Employee benefits compliance made clear.

IRS guidance on HSAs changes under One Big Beautiful Bill Act (OBBB)

IRS Notice 2026-5 explains how recent law changes expand HSA flexibility, including permanently allowing first-dollar telehealth coverage retroactive to 2025 and clarifying that certain bronze, catastrophic, and direct primary care (DPC) arrangements can be compatible with HSAs starting in 2026. The guidance provides employers and employees with clearer rules around telehealth, individual market coverage, and DPC fees, while highlighting key compliance considerations to preserve HSA eligibility.

IRS indexes highly compensated and key employee thresholds

The IRS released Notice 2025-67, updating income thresholds that define highly compensated and key employees for non-discrimination testing across retirement and many non-retirement benefit plans. These updates affect employers offering §125 plans, DCAPs, FSAs, group term life, education assistance, and other benefits that rely on §414(q) definitions to ensure plans do not disproportionately favor higher earners. Employers should review these changes ahead of annual testing, particularly for plans like DCAPs that require early-year preliminary testing.

IRS finalizes instructions for ACA reporting (1094/1095-B & 1094/1095-C)

The IRS finalized 2025 ACA reporting instructions on October 30, 2025, confirming that employers no longer need to proactively distribute Forms 1095-B/C if they post a clear website disclaimer and provide the forms upon request (except for New Jersey residents, who must still receive them directly). The forms, codes, and deadlines remain unchanged—March 2, 2026, for furnishing forms to individuals and March 31, 2026, for electronic filing with the IRS. Employers should ensure compliance with the website disclaimer rules and verify their ACA reporting vendor contracts ahead of the 2026 reporting season.

PCORI fee amount adjusted for 2025-2026

The IRS released Notice 2025-61, increasing the PCORI fee to $3.84 per covered life for plan years ending on or after October 1, 2025, and before September 30, 2026. Employers with self-insured or level-funded plans, including HRAs and ICHRAs, must file and pay this fee using the second quarter Form 720 by July 31, 2026. Although the fee is relatively small, the IRS enforces compliance closely, so employers should carefully verify plan year end dates, use the correct form version, and retain documentation for at least four years.

IRS releases 2026 inflation adjustments, including FSA maximums

In Rev. Procedure 2025-32, the IRS announced updated inflation-adjusted limits for 2026 across several benefit arrangements such as health FSAs, transportation benefits, and QSEHRAs. Employers must ensure these new amounts are reflected in their plans and communicated to employees.

IRS releases 2026 inflation adjustments, including FSA maximums

The IRS has released new 2026 inflation adjustments impacting FSAs, QSEHRAs, commuter benefits, and more. This article breaks down each update in plain language, helping HR leaders understand what’s changing, what to review, and how to keep their benefits plans compliant. Learn how proactive HR teams use these annual updates to strengthen compliance processes and build employee trust.

Time to prepare for Gag Clause Prohibition Compliance Attestation (GCPCA) due to CMS by December 31, 2025

Under Section 201 of the Consolidated Appropriations Act (CAA-21), all group health plans must attest by December 31 each year that their contracts do not contain prohibited “gag clauses” restricting access to provider cost or quality data. Employers should confirm with carriers or TPAs whether such clauses exist, document efforts to remove them, and determine who will complete the online attestation to CMS. Even if a TPA or insurer handles the filing, the employer remains legally responsible for compliance and should keep all confirmations and documentation on file.

MLR rebates reminder for employers

Minnesota paid family and medical leave begins in 2026

Minnesota’s new Paid Leave program will require all employers to begin payroll contributions and offer job-protected family and medical leave starting January 1, 2026, with the first premium payment due April 30, 2026. Employers must also provide written notices to employees and display state-issued posters by December 1, 2025, and should prepare a formal Paid Leave policy to ensure compliance.

New flexibility for fertility benefits

On Thursday, October 16, 2025, federal agencies published new FAQs Part 72 granting additional flexibility for employers with respect to fertility benefits.

ACA women’s preventive service updates for 2026

The Affordable Care Act (ACA) requires non-grandfathered health plans to cover a specific list of preventive health services in-network without cost-sharing to the plan participant. As ACA-required preventive service recommendations are updated, plan years starting one year after the new recommendation must cover those updated services in-network with no cost-sharing.

