Health and Welfare Plans Archives - EMPLOYEE BENEFITS BLOG

FAQs regarding the Skrmetti decision for healthcare entities and payors

by Gregory Fosheim, Travis Jackson, Kristen O'Brien, Sarah Raaii and Alden Bianchi | Jul 1, 2025 | Employee Benefits, Health and Welfare Plans

On June 18, 2025, the Supreme Court of the United States ruled in United States v. Skrmetti, upholding Tennessee’s SB1 law that limits access to gender-affirming care for minors. The court’s 6-3 decision, written by Chief Justice John Roberts, deemed the law constitutional under a rational basis review, determining it classifies based on age and medical use rather than sex or transgender status.

These FAQs highlight key implications for healthcare providers, hospitals, health systems, health plans, and employer plan sponsors navigating the ruling’s consequences.

Download the FAQs.

Vermont Enacts New Telehealth Legislation Impacting Health Insurers

by Amanda Enyeart and Alan LeBlang | Jun 18, 2025 | Digital Health, Employee Benefits, Health and Welfare Plans

Vermont’s governor recently signed S 30 into law. The legislation, which goes into effect on September 1, 2025, requires that health insurance plans provide coverage for healthcare and dental services delivered through telemedicine to the same extent as if the services were provided through in-person consultations. Health insurance plans must also provide the same reimbursement rate for services billed using equivalent procedure codes and modifiers, subject to the terms of the health insurance plan and provider contract, regardless of whether the service was provided in person or through telemedicine.

For more updates on state legislative and regulatory developments related to telehealth, check out the latest Trending in Telehealth published by the Health & Life Sciences Group.

Health Plan Provisions in the House Reconciliation Package

by Kayla Holgash, Maddie News, Debra Curtis, Rodney Whitlock, Amy Kelbick, Leigh Feldman, Josh Jorgensen and Julia Grabo | Jun 17, 2025 | Employee Benefits, Health and Welfare Plans

On May 22, 2025, the US House of Representatives passed its reconciliation package, now known as H.R.1, One Big Beautiful Bill Act, by a 215 – 214 – 1 vote, advancing an agenda that extends and builds on tax cuts enacted in President Trump’s first term. The bill contains several policies impacting group health insurance plans, health savings accounts, and employer tax credits for paid family and medical leave.

Read more about these proposed policy changes and others in this comprehensive report, which highlights the health-related provisions in the House reconciliation package.

IRS Releases 2026 Limits for HSAs and Excepted Benefit HRAs

by Evan Walters, Samuel Hamer, Edward Froelich, Michael Scarduzio and Matthew J. Blaney | Jun 10, 2025 | Employee Benefits, Health and Welfare Plans

On May 19, 2025, the Internal Revenue Service (IRS) released Internal Revenue Bulletin 2025-21. It includes Revenue Procedure 2025-19, which provides the 2026 inflation-adjusted amounts for health savings accounts (HSAs) as determined under Code § 223, as well as the maximum amount that may be made newly available for excepted benefit health reimbursement arrangements (HRAs) under Code § 54.9831-1(c)(3)(viii). Revenue Procedure 2025-19 is effective for HSAs for the 2026 calendar year and for excepted benefit HRAs beginning in 2026.

Learn more about other new IRS guidance in this Weekly IRS Roundup published by McDermott’s Tax Group.

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.

Read more here.

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.

Read more here.

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.

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