"Step one is determining which measurement method the employer will utilize. Step two is understanding which hours 'count' during the ACA measurement period. This is one of the most operationally complex aspects of an employer's ACA compliance. This article will therefore focus on which hours employers need to include in their applicable measurement periods."  MORE >>

"The PBM regulatory landscape is evolving rapidly at both the federal and state levels, making it critical for [those] involved in the PBM space to stay apprised of developments in the industry as they happen.... This update ... highlights federal and state activity from October 2025 to mid-February 2026."  MORE >>

"Eligible employees may receive up to 12 weeks of paid leave, with wage replacement of up to 80% of the employee’s average weekly wage, subject to a statutory cap. The program is funded through employer and employee payroll contributions.... Payroll contributions will begin April 1, 2028, and the VEC will begin receiving claims and paying benefits to covered individuals starting Dec. 1, 2028."  MORE >>

"As the market for top talent becomes more competitive, relying solely on perks is rarely enough. Today, employers are encouraged to move beyond generic offerings and consider benefits that thoughtfully support both employee needs and broader organizational objectives.... The ROI of purpose-driven benefits ... Navigating major workforce shifts ... A step-by-step guide to alignment ... High-impact employee benefit solutions ... Showcasing the value of your package."  MORE >>

"The decisions employers make in the next few months regarding Medicare Advantage and Part D will determine whether they stay ahead of the curve or get caught in a wave of volatility driven by high medical and drug cost trends, the emerging impact of GLP-1s on program budgets and ongoing reforms at the federal level to drive efficiencies within the federal Medicare system. While these forces impact all Medicare coverages, this is a structural shift that will reshape the fundamental economics of group-based retiree medical plans as we know them."  MORE >>

"A recent ... article explains how [the IDR process of the No Surprises Act] has quickly come to be used by out-of-network providers to obtain significant overpayments for routine medical procedures.... [In] many cases, [self-insured] plan sponsors will bear the brunt of the increased financial exposure, and some may be caught off-guard ... Your third-party administrator (TPA) likely handles these disputes on your plan's behalf, but TPAs may not proactively report on the volume, outcomes, or cost of IDR cases unless the plan sponsor specifically requests that information."  MORE >>

"Participating plans are adopting a standardized approach for providers submitting electronic prior authorization requests for the majority of medical services. The standardized approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries and imaging services, including CT scans and MRIs.... Additional services will be added over time. The standards do not impact individual plans' clinical policies or coverage determinations."  MORE >>

"The DOL engaged in less correspondence with health plans and issuers about the NQTLs at issue, but also issued more initial determination letters in the same time period. This indicates that the DOL proceeded with citing MHPAEA violations while asking fewer questions.... CMS issued far more insufficiency letters ... CMS noted there were many times where there was no comparative analysis, and that additional information was still needed even after reviewing the comparative analyses. Both the DOL and CMS issued more final determination letters in 2025 than in prior years showing that they are increasingly willing to cite a plan or issuer ... for providing deficient comparative analyses."  MORE >>

"If health insurers are largely passing health care costs to employers and consumers, it raises the question of what value they are providing. Insurers point to consolidation in the hospital industry as driving up prices and, in turn, premiums.... [H]ealth insurers' profit margins are generally modest as a share of premium revenues, typically no more than a few percentage points. However, that can add up to a substantial dollar amount in total.... Without prior authorization, insurers might create other mechanisms to limit health care use, and health spending and premiums would be higher."  MORE >>