Benefit Buzz - August 2025
August 20, 2025
Benefit tips brought to you by MFC Benefits, LLC
Learn more about the OBBB Act and the Supreme Court upholding ACA's Preventative Care Mandate.
OBBB ACT INCLUDES CHANGES FOR EMPLOYEE BENEFITS
On July 4, 2025, President Donald Trump signed the "One Big Beautiful Bill Act" (OBBB Act) into law. The OBBB Act includes a variety of changes for employee benefit plans, most of which are effective for 2026. Key changes include the following:
Health savings accounts (HSAs) - Effective Jan. 1, 2026, the OBBB Act allows individuals with direct primary care (DPC) arrangements to make HSA contributions if their monthly fees are $150 or less ($300 or less for family coverage). These dollar limits will be adjusted annually for inflation. A DPC arrangement is a subscription-based health care delivery model where an individual is charged a fixed periodic fee for access to medical care consisting solely of primary care services. In addition, the OBBB Act treats DPC fees as medical care expenses that can be paid using HSA funds.
Telehealth exception for high deductible health plans (HDHPs) - The OBBB Act permanently extends the ability of HDHPs to provide benefits for telehealth and other remote care services before plan deductibles have been met without jeopardizing HSA eligibility. This extension applies to plan years beginning after Dec. 31, 2024.
Dependent care assistance programs (DCAPs) - Effective Jan. 1, 2026, the OBBB Act increases the maximum annual limit for DCAPs from $5,000 to $7,500 ($3,750 for married individuals filing separately). The new limit is not adjusted for inflation going forward.
Student Loan Assistance - The OBBB Act permanently extends the student loan payment option for education assistance programs and adjusts the annual $5,250 limit for inflation beginning in 2027.
Trump Accounts - The OBBB Act creates a new type of tax-advantaged savings account for children, named Trump Accounts, effective for 2026. Employers may make tax-free contributions to the Trump Account of an employee's dependent of up to $2,500 (as adjusted annually for inflation beginning after 2027).
SUPREME COURT UPHOLDS ACA'S PREVENTIVE CARE MANDATE
On June 27, 2025, the U.S. Supreme Court upheld a key component of the Affordable Care Act's (ACA) preventive care mandate. As background, the ACA requires non-grandfathered health plans and health insurance issuers to cover a set of recommended preventive services without imposing cost-sharing requirements, such as deductibles, copayments or coinsurance, when the services are provided by in-network providers. The recommended preventive care services covered by these requirements include evidence based items or services with an A or B rating in the U.S. Preventive Services Task Force (USPSTF) recommendations.
The plaintiffs in this case had religious objections to the ACA's preventive care mandate and challenged its legality on various grounds, including the USPSTF's recommendations being not constitutional because its members had not been validly appointed. The lower courts agreed with the plaintiffs; however, health plans and issuers were required to fully comply with the ACA's preventive care mandate without interruption while the lawsuit proceeded.
The Supreme Court reversed the lower court's decision and upheld the constitutionality of the USPSTF's recommendations. Due to the Court's ruling, the ACA's preventive care mandate remains in full effect and health plans and issuers are required to continue covering the entire range of recommended preventive care services without cost sharing.
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Learn more about safe grilling tips, first-aid kit essentials and understanding the label on your sunscreen. GRILLING SAFETY TIPS Although grilling is a popular way to prepare food, it can also be dangerous. According to the National Fire Protection Association, an average of 9,000 home fires involve grills, hibachis or barbecues each year. May, June, July and August are the most active months for grill fires, with July being the top month. Some 4 million outdoor grills are used across the United States on any given summer day. Keep these 10 fire safety tips in mind when grilling: 1. Keep your grill at least 10 feet away from other objects, including your house, decks, outdoor seating and overhanging branches. 2. Set up the grill on a flat surface, and don’t bring it into an unventilated or enclosed space (e.g., garage or porch). This is not only a major fire hazard but also a carbon monoxide hazard. 3. Check the connection between the propane tank and the fuel line before using a gas grill to ensure it’s not leaking and is working properly. 4. Turn off the gas if you suspect that your gas grill is leaking, and get the unit fixed before lighting it. Never use a match to check for leaks. 5. Turn off the grill and the gas if your propane grill’s flame goes out, and wait at least five minutes before relighting the grill. 6. Only use starter fluid with charcoal grills— never with gas grills. 