On January 29, 2026, the U.S. Department of Health and Human Services (HHS) officially released the maximum cost-sharing limits for the 2027 plan year. These figures represent a significant 13.2% increase over the 2026 limits, marking a substantial shift in potential out-of-pocket expenses for plan participants. 2027 Maximum Out-of-Pocket Limits For 2027, the maximum annual…
Employers must prepare for Affordable Care Act (ACA) reporting covering the 2025 calendar year. Staying ahead of these deadlines is critical for Applicable Large Employers (ALEs) and providers of self-insured health plans. Who is Required to Report? Reporting obligations under Internal Revenue Code Sections 6055 and 6056 fall into two main categories: Note for Self-Insured…
How to position yourself as a trusted ACA compliance advisor For brokers and benefits advisors, Q4 planning doesn’t start in October. It starts now. September marks a critical moment in the annual ACA compliance cycle, when employers begin thinking about year-end strategies, benefits renewals, and how to avoid last-minute reporting panic. That makes now the perfect…
Big changes are coming to women’s preventive care coverage! Starting with plan years on or after December 31, 2025, group health plans and health insurance issuers must expand their no-cost coverage for women’s preventive care. This expansion includes additional breast cancer imaging or testing needed to complete an initial mammogram, as well as patient navigation…
Big changes are coming to women’s preventive care coverage! Starting with plan years on or after December 31, 2025, group health plans and health insurance issuers must expand their no-cost coverage for women’s preventive care. This expansion includes additional breast cancer imaging or testing needed to complete an initial mammogram, as well as patient navigation…
At the close of 2024, Congress passed two new pieces of legislation: the Paperwork Burden Reduction Act and the Employer Reporting Improvement Act. These laws simplify the Affordable Care Act (ACA) reporting requirements for employers and introduce new limits on the IRS’s authority to enforce “pay-or-play” penalties, among other changes. Under the ACA, applicable large…
For employers subject to the Affordable Care Act (ACA), staying compliant with reporting requirements is non-negotiable. With 2025 due dates just around the corner, now is the time to prepare for distributing Forms 1095-C to employees and filing with the IRS. These forms provide essential information about health coverage offered to employees and are critical…
Most organizations treat employee benefits like a seasonal event. Open enrollment brings a flurry of activity – emails, seminars, and even benefits fairs. However, communication often dwindles after this initial push, leaving employees confused and underutilizing their valuable benefits. This is a missed opportunity. Research shows that employees crave more benefits education, spending hours researching…
The Affordable Care Act (ACA) requires large employers to offer affordable health insurance coverage to their full-time employees or face a penalty known as the “Pay or Play” tax. This tax is based on the employer’s average monthly wage (AMW) and the number of full-time employees. The affordability rate for employer-sponsored health coverage will increase from 8.39% to…
The Department of Health and Human Services (HHS) has issued a final rule that significantly expands the Mental Health Parity and Addiction Act (MHPAEA) requirements under the Affordable Care Act (ACA). This rule aims to ensure that health plans provide equal coverage for mental health and substance use disorder (MH/SUD) benefits as they do for…
