Newsroom

Curious about the CAA’s Gag Clause Attestation? This column covers why it exists, how it promotes transparency, and which plans must file by December 31. Fully insured employers have minimal responsibility, while self-funded and level-funded plans face distinct obligations.

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 ACA’s annual Special Open Enrollment Window runs 11/15 – 12/15, giving Small Group employers a one-month opportunity to enroll in medical coverage without meeting participation or contribution requirements. Learn what this means for 2026 coverage and what to keep in mind when submitting cases.

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.

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.

Medicare Part D creditable coverage notices are due October 14, 2025. IRA changes and a new CMS test impact employer plans. Fully insured carriers handle statuses, but self-funded and level-funded employers must confirm theirs. Resources are available to assist fully-insured clients.

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.