ERISA-ACA Compliance

The final version of the OBBBA contains a few items of note to the employee benefits community. Here are some of the details.

As we explained previously, funding for the Patient-Centered Outcomes Research Institute (PCORI) was supposed to end with filings and fees for plan years that began before October 1, 2019. In the words of the great philosopher Emily Litella, “Never mind.”

Starting in 2007, the Tax Relief and Health Care Act of 2006 (TRHCA) requires that the IRS release the upcoming year’s new HSA limits prior to June 1st. Thus, we now have the 2026 HSA limits.

The Affordable Care Act set affordability limits on group health plans. It also set significant penalties for failure to offer affordable plans. You need to use the new calculations to determine affordability of your plans.

When it seems like every letter of the alphabet has been thrown at you, we want to help you understand the similarities and differences between all of these different types of health care accounts available to employers to offer to their employees.

Apparently, when Christmas and Chanukah fall on the same day, Congress and the President believe a gift to employers is in order.

Two bills were signed into law on December 23, 2024. These two Acts change the requirements for distributing IRS Form 1095s to all employees, and much more.

Employers that offer High Deductible Health Plans (HDHPs) that provide telehealth benefits before the participant meets their annual deductible may need to amend their plan prior to their plan's year-end. The reason for this is that...

Employers that offer prescription drug benefits are required to provide an annual notice to all Medicare-eligible plan participants and qualified beneficiaries before October 15th of each year, the start of the Medicare open enrollment period. Most send it to all participants.

The IRS has released the 2025 ACA affordability percentage. Applicable Large Employers (ALEs) are subject to the affordability rules of the ACA. ALEs are defined as those employers who have 50 or more full-time equivalents during the appropriate Measurement Period.

We're often asked if vitamins of any kind (multivitamin, specific vitamins [such as B12, D, or K for example]) or others are eligible for reimbursement under a health care flexible spending account (FSA) or health reimbursement arrangement (HRA).

Spousal Incentive HRAs aren't new. But they're getting new exposure as a means of helping employers control health care costs, increasing employee recruiting and retention, and aiding employees when they have choices between two group health plans to elect a spouse's coverage over the employer's.

As we explained previously, funding for the Patient-Centered Outcomes Research Institute (PCORI) was supposed to end with filings and fees for plan years that began before October 1, 2019. In the words of the great philosopher Emily Litella, “Never mind.”