7. Keep children and pets at least 3 feet away from the area until the grill is completely cool. 8. Never leave your grill unattended while in use. 9. Avoid overloading the grill, as too much fat dripping at once can cause flare-ups. 10. Clean the grates and trays regularly to remove grease and fat buildup. Not only can grills start fires, but they can also cause burns. Exercise caution as you flip food on the grill to ensure your hands and arms do not get burned. Additionally, be sure to use long-handled utensils to help keep your hands at a safe distance from the flames. Overall, practicing vigilance and taking proper precautions while grilling can help reduce fires and associated burn injuries. FIRST-AID KIT ESSENTIALS Summer is synonymous with adventure and outdoor fun. Whether exploring a park, swimming, hiking a trail or road-tripping, having a first-aid kit can make all the difference in an emergency. A well-stocked first-aid kit can help you respond quickly and effectively to common injuries. Keep at least one first-aid kit in your home and your vehicle. Consider stocking these basic first-aid kit supplies: • Bandages of various sizes • Elastic bandage wrap • Flashlight and batteries • Hydrogen peroxide • Instant hot and cold packs • Scissors • Sterile gauze pads and tape • Thermometer • Tweezers Additionally, you can stock your kit with over-the-counter items, such as aloe vera gel, antihistamines, hydrocortisone cream, pain and fever medications, and sunscreen. Ongoing, remember to check the expiration dates and make sure you haven’t used up items and need replacements. UNDERSTANDING THE LABEL ON YOUR SUNSCREEN Skin cancer is the most common cancer in the United States. Most cases of melanoma, the deadliest kind of skin cancer, are caused by exposure to ultraviolet (UV) light. The sun’s rays can damage your skin in as little as 15 minutes. While there are several steps you can take to limit your exposure to the sun, proper sunscreen selection and application are critical. The Environmental Working Group (EWG) analyzed more than 2,200 sunscreens available for purchase in 2025. The EWG report revealed that just one-fourth of sunscreens on store shelves provide safe and effective protection. Remember that not all sunscreens are created equal, so it’s about finding the one you need for the specific weather and activity. Sunscreen labels must follow specific guidelines, so here’s what they exactly mean: • Broad-spectrum protection works against UVA (skin cancer and premature aging) and UVB (sunburn rays). • SPF is the level of protection against UVB rays. Experts recommend using sunscreen with an SPF value of at least 30. • Water-resistant sunscreen needs to be reapplied, depending on the brand, after 40 or 80 minutes of swimming or excessive swimming. • Sunscreens maintain their full strength for three years but always check the expiration date . Routinely inspect your skin for any spots or changes in color or appearance. If you have any concerns, talk to your doctor. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
Learn more about the U.S Supreme Court upholding state ban on gender-affirming care for minors and PCORI fees are due July 31,2025. U.S. SUPREME COURT UPHOLDS STATE BAN ON GENDER-AFFIRMING CARE FOR MINORS On June 18, 2025, the U.S. Supreme Court upheld the constitutionality of a Tennessee law banning certain medical care, such as puberty blockers and hormone therapy, for transgender minors under the age of 18. As a result of the ruling, the law will remain in effect and may shape how courts and legislatures approach gender-affirming care nationwide. Tennessee’s Senate Bill 1 (SB1) prohibits certain medical treatments (such as surgery, puberty blockers and hormones) that are intended to allow a minor “to identify with, or live as, a purported identity inconsistent with the minor’s sex” or to treat “purported discomfort or distress from a discordance between the minor’s sex and asserted identity[.]” The plaintiffs alleged that SB1 violated the equal protection clause of the 14th Amendment. The Supreme Court, in a 6-3 ruling, held that SB1 does not classify individuals based on sex or transgender status, and therefore, the law did not trigger heightened scrutiny. Instead, the Court applied the more deferential “rational basis” standard, which requires only that there are plausible reasons for government action. The Court found that SB1 “clearly met” this standard of review and did not violate the equal protection guarantee of the 14th Amendment, reasoning that the judiciary must grant states “discretion to pass legislation in areas where there is medical and scientific uncertainty.” Notably, the Court found their 2020 decision in Bostock v. Clayton County, which held that discrimination on the basis of sexual orientation constitutes sex discrimination under Title VII of the Civil Rights Act (Title VII), did not alter the analysis and declined to address whether Bostock’s reasoning reaches beyond the Title VII employment discrimination context. PCORI FEES ARE DUE BY JULY 31, 2025 The Affordable Care Act requires employers with self-funded health plans and health insurance issuers to pay Patient-Centered Outcomes Research Institute fees (PCORI fees). The fees are reported and paid annually using IRS Form 720, the Quarterly Federal Excise Tax Return. Form 720 and full payment of the PCORI fees are due by July 31 of each year and generally cover plan years that end during the preceding calendar year. For plan years ending in 2024, the PCORI fees are due by July 31, 2025. The PCORI fee amount is based on the average number of individuals covered under the plan. Final rules from the IRS require employers with self-funded health plans to use one of three alternative methods to determine the average number of individuals covered under the plan for a plan year: the actual count method, the snapshot method or the Form 5500 method. That number is then multiplied by the applicable rate for that tax year ($3.47 for plan years ending on or after Oct. 1, 2024, and before Oct. 1, 2025, or $3.22 for plan years ending on or after Oct. 1, 2023, and before Oct. 1, 2024). To assess their obligations, employers should: • Determine which plans are subject to the PCORI fees; • Assess plan funding status (insured versus selfinsured) to determine whether the issuer or the employer is responsible for the fees; and • Select an approach for calculating average covered lives for self-insured plans. The IRS provides helpful resources regarding PCORI fees, including a chart on how the fees apply to specific types of health coverage or arrangements. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
