provide greater possibility that they can handle large claims, even in catastrophic situations.... The best carriers go beyond basic coverage, offering predictive analytics, specialty drug management, and alternative care programs.... Partnering with a carrier that offers pricing stability and customized solutions can help you adapt over time, and may help reduce volatility in your benefits strategy."  MORE >>

"The Paperwork Burden Reduction Act gives employers new flexibility in how they distribute Forms 1095-B and 1095-C. Instead of sending forms to everyone, employers can use an alternative furnishing method, providing the forms only upon request -- as long as IRS requirements are met."  MORE >>

"Per person spending among people with employer-sponsored insurance grew nearly 19% from 2018 to 2022, a combination of 14% price growth and 4% utilization growth.... Spending on urgent care grew at a substantially faster rate (more than 50%) from 2018 to 2022, and, unlike most health care categories, was driven primarily by a substantial increase in utilization."  MORE >>

"While ChatGPT Health and Claude for Healthcare offer useful capabilities, they also present risks and limitations that users, healthcare providers, and organizations should evaluate before adoption."  MORE >>

"An OPEB experience study is a comprehensive review of your plan's historical data to evaluate and refine the assumptions that drive actuarial valuations. By analyzing actual participant behavior and economic trends, plan sponsors can ensure that their assumptions align with current realities and future expectations -- leading to more reliable financial disclosures and, if applicable, funding strategies."  MORE >>

"The average value of APTC subsidies was originally designed to be worth 5% less to workers than the ESI tax exemption, in order to maintain incentives for employers to provide health-care benefits. But the expanded subsidies average 65% more than the value of the ESI tax exemption. If all employers stopped offering health-care coverage to workers, to allow them to claim these expanded subsidies, it would increase the cost to the federal budget by $250 billion per year."  MORE >>

"Comments are invited on: [1] Whether the collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; [2] the accuracy of the agency's estimate of the burden of the collection of information; [3] ways to enhance the quality, utility, and clarity of the information to be collected; [4] ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or other forms of information technology; and [5] estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to provide information.... There is no change to the previously approved information collection."  MORE >>