"The FEHB Protection Act of 2025 (FPA) requires OPM to issue regulations and implement a process to verify: [1] the veracity of any qualifying life event (QLE) through which a health benefits plan enrollee seeks to add a member of family to their enrollment and [2] that when an enrollee adds a family member to the health benefits plan, including during any open season, the individual is a qualified member of family. This final rule also clarifies responsibilities for initial family member eligibility determinations for the Postal Service Health Benefits (PSHB) Program."  MORE >>

"The final rule governs key operational steps in the federal IDR process for out-of-network payment disputes, but does not change the substantive standard IDR entities apply when selecting between offers. The rule lowers the administrative fee to $15 while making the federal IDR process more formal and documentation-driven. Payors will also face new disclosure, remittance-code, registry, open negotiation and IDR response requirements."  MORE >>

"While the final rule does lay the groundwork for upcoming improvements to the IDR process, the long implementation timeline and the need for additional guidance to effectuate certain policies create some uncertainty about the overall impact of all these changes once they are eventually adopted."  MORE >>

"In 2027, tax-deductible/tax-free HSA contribution limits, HDHP in-network out-of-pocket maximums, and HDHP minimum annual deductibles will rise from 2026 levels for both self-only and family coverage levels. The aggregate fixed monthly fees for an HSA-compatible direct primary care service arrangement (DPCSA) will remain unchanged.... The 2027 maximum annual employer contribution for an excepted-benefit HRA will increase to $2,250."  MORE >>

"The [IRS] recently announced cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs), high-deductible health plans (HDHPs), and excepted benefit health reimbursement arrangements (HRAs) for 2027. In addition, this year's guidance includes inflation-adjusted limits for the aggregate fees that can be made available under direct primary care service arrangements (DPCSAs), which were first made available under the One Big Beautiful Bill Act (OBBBA). Most of the dollar limits currently in effect for 2026 will change for 2027."  MORE >>

"The paid sick leave legislation ... includes provisions that could create challenges for employers, including very loose requirements on the notice employees must give before taking leave. The paid family and medical leave law establishes a payroll-funded insurance program, providing qualifying employees with up to twelve weeks of paid leave at 80 percent of their average weekly wage, with contributions split between employers and employees."  MORE >>

"Participants in welfare benefit plans are using the same ERISA principles and legal theories prevalent in the 401(k) excessive fee litigation ... [including] [1] breach of fiduciary duty of prudence, [2] failure to monitor, [3] prohibited transactions with parties in interest, and [4] knowing participation in fiduciary breaches. This [article] provides an overview of voluntary benefits, the key allegations in this emerging litigation, and practical steps employers can take to mitigate risk."  MORE >>

"Alternative health plan designs are seen as a way to mitigate cost trends without resorting to blunt cost-cutting measures that can disrupt workforce satisfaction. In fact, nearly one-quarter of U.S. employers are expected to offer an alternative health plan this year, with another 36% actively considering adoption in 2027 or 2028. As these models gain traction, the industry is seeing a familiar pattern. Savings may look compelling on paper, but execution is the determining factor for success."  MORE >>

"[1] The IDR process has allowed providers to weaponize arbitration and must be addressed ... [2] [ERIC encourages] the Department to ... issue a new [MHPAEA] proposed rule ... to ensure employers have the clarity and flexibility they need to offer robust behavioral health benefits for a healthy, productive workforce.... [3] In working with DOL and PBGC ... reduce unneeded notices and simplify current disclosures while still providing important information regarding plan costs and financial literacy."  MORE >>