Learn more about summer food safety tips, reaping the health benefits of gardening, and sleep tips for the long summer days. SUMMER FOOD SAFETY TIPS You'll likely spend time outside with family and friends this summer at a picnic or backyard barbecue. However, if you aren't careful about handling foods and beverages during these cookouts, you're putting yourself and others at risk for potential food-related illnesses. The U.S. Centers for Disease Control and Prevention (CDC) estimates that 1 in 6 people get sick from a foodborne illness each year. Bacteria multiply especially fast in the summer heat, making outdoor cookouts prime breeding grounds for E. coli and salmonella. Symptoms of foodborne illnesses may include nausea, vomiting, diarrhea and abdominal cramping. Prevent food poisoning at picnics and barbecues with these four simple steps from the CDC: 1. Clean. Wash cooking equipment, dishes and utensils between uses. Be sure to clean the grill's surface after each use and wash cutting boards after preparing raw meat. Germs can survive in many places, so washing your hands and surfaces is critical. 2. Separate . Use one cooler for drinks and one for food. It's also important to separate raw foods (e.g., poultry, seafood and eggs) from those ready to eat. Lastly, never eat anything left out of a refrigerator or cooler for more than 2 hours or 1 hour if the temperature is above 90 degrees Fahrenheit. 3. Cook. Food is safely cooked when the internal temperature is high enough to kill germs that can make you sick. The best way to know if food is cooked properly is by using a meat thermometer. For example, burgers and hot dogs should be cooked to 160 degrees Fahrenheit and chicken to 165. 4. Chill. Refrigerate food promptly since bacteria can rapidly multiply if left at room temperature. The "danger zone" for bacterial growth is 40-140 degrees Fahrenheit. If you have mild food poisoning, it's important to say hydrated. Keep in mind that more serious cases, which often include a fever and dehydration symptoms, require medical attention. REAPING THE HEALTH BENEFITS OF GARDENING Interest in home gardening continues to rise amid economic concerns. Although the annual Axiom Gardening Outlook Study found overall decreases in time spent gardening and plans to expand gardens, younger generations have been picking up gardening tools in recent years and plan to continue. Generation Z (69.2%) and millennials (51%) are expected to spend more time gardening in 2025. There's no denying that gardening has numerous benefits. It's a good way for households to get healthier and cheaper food, but it also helps people reach their movement goals. The CDC counts weeding, mulching and mowing as moderate exercises, while raking and digging are vigorous. In addition to physical activity and healthier eating habits, consider these health benefits of gardening: - Increased vitamin D levels that are essential for body functions - Reduced cortisol levels that trigger stress - Improved mood - Relaxation and reduced anxiety - Boosted self-esteem If you haven't started gardening yet, it's not too late to start and reap the benefits of time outside. Talk to your doctor to learn more about ways to manage your well-being. SLEEP TIPS FOR THE LONG SUMMER DAYS As the days grow longer and temperatures rise, many people find falling and staying asleep increasingly difficult. In addition, people may have busy social schedules for the summer. Summer sleep disturbances can be frustrating, but with a few practical tips, you can improve your sleep quality despite the seasonal changes. Try these tips: - Keep a consistent schedule . Late nights can happen in the summer, and that's OK. Overall, try to stick to a regular and consistent sleep schedule to regulate your circadian rhythm. - Create a cool sleep environment. Keep your bedroom cool with fans and air conditioning, or prop open doors and windows. - Use lightweight fabrics. Opt for lightweight and moisture-wicking pajamas and bedding. Materials like cotton, linen, bamboo and silk can help you stay comfortable. - Try a sleep mask. Longer daylight hours can disrupt your sleep cycle, so wearing a sleep mask can help create a dark environment. Experts advise against blackout curtains, as some light alerts your body that the day is coming, - Stay hydrated. Drink plenty of water throughout the day to stay hydrated in the heat, but avoid large amounts right before bed to prevent waking up for bathroom trips. Remember, a good night's sleep is essential for overall health and well-being. Small changes can improve your summer slumber, but talk to your doctor for further sleep guidance. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
