BENEFITS DIGEST

Certain employers at San Francisco International Airport will have to spend more on worker health care. Jackson Lewis reports that the ordinance, signed October 16 and taking effect January 1, 2027, raises the required hourly health expenditure for covered airport workers to the rate set by the city’s health care accountability law plus $2 an hour, with an alternative compliance path through a health plan that pays at least 84% of covered medical costs on average, charges no premium for employee-only coverage and caps dependent costs. The dollar figures in the article are illustrations rather than published rates, and the waiver and recordkeeping details await city guidance.

Jill Hughes interviews Epic about what the January 1, 2027 deadline for electronic prior-authorization interfaces looks like from the vendor side. The requirement applies to payers CMS regulates, not to every self-funded employer plan, and Epic’s experience says scheduling data and smaller payers’ readiness are where the friction lives. The time savings reported from early implementations are anecdotes rather than a promise, and an interface requirement doesn’t by itself remove the clinical back-and-forth that makes prior authorization slow. For plan sponsors, the piece is a reality check on how fast the paperwork actually gets faster.

KFF’s comparison complicates the story that American health care is simply worse. Life expectancy runs 3.7 years below comparable countries, and maternal mortality and avoidable admissions for heart failure and diabetes run higher, but reported 30-day mortality after heart attacks and strokes is lower, as are avoidable admissions for asthma and chronic lung disease. Fewer American adults report a regular source of care, 87% against 93%, and more report emergency visits a regular doctor could have handled. The underlying data mix years from 2022 through 2024. For employer purchasers, the access and quality measures describe what health spending buys across systems, useful context for judging their own plans’ results, though national comparisons establish nothing about any particular plan’s performance and don’t show that spending causes the outcomes.

Marketplace enrollees would have to clear up eligibility discrepancies before advance premium tax credits and income-based cost-sharing reductions are paid, under a CMS proposal filed for public inspection October 23 and scheduled to publish October 27. Starting with 2028 coverage, enrollees would also need to affirm or update their information annually, with a verification period opening August 1, 2027, and consumers could still pick a plan while verification is pending. CMS estimates 332,500 fewer enrollees a year, $7.6 billion less in annual advance-credit spending and a 0.4% premium increase beginning in 2028, and those are projections rather than observed results. Existing ways of verifying an employer’s offer of coverage are expressly retained. The comment deadline arrives with Tuesday’s published text.

Amazon, Axon Enterprise, Google, Meta and Oracle joined a voluntary effort to speed prior authorization in the health plans they fund themselves. The initiative emphasizes real-time decisions and adoption of an electronic standard for exchanging health information. These are commitments by large employers, not enforceable obligations. For other employers, the development is a benchmark for what plan sponsors are starting to demand from their networks and administrators.

Writing for benefits brokerage Borislow, Sena Meilleur argues that smaller employers can no longer treat renewal season as the moment to manage catastrophic claim risk. GLP-1 pharmacy spend, cell and gene therapies that can cost more than $1 million per claim, and AI-driven coding intensity are reshaping medical budgets, so the useful decisions, about self-funding, captives and reinsurance against the biggest claims, happen early in the plan year, before an adverse claim limits the options. She treats a good renewal as a signal to dig in rather than coast.

USI’s national benchmarking report compares health-plan costs across more than 10,000 participating employers. Monthly family premiums run $2,184 for qualified high-deductible plans, $2,511 for traditional plans and $2,291 for regional or performance networks, with employee contributions of $604, $846 and $837. USI reports premiums and contributions both rising 7% to 8%, and pharmacy accounted for 27% of claims in 2025, up from 22% four years earlier. The figures describe different groups of plans and don’t establish that switching plan types would produce the same savings.

A provider directory is useful only if it helps someone find care. In a study involving more than 5,800 calls across five states, fewer than a quarter of calls to listed mental health clinicians produced an appointment. 60% went unanswered. Among calls researchers could evaluate, 56% revealed a directory error. Unanswered calls weren’t all confirmed errors, but the access problem is still substantial. Employers evaluating mental health networks need to ask about appointment availability as well as how many names appear in the directory.

An alternative medical plan may require different ID cards, reports, apps and connections to other benefit vendors, even when it comes from the employer’s existing carrier. Nancy Vick urges employers to identify those differences before rollout. Her four myths concern employee confusion, savings, administrative complexity and the assumption that an alternative plan operates like a traditional one. Mercer reports that 31% of large employers plan to offer an alternative option in 2027 and 38% are considering one by 2028. Those plans and intentions are a sign of interest, not evidence that every design will save money.

Lowering employees’ costs for using selected providers can mean the employer pays a larger share of each bill. Mercer’s Tracy Watts and Neil Freedman argue that the approach pays off when better care reduces total claims enough to offset that shift. They describe lower cost sharing for higher-quality providers, primary-care-centered plans and incentives layered over an existing network. Buyers should examine how quality is measured, whether suitable providers are available where employees live and whether savings have been independently validated. Changing the incentives takes more than changing the plan’s name.

Ray Fabius, cofounder and president of HealthNEXT, argues that employers should measure well-being programs through workplace injuries, absence, disability, retention and productivity as well as medical spending. He recommends adjusting comparisons for workforce size, illness burden, benefit design and inflation. His supporting example comes from a client engagement, rather than a controlled study establishing that the program caused every improvement.

