Insights

On February 6, 2025, the New Hampshire Insurance Department announced the expansion of the New Hampshire Paid Family and Medical Leave (NH PFML) Program to include mental wellbeing support. Specifically, employees enrolled in an employer-sponsored NH PFML plan will now have access to cognitive behavioral therapy (CBT) services. These services will provide employees with an initial clinical assessment, personalized consultations with therapists, structured therapy modules, and ongoing mental hea

On December 20, 2024, the federal government approved New York's request to create a new tax aimed at generating billions of dollars in additional Medicaid reimbursement funds for the state. This “MCO Provider Tax” was originally instituted in the New York State fiscal year 2025 budget (signed April 20, 2024) as an amendment of the New York Public Health Law. Following a model already approved in California, the MCO Provider Tax would apply varying tax rates to Medicaid and non-Medicaid plans,

Effective January 1, 2025, the essential health benefit (EHB) benchmark plan for ACA plans in the state of North Dakota was updated. These changes affect plans offered in the individual market and small group plans offered by small employers in the state and include both cost-saving and coverage-enhancement measures. Changes to North Dakota’s EHB benchmark plans do not apply to grandfathered plans or large-group plans. Among the notable changes are increased coverage for hearing aids, dietary o

Beginning January 2025, employees taking Paid Leave Oregon were entitled to use any accrued sick leave, vacation, or other employer-provided paid time off (PTO) benefit to “true up” the wage-replacement benefit they receive from the Oregon Employment Department so that they receive a full-wage replacement while on Paid Leave Oregon. Also, the Oregon Employment Department is able to share an employee’s potential weekly benefit amount with employers so that employers know what amount of employer-

In 2024, the governor signed Senate Bill 2121, which included amendments to the temporary caregiver insurance (TCI) law that increased the amount of leave benefits available to employees beginning January 1, 2025. Under the previous law, eligible employees in Rhode Island could take six weeks of leave under TCI to care for a newborn, a newly adopted child, or a family member with a serious health condition. As of January 1, 2025, employees are entitled to seven weeks of leave, which will increa

With the enactment of H 35 on February 19, 2025, Vermont permanently separated its individual and small group health insurance markets. The state had required health insurance carriers to merge the two markets and their underlying risk pools following the passage of the federal ACA. However, the state began allowing the separation of the two markets on a temporary basis in 2022. Effective January 1, 2026, insurance carriers in Vermont shall determine the premiums for individual market plans sep

Beginning January 1, 2025, California employers are no longer able to require employees to use up to two weeks of paid time off (PTO) or vacation leave before receiving state-paid family leave (PFL) benefits. Previously, California employers could require employees to take up to two weeks of accrued vacation before employees could access PFL benefits. This change was a result of legislation, AB 2123, which was signed by Gov. Newsom on September 29, 2024. Employers should carefully review their

The current focus on ERISA health and welfare plan fiduciary obligations is likely here to stay.

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