"The lengthy payment rule is an annual exercise in which the Centers for Medicare & Medicaid Services, which oversees the ACA, can set new standards for coverage. The rule for next year is more ambitious than in past years, with changes to how plans are designed, eligibility verification, and adjustments needed to implement congressional legislation, along with technical updates."  MORE >>

"holding that a decedent's repeated statements of intent to remove that beneficiary did not effect a change where he never took action to carry the intent out. The decision is a clear application of the substantial-compliance doctrine to a contested beneficiary designation under an ERISA plan, and it underscores how much weight the written designation carries when the record shows intent but no completed change." [Unum Life Ins. Co. of Am. v. Crane, No. 24-00230 (E.D. Ky. June 12, 2026)]  MORE >>

"[PwC estimated] that medical costs will go up by 9% in the employer market next year, and by 8.5% in the individual market. One of the largest drivers is providers' use of AI-enabled software and scribes that more thoroughly document the care that's delivered.... PwC said the financial impact isn't so much due to people using more medical services as 'changes in coded severity, case mix and paid amount per claim.' "  MORE >>

"Health plans are projecting the highest medical cost trend in nearly two decades, with commercial healthcare cost trend expected to rise to 9% in 2027.... [I]nflators include provider adoption of AI-enabled revenue optimization tools, growing provider reimbursement pressure, rising pharmacy spending, sustained growth in behavioral health utilization, and escalating out-of-network payment disputes under the No Surprises Act. Without macro health cost deflators, payers and employers face mounting pressure to act."  MORE >>

"Fiduciary oversight in health plan consulting means an advisor accepts legal accountability for acting in the plan's best interest, not just advisory responsibility, but a formal, contractual commitment to prudent plan stewardship. For self-funded employers, understanding why this standard is gaining traction is increasingly important as regulatory scrutiny and litigation risk around health plan management continue to grow."  MORE >>

"Even when ICHRA isn't the right fit, it creates leverage. Employers may get an ICHRA quote showing six- or seven-figure cost savings -- and, whether they switch or not, that quote puts pressure on the current carrier to negotiate. For smaller businesses, especially, that kind of leverage didn't exist before. This is about power. That leverage disappears if you're pitching ICHRA on the wrong assumptions -- and many brokers are, because the two biggest assumptions they bring to it are outdated."  MORE >>

"Voluntary benefits have officially outgrown their 'extras' label. What was once a supplemental perk has become a central lever in shaping the employee experience and, increasingly, a differentiator in the war for talent. The future of voluntary benefits is about delivering intentional, seamless and employee-centric experiences. Because at the end of the day, value isn't defined by how much you offer but by how it benefits employees and their families."  MORE >>