2026 Affordability Percentage Set at 9.96 Percent

This update was originally published by Larry Grudzien. The IRS recently issued Revenue Procedure 2025-25, which significantly increases the affordability threshold for ACA employer mandate purposes to 9.96 percent for plan (more…)

PCORI Fees Due to IRS No Later Than July 31, 2025

Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due to the IRS no later than July 31, 2025, from employers who sponsor certain self-insured health plans, such as (more…)

Important Marketplace Loss of MEC SEP Verification Update

Pre-enrollment verification for the Marketplace loss of minimum essential coverage (MEC) Special Enrollment Period (SEP) began on Friday, May 16, 2025. How will this impact my clients? If your Marketplace (more…)

HSA/HDHP Limits Will Increase for 2026

On May 1, 2025, the IRS released Revenue Procedure 2025-19 to provide the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2026. The IRS (more…)

IRS Announces Excepted Benefit HRA Limit for 2026

On May 1, 2025, the IRS released the inflation-adjusted limit for excepted benefit health reimbursement arrangements (EBHRAs) for plan years beginning on or after Jan. 1, 2026. Effective for 2026 (more…)

New Executive Order Seeks to Lower Drug Prices and Improve PBM Transparency

On April 15, 2025, President Donald Trump issued an executive order (EO) that directs his administration to take a wide range of actions to lower prescription drug prices for patients (more…)

CMS Finalizes Revised Simplified Determination Method for 2026 Creditable Coverage Determinations

On April 7, 2025, the Centers for Medicare and Medicaid Services (CMS) issued Final Part D Redesign Program Instructions for calendar year 2026. The instructions contain a detailed description of, (more…)

Update Regarding Anthem’s Chamber Advantage Benefit Plan 1094B/1095B Tax Filings

This update applies to OH, KY, and IN MEWAs. Anthem Kentucky’s 1094B/1095B tax filings have been successfully completed for the participating employer groups enrolled in the ChamberAdvantage Benefit Plan for (more…)

Medical Mutual 1095-B Tax Forms Will Be Available on My Health Plan in Mid-Late February 2025

Medical Mutual members may download their 2024 1095-B tax forms directly from My Health Plan, their secure member portal, starting in mid-late February 2025. Here’s a list of Medical Mutual’s (more…)

Carrier Information for 2024 Prescription Drug Data Collection Submissions

The following post will be continually updated as we gather more information from our carrier partners. Please be sure to subscribe to the Monday Minute to ensure you’re receiving the (more…)

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