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Agencies Clarify How Certain Fertility Benefits May Be Treated as Excepted Benefits

"The Agencies also announced that they intend to propose notice and comment rulemaking to provide additional ways that certain fertility benefits may be offered as a limited excepted benefit if certain conditions are met and are considering whether to modify the standards under which supplemental health insurance coverage provided by a group health plan, including a supplemental benefit for fertility coverage, will be considered to satisfy the conditions for being an excepted benefit."

Open Enrollment Tips for Employers: Steps to Success

"[M]ake sure your deliverables are available in multiple formats ... [M]ap out how and when they will be deployed.... Use carrier resources ... After the open enrollment season ends ... Send out an email or newsletter.... Create a survey ... Respond to feedback."

California’s New Fertility Coverage Mandate: What Employers Need to Know

"[T]he law applies to certain fully insured medical plans in California that are issued or renewed on or after January 1, 2026.... This mandate does not apply to self-insured plans.... Plans subject to this mandate should expect to see some increase to their medical premiums upon their next renewal."

IRS Issues Affordability Percentage Adjustment for 2026

"[F]or plan years beginning in 2026, the affordability percentage for employer mandate purposes is indexed to 9.96%. This is a significant increase from 2025.... The IRS has also released Rev. Proc. 2025-26, which contains the indexed amounts used to calculate employer shared responsibility payments (ESRP) for 2026."

Enforcement of the HIPAA Reproductive Health Care Privacy Rule Vacated Nationwide

"This decision only impacts the changes to the Privacy Rule related to Reproductive Health Care Privacy Protections included in the Final Rule. It does not impact Covered Entities' or Business Associates' other obligations under the HIPAA privacy and security rules, nor does it impact any state law protections that may limit the disclosure of this information, which vary from state to state."  [Purl v. HHS, No. 24-0228 (N.D. Tex. Jun. 18, 2025)]

​​​​​Agencies Push Pause Button on Enforcement of MHPAEA 2024 Final Rule

"Employers with fully insured plans subject to MHPAEA should continue to communicate with their carriers to ensure the carrier is performing the NQTL analyses Employers with self-insured plans subject to MHPAEA ... should ensure their contract with their third party administrator (TPA) requires that the TPA complete and/or provide all of the data necessary for another party to complete the NQTL analyses ... Employers who have any carved-out coverages subject to MHPAEA should ensure the TPA for those benefits is assisting with and/or completing NQTL analyses relative to the specific benefits involved."

Fiduciary Duty in the Digital Age: Cybersecurity Best Practices for ERISA Plans

"Cybercriminals exploit weaknesses in systems, software, or human behavior to find opportunities for easy access (like compromised credentials) and steal information.... The digital nature of plan administration and the reliance on third-party service providers create ample access given the broad attack surface."

Critical Compliance Issues for Employee Benefits in 2025

"[1] Executive actions affecting health plans ... [2] Budget and spending priorities ... [3] Tax reforms and implications ... [4] Staffing cuts and their impact ... [5] Reducing employer reporting burdens ... [6] ACA market reforms ... [7] HIPAA and reproductive health privacy ... [8] Mental health parity compliance ... [9] FICA tax avoidance schemes."

Reminder: RxDC Reporting Due June First

"The 2024 reference year RxDC Reporting Instructions have been released, though there were no changes to the reporting requirements or data elements from last year.... The deadline to submit reporting for calendar year 2024 is June 1, 2025 (and continues each June 1st thereafter)."

Building Better Retirement Plans: Applying SECURE 2.0 Reforms

"Start with a comprehensive review of the current legislative landscape.... Evaluate each provision based on your unique needs, considering your industry, employee population, and retirement program goals.... Collaborate closely with stakeholders, including your recordkeeper, to ensure accurate amendments to your plan document for the selected provisions.... The retirement plan advisor should coordinate with your recordkeeper, payroll provider, and third-party administrators to ensure a smooth rollout of the updates."