News & Analysis as of

Employer Group Health Plans Internal Revenue Service Health Insurance

Seyfarth Shaw LLP

Agencies Release 2026 Out-of-Pocket Limits and 2025 Limits for Health FSAs

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Recently HHS issued a memorandum announcing the maximum annual limitation on cost sharing (a/k/a out-of-pocket maximum) for 2026 and the IRS issued Rev. Proc. 2024-40 announcing the cost-of-living adjustments to certain...more

Ballard Spahr LLP

IRS Guidance Expands List of Preventive Care Benefits Under HDHPs

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The IRS recently issued Notices 2024-71 and 2024-75, which expand the list of “preventive care” benefits permitted to be provided by a high deductible health plan (HDHP) without a deductible and the list of benefits...more

Schwabe, Williamson & Wyatt PC

Is Your Group Health Plan “Affordable,” According to the IRS? ‎

The 2025 open enrollment season for employee benefits is swiftly approaching. With newly released IRS guidance, employers should review the cost of their group health plan(s) to ensure affordability. Companies that rely on...more

Genova Burns LLC

10th Birthday Wishes to the Affordable Care Act’s Employer Mandate

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The Patient Protection and Affordable Care Act (“ACA”) was signed into law by President Obama on March 23, 2010. ACA affected health insurance coverage, costs and preventive care. It also established the Health Insurance...more

Fisher Phillips

Open Enrollment Season in the Workplace: 5 Legal Considerations + Employer Takeaways

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Open enrollment season can put a spotlight on the many complex rules applicable to employer-sponsored health and welfare plans. As you announce your benefit offerings for the upcoming plan year and tirelessly work to inform...more

Bricker Graydon LLP

You May be Able to Increase Health Plan Premiums and Stay Affordable in 2025

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For the first time in four years, the IRS adjusted the affordability percentage used for the shared responsibility penalties. The IRS recently announced that the affordability percentage for 2025 will be 9.02%....more

Hall Benefits Law

Federal Agencies Issue Updated Instructions for Annual Submission of Gag Clause Prohibition Compliance Attestation

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​​​​​​​The U.S. Department of Labor (DOL), the U.S. Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) have updated the Submission Instructions and User Manual for the Gag Clause Prohibition...more

Woodruff Sawyer

Navigating Mid-Year Benefit Election Changes

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One of the most common questions that we receive is whether an employee can change their benefits elections after the plan year has already started (also referred to as a mid-year change).  The answer is very fact-specific...more

McDermott Will & Emery

IRS Announces 2025 Limits for Health Savings Accounts, High-Deductible Health Plans and Excepted Benefit HRAs

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The Internal Revenue Service (IRS) recently announced (see Revenue Procedure 2024-25) cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs), high-deductible health plans (HDHPs) and...more

Maynard Nexsen

Advantages and Disadvantages of Offering a Level-Funded Group Health Plan

Maynard Nexsen on

While level-funded group health plans are not entirely new, their adoption has expanded rapidly over the last few years, particularly among small to midsized employers. According to an annual KFF survey, among employers with...more

Seyfarth Shaw LLP

Employers May Have to Pay More in 2024 as Affordability Threshold Hits New Low for Second Year in a Row

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Seyfarth Synopsis: The IRS has announced adjustments decreasing the affordability threshold for plan years beginning in 2024, which may cause employers to have to pay more for ACA compliant coverage in 2024. The IRS...more

Williams Mullen

IRS Reduces 2024 Affordability Percentage

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The Internal Revenue Service (IRS) decreased the Affordable Care Act (ACA) affordability percentage for 2024 to 8.39%. This percentage is used to assess whether an applicable large employer’s (ALE) lowest-premium health plan...more

Bass, Berry & Sims PLC

Planning for Open Enrollment? Note the ACA Affordability Threshold Drop

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On August 23, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable Care Act (ACA) affordability threshold will be 8.39% for plan years beginning in 2024, a substantial decrease from the 9.12%...more

Baker Donelson

ACA Affordability Test Will Be More Difficult to Pass in 2024

Baker Donelson on

As employers are preparing for 2024 open enrollment, they should be aware that the Affordable Care Act (ACA) affordability safe harbors are going DOWN for 2024. The IRS has just released Revenue Procedure 2023-29, which...more

Bricker Graydon LLP

You May Need to Lower Employees’ Premiums to Keep Your Plan Affordable Under the ACA

Bricker Graydon LLP on

For the third year in a row, the IRS adjusted the affordability percentage used for the shared responsibility penalties down. The IRS recently announced that the affordability percentage for 2024 will be 8.39%. This is down...more

Woodruff Sawyer

Compliance Alert: Reminder PCORI Fees Due By July 31, 2023

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Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2023 deadline for paying fees that fund the Patient-Centered Outcomes...more

Poyner Spruill LLP

Cafeteria Plan Check-In: Claims Substantiation

Poyner Spruill LLP on

A recent memorandum from the IRS Office of Chief Counsel serves as a helpful reminder to check in on cafeteria plan administration and ensure all processes—including claims substantiation for medical expenses and dependent...more

Ruder Ware

2024 HSA Limits Are Announced

Ruder Ware on

On May 17, 2023, the IRS announced the Health Savings Account limits for 2024.  With respect to contribution limits, the limits are higher than the ones for 2023 and the required deductible and out-of-pocket maximums have...more

Goodwin

Employee Benefits Post-Dobbs: Considerations for Year-End Planning

Goodwin on

Much has been written about the Supreme Court’s decision in Dobbs v. Jackson to overturn the constitutional right to abortion. For employers in particular, the Dobbs decision raised a number of questions about employee...more

Woodruff Sawyer

IRS Releases Final Rule to Fix ACA’s Family “Glitch”

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On October 13, 2022, the IRS finalized regulations (the “Final Rule”) intended to revise the method of determining affordability under the Affordable Care Act (ACA) for an employee’s family members by considering whether the...more

Jackson Lewis P.C.

4th Quarter 2022 Quick Hits for Plan Sponsors and Administrators

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As we enter the fourth quarter of 2022, sponsors and administrators of employee benefit plans have a lot to juggle. From open enrollment and required notices to plan document deadlines, it is a busy time of year. Yet, there...more

Fisher Phillips

5 Most Important Steps for Employers Doing Their 2023 ACA Compliance Planning

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Applicable large employers must adhere to many Affordable Care Act (ACA) rules to remain compliant regarding group health plan offerings. We offer the following checklist of the five most helpful reminders you should take...more

Pillsbury - Policyholder Pulse blog

Abortion as an Employee Health Benefit – How to Protect against Potential Liability Post-Dobbs

Amazon. Bank of America. Citigroup. Dick’s Sporting Goods. JP Morgan. Kroger. Meta. Microsoft. Procter & Gamble. Target. Walt Disney Company. These are just a few of what is a growing list of companies that have offered to...more

Fisher Phillips

Treasury Proposes Rule to Fix Family Glitch for ACA Marketplace Coverage

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The Department of Treasury recently issued proposed regulations to alter the rules for how individuals can get a premium tax credit (PTC) to help pay for Marketplace health coverage starting in 2023. The new rules would base...more

Woodruff Sawyer

Compliance Alert: IRS Proposes Permanent 30-day Extension to ACA Reporting Deadline

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Insights December 3, 2021 /Employee Benefits On November 22, 2021, the IRS filed a Notice of Proposed Rulemaking (“Proposed Rule”) that among other things, provides for an automatic 30-day extension of the deadline for...more

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