"The final rule aims to make improvements, particularly related to communications among group health plans and insurers, providers, and facilities with the certified IDR entities. The final rule includes varying applicability dates ranging from August 3, 2026, the effective date of the regulation, to 90 days after the effective date, depending on the specific provision. Final Rule on Independent Dispute Resolution Operations Share this page While the final rule is intended to improve IDR operations, it does not address other challenges."  MORE >>

"HHS and plan sponsor Star Group (SG) reached an agreement to resolve alleged HIPAA violations related to Star Group’s health plan, imposing $245,000 in fines and an extensive corrective action plan. The two-year corrective action plan will require the health plan to conduct a comprehensive HIPAA data security risk analysis, update training materials, and make annual reports to HHS. This enforcement action emphasizes the need for employers to prioritize security measures for health plan protected health information (PHI) and electronic protected health information (ePHI), as ransomware incidents can trigger government scrutiny and potential penalties under HIPAA."  MORE >>

"Cigna informed Plaintiff that it was denying coverage ... citing only its internal Medical Coverage Policy No. 0104 (MCP), a non-plan document ... The Ninth Circuit held that this was an improper post-hoc rationalization, because Cigna had relied only on the MCP during the administrative process, and the MCP and SPD are meaningfully different documents. A court may not affirm a denial on a rationale the administrator did not assert during the administrative process, as doing so deprives the claimant of the opportunity to respond and of the statutory right to full and fair review." [Roggenkamp v. Morgan Stanley Medical Plan, No. 24-7864 (9th Cir. June 5, 2026; unpub.)]  MORE >>

"Rising healthcare costs make parental leave an especially visible target for cost reduction. But PFML has become one of the most valued benefits outside of medical coverage -- particularly since the COVID-19 pandemic -- and remains a driver of employee morale and retention. There's a difference between cutting costs and creating savings; PFML cuts often deliver the first, while PFML optimization delivers the second."  MORE >>

"For adults in households below 150% of the federal poverty level (FPL), increases in public insurance coverage were associated with one-for-one decrease in uninsured and no change in ESI. For adults with incomes between 151% -- 400% FPL, each percentage point increase in public coverage was associated with about a 0.6 percentage point decrease in uninsured and a 0.4 decrease, or crowd out, in ESI."  MORE >>

"While good health may buy you more time and a higher quality of life in your later years, it can also bring greater health care costs in retirement. That's because living longer not only extends the amount of time you'll need to pay for routine health care but also increases your risk of chronic disease.... Here's what health care could cost you -- and how to plan for it."  MORE >>