Newsroom

January sets the tone for group health plan compliance and employee understanding. This column covers annual group size determinations, year-long settings, and why January is perfect for reinforcing benefits education as employees tackle new deductibles and rising health care costs.

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.

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.

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.

We break down the San Francisco HCSO – a local health care spending law that can apply to employers both inside and outside California. Whether fully insured or self-funded, employers with even one SF-based employee are generally subject to HCSO’s spending, reporting, & compliance requirements.

Paul Roberts breaks down ACA IRS reporting requirements for Applicable Large Employers (ALEs) and all employers with self-funded plans, California’s individual mandate reporting, reporting relief for employers impacted by LA fires, and new federal laws designed to ease reporting burdens.