The ACA requires large employers that sponsor fully insured or self-insured (including level-funded) group health plans to report information to the IRS annually, via Form W-2, regarding the cost of health coverage provided to employees during the prior calendar year. The reporting is intended for informational purposes.

ACA reporting season has arrived, and employers that sponsor group health plans should be prepared to meet their reporting obligations under IRC Sections 6055 and 6056 as applicable. The reporting involves timely filing forms with the IRS and furnishing copies to individuals.

Recent changes to the HIPAA Privacy Rule require covered entities, including group health plans, to update their Notice of Privacy Practices (NPP) by February 16, 2026. Generally, the changes are designed to align HIPAA and a final rule modifying the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations with heightened confidentiality protections for sensitive SUD treatment information.

The deadline for 2025 CAA gag clause attestations is just around the corner. Employers should act now to ensure their group health plan contracts are compliant and that attestations are timely submitted.

The deadline for 2025 CAA gag clause attestations is just around the corner. Employers should act now to ensure their group health plan contracts are compliant and attestations are timely submitted.

The ACA requires insurers to submit an annual report to HHS to account for plan costs. If the insurer does not meet the medical loss ratio (MLR) standards, this means that too large a portion of the premiums charged in the previous year went toward the insurer’s administration, marketing, and profit instead of going toward paying claims and quality improvement initiatives.

Employers of all sizes that sponsor prescription drug plans (whether fully insured or self-insured) are required to annually inform Medicare eligible individuals whether the plan’s coverage is “creditable” or “non-creditable.”

The CAA, 2021 requires fully insured and self-insured group health plans to annually report certain information regarding prescription drug and healthcare spending to CMS. Reporting for the 2024 calendar year (termed the “reference year”) is due by June 1, 2025.

Individuals who were HSA-eligible in 2024 have until the tax filing deadline, April 15, 2025, to make or receive 2024 HSA contributions. The 2024 HSA contribution limit is $4,150 for self-only HDHP coverage and $8,300 for any tier of HDHP coverage other than self-only. Employer HSA contributions, if any, are included in the applicable limit. Those aged 55 and older are permitted an additional catch-up contribution of $1,000. As indicated below,

Under prior guidance, the Forms 1095-C must be delivered to full-time employees by March 3, 2025, by mail, hand delivery, or electronic delivery (the latter only if proper consent in accordance with IRS instructions). However, under the Paperwork Burden Reduction Act (PBRA), which was recently enacted, employers have the option to provide Form 1095-C to such employees only upon request.