Health and Welfare Plans Archives - EMPLOYEE BENEFITS BLOG

Trump Administration Takes Steps to Enhance Healthcare Price Transparency

by Jeffrey Davis and Leigh Feldman | Jun 5, 2025 | Employee Benefits, Health and Welfare Plans

In May, the Trump administration issued guidance and requests for information (RFIs) to enhance healthcare price transparency, focusing on both hospitals and health plans. For hospitals, the guidance reiterates the need to provide actual dollar amounts for payer-specific negotiated charges in machine-readable files (MRFs) rather than percentages, and it seeks input on improving the accuracy and completeness of MRF data. For health plans, the RFI addresses concerns about file size and data integrity, and it explores the implementation of net prices for covered prescription drugs, indicating that the administration plans to issue revised schemas and may pursue further transparency rulemaking.

Read more here.

One Big Beautiful Bill Act Has Compensation & Benefits Impacts for Nonprofit Health Systems

by Travis Jackson, Robert C. Louthian, III and Kristen O'Brien | Jun 3, 2025 | Employee Benefits, Executive Compensation, Health and Welfare Plans

The US House of Representatives passed its One Big Beautiful Bill Act on May 22, 2025 (the Act), but nonprofit health systems may not find much about the Act that’s attractive. If passed by the US Senate and signed into law, the Act would threaten already thin operating margins at nonprofit hospitals and health systems by expanding the executive compensation excise tax, taxing parking, and similar employee benefits.

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Food as Medicine: A Deep Dive Into Reimbursement

by Mary Moll Alexandre, Stephen Bernstein, Debra Curtis, Amanda Enyeart, Jayda Greco, Dexter Golinghorst, Kayla Holgash, Alan LeBlang, Sarah Raaii and Kerrin B. Slattery | May 20, 2025 | Health and Welfare Plans

The topic of “food as medicine” has gained increased attention recently, driven by a growing recognition of the role nutrition plays in preventing and managing chronic diseases. However, marketplace participants continue to face various hurdles, such as funding and reimbursement, in launching initiatives and demonstrating their value and beneficial impact on global health and well-being.

Read more here.

New EO Targets Prescription Drug Costs – and Drug Manufacturers, Hospitals, and Health Centers

by Emily J. Cook, Michael Ryan and Sydney Merritt Martinez | May 15, 2025 | Employee Benefits, Health and Welfare Plans

On April 15, 2025, President Trump signed an executive order (EO) aimed at addressing the cost of prescription drugs. This EO, titled “Lowering Drug Prices by Once Again Putting Americans First,” outlines specific directives designed to reduce drug prices and improve access for US patients. Of particular note for sponsors and providers of employer health plans, the EO tasks the US secretary of labor with proposing regulations to improve employer health plan fiduciary transparency into direct and indirect compensation received by pharmacy benefit managers.

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5 Trends in Health Plan Regulations to Watch in New Trump Administration

by Sarah Raaii and Alden Bianchi | May 8, 2025 | Health and Welfare Plans

With a new presidential administration, the changing regulatory landscape regarding health benefits – often, the second-largest expense for a business after salaries – has been top of mind for HR executives. Much of the early commentary focused on contested “red state/blue state” issues, such as gender-affirming care. The president’s ever-growing list of executive orders now gives us additional hints about the health benefits items that have attracted the administration’s interest and driven changes in health plan regulation trends.

In this HR Executive article, Sarah Raaii and Alden Bianchi discuss five key health plan regulation trends that HR executives should watch under the new administration.

Access the article.

IRS Announces 2026 Limits for Health Savings Accounts, High-Deductible Health Plans, and Excepted Benefit HRAs

by Jacob Mattinson and Sarah Raaii | May 6, 2025 | Employee Benefits, Health and Welfare Plans

The Internal Revenue Service recently announced cost-of-living adjustments to the applicable dollar limits for health savings accounts, high-deductible health plans, and excepted benefit health reimbursement arrangements for 2026. All of the dollar limits currently in effect for 2025 will change for 2026, with the exception of one limit.

Read more here.

PBMs Score a Win in Federal Court Against State Regulation

by Alden Bianchi and Sarah Raaii | Apr 25, 2025 | Employee Benefits, Health and Welfare Plans

A recent federal court decision in McKee Foods Corp. v. BFP Inc. declared that Tennessee’s “any willing pharmacy” requirement was preempted by the federal Employee Retirement Income Security Act of 1974. This decision impacts self-funded group health plans, potentially allowing them to comply with a single set of rules nationwide rather than navigating conflicting state laws.

Read more here.

Trending in Telehealth: March 2025

by Amanda Enyeart and Lauren Ellison | Apr 22, 2025 | Digital Health, Health and Welfare Plans

In recent telehealth news, the governor of Mississippi has signed SB 2415 into law, which mandates that health insurance plans cover telemedicine services to the same extent as in-person consultations. The bill also requires that all health insurance and employee benefit plans in Mississippi reimburse out-of-network providers for telemedicine services under the same reimbursement policies applicable to other out-of-network providers.

Read more about other telemedicine-related legislative and regulatory developments in our monthly Trending in Telehealth report.

Senate Committee Advances Bills to Tackle High Drug Prices, Enhance Market Competition

by Christopher M. Bruno | Apr 18, 2025 | Employee Benefits, Health and Welfare Plans

The US Senate Judiciary Committee has advanced six bills aimed at reducing pharmaceutical prices and improving market competitiveness. These bills address various issues, including limiting the number of patents a biologics license holder can assert in litigation, clarifying the boundaries of permissible settlements in “pay for delay” agreements, and preventing “product hopping” by branded drug manufacturers. Additionally, the bills seek to curb abuses of the US Food and Drug Administration’s citizen petition process, improve interagency coordination on patent information, and mandate the Federal Trade Commission publish a report analyzing pharmaceutical benefit manager pricing practices and the pharmaceutical supply chain.

Read more here.

Reproductive Health Under Trump: What’s New and What’s Next

by Stacey Callaghan, Evie Atwater, Dexter Golinghorst and Caroline Reignley | Apr 1, 2025 | Digital Health, Employee Benefits, Health and Welfare Plans

Over the past two months, the second Trump administration has shifted federal policies and priorities regarding abortion, in vitro fertilization (IVF), contraception, and other reproductive-health-related matters – and it is expected to continue to do so.

Meanwhile, new regulatory developments in this area at the state level are also ongoing. Many states now require that insurance plans provide some combination of fertility benefits, fertility preservation, and coverage for a number of IVF cycles. After July 1, 2025, all large employers in California must provide insurance coverage for fertility treatments, including coverage for unlimited embryo transfers and up to three retrievals.

Read more here.

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