Open enrollment is a hectic and critical period for employers that often brings a risk of compliance errors. These mistakes can confuse employees and cause missed benefits, while also exposing employers to legal risks. This article highlights five common compliance pitfalls to avoid during open enrollment: Ineffective Communication of Benefit Changes – Benefit offerings often change … Continued
UNDERSTANDING AND DISTRIBUTING MLR REBATES Insurance carriers must issue Medical Loss Ratio (MLR) rebates by September 30 when too much of the prior year’s premiums went to administrative costs or profit instead of claims and quality improvements. Employers who received MLR rebate checks will need to determine how much—if any—belongs to the plan and its … Continued
How to position yourself as a trusted ACA compliance advisor For brokers and benefits advisors, Q4 planning doesn’t start in October. It starts now. September marks a critical moment in the annual ACA compliance cycle, when employers begin thinking about year-end strategies, benefits renewals, and how to avoid last-minute reporting panic. That makes now the perfect … Continued
NORTH CAROLINA PASSES NEW PBM LAW On July 10, 2025, North Carolina Governor Josh Stein signed into law the Act Supporting Community Retail Pharmacies and Improving Transparency (“the SCRIPT Act”). The sweeping law regulating pharmacy benefit managers (PBMs) in North Carolina is designed to improve transparency, strengthen consumer protections, and support community pharmacies. While most … Continued
THE ONE BIG BEAUTIFUL BILL ACT IMPACT ON EMPLOYEE BENEFITS The One Big Beautiful Bill Act of 2025 (OBBBA) introduces permanent changes to a range of employee benefits, creating a more stable and generous framework for employers and employees. HDHPs and HSAs Telehealth Services: High-deductible health plans (HDHPs) can now permanently cover telehealth before deductibles … Continued
SUPREME COURT AFFIRMS PREVENTIVE CARE PROTECTIONS UNDER THE ACA The U.S. Supreme Court has upheld a critical component of the Affordable Care Act (ACA), reinforcing the requirement that health insurers provide coverage for preventive services recommended by a federal expert panel. The decision ensures that Americans will continue to have access to early detection and … Continued
CONSOLIDATED APPROPRIATIONS ACT 2024 RXDC REPORTING DEADLINE The Centers for Medicare & Medicaid Services (CMS) has reaffirmed that the instructions for reporting 2024 Prescription Drug Data Collection (RxDC) remain unchanged from 2023. The deadline for employers and plan sponsors to submit 2024 data is Sunday, June 1, 2025. Overview of RxDC Reporting Requirements Each year, employers sponsoring … Continued
If your company provides an employee benefit plan governed by the Employee Retirement Income Security Act (ERISA), you are likely obligated to file Form 5500. This annual report discloses key details about your organization’s benefit offerings, such as welfare benefit plans (including medical, dental, life, and disability coverage), retirement plans, fully insured plans, and self-funded … Continued
The annual EEO-1 Report, mandated by the Equal Employment Opportunity Commission (EEOC), is a cornerstone of workplace diversity and anti-discrimination efforts in the United States. This data collection provides a demographic snapshot of America’s workforce, helping to monitor for discrimination and promote equal employment opportunity. Missing the deadline can lead to serious consequences, making it … Continued
ACA REPORTING Affordable Care Act (ACA) reporting for applicable large employers (those with 50 or more employees) was due for the 2024 plan year in March. Reporting to Employees – due March 3, 2025 Form 1095-C: For Applicable Large Employers (ALEs) to report health coverage offered to full-time employees. Form 1095-B: For employers with self-funded … Continued