Learn more about the IRS releasing HSA/HDHP Limits for 2026 and Federal Agencies announcing the Nonenforcement Policy for Mental Health Parity Rule. IRS RELEASES HSA/HDHP LIMITS FOR 2026 On May 1, 2025, the IRS released the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2026. The IRS is required to publish these limits by June 1 of each year. These limits include the following: - The maximum HSA contribution limit - The minimum deductible amount for HDHPs - The maximum out-of-pocket expense limit for HDHPs These limits vary based on whether an individual has self-only or family coverage under an HDHP. Eligible individuals with self-only HDHP coverage will be able to contribute $4,400 to their HSAs in 2026, up from $4,300 in 2025. Eligible individuals with family HDHP coverage will be able to contribute $8,750 to their HSAs in 2026, up from $8,550 in 2025. Individuals aged 55 or older may make an additional $1,000 “catch-up” contribution to their HSAs. The minimum deductible amount for HDHPs increases to $1,700 for self-only coverage and $3,400 for family coverage for 2026 (up from $1,650 for self-only coverage and $3,300 for family coverage for 2025). The HDHP maximum out-of-pocket expense limit increases to $8,500 for self-only coverage and $17,000 for family coverage for 2026 (up from $8,300 for self-only coverage and $16,600 for family coverage for 2025). Employers sponsoring HDHPs should review their plans’ cost-sharing limits (i.e., the minimum deductible amount and maximum out-of-pocket expense limit) when preparing for the plan year beginning in 2026. Also, employers allowing employees to make pre-tax HSA contributions should update their plan communications with the increased contribution limits. FEDERAL AGENCIES ANNOUNCE NONENFORCEMENT POLICY FOR MENTAL HEALTH PARITY RULE On May 15, 2025, the U.S. Departments of Labor, Health and Human Services, and the Treasury (Departments) released a statement regarding the nonenforcement of the 2024 final rule under the Mental Health Parity and Addiction Equity Act (MHPAEA). The statement relates to a lawsuit brought by an employer trade group seeking to invalidate the final rule. The litigation has been put on hold while the Departments reconsider the final rule, including whether to modify or rescind it altogether. According to the Departments’ statement, they will not enforce the 2024 final rule (or otherwise pursue enforcement actions) based on a failure to comply that occurs prior to a final decision in the litigation, plus an additional 18 months . The Departments are also reexamining their MHPAEA enforcement program more broadly. MHPAEA requires parity between a group health plan’s medical/surgical benefits and mental health/substance use disorder benefits. The 2024 final rule’s changes are extensive and primarily focus on nonquantitative treatment limitations (NQTLs). NQTLs include a variety of strategies that generally limit the scope or duration of benefits, such as prior authorization requirements. The final rule generally applies for plan years beginning on or after Jan. 1, 2025; however, certain key requirements apply for plan years beginning on or after Jan. 1, 2026. Employer-sponsored health plans should continue to comply with MHPAEA’s statutory requirements and refer to a final rule from 2013 for guidance. Employers should also monitor updates regarding any modifications to the 2024 final rule. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
Learn more about boosting your mental health daily, spring clean your routine and how to reduce processed food in your diet. BOOSTING YOUR MENTAL HEALTH DAILY Mental Health Awareness Month is observed every May to help break the stigma and support people living with mental health conditions. Mental illness refers to a range of diagnosed conditions that affect a person's mood, behavior, feelings, thinking and, ultimately, ability to function in daily life. Millions of Americans live with serious mental disorders, such as anxiety, major depression and bipolar disorder. Half of the people in the United States will be diagnosed with a mental disorder at some point in their lifetime. Mental health plays a huge role in your overall health and well-being. It affects everything, including how you think, feel and act, and helps determine how you make healthy choices and cope with stress. Mental health is always there; your state continually changes depending on resources and challenging. Focusing on maintaining or improving your mental health is important, so here are five ways to boost your mental health on a daily basis: 1. Express gratitude . Taking five minutes daily to write down the things you are grateful for has been proven to lower stress levels and help you achieve a more positive mindset. 2. Be kind . Helping others and being kind not only helps the recipient but can also benefit your mental health. Simply holding the door for someone or giving a compliment can go a long way. 3. Get moving . Exercising regularly can benefit your brain function, reduce anxiety and improve your self-image. 4. Get a good night's sleep . Fatigued individuals typically experience drowsiness, mood changes, loss of energy and appetite, headaches, and a lack of motivation, concentration and alertness. Strive for seven to eight hours of quality sleep at night. 