"For the 2026 benefit year and beyond, HHS is replacing the May 13, 2024, Risk Adjustment Telehealth and Audio-only Services FAQ, with [these] FAQs to clarify how HHS determines eligible services for the filtering criteria HHS uses to extract risk adjustment-eligible diagnoses from claims. HHS continues to accept certain telehealth and audio-only service codes for risk adjustment diagnosis filtering."  MORE >>

"There are several potential minefields employers must watch out for when considering state paid family medical leave programs ... With an expanding remote workforce, employers must ensure they know the laws in the state where the employee works. In some instances, employees may even work in more than one state during the course of a given year."  MORE >>

"The decision highlights key differences between the PFML and other laws covering Massachusetts employers, and holds that, unlike statutes that expressly permit claims against individual corporate officers and agents, the PFML limits liability to the employer entity itself."  [Laughlin v. BinStar, Inc. (Delaware), No. 2584CV01816 (Mass. Super. Ct. Feb. 26, 2026)]  MORE >>

"[E]mployees spend more time searching for health benefits information than any other HR-related topic, signaling both the complexity of the benefits landscape and employee confusion about how to find what they need.... Building an effective access point to health benefits can help contain burgeoning costs by nudging employees toward cost-effective care, encouraging preventive services, assisting members in managing chronic conditions, and generally ensuring that participants can navigate the benefits ecosystem effectively."  MORE >>

"Should we offer COBRA subsidies? ... What happens to employees' FSA balances after a RIF? ... Could a RIF trigger re-rating or mid-year changes to our benefits plans? ... Do compliance requirements change when our headcount drops? ... What's the best way to communicate benefits information to departing employees? ... How should we support remaining employees after a RIF? ... How can we avoid administrative errors during a RIF? ... When should we bring our benefits advisor into planning a RIF?"  MORE >>

"Employers have shouldered the burden of a fragmented vendor ecosystem -- multiple point solutions, inconsistent engagement, and siloed data. Integrated virtual ecosystems are replacing that complexity with more streamlined, clinically connected models of care.... For employers, the opportunity is no longer about adopting new tools -- it is about leveraging and communicating a redesigned infrastructure that enables easier access to care. "  MORE >>

"For over 50 years, [ERISA] has served as the foundation around which employer benefit plans are built. That foundation, however, has shown cracks in recent years as the cost of healthcare continues to rise and many states try to take regulatory matters into their own hands. From Alabama to California, state houses have passed legislation intent on keeping pharmaceutical costs in check. Many of these laws are being challenged in the courts. How those cases play out could mean change and greater complexity in the ways that employers manage health and welfare benefits."  MORE >>

"Ancillary employee benefits, like wellness programs, flexible work options, and financial wellness tools, go beyond traditional offerings to support employees' full lives and boost satisfaction, productivity, and retention. This guide breaks down the types of ancillary benefits, how to implement them effectively, and why they're essential in a modern, people-first workplace. With actionable tips and real-world examples, it's your roadmap to building a benefits package that truly stands out."  MORE >>

"Federal policy changes that decrease risk pooling will lead to higher insurance premiums for less-healthy populations and greater numbers of uninsured Americans....[W]ith fewer people likely to be enrolled in Medicaid or in ACA plans, expected health care costs (risk) will be spread (pooled) across a smaller population. This explainer describes how these policy choices affect risk pooling and what the implications are for those seeking health care coverage."  MORE >>

"For plan sponsors, the potential lag between the date when mail is deposited at USPS and when it is actually processed and postmarked creates risk that time-sensitive materials (e.g., COBRA election notices, HIPAA certificates, decisions on benefit claims and appeals, summary plan descriptions, QDIA notices, fee disclosures and other required disclosures) may bear a postmark date later than intended, even if mailed before the deadline."  MORE >>