"Immediate actions (before final rule): [1] Inventory existing fertility benefits.... [2] Assess state requirements.... Planning (once final rule is published): [1] Decide whether to adopt excepted fertility benefits.... [2] Choose a delivery structure.... [3] Set benefit parameters.... [4] Prepare required participant notices.... [5] Review summary plan descriptions (SPDs) and plan documents ... [5] Coordinate with benefits counsel on tax treatment."  MORE >>

"[N]ew emerging 'dynamic copay' plans ... translate negotiated price variation into provider- and service-specific dollar copays displayed pre-service, often through app-based tools ... [The authors] examine the operational pre-requisites for 'copay integrity,' likely effects on out-of-pocket (OOP) predictability and spending in light of peer-reviewed evidence on tiered designs, and the constraints imposed by health insurance literacy ... [P]airing dynamic copays with reference pricing, layered onto a tiered network, may better address these limitations by strengthening steerage, improving OOP predictability and aligning member shopping incentives with higher-value care."  MORE >>

"Despite rising costs, enterprise employers aren't pulling back on benefits in 2026. They're taking a closer look at where dollars are going, paying more attention to how programs perform, and finding ways to stay competitive without letting benefits spending grow unchecked.... [O]rganizations with 500 or more employees are preserving core benefits while introducing tighter controls around spending, utilization, and administration."  MORE >>

"Start with the question. ... Validate the data. ... Integrate quantitative and qualitative data. ... Use a sequential process to analyze data. ... Look at the data through multiple lenses. ... Don’t overreact to outliers. ... Put the pieces together."  MORE >>

"Healthcare costs aren't evenly spread. A small group of members accounts for a disproportionate share of spending. Today, 1% of members drive 21% of costs, and 5% drive half. That concentration is only intensifying. High-cost claimants, those with over $100,000 in annual spend, have grown 61% in just a few years. No deductible can solve that."  MORE >>

"In 2021, the CBO estimated that the newly signed law would lower provider payments, especially out-of-network rates, while reducing commercial insurance premiums by roughly 1% and decreasing federal deficits by $17 billion through 2030. New data suggests a different trajectory, the CBO wrote ... even as the law fulfills its core goal of protecting patients from out-of-network balances on surprise bills. The issue stems from arbitration outcomes that have tilted in favor"  MORE >>

"Ultimately, in order to bridge the benefits trust gap, employees do not need more information. They need better context. Clear explanations, relevant examples, and insight into the rationale behind benefits decisions help employees connect cost, coverage, and value. When that connection becomes clear, trust strengthens. When it remains unclear, confidence declines."  MORE >>

"Rising caregiving burdens threaten retention, productivity and employer talent competitiveness.... 90% of HR report caregiving impacts absenteeism/productivity; only 37% trust current benefits are enough."  MORE >>

"These unofficial 2027 limits are determined using the Internal Revenue Code (IRC)'s cost-of-living adjustment methods, the Chained Consumer Price Index for All Urban Consumers (C-CPI-U) values through June, and Mercer's projected C-CPI-U for July and August. While adoption assistance program limits generally use the same indexing formula, they can't be reliably projected due to the small rounding threshold."  MORE >>

"In deciding whether to distribute the SMM versus an updated SPD, plan administrators should consider the number of modifications that need to be described and whether the use of the SMM alone would sufficiently apprise covered persons of their benefits, rights, and obligations under the plan."  MORE >>