5. Spend time outdoors . Getting outside, especially when it's sunny, can greatly improve your mood and ability to focus. Seek help from your primary care doctor or a mental health professional if you're concerned about your mental health. If you need mental health-related crisis support or are worried about someone else, the 988 Suicide and Crisis Lifeline is available by calling or texting 988 and chatting online at 988lifeline.org. SPRING CLEAN YOUR ROUTINE Springs isn't just for cleaning out your closet. It's also a great time to refresh your mind and body. It's important to check in on yourself regularly; a routine refresh can help you avoid illness, reduce stress and feel in control. Consider the following ways to freshen up your daily routine this spring: - Assess your current routine. The first step in spring cleaning your routine is to take stock of your current habits and activities. Are there tasks or commitments that no longer serve you? Are there areas where you feel overwhelmed or stressed? - Declutter your home . No clothing, equipment or other belongings are off-limits, so get rid of items you don't use anymore. - Create space for self-care. Prioritize self-care activities or take a few moments each day to relax and recharge. You can better manage stress and improve you overall well-being by carving out time for the activities you enjoy. - Reset your recipes with seasonal produce and other ingredients. Spring produce includes vegetables like asparagus, artichokes, radishes, rhubarb and peas, as well as fruits like strawberries. In-season produce is picked at the peak of their freshness and nutritional value, packed with essential vitamins, minerals and antioxidants that boost the immune system. - Establish healthy habits. For example, you could commit to a regular sleep schedule or incorporate more movement into your day. Refreshing your routine can have a profound impact on your mental health. It can help you reduce stress, increase feelings of control and improve overall well-being. Start spring cleaning your routine today to create one that supports your mental health and enables you to thrive in spring and beyond. REDUCING PROCESSED FOOD IN YOUR DIET Processed foods have become a staple in American diets due to their convenience, taste, affordability and long shelf life. Yet, an increasing number of health experts are warning of the concerning impacts of these foods. A diet largely consisting of processed food can lead to chronic diseases, mental health issues, and even early death. Consider the following tips to remove ultra-processed food from your diet: -Read the label, checking for high amounts of additives, preservatives, sulfites, saturated and trans fats, and added sugar and salt. -Shop the perimeter of the grocery store and buy whole foods like fruits and vegetables. -Have healthy snacks on hand. - Swap refined grains - such as white pasta, rice and bread - for whole-grain options. - Cook meals at home and prep ahead of time. - Avoid processed meat (e.g., sausage, hot dogs, and lunch meat) Cutting highly processed items out entirely can be difficult, so start with these small steps. Before making dietary changes, consult your doctor. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
Learn more about the new executive order that is aiming to reduce drug costs by aligning with global prices. NEW EXECUTIVE ORDER AIMS TO REDUCE DRUG COSTS BY ALIGNING WITH GLOBAL PRICES On May 12, 2025, President Donald Trump issued an executive order (EO) that aims to bring the prices Americans pay for prescription drugs in line with those paid by similar nations. According to a White House fact sheet, the prices Americans pay for brand-name drugs are more than three times the price other nations pay. In April, President Trump signed another EO aimed at lowering prescription drug prices, which included a variety of directives related to the Medicare program and the pharmaceutical industry. The directives may not have an immediate impact on drug costs, as they will take time to implement. Key Directives The most recent EO outlines a number of actions intended to lower prescription drug prices in the United States. Among other things, the EO directs: - The U.S. Trade Representative and Secretary of Commerce to take action to ensure foreign countries "...are not engaged in practices that purposefully and unfairly undercut market prices and drive price hikes" in the U.S.; - The Trump administration to communicate price targets to pharmaceutical manufacturers; and - The Secretary of Health and Human Services (HHS) to establish a mechanism through which American patients can buy their drugs directly from manufacturers who sell to Americans at a "Most-Favored-Nation" price. Notably, if drug manufacturers fail to offer most-favored-nation pricing, the EO directs the Secretary of HHS to: 1. Propose rules that impose most-favored-nation pricing; and 2. Take "other aggressive measures to significantly reduce the cost of prescription drugs to the American consumer and end anticompetitive practices." This includes, but is not limited to, enforcement action by the U.S. Federal Trade Commission. Potential Legal Hurdles While the EO directs the Secretary of HHS to communicate most-favored-nation price targets to pharmaceutical manufacturers within 30 days, it is expected to face legal challenges. Industry professionals reference a similar proposal from Trump's first term, which aimed to link Medicare payments for certain medications to the lowest prices paid by other countries. This proposal was blocked by federal courts for not adhering to the notice and comment process required by the Administrative Procedure Act. Thus, the immediate impact on drug costs remains to be seen. Highlights - The EO directs HHS to communicate most-favored-nation price targets to pharmaceutical manufacturers within 30 days -The EO is expected to face legal challenges, so the immediate impact on drug costs remains to be seen Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
