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Articles by Jesse Hansen
FICA Wellness & SIMERP: Tax Savings vs. Compliance Risk
In a competitive labor market, employers are understandably looking for ways to stretch benefit dollars while enhancing the employee value proposition. Recently, we have seen a renewed marketing activity around so-called "FICA savings" arrangements that promise to reduce employment taxes while maintaining or even increasing employees' take-home pay. Prefer a quick overview?
IRS Releases 2026 HSA and HDHP Limits
Article Summary The IRS has released 2027 HSA and HDHP limits, giving employers and employees an early look at key contribution and plan design changes for the upcoming year. HSA contribution limits and HDHP thresholds will increase in 2027, making now a good time for employers to begin evaluating benefits strategies, employee communications, and enrollment planning.
Transparency in Coverage Requirements for Employers
Both the final regulation on Transparency in Coverage (TiC) rule, issued October 29, 2020, and the transparency requirements provisions for plans and issuers within the Consolidated Appropriations Act of 2021 (CAA) require notice and disclosure of health plan costs. Reporting requirements have been in place for a few years, but there remains confusion about what needs to be reported and when those reporting requirements went into effect.
RxDC Reporting 2026: What Employers Must Do
Under the Consolidated Appropriations Act, 2021 (CAA), group health plans and health insurers offering group or individual health insurance coverage must annually submit information about prescription drug and healthcare spending to the Center for Medicare and Medicaid Services (CMS). At the beginning of February, CMS released new instructions for the annually required prescription drug data collection (RxDC) reports due June 1, 2026. Prefer a quick overview?
San Francisco Releases Expenditure Rates for Health Care Security Ordinance
Quick Look San Francisco recently released the required 2026 expenditure rates for its Health Care Security Ordinance (HCSO). The HCSO requires covered employers to spend a certain dollar amount on healthcare (i.e. medical, dental, vision, prescription drugs) for covered employees. The minimum healthcare expenditure for each covered employee is determined quarterly by multiplying the employee’s total number of payable hours in the quarter by the applicable healthcare expenditure rate.
HIPAA Notice of Privacy Practices Update Required by February 16, 2026
Date 1.30.2026 Read Time 3 minutes HIPAA Notice of Privacy Practices update deadline: what employer health plans need to do by February 16, 2026 The deadline for covered entities to update their HIPAA Notice of Privacy Practices (Notice) to address substance use disorder (SUD) protections is February 16, 2026.
Year-End Benefits Compliance Reminders for Employers
Date 12.09.2025 Read Time 4 minutes End of year is a great time to review and prepare for upcoming compliance deadlines related to your group health plan offerings. Here’s what you need to know to prepare for a new year: The end of the calendar year means it is time again for employers that are “applicable large employers” (ALEs) or employers that sponsor self-insured health plans constituting minimum essential coverage (MEC) to prepare for ACA reporting.
OBBB Tax Credits and Deductions: What Employers Need to Know
Date 11.19.2025 Read Time < 1 minute In July, the “One Big Beautiful Bill Act” (OBBBA) was signed by the President. This new law includes significant changes impacting employers. These changes cover employee deductions for tips and overtime, and they expand the paid family and medical leave tax credit. In summary, the new legislation includes the following changes for employers: Tax deduction for employee tips up to $25,000 for tax years 2025 through 2028.
Updated Fertility Benefits Guidance: What Employers Need to Know
Date 10.30.2025 Read Time 5 minutes Quick Look The Departments of Labor, Health and Human Services (HHS), and Treasury jointly released new guidance on excepted benefits and the evolving landscape of fertility coverage, especially in light of Executive Order 14216. This article explains how employers can offer fertility benefits without triggering ACA compliance burdens. What are Excepted Benefits?
