The PCORI fee applies to plan or policy years ending after Sept. 30, 2012, and before Oct. 1, 2029. IMPORTANT DATES Payment Deadline Issuers and plan sponsors must report and pay the PCORI fees annually using IRS Form 720. PCORI […]
GLP-1 Drugs: Employer Considerations
Health Coverage for GLP-1 Drugs: Employer Considerations Action Items KFF’s 2025 Employer Health Benefits Survey shows that: Nearly 20% of large employers (200+ employees) cover GLP-1 drugs when used primarily for weight loss; The largest employers (5,000+ employees) are the […]
Medicare Part D Changes
Medicare Part D Changes Affecting Employer Plans for 2026 and 2027 The Medicare Part D changes implemented under the IRA continue to apply for 2026 and are codified for 2027 and beyond. Employers that sponsor prescription drug coverage for Medicare‑eligible […]
RxDC Report
ACTION STEPS Deadline Reminder: RxDC Reports Are Due by June 1, 2026 Group health plans and health insurance issuers must annually submit detailed information on prescription drug and health care spending to the federal government. This reporting is referred […]
Health FSA Employee Guide
This Health FSA Guide explains what health flexible spending accounts are and how they work, discusses why they are a good choice and provides several FSA case studies.
Medicare Part D creditable/non‑creditable coverage disclosure to CMS due March 2, 2026
Employers with group health plans that provide prescription drug coverage to Medicare‑eligible individuals must submit an annual disclosure to the Centers for Medicare & Medicaid Services (CMS) indicating whether their prescription drug coverage is creditable or non‑creditable. Creditable coverage means […]
Medicare Part D Notice Due October 15th
Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. […]
Premium Tax Credit Income ranges for different household sizes
Below is a chart of the Premium Tax Credit calculation for 2026 In order to qualify for a PTC your income needs to be above 100% and below 400% of the federal poverty line. If your income is lower than […]
New Notice Requirement for Fixed Indemnity Coverage for 2025
Employers offering fixed indemnity coverage must comply with a new notice requirement for plan years beginning on or after Jan. 1, 2025.The new notice is designed to explain the limitations of fixed indemnity coverage and help prevent employees from mistakenly […]