Learn more about the DOL updating the Model Employer CHIP Notice and when the Prescription Drug Report is Due. DOL UPDATES MODEL EMPLOYER CHIP NOTICE The U.S. Department of Labor (DOL) has released a new model Employer Children’s Health Insurance Program (CHIP) Notice with information current as of March 17, 2025 . As a reminder, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) imposes an annual notice requirement on employers that maintain group health plans in states that provide premium assistance subsidies under a Medicaid plan or a CHIP plan. An employer can choose to provide the notice on its own or concurrent with the furnishing of: • Materials notifying the employee of health plan eligibility; • Materials provided to the employee in connection with an open enrollment or election process conducted under the plan; or • The Summary Plan Description. An employer is subject to this annual notice requirement if its group health plan covers participants who reside in a state that provides a premium assistance subsidy, regardless of the employer’s location. The DOL’s model notice, which employers may use for this disclosure, is updated periodically to reflect changes in the states that offer premium assistance subsidies. The DOL’s model Employer CHIP Notice includes information current as of March 17, 2025. Employers could also choose to prepare their own notices or modify the model notice. Employers should be sure to include at least the minimum relevant state contact information for any employee residing in a state with premium assistance. PRESCRIPTION DRUG REPORT IS DUE BY JUNE 1, 2025 Group health plans must annually submit detailed information on prescription drug and health care spending to the federal government. This reporting is referred to as the prescription drug data collection, also known as the RxDC report. The next RxDC report is due by Sunday, June 1, 2025 , covering data for 2024. Employers should confirm they are taking steps to comply with this reporting deadline, such as providing information to third-party vendors on a timely basis. The RxDC report is comprised of several files, including those that require specific plan-level information, such as plan year beginning and end dates and enrollment and premium data. It also includes files that require detailed information about medical and pharmacy benefits. RxDC reports must be submitted through an online portal maintained by the Centers for Medicare and Medicaid Services (CMS). The agency’s RxDC website includes updated reporting instructions and other reporting resources. Employers commonly use third parties, such as issuers, third-party administrators (TPAs) and pharmacy benefit managers (PBMs), to submit RxDC reports on behalf of their health plans. Employers using third parties to submit RxDC reports must ensure that this reporting responsibility is reflected in a written agreement with the third party. Employers may work with multiple third parties to complete the RxDC report for their health plans. For example, a self-insured employer may use both its TPA and PBM to submit different portions of the RxDC report. A health plan’s submission is considered complete if CMS receives all required files, regardless of who submits them. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
Learn more about allergy-proofing your spring, creative ways to take more steps and the impact of chronic stress. ALLERGY-PROOF YOUR SPRING You may notice that you sneeze and cough more during certain times of the year. In this case, you may have seasonal allergies, which are allergy symptoms that occur during specific times of the year, typically when allergens are released into the air. The most common spring allergy trigger is tree pollen, which peaks from March to May. The Asthma and Allergy Foundation of America reports that 81 million people in the country are allergic to pollen, grass and weeds in the spring. You can reduce your exposure to seasonal allergens and their impact on your body, such as sneezing, stuffy or runny nose, and watery eyes. Try these strategies to manage seasonal allergies: • Keep track of pollen and mold counts. Pollen and mold counts can be found online or on the local news. Monitoring allergens, especially tree pollen, can help you know when to avoid spending excessive time outside. • Keep the indoor air clean. Closing windows and doors can help prevent allergens from entering your home and sticking to items like furniture and carpet. Lean on air conditioning, and be sure to change high-efficiency particulate air (HEPA) filters often. • Shower and put on clean clothing after spending time outdoors . After playing or working outdoors, pollen may be stuck to your clothes, hair and skin, which can irritate your allergies. • Bathe pets often. If your pets go inside and outside, they are likely tracking in pollen on their coats. Bathe them weekly, especially after spending a lengthy time outdoors. • Wash bedding weekly in hot water. Pollen can settle on sheets and blankets, triggering allergy symptoms at bedtime and disrupting your rest. • Vacuum regularly . When pollen levels are high, vacuum floors at least once a week. It’s also best to use a vacuum with a HEPA filter. For many people, avoiding allergens and using over-the- counter medications are enough to ease their allergy symptoms. Talk to your doctor if your symptoms remain bothersome; they can provide guidance on alternative treatments. CREATIVE WAYS TO TAKE MORE STEPS Walking is one of the most accessible forms of exercise. Its benefits extend beyond physical health, as it can also boost your mood and help with mental clarity. Whether new to fitness or just looking to increase your daily movement, walking offers an easy and effective way to improve your well-being. However, finding the time or motivation to walk more often can be