Newsroom

The Affordable Care Act requires Medical Loss Ratio rebates when health plans fall short of required minimum spending on care and activities to improve the quality of care. Get details on 2024 rebates due in September in Paul Roberts’s new column.

The new federal budget law, OBBBA, brings sweeping changes to Medicaid, ACA subsidies, hospitals, and even HSAs and FSAs. These shifts will reshape coverage options for employees and pose new challenges for employers. Learn what’s coming in 2025–2026 and how group plans may need to respond.

Learn about California's new fertility benefit mandate for fully insured health plans, including IVF coverage, delayed to January 1, 2026. Find out who it applies to and what it means for employers and insurers.

California’s infertility and IVF mandate for fully insured plans just got a last-minute extension to January 1, 2026. The Legislature approved the change via a late-June budget trailer bill. Here’s what benefits professionals need to know about the delay — and what hasn’t changed.

PCORI fee season is here – but if your clients only offer fully insured plans, you can skip this one. For self-funded, level-funded, and certain HRA arrangements, however, the July 31 filing deadline matters. This column breaks down who files, how much to pay, and what’s excluded.

Clients often need to access Rx benefits before receiving their health plan ID Cards. Our handy Small Group Rx BIN and PCN table can provide the information they need.

The 6/1 deadline for RxDC reporting is approaching; group health plans must submit data on drug costs and healthcare spending. While carriers handle reporting for fully insured plans, employers still have responsibilities. For self-funded plans, the employer is responsible. Learn what’s required.