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What Happens to COBRA Coverage When Someone Moves Out of Their HMO Area?
When employees or their dependents lose group health coverage due to a qualifying event, COBRA ensures they can continue their health benefits. But what happens when a qualified beneficiary under COBRA relocates outside the service area of their HMO (Health...
ACA Compliance: Are Employers Required to Cover Spouses Under Group Health Plans?
As healthcare costs continue to rise, many large employers are reevaluating their group health plan offerings. A common cost-saving strategy is to exclude spousal coverage. But does this decision expose employers to penalties under the Affordable Care Act (ACA)? Let’s...
Are TPA-Administered Health FSAs Subject to HIPAA? What Employers Need to Know
As employers prepare to offer health flexible spending accounts (FSAs), a common question arises: Are health FSAs administered by third-party administrators (TPAs) subject to HIPAA’s privacy and security rules? The short answer is yes—and here’s why...
Do You Have to Offer Health Insurance? How to Count Employees for ACA Rules
If your business hires extra help during the holidays, you might wonder if you’re required to offer health insurance. That depends on whether you’re an Applicable Large Employer (ALE) under the Affordable Care Act (ACA). What’s an ALE? You’re an ALE if...
IRS Announces 2026 HSA Contribution Limits
The IRS recently announced the 2026 limits for Health Savings Accounts (HSAs) and High Deductible Health Plans (HDHPs). HSA contribution and plan limits will increase to $4,400 for individual coverage and $8,750 for family coverage. Changes to these limits will take...
Midyear Cafeteria Plan Election Changes: Financial Hardship and Health FSAs
Navigating cafeteria plans can be tricky for both employers and employees. A common question is whether financial hardship allows midyear election changes to health FSAs. Unfortunately, it doesn't. Why Financial Hardship Isn't a Qualifying Event IRS rules state that...
Managing Health Coverage for Employees on FMLA Leave: Handling Late Premium Payments and Account-Based Plans
Navigating the complexities of the Family and Medical Leave Act (FMLA) can be challenging, especially when it comes to maintaining health coverage for employees on unpaid leave. This guide will help you understand what to do when an employee on FMLA leave fails to pay...
HIPAA Special Enrollment Rights: Notices for Group Health Plans and Their Impact on HRAs, HSAs, and FSAs
HIPAA special enrollment rights allow eligible employees to enroll in health plans outside the regular enrollment period due to specific life events. These rights also impact Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs), and Flexible...
Are PCORI Fees Still Required for Self-Insured Health Plans in 2025? Everything You Need to Know
If your company sponsors a self-insured health plan, you might be wondering whether you still need to pay Patient-Centered Outcomes Research Institute (PCORI) fees. These fees, which fund research on patient-centered outcomes, have been a requirement for several...
HSA Contribution Limits for Spouses with Self-Only HDHP Coverage
Health Savings Accounts (HSAs) are a valuable tool for managing healthcare expenses, especially for those enrolled in high-deductible health plans (HDHPs). However, understanding the contribution limits can be tricky, particularly for married couples with self-only...
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