challenging. Here are some creative and fun ways to get more steps in: • The 6-6-6 method —One version of this challenge involves walking for 60 minutes at 6 a.m. and 6 p.m. daily, with a suggested six minute warm-up and six-minute cool-down. Another version is to walk for six minutes six times a day for six days a week to fit in more movement during the day. • The 12-3-30 workout —Set a treadmill at a 12% incline and 3 mph and walk for 30 minutes. Incline walking adds intensity to your walk to help boost calorie burn and muscle engagement. If you take a walk outdoors instead, use hilly routes or find stairs. • An active (or fake) commute —If you’re a remote worker, you could take a 10-minute walk in the morning or stroll after work. The point of a fake commute is to use the time that’d normally be spent commuting to an office and use it to make the day more active. • Walking in place —You can do this anywhere: while watching TV, during a phone call or while waiting for something. For an extra challenge, try adding variations like marching, high knees or using light hand weights. Walking is one of the easiest ways to improve your health and well-being; these creative strategies can help make it a regular part of your lifestyle. Talk to your doctor and discuss what works best for you to learn more about creating an active routine. THE IMPACT OF CHRONIC STRESS Stress is defined as a “state of worry or mental tension” often brought on by a difficult situation. It’s a natural reaction to perceived threats. Stress can be a good thing in small doses; it’s the body’s way of handling sudden demands and challenges. Stress responses can enhance your focus, increase energy and promote quick responses. However, frequent and long-term chronic stress can negatively impact your health. Stress triggers are deeply personal, and each person experiences this feeling differently. While stress is a normal part of life that will come and go as you navigate various life circumstances (e.g., getting a new job or presenting a project), chronic stress is different. It’s characterized by prolonged and constant feelings of pressure and anxiety. Chronic stress can contribute to feelings of anxiety and depression, issues with high blood pressure, a weakened immune system, sleep disturbances and digestive issues. Chronic stress, if left unchecked, can have a long-lasting impact on your physical and mental well-being. If you’re experiencing symptoms of chronic stress, reach out to your health care provider or employee assistance program for guidance and support. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
Learn more about class-action lawsuits that target health plan tobacco surcharges and the IRS issues ACA reporting guidance on individual statements. CLASS-ACTION LAWSUITS TARGET HEALTH PLAN TOBACCO SURCHARGES Numerous class-action lawsuits have recently been filed against employers alleging that health plan premium surcharges related to tobacco use violate federal compliance requirements. These lawsuits have been filed by current and former employees of major U.S. companies who have paid more in premiums due to their tobacco use, often hundreds of dollars more per employee per year. Employers commonly require tobacco users to pay an additional charge for health plan premiums, whether they use cigarettes, cigars, e-cigarettes or smokeless tobacco. To comply with federal law, tobacco surcharges must be offered through a wellness program that meets the Health Insurance Portability and Accountability Act’s (HIPAA) nondiscrimination requirements. In general, the lawsuits assert that the health plans violated HIPAA’s nondiscrimination rules by: • Not offering a reasonable alternative standard to avoid the surcharge (or only applying the premium reduction on a prospective basis after completing the alternative standard) • Not describing the availability of the alternative standard in all plan materials The lawsuits request various forms of relief, including reimbursing employees who paid the surcharges with interest, disgorging any benefits or profits, and paying all attorney fees and costs. Given the recent wave of litigation, employers that impose tobacco surcharges should review whether their wellness programs are administered in accordance with HIPAA’s requirements, including making available a reasonable alternative standard to qualify for the full reward and communicating the surcharge to employees in all materials. IRS ISSUES ACA REPORTING GUIDANCE ON INDIVIDUAL STATEMENTS The IRS has issued Notice 2025-15, providing guidance on the alternative manner of furnishing statements to covered individuals and full-time employees using Forms 1095-B and 1095-C in accordance with the Affordable Care Act’s (ACA) reporting requirements. The Paperwork Burden Reduction Act, enacted at the end of 2024, provides that reporting entities are no longer required to send Forms 1095-B and 1095-C to covered individuals and full-time employees unless a form is requested. Essentially, IRS Notice 2025-15 confirms that employers can satisfy the alternative manner of furnishing Forms 1095-C upon request if they comply with the alternative manner of furnishing Forms 1095-B, which has been in effect for the past few years. To take advantage of the alternative reporting method, IRS Notice 2025-15 confirms that an employer must post a clear and conspicuous notice on its website stating that individuals may receive a copy of their statement upon request. The notice must be posted by the furnishing deadline (e.g., March 3, 2025, for 2024 statements). It must include an email address, a physical address to which a request may be sent and a telephone number to contact the employer. Employers must retain the notice in the same location through Oct. 15 of the year following the calendar year to which the statement relates (e.g., Oct. 15, 2025, for 2024 statements). In addition, any request must be fulfilled by Jan. 31 of the year following the calendar year to which the return relates or 30 days after the date of the request, whichever is later. Employers must continue to comply with applicable state reporting requirements. The alternative furnishing method set forth in IRS Notice 2025-15 applies to federal reporting requirements. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
