Each year group health plan (GHP) sponsors that provide prescription drug (Rx) coverage are required to annually disclose to Medicare Part D eligible individuals whether the coverage they offer is “creditable” or “non-creditable.” This is a mandatory annual requirement to inform Medicare-eligible individuals if their employer-sponsored Rx coverage is at least as good as Medicare Part D coverage, which helps them avoid lifetime late enrollment penalties. Plan sponsors must pro

The One Big Beautiful Bill Act created a new tax-advantaged savings vehicle called a Trump Account (TA), which is a new type of traditional individual retirement account (IRA) established by authorized individuals for the benefit of eligible children. These TAs are intended to encourage children to start saving and investing at an early age. Contributions to TAs were allowable starting July 4, 2026, and can be made by anyone, including parents/guardians, grandparents, philant

The IRS has issued proposed regulations addressing the Internal Revenue Code Section 129 nondiscrimination requirements for dependent care assistance programs (DCAPs), including dependent care flexible spending accounts (FSAs). In general, eligibility to participate in DCAPs and contributions and benefits under DCAPs must not discriminate in favor of highly compensated employees (HCEs) or their dependents. This requirement is generally satisfied if the DCAP eligibility classi

The U.S. Department of Labor (DOL) has issued a new proposed rule that would establish a new electronic delivery option for group health plan (GHP) administrators to furnish disclosures required under ERISA. The proposed rule, if finalized, would apply to GHPs on the first day of the first calendar year following publication of the final rule. The proposal aims to reduce the administrative burdens related to delivery of GHP disclosures and to improve participants’ ability to

The various federal agencies regularly release Affordable Care Act (ACA) and other indexed dollar limits for health and group benefit plans. We have updated the chart below (last published June 2026) to reflect the recently released ACA affordability percentage threshold and Federal Poverty Level Affordability Monthly Amount applicable for 2027. *PCORI fee amounts are generally effective for plan years ending on or after October 1st of the referenced year and before October 1

As of July 1, 2026, the State of New Jersey has enacted a new law, signed by Governor Mikie Sherrill, that effectively creates a new employer assessment designed to help fund the State’s growing Medicaid obligations. The law, among the first of its kind in the nation, imposes an annual assessment on employers that have 50 or more employees enrolled in Medicaid. The amount of the assessment varies based on the number of Medicaid beneficiaries associated with the employer. The

The Patient-Centered Outcomes Research Institute (“PCORI”) fee was established as part of the Affordable Care Act (“ACA”) to fund medical research through the PCORI Institute. Employers and plan sponsors who sponsored a self-insured medical plan that ended anytime during calendar year 2025 are required to report and pay the PCORI fee no later than July 31, 2026. Detailed guidance regarding how to calculate, report, and pay the fee is provided on the IRS PCORI fee webpage. A s

The various federal agencies regularly release Affordable Care Act (ACA) and other indexed dollar limits for health and group benefit plans. We have updated the chart (last published November 2025) to reflect the recently released maximum annual limit on cost sharing, the ACA failure to offer penalty amounts, and the Health Savings Account (HSA) and high-deductible health plan (HDHP) numbers for 2027. *PCORI fee amounts are generally effective for plan years ending on or afte

New Jersey has enacted an updated newborn coverage mandate that extends the period of automatic newborn coverage from 60 days to 90 days under certain health plans. This change reflects New Jersey’s continued effort to expand dependent eligibility protections—but its applicability varies significantly based on funding arrangement. Here’s what you need to know: What This Means for Fully Insured Plans For fully insured plans in New Jersey issued or renewed on or after March 8,

The One Big Beautiful Bill Act created a new tax-advantaged vehicle called a Trump Account (TA), which is a new type of traditional individual retirement account (IRA) established by authorized individuals for the benefit of eligible children. These TAs are intended to encourage children to start saving and investing at an early age. Contributions to TAs may start July 4, 2026, and can be made by anyone, including parents/guardians, grandparents, philanthropic contributors a

Group health plan (GHP) sponsors that offer prescription drug (Rx) coverage must, at least annually, notify Medicare Part D eligible individuals and the Centers for Medicare & Medicaid Services (CMS) of their plan’s creditable coverage status. Both disclosures (to Medicare Part D eligible individuals and to CMS) must meet specific form, content and timing requirements as prescribed by CMS . This update addresses the required disclosure to CMS and reminds plan sponsors that on

The Affordable Care Act’s (ACA) enhanced premium tax credits for low-income earners needing individual coverage were first expanded under the American Rescue Plan Act (ARPA) of 2021 and extended through 2025 under the Inflation Reduction Act (IRA). These subsidies are now set to expire on December 31, 2025. This has been a hotly debated issue and was in part what Congress and the President were fighting about, which led to the government shutdown. Objectively, these enhanced

The various federal agencies regularly release Affordable Care Act (ACA) and other indexed dollar limits for health and group benefit plans. We have updated the chart (last published October 2025) to reflect the recently revised final ACA cost sharing limit amounts for 2026 based on the new HHS methodology for calculating the limits. *PCORI fee amounts are generally effective for plan years ending on or after October 1st of the referenced year and before October 1st of the f

The various federal agencies regularly release Affordable Care Act (ACA) and other indexed dollar limits for health and group benefit plans. We have updated the chart (last published July 2025) to reflect the recently revised final ACA cost sharing limit amounts for 2026 based on the new HHS methodology for calculating the limits. *PCORI fee amounts are generally effective for plan years ending on or after October 1st of the referenced year and before October 1st of the foll

Each year group health plan (GHP) sponsors that provide prescription drug (Rx) coverage are required to annually disclose to Medicare...

On July 4, 2025, a major tax and spending bill was signed into law, commonly referred to as the One Big Beautiful Bill Act (the “OBBB”)....

President Donald Trump’s One Big Beautiful Bill (OBBB) was signed into law on July 4th. The OBBB was subject to intense negotiation and...

The various federal agencies regularly release Affordable Care Act (ACA) and other indexed dollar limits for health and group benefit...

The Patient-Centered Outcomes Research Institute (“PCORI”) fee was established as part of the Affordable Care Act (“ACA”) to fund medical...

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) generally requires parity between a group health plan’s medical/surgical (M/S) benefits and mental health/substance use disorder (MH/SUD) benefits. Plan sponsors should continue to ensure that they comply with MHPAEA and monitor any participant complaints and litigation regarding access to MH/SUD coverage under their group health plans. This update addresses a recently announced non-en