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News & Updates

ACA Pay-or-Play Rules: Key Changes for 2026

  • On September 17, 2025
The Affordable Care Act (ACA) requires applicable large employers (ALEs) to provide affordable, minimum-value (MV) health coverage to full-time employees (FTEs). Employers that fail to do so may face penalties if at least one FTE qualifies for a premium tax credit (PTC) to buy coverage on the Exchange. This requirement—commonly called the “employer shared responsibility” […]
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Year-End Disclosure Deadlines for Health Plans

  • On September 9, 2025
As the end of the calendar year approaches, employers that sponsor group health plans must ensure timely compliance with several federal reporting and disclosure requirements. These obligations, mandated under various federal laws, including the Employee Retirement Income Security Act (ERISA), the Affordable Care Act (ACA), and the Consolidated Appropriations Act(CAA), must be fulfilled promptly to […]
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MMO: 9/3/25 Broker Update

  • On September 3, 2025
Update: MedMutual WELL Webinar Cancelled Topic: Broker Relations | Companies: Medical Mutual Segment: 51-99, 100+, MEWA The upcoming MedMutual WELL™ webinars on Sept 9 at 10 a.m. and 3 p.m. are cancelled and will be rescheduled. Medical Mutual apologizes for any inconvenience and will update you with new dates soon. Reminder: Retro termination and addition guidelines […]
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ACA Employer Shared Responsibility: Key Updates for 2026

  • On September 3, 2025
The Affordable Care Act (ACA) requires applicable large employers (ALEs) to provide full-time employees (FTEs) with health coverage that is both affordable and of minimum value (MV). Employers that fail to meet these standards may face penalties under the “employer shared responsibility” (commonly called the “pay-or-play” rules). An ALE only becomes liable for penalties if one or more […]
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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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