Learn more about the power of protein, a 5-minute daily walk, and preparing for tax-filing season. THE POWER OF PROTEIN Protein is having a moment, and it’s for good reason. While some focus on it for muscle-building, others view it from a weight-loss perspective. Regardless of personal goals, protein is a macronutrient essential for body function. It is made up of many building blocks called amino acids and is fundamental for good health. The Dietary Guidelines for Americans 2020–25 recommend that adults consume 10%-35% of their total calories from protein. Depending on their activity level, age and weight, some people might need more. Some people like to calculate their protein needs in grams instead of percentages. For example, if their daily needs are 2,000 calories, protein would make up 200-700 calories, which is 50-175 grams. Healthy protein sources include eggs, fish, lean meats and low-fat dairy. Good plant sources include nuts, seeds, beans and lentils. Health experts recommend spreading out your protein consumption throughout the day. Eating more protein at breakfast could also help decrease hunger and cravings later in the day. Keep in mind that protein shouldn’t make up your entire meal; it should accompany fruits, vegetables and whole grains. Most people get enough protein from whole foods, but protein supplements are popular alternatives, especially for vegans and lactose intolerant individuals. Benefits of Protein Protein is a vital part of one’s diet. As such, there are several benefits of protein, including the following: • Builds muscle mass and strength • Strengthens bones • Aids in injury recovery • Reduces hunger by keeping you full for long periods • Forms essential enzymes, hormones and vitamins Recognizing the multifaceted importance of protein underscores the need to incorporate protein sources into your diet to maintain optimal health. Talk to your doctor if you have any questions about your diet or how to develop a balanced eating plan. A DAILY 5-MINUTE WALK COULD MAKE A DIFFERENCE It’s easy to feel overwhelmed by fitness trends or goals. While research shows that 11 minutes of moderate-to-vigorous exercise daily may lower your risk of cancer, cardiovascular disease or premature death, another health expert is praising the accessible exercise form of walking. The National Jewish Health’s director of cardiovascular prevention and wellness expressed that even a short amount of walking—just five minutes—has health benefits and supports future exercise goals. Walks improve the body’s blood flow and boost creativity and productivity. Like any other exercise, walking also helps strengthen muscles and delivers oxygen to the brain and muscles. How to Walk More Each Day Fortunately, walking can easily be implemented into a routine. Consider the following tips for including more walking into your daily routine: • Make small goals. For example, you could take a five-minute walk at lunch each day. Doing so makes you more likely to succeed in maintaining a new walking habit. • Walk with friends. This encourages you to keep the habit because you know others are counting on you, and it also keeps the walks from becoming monotonous. • Set reminders. Decide when to walk during the day and set reminders. It’s easy to forget to take a break when you get into your work. • Diversify your routine. Change your walking routes to prevent boredom, or try walking at different speeds throughout your walk. • Listen to your body. Don’t be afraid to take time off or modify your routine. Pay attention to your body’s signals and take care of yourself so you can maintain your new routine. The key is to make movement a regular part of your day, even if it’s a five-minute walk. Talk to your doctor and discuss what works best for you to learn more about creating an active routine. PREPARING FOR TAX-FILING SEASON Tax season is here, so if you haven’t done so already, it’s time to gather all the appropriate information you need to file your 2024 tax returns. The federal tax return deadline is Tuesday, April 15, 2025. However, due to federal disaster relief, millions of Americans have extensions this year. Taxpayers in Alabama, Florida, Georgia, North Carolina and South Carolina, and parts of Alaska, New Mexico, Tennessee, Virginia and West Virginia have until May 1 to file their returns and pay taxes. The IRS also extended the deadline to Oct. 15 for victims of California wildfires. Many people elect to file their tax returns electronically. This can be done in various ways, such as using tax preparation software or consulting a tax professional. If you are filing with a paper form, there are certain documents you must include. The documentation needed may vary based on your employment status over the past year. If you have questions about your tax-filing situation, consult with a tax professional. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