New Illinois Law Requires Coverage for Parents in Limited Circumstances
Date 10.08.2025 Read Time 2 minutes Illinois recently passed House Bill 5258, which requires that group health plan issued, amended, or renewed in the state offer coverage to parents and stepparents in limited circumstances. To meet the requirements, the parent or stepparent must live in the plan’s service area, and they must meet the IRS’ definition of qualifying relative. The new rules take effect January 1, 2026.
IRS Announces ACA Pay or Play Penalties
Date 7.24.2025 Read Time < 1 minute The IRS recently announced ACA pay or play penalty amounts for 2026. Quick Look The penalties apply to all Applicable Large Employers (ALEs). For 2026, the “A” penalty is $3,340 and the “B” penalty is $5,010. As a reminder, these penalties are calculated monthly. The monthly penalty is equal to the annual penalty listed above divided by 12. The IRS only counts full-time employees calculating penalties.
Do You Know What Your Annual Medicare Part D Notice Requirements Are?
Date 7.09.2025 Read Time 2 minutes October might seem far away, but it's never too early for a reminder that all employers sponsoring group health plans with prescription drug coverage, regardless of size, must ensure the Medicare Part D Creditable Coverage Disclosure notice is provided before October 15.
“Big, Beautiful Bill” and Its Impact on Employee Benefits
Date 7.07.2025 Read Time 3 minutes Quick Look Major Employee Benefit Updates: The OBBB permanently expands HSA eligibility (including for telehealth and direct primary care), raises the Dependent Care FSA limit to $7,500, and introduces “Trump Accounts” to support long-term savings for children.
United States Supreme Court Upholds HHS Authority Over ACA Preventive Service Requirements | OneDigital
Date 6.26.2025 Read Time 2 minutes Quick Look The U.S. Supreme Court upheld the authority of the HHS to enforce ACA preventive service mandates. USPSTF Secretary. Non-by the USPSTF without cost-sharing. The United States Supreme Court has issued its case challenging the Affordable Care Act’s (ACA) preventive services coverage requirements.
2025 Federal HR Regulations: Where Are We Now?
Date 6.17.2025 Read Time < 1 minute The pace of change this year has been relentless, especially regarding the slew of regulations impacting employers, their workforce and their businesses. With new rules emerging and change fatigue setting in, it was more important than ever to stay informed and ahead of compliance risk. As we reach the midyear mark, OneDigital’s Compliance Consulting leaders hosted a fast-paced webinar designed to catch you up and keep you compliant.
Staying Compliant: Health Plan Eligibility Do’s and Don’ts for Employers
Date 6.12.2025 Read Time 3 minutes While businesses do have some flexibility in designing eligibility criteria, those choices must align with a range of federal compliance requirements, including rules under the Affordable Care Act (ACA), ERISA, HIPAA, and Medicare Secondary Payer (MSP) regulations. To help employers navigate these rules with confidence, we've outlined the most important health plan eligibility do’s and don’ts.
Latest Trump Executive Order Aims to Cut Prescription Drug Prices
Date 5.14.2025 Read Time 2 minutes President Donald Trump has signed a new executive order that aims to reduce prescription drug costs through a “most favored nation” pricing policy. This order directs the U.S. government to pay no more for certain prescription drugs than other developed nations pay as their lowest price.
Need-to-Know Quarterly Compliance Recap for Employers [May 2025 Update]
Date 5.13.2025 Read Time < 1 minute Do you have trouble staying up-do-date on the whirlwind of requirements and regulations affecting your business? Our team has you covered. From new legislation to executive action, 2025 is shaping up to be a big year for compliance and employers need to be ready. Watch this on-demand webinar to hear insights from leaders in benefits, HR, and retirement planning as they break down what these latest developments mean for organizations like yours.
IRS Releases 2026 HSA and HDHP Limits
Date 5.07.2025 Read Time < 1 minute The IRS recently released Revenue Procedure 2024-25, which contains the 2025 limits for HSAs and high deductible health plans (HDHPs). Qualified individuals with self-only coverage will be able to contribute $4,300, a $100 increase from 2025. Qualified individuals with family coverage may contribute up to $8,750, a $200 increase from 2025. As always, individuals age 55 and older may make an additional $1,000 catch-up contribution.
