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Anthem: Two Emergency Physicians Groups are Leaving Your Clients’ Health Plan Network

  • On August 28, 2025
The contracts with Allen Emergency Physicians, LLC and Lorain Emergency Physicians, LLC, are ending August 31, 2025. This means your client’s employees may pay more for non-emergency care received from these providers after August 30. Employees May Not Recognize These Provider Names If your client’s employees (or someone on their plan) received care from Allen and/or […]
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Medicare Creditable Coverage Determinations for 2026

  • On August 27, 2025
The Centers for Medicare and Medicaid Services (CMS) issued Final Part D Redesign Program Instructions for calendar year 2026. The instructions contain a detailed description of and guidance related to changes to the Medicare Part D benefit made by the Inflation Reduction Act of 2022 (IRA) that are newly in place for calendar year 2026. These changes […]
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Medicare Part D Notices Are Due Before Oct. 15, 2025

  • On August 19, 2025
Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare-eligible individuals before Oct. 15, 2025—the start […]
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OBBB Act Could Drive Migration Back to Group Health Plans — Consultants Should Prepare Now

  • On August 11, 2025
The One Big Beautiful Bill Act (“OBBB Act”), signed into law on July 4, 2025, is poised to reshape the health insurance landscape—particularly in the individual market. By rolling back key Affordable Care Act (ACA) subsidies, the legislation will likely drive premiums higher and reduce affordability for many individuals who have been relying on marketplace coverage. For […]
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Key Points for Employers: The OBBB Act and the Shift Back to Group Health Plans

  • On August 11, 2025
The intent of this article is to help employers understand how the One Big Beautiful Bill Act (“OBBB Act”)—specifically the rollback of Affordable Care Act (ACA) subsidies—may influence employee health coverage choices and drive enrollment back into your group health plan. What Changed? Why this Matters to Employers The Employee Decision Equation When choosing between individual coverage […]
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The “One Big Beautiful Bill” Act: What Employers Need to Know About the Potential Shift Back to Group Health Plans

  • On August 11, 2025
On July 4, 2025, President Donald Trump signed the One Big Beautiful Bill Act (“OBBB Act”) into law. While the legislation covers a wide range of tax and spending measures, several provisions have direct implications for the individual health insurance market—and, by extension, for employer-sponsored health plans. If your organization offers a group health plan, or is […]
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ACA Penalties for Applicable Large Employers (ALEs) Updated for 2026

  • On August 4, 2025
The IRS recently announced ACA pay or play penalty amounts for 2026. Quick Look As a reminder, these penalties are calculated monthly. The monthly penalty equals the annual penalty listed above divided by 12. The IRS only counts full-time employees when calculating penalties. The “A” Penalty An employer is subject to the “A” penalty if they fail […]
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Anthem: New Multi-Year Agreement with OhioHealth

  • On August 1, 2025
Anthem is pleased to confirm they reached a new multi-year agreement with OhioHealth effective 8/1/25. This agreement continues uninterrupted access to care at OhioHealth hospitals, facilities, and physician practices for Anthem members in all health plans, including employer-sponsored, individual, Medicare Advantage, and Medicaid health plan networks. If you have any questions, please visit anthem.com/OhioHealth or […]
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