"The premium adjustment percentage for the 2027 benefit year is 1.8916224814 ($8,919/$4,715), which represents an increase in PHI premiums of approximately 89.2 percent over the period from 2013 to 2026....

'[T]he 2027 maximum annual limitation on cost sharing is $12,000 for self-only coverage and $24,000 for other than self-only coverage. This represents an approximately 13.2 percent increase from the 2026 parameters of $10,600 for self-only coverage and $21,200 for other than self-only coverage....

'[T]he 2027 required contribution percentage under section 5000A of the Code [is] ... 8.50 percent ... an increase of approximately 0.45 percentage points from the 2026 value."  MORE >>

"Covered service providers would be required to provide initial disclosures to the plan fiduciary reasonably in advance of entering into, renewing, or extending a contract or arrangement. The initial disclosures would include a description of the pharmacy benefit management services as well as information on the direct compensation from the self-insured group health plan and compensation reasonably expected to be received from other arrangements ... The proposed rule would also require covered service providers to provide semiannual disclosures of the same compensation categories based on amounts actually received."  MORE >>

"[A] February 16, 2026, deadline ... requires health plans and most health care providers to update their Notices of Privacy Practices (NPPs).... Although the task may appear administrative, the revisions present a strategic opportunity to evaluate privacy practices, modernize internal systems, and reinforce protections for sensitive health information."  MORE >>

"HHS has announced adjustments to civil monetary penalties for statutes within its jurisdiction. The latest amounts are based on a cost-of-living increase of 1.02598%. These adjustments are effective for penalties assessed on or after January 28, 2026, for violations occurring on or after November 2, 2015."  MORE >>

"[T]he NJFLA's employer‑coverage threshold will decrease from 30 employees to 15 employees anywhere, reflecting a substantial change for small employers ... Employers newly covered by the statute must implement comprehensive NJFLA processes for the first time, including notice requirements, documentation protocols, anti‑retaliation protections, and reinstatement obligations, before July 17, 2026."  MORE >>

"The new legislation significantly expands the leave-related obligations of New Jersey employers. Moreover, the potential link between TDI and FLI benefits and job restoration introduces uncertainty for employers managing medical leaves that extend beyond current legal entitlements."  MORE >>

"The special leave applies only to non-exempt employees who have used all their regular accrued sick and vacation leave and are still unable to work due to the illness or suspected illness that prompted the emergency (in this case, the flu).... Up to five paid working days are available per eligible employee during the declared emergency."  MORE >>

"The complaints generally allege that the employers offering these programs could and should have negotiated lower premiums. According to the plaintiffs, the higher premiums may be the result of potentially excessive broker commissions, and excessive compensation to the consultants that administer them. The complaints speculate that employers offer these voluntary benefit programs without first engaging in a request for proposal process."  MORE >>

"For self-insured employers, rising medical claim denials are no longer a back-office nuisance, they represent a direct fiduciary risk under [ERISA].... This article reframes claim denials through the plan sponsor lens ... [exploring] the drivers behind rising denials, the financial and legal implications, recent court cases, and practical steps to strengthen governance and protect both plan integrity and member trust."  MORE >>

"The default approaches are either to immediately move the continuing employees to the buyer's health plan or to continue coverage under the seller's health plan for a transitional period. However, in some situations (particularly where the buyer does not acquire the seller's health plan) the parties will consider a variety of health coverage alternatives for the continuing employees. Each of these alternatives comes with multiple potentially significant issues[.]"  MORE >>

"EBRI research has examined the premium implications of expanding pre-deductible coverage in high-deductible health plans (HDHPs) paired with HSAs ... This analysis of IRS Notice 2019-45 found little to no impact on premiums. More recent EBRI research extending pre-deductible coverage to a much broader set of 116 drug classes similarly found that estimated premium increases remained modest."  MORE >>

"[1] 2025 drug approvals influencing benefits ... [2] Lipid lowering drug trends ... [3] Vaccine guideline revisions ... [4] Biosimilar use  ... [5] Injectable drug growth ... [6] GLP-1 update."  MORE >>

"How could an eye doctor be in-network and out-of-network at the same time? ... UnitedHealthcare representatives explained that the eye clinic was in-network under her vision plan, so her policy would cover the clinic's services related to glasses or contact lenses. But they said the clinic was not in-network for her medical insurance plan, and glaucoma treatment is considered a medical issue.... [A] UnitedHealthcare spokesperson ... said such arrangements are common, including with non-Medicare insurance provided by employers or purchased by individuals."  MORE >>