White House Releases New Executive Order on Healthcare Price Transparency
Date 3.04.2025 Read Time 2 minutes The Trump administration has released another executive order (EO) with the potential to impact employers. It is titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information”.
New IRS Revenue Ruling Provides Tax Guidance for Paid Family and Medical Leave Laws
Date 1.23.2025 Read Time 2 minutes The IRS has published Revenue Rule 2025-4, which provides much-needed guidance on federal tax treatment of state paid leave laws. Over the last several years, many states have passed mandatory paid leave laws allowing employees to continue to receive at least partial wages when they cannot work due to injury, illness, or disability to themselves or covered family members.
United States Supreme Court Agrees to Hear Appeal on ACA Preventive Service Requirements
The upcoming Supreme Court case is the latest flare-up in a long-running dispute over the legality of Affordable Care Act provisions that compel insurers to cover preventative healthcare services. The United States Supreme Court agreed to hear an appeal that challenges the Affordable Care Act’s (ACA) coverage of preventive services. Originally heard in a Texas district court, a federal judge issued a ruling on the latest legal challenge to the ACA in Braidwood Mgmt. Inc. v. Becerra (Braidwood).
An Overview of Major State Law Changes in Health Insurance for 2025
Date 1.07.2025 Read Time 3 minutes During their 2024 legislative session, many states passed laws impacting employer group health insurance. With the start of the new year, these laws are now in effect. Read the roundup below to see where things currently stand. California Large employers (100 or more employees) are required to cover the diagnosis and treatment of infertility, including in vitro fertilization (IVF).
What Happens Next? 2024 Election Results and Other Compliance News
Date 11.19.2024 Read Time < 1 minute Attendees will walk away with: How GOP control of the Presidency and both houses of Congress could impact employers The impact of several state-level ballot initiatives on benefits and compensation regulations Analysis on the future fate of the ACA and Biden-era regulatory initiatives An overview of recent pieces of key compliance news, such as the termination of the DOL’s increase in overtime exempt salary thresholds by a federal judge Copyright © 2024...
New Jersey Releases 2025 Contribution Structure for Temporary Disability and Family Leave Programs
Date 11.14.2024 Read Time < 1 minute New Jersey recently announced the 2025 rates for the state’s temporary disability and family leave programs. New Jersey’s temporary disability insurance program (TDI) provides qualifying employees with up to 26 weeks of cash benefits through either a state or private employer plan. New Jersey’s temporary disability insurance program (TDI) provides qualifying employees with up to 26 weeks of cash benefits through either a state or private employer plan.
Federal Agencies Announce Benefit Plan Relief for Hurricane Victims
Date 11.13.2024 Read Time 2 minutes The Department of Labor, Treasury Department, IRS, and Employee Benefits Security Administration (“Departments”) recently announced benefit plan relief for individuals affected by Hurricane Helene and Hurricane Milton. The relief primarily impacts special enrollment periods, benefit claims and appeals, and COBRA timelines.
IRS Releases Guidance on Retirement Plan Overpayments
Date 10.24.2024 Read Time 2 minutes The IRS has published much-awaited guidance on what retirement plan sponsors should do in response to accidental overpayments. The IRS recently released Notice 2024-77, giving plan sponsors long needed guidance on how to correct inadvertent overpayments from a retirement plan. Prior to SECURE 2.0, plan sponsors either had to recoup overpayments or pay corrective contributions. SECURE 2.0 provided plan sponsors more options, which this notice helps clarify.
