Insights

In this quarter's The WellCents^® Show, the hosts share practical tools and knowledge to confidently manage investments, plan for retirement, and navigate market changes.

Learn how climate change and tariffs are impacting the construction industry and discover the evolution of family caregiver benefits.

On June 20, 2025, CMS issued the “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability Final Rule.” The rule makes several changes to annual cost-sharing limits and the definition of essential health benefits. The rule updates the methodology for calculating the “premium adjustment percentage,” which results in a revision of the previously announced maximum annual limit on cost-sharing for 2026 (which we originally reported on in an article in the October 22, 2024

On June 16, 2025, in J.H. et al v. United Behavioral Health et al, the United States District Court for Utah ruled that the defendant insurer’s decision to deny residential treatment benefits for an ERISA plan participant was arbitrary and capricious. The court granted summary judgment to the plaintiffs and remanded the case back to the insurer for reconsideration of the denied claims. Background In this case, the plaintiffs are parents of a daughter who was treated in a residential treatment f

Forty-four states currently have laws that require the continuation of group health insurance coverage that would otherwise be lost because of the termination of employment, reduction of hours, or other reasons. Many of these laws mirror some or most of the provisions of the federal COBRA law and are, for this reason, often called "mini-COBRA" laws for short. The key to understanding mini-COBRA laws is the general principle that where a state law and a federal law conflict, the federal law take

On June 11, 2025, Gov. Reynolds signed HF 330, which amends Iowa’s coverage mandates for autism spectrum disorder treatments. Specifically, the new law prohibits group health plans and insurance policies in the state from imposing coverage limits on the number of outpatient visits for applied behavior analysis and the number of visits with an autism service provider for treatment of autism spectrum disorder. The bill also removes references to annual limits to conform to federal mental health p

On May 24, 2025, Gov. Abbott signed SB 1257 into law. The law relates to gender transition procedures and requires both public and private plans in the state to cover the costs relating to the adverse effects of gender transition procedures, as well as the costs relating to reversing such procedures. The law imposes this requirement on fully insured plans (regardless of where the policy is issued) that provide coverage for gender transition. The requirements outlined in the law take effect on S

On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law. While the final bill omitted several of the benefit provisions included in the initial House legislation, it includes some noteworthy changes for employers as group health and welfare plan sponsors. (We previously provided our initial insights on the OBBBA in an article on July 8, 2025, which is included here with some additional commentary.) Extended Telehealth Provisions Relating to HSA Eligibility First,

On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law. While the final bill omitted several of the benefit provisions included in the initial House legislation, it includes some noteworthy changes for employers as group health and welfare plan sponsors. Extended Telehealth Provisions Relating to HSA Eligibility First, the new law permanently extends the telehealth relief provisions, which allow telehealth services to be offered to HDHP participants before the H