Employer Action Required: Distribute Medicare Part D Notices by October 15, 2025

This post is continually updated with the latest carrier information. Please be sure to check back for any additions. Group health plan sponsors must provide Medicare Part D “creditable coverage” (more…)

Medical Mutual Updates Regarding Modified Amendments Approved for ORC 3902.63 (Ohio HB 315) Cost-Sharing

Updated Certificate amendments were approved by the Ohio Department of Insurance in regards to the Ohio Revised Code section 3902.63 portion of Ohio House Bill 315 stating any cost-sharing, including (more…)

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…)

U.S. Supreme Court Upholds ACA’s Mandate for Free Preventive Care

On June 27, 2025, the U.S. Supreme Court upheld a key component of the Affordable Care Act’s (ACA) preventive care mandate (Kennedy v. Braidwood Management, Inc.). The Court’s decision requires (more…)

Medical Mutual: ODI Updates Therapy, Chiropractic Services Cost-Sharing Related to Ohio House Bill 315

Recently, Ohio Department of Insurance (ODI) clarified the Ohio Revised Code 3902.63 portion of Ohio House Bill 315 that any cost-sharing—copays, deductibles and coinsurance—applicable to services rendered by occupational therapists, (more…)

New Rule Cracks Down on Improper Enrollments, Protects Patient and Taxpayer Dollars, and Restores Marketplace Integrity

This post was originally published by the Centers for Medicare and Medicaid Services. The Centers for Medicare & Medicaid Services (CMS) is finalizing a major rule that will lower individual health (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 Updates From Kentucky kynect

Disaster Supplemental Nutrition Assistance Program Benefits for Those Affected by Severe Weather in Kentucky The Governor announced that residents in six counties who were affected by severe weather on May (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…)

UnitedHealthcare Nondiscrimination, Languages, and Accessibility Notice Available for Use

Please note: This 1557 communication and call to action does not apply to UMR, individual or standalone ancillary such as dental, vision, life. National Account customers should have already received (more…)

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