Compliance Wrapped Riverside
« All Events - 7:00 pm PST Join us for a year-end compliance update and holiday networking event. Learn about key regulatory changes to prepare your business for the new year. Details Time: 4:30 pm - 7:00 pm PST Venue Mission Inn Hotel & Spa 3649 Mission Inn Avenue Riverside, CA 92501 United States
Compliance Wrapped San Jose
« All Events - 6:00 pm PST Join us for a year-end compliance update and holiday networking event. Learn about key regulatory changes to prepare your business for the new year. Details Time: 3:30 pm - 6:00 pm PST
IRS Expands Preventative Care Benefits for High Deductible Health Plans
Date 10.18.2024 Read Time 2 minutes Two new IRS notices expand allowances for the reimbursement and tax deduction of medical purchases made by individuals with High Deductible Health Plans (HDHPs). The IRS recently released two important benefit plan notices. The first, Notice 2024-71, expands the products available for reimbursement under Code 213(d). Code 213 allows these expenses to be paid or reimbursed under an HSA, FSA, Archer MSA, or HRA.
Reminder: Massachusetts’ Health Insurance Responsibility Disclosure Form is Due December 15
Date 10.08.2025 Read Time 2 minutes Quick Look Employers with six or more Massachusetts’ employees need to complete and submit the state’s annual Health Insurance Responsibility Disclosure (HIRD) form by December 15, 2025. This year’s form will be made available on November 15, 2025. HIRD forms must be filed electronically. Who Must File the Massachusetts HIRD Form?
IVF Treatment Coverage Mandates: A State-by-State Breakdown
Date 10.10.2024 Read Time 10 minutes Recent attempts by Congress to mandate nationwide IVF insurance coverage have come up short. Now, numerous state governments are passing their own requirements. Insurance coverage of infertility treatments is one of the major benefit topics of the 2024 election.
IRS Increases 2025 ACA Affordability Percentage to 9.02% and Begins Publishing 2025 Plan Limits
Date 9.10.2024 Read Time 2 minutes With 2025 approaching fast, the IRS has begun to release some of next year’s indexing adjustment and benefit limits for health and welfare plans. One of the most-watched IRS adjustments each year is the required contribution percentage used to determine whether employer-sponsored health coverage is considered affordable under the Affordable Care Act (ACA). The IRS once again decreased the affordability baseline from 8.39% in 2024 to 9.02% in 2025.
San Francisco Releases Expenditure Rates for Health Care Security Ordinance
Date 8.05.2025 Read Time 4 minutes San Francisco has released the required 2026 expenditure rates for its Health Care Security Ordinance (HCSO). Quick Look San Francisco recently released the required 2026 expenditure rates for its Health Care Security Ordinance (HCSO). The HCSO requires covered employers to spend a certain dollar amount on healthcare (i.e. medical, dental, vision, prescription drugs) for covered employees.
IRS Releases FAQs on Education Assistance Benefits
Date 7.15.2024 Read Time 2 minutes The IRS has issued a new fact sheet that offers expanded guidance on employer-sponsored educational assistance programs, which can be a powerful recruiting and retention tool for business leaders. The Internal Revenue Service (IRS) recently issued fact sheet FS-2024-22 to answer frequently asked questions related to educational assistance programs, or EAPs, under Section 127 of the Internal Revenue Code (IRC).
Two Supreme Court Decisions Inject Uncertainty Into Benefit Plan Regulations
Date 7.09.2024 Read Time 3 minutes A pair of consequential Supreme Court decisions have complicated America's regulatory landscape. Here's what benefit plan sponsors need to know. Two recent United States Supreme Court decisions may increase employer confusion on the regulations that apply to their employee benefit plans. The decisions, Loper Bright Enterprises v. Raimondo and Corner Post, Inc., v. Board of Governors of the Federal Reserve System, did not deal with employee benefit plans directly.
Fifth Circuit Ends Nationwide Injunction on ACA Preventive Service Rules
Date 7.02.2024 Read Time 2 minutes On June 21, 2024, the Fifth Circuit Court of Appeals ended a nationwide injunction blocking federal agencies from enforcing the recent disputed Affordable Care Act’s (ACA) preventive health service mandates. However, in its ruling, the Fifth Circuit agreed with a lower court’s decision that the mandates could not be enforced against the parties that brought the litigation.