Court decisions on gender dysphoria treatment

Health plans imposing restrictions or exclusions on gender dysphoria treatment can run into several legal discrimination issues. From ACA §1557 to mental health parity and Title VII civil rights, the law remains unsettled on this topic. So, restricting or excluding gender dysphoria treatment that is otherwise covered by the plan for other reasons (such as for cancer or congenital deformities) remains risky.

Price transparency rule

On September 2, 2025, the Department of Health and Human Services (HHS) published a final rule to enable better real-time cost-sharing of prescription drug benefits and speed up the process of securing prior authorizations for medications. The rules will modernize electronic prescribing, allow real-time prescription benefit checks (which show the drug cost for the insured patient at various pharmacies and what they could pay for alternative medications), and streamline prior authorization with modern API technology.

Nava ACA employer guide

Medicare Part D notices due October 15

Employers offering prescription drug coverage must notify all Medicare-eligible employees, dependents, and retirees each year by October 15 whether their plan is “creditable” or “non-creditable,” based on how it compares to Medicare’s standard drug coverage. Using CMS’s model templates, employers should confirm their plan’s status, send the appropriate notice, and retain distribution records for compliance.

Trial court vacates rules which expanded exemptions to contraceptive mandate

A recent court ruling vacated the ACA’s 2017 religious and moral exemption rules for contraceptive coverage, meaning most employers with non-grandfathered medical plans can no longer rely on those broad exemptions. Until the issue moves through expected appeals, only a very narrow set of employers qualify for outright exemption, while others with religious objections must follow the established accommodation process or work with legal counsel to determine next steps.

Affordability percentage increased to 9.96% for plan years beginning in 2026

The IRS increased the ACA affordability percentage to 9.96% for plan years starting in 2026, meaning employers can charge employees more for the lowest cost self-only plan while still meeting affordability requirements. Applicable large employers must choose a safe harbor method and set contributions before the plan year begins, with 2026 FPL affordability set at $129.89 per month.

Benefit provisions in the budget reconciliation bill signed into law

President Trump signed a major budget reconciliation bill on July 4, 2025, introducing several benefit-related changes, including permanent HSA compatibility with first-dollar telehealth, new allowances for direct primary care starting in 2026, and higher limits or expanded eligibility for programs like Dependent Care FSAs, adoption assistance, student loan repayment, and paid family leave credits. While proposals to enhance ICHRAs were not included, employers will need to prepare for these updates, consider plan amendments, and await IRS guidance on new tax-favored “Trump Accounts” launching in 2026.

House Ways and Means Committee introduces “Big Beautiful Bill”

The House Ways and Means Committee introduced a bill on May 13, 2025 that advances the President’s campaign promise to extend the 2017 tax cuts and includes several significant employee benefit proposals. Key provisions would codify and expand ICHRAs, enhance PFML and education assistance benefits, and make wide-ranging updates to HSAs and FSAs, including new compatibility rules, expanded contribution opportunities, and broader reimbursable expenses.

HR’s must-know guide to benefits compliance in Q1 2024

An on-demand recording covering the critical compliance items you need to understand and tackle over the next 90 days.

What is the Consolidated Appropriations Act of 2021 (CAA) and how does it impact employee benefits?

The Consolidated Appropriations Act (CAA) reveals the commissions, fees, and non-cash compensation that has historically been kept under wraps by benefits brokers. Our experts offer a brief overview of what the CAA means for employers, how this changes healthcare benefits, and steps to take to avoid a lawsuit.

What is ERISA (and what are ERISA employee benefits?)

The Employee Retirement Income Security Act (ERISA) oversees most employer-sponsored benefit plans, including health insurance. HR professionals must understand ERISA employee benefits and follow the guidelines to remain compliant. Here’s your guide to ERISA, what it covers, and how to stay compliant.

How do brokers support employee benefits compliance?

Employee benefits compliance is increasingly complex, and HR teams often struggle to keep up with changing regulations, documentation requirements, and eligibility rules. A strong employee benefits broker acts as a year-round compliance partner who helps manage risk, maintain accurate processes, and keep your organization audit ready. This guide explains what compliance entails and how the right broker provides the expertise and structure HR teams need.