IRS Releases 2025 HSA and HDHP Limits
Date 5.14.2024 Read Time < 1 minute Beginning in 2025, qualified individuals with self-only coverage will be able to contribute $4,300. This marks a $150 increase from 2024 limits. Qualified individuals with family coverage may contribute up to $8,550; a $250 increase from 2024. As always, individuals aged 55 and older may make an additional $1,000 catch-up contribution.
HHS Issues Final Rule Aimed to Strengthen Nondiscrimination Protections in Health Plans
Date 4.30.2024 Read Time 4 minutes Section 1557 of the Affordable Care Act is historically one of the most litgated provisions of the sprawling healthcare law. After years of uncertainty, the final rule by the HHS provides clarity for health plan sponsors.
HHS Announces New HIPAA Rule to Support Reproductive Health Care Privacy
Date 4.25.2024 Read Time 3 minutes The new HIPAA provision imposes requirements on regulated entities that will provide additional protections for those seeking reproductive care. The Department of Health and Human Services (HHS) announced a new final rule meant to strengthen the HIPAA Privacy Rule by adding new prohibitions on the disclosure of protected health information (PHI) related to lawful reproductive health care.
Structural Biology 2024
This collection explores the nanoscale organization and function of proteins, protein complexes, and organelles. Readers will discover new views into the organization of the extracellular matrix, the ribosome, and Drosophila mechanosensation.
Lawsuit Filed Alleging Fiduciary Breach of Johnson & Johnson Health Plan
Date 2.16.2024 Read Time 3 minutes Johnson & Johnson, the medical and pharmaceutical megacorporation, is facing a novel class action lawsuit alleging that it overpaied for pharmacy benefits and therefore overcharged employee plan members and their dependents. A class action lawsuit has been filed against Johnson & Johnson. The plaintiff in Lewandowski v.
New York Releases 2024 Benefits for Disability Benefit Law
Date 10.17.2024 Read Time < 1 minute New York is one of a growing number of states that requires employers to provide disability benefits for off-the-job injuries and illnesses. The law provides certain weekly benefits to employees to offset lost wages. These disability benefits are cash only and cannot be combined with benefits received under New York’s Paid Family Leave law. A covered worker is any employee that is also a covered worker under New York’s workers’ compensation law.
Everything You Need to Know About Paid Family Leave in New York State
Date 11.18.2024 Read Time 2 minutes New York State’s Paid Family Leave Program provides paid leave to bond with a new child, care for a loved one with a serious health condition, or to help relieve family pressures when someone is called to active military service. New York Paid Family Leave Law applies to any employees of employers covered by the New York State Worker’s Compensation Law, regardless of the size of the employer. Public employers may opt-in to the program.
Gag Clause Prohibition and Attestation: How Can Health Plan Sponsors Comply?
Date 10.28.2024 Read Time 2 minutes In 2023, the Department of Labor, Health and Human Services, and the Treasury (Departments) jointly issued FAQ guidance addressing provisions of the Consolidated Appropriations Act, 2021 (CAA-21).
Complying With Various State Individual Health Care Mandates
Date 1.07.2025 Read Time 4 minutes One of the pillars of the Affordable Care Act (ACA) is the Shared Responsibility for Individuals. This provision requires individuals to carry minimum essential health care coverage or pay a shared responsibility penalty.
Washington’s Partnership Access Line (PAL) Assessment Due Dates for 2025
Date 10.16.2024 Read Time 2 minutes The state of Washington is now requires all “assessed entities” (which includes health carriers, self-funded multiple employer welfare arrangements, and other employer or entities that provide healthcare in the state) to pay a quarterly assessment to the state in order to fund its Partnership Access Lines (PAL) program. The assessment does not apply to dental-only or vision-only plans.
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