Virgie Bright Ellington, a former insurer medical director now at bill-review vendor MBS Tech, maker of Medical Bill Shield, argues that employers should test whether paid claims and patient bills match the care actually delivered, asking about independent bill review, wrongly shifted patient liability, and comparisons against patient records. Her affiliation means the prescription matches her product, and the sweeping claims about what no plan checks are hers. The underlying audit questions remain reasonable ones to put to any administrator.

Reported by EBN contributor Bruce Shutan, this piece gathers broker and carrier views on what ancillary lines now compete on, which is ease of enrollment, data integration, and service rather than premium alone. The quoted executives argue brokers should make service expectations explicit and measurable in carrier selection. The perspectives are industry participants’ own, and the shift they describe runs from price shopping to service-level accountability in dental, vision, and supplemental lines.

Segal’s walkthrough of the transparency final rule is organized the way administrators actually have to implement it, separating machine-readable file changes from reporting, attestations, and the phone-access requirement. The dates deserve care because applicability and first-disclosure deadlines differ. Segal places schema changes at March 6, 2027 with first disclosures that April, new contextual files at September 6 with first files that October, the first provider-utilization file in July 2028, and price-comparison tool changes for plan years beginning in 2027. The firm also stresses that a self-funded plan keeps responsibility when vendors do the work.

Sidecar Health’s founder argues that the new transparency files will matter only if plans put prices and quality in front of patients before they choose care and give them a financial reason to use the information. He illustrates with his own MRI shopping and Sidecar’s cash-pay model. The savings figures are company claims.

New Horizon Academy describes four benefits it credits for retention in a high-turnover field, education assistance, visible career paths, affordable health coverage with a childcare discount of nearly 65% for employees, and retirement saving with a match of one third of contributions up to 6% of pay, an effective maximum of 2%. The company says it is helping 468 of its roughly 3,000 educators obtain degrees, and reports five-year average teacher tenure with about 90% retirement-plan participation. The results are employer-reported.

Bhargav Raman, cofounder of the primary-care firm Ten Ten Ten, argues that fee-for-service medicine and intermediary compensation reward higher spending, and that employers should move toward fixed payments agreed in advance, tied to responsibility for patients’ care and costs. He warns against shoving unprepared practices straight into full risk, recommending graduated arrangements, independent benchmarks, disclosed flat fees, audit rights, and workable exit terms. The headline and the cost claims are the argument of a vendor with a model to sell.

Seyfarth lays out the new price-transparency package’s staggered calendar. The rule is effective December 7, 2026, the price-comparison phone tool changes apply for plan years beginning on or after January 1, 2027, specified machine-readable file changes land March 6, 2027, new context files follow September 6, 2027, and the first annual provider-utilization file is due July 1, 2028. The allowed-amount reporting threshold drops from 20 claims to 11, and a plan may limit telephone requests so long as a caller can still get cost information for at least 20 providers per day, a permitted floor rather than a duty to refuse more. The firm also separates an insured plan’s written allocation of responsibility to its issuer from a self-funded plan’s arrangement with its administrator, where responsibility stays with the plan.

Aon’s 2026 Human Capital Trends Study projects the North American gross medical trend easing to 9.2% in 2027, the first time in five years the region’s forecast has come in below the prior year’s, and finds 87% of responding organizations planning to use well-being initiatives next year. Aon’s Kathryn Davis cautions in an accompanying interview that moderation is not relief, since costs keep rising from an elevated base while aging populations, chronic conditions and new treatments push the other way. She frames GLP-1 coverage as a question of access, clinical appropriateness and the whole employee health journey rather than a standalone pharmacy decision, and urges targeted, data-driven cost management over across-the-board cuts.

Marsh McLennan benefits consultant Marybeth Gray told a CFO conference on October 13 that employers should start planning far earlier, identify the chronic conditions driving their spend, and consider targeted clinical tools. Her timing example is to begin a 2028 benefits strategy in January 2027 rather than the following June. The article cites a 76% rise in costs over the past decade, attributed to the Business Group on Health, and floats genomic and pharmacogenomic testing as options. This is conference advice from a consultant, options to evaluate rather than promised savings.

The underlying WTW numbers show physical and financial well-being moving in opposite directions. Workers reporting they are physically thriving rose to 64% from 54% in 2019 while those feeling financially secure fell to 36% from 46%, and about half live paycheck to paycheck. Health costs register as a retirement barrier for 47% of respondents, and the high-stress group reports 23.6 days of combined absence and presenteeism, time at work impaired by poor health or stress. The article argues for affordable core health, retirement and leave benefits rather than more choices.

King & Spalding lays out the final transparency rule’s staggered calendar. The rule takes effect December 7, 2026, core machine-readable-file and attestation changes land March 6, 2027, and the new context files and related requirements apply September 6, 2027. The first annual provider-utilization file, which identifies providers reimbursed for at least one covered claim, is due July 1, 2028. Allowed-amount reporting thresholds drop from 20 claims to 11, with a six-month reporting window and a nine-month lookback, and telephone cost estimates attach to plan years beginning on or after January 1, 2027.

Haynes Boone’s practical alert concentrates on the telephone disclosure. For plan years beginning on or after January 1, 2027, participants must be able to call the number on their plan ID card and get personalized cost-sharing information, so employers should confirm now that their vendors can deliver it. Self-funded sponsors keep the compliance obligation even when a vendor does the work, while fully insured plans can shift it to the insurer by written agreement.

Bricker Graydon’s angle is the attestation. Plans must attest to the accuracy of their posted files and identify a senior official responsible for the data, and a qualifying vendor agreement can assign the attestation to that vendor. That makes it important for sponsors to understand what their vendors actually post rather than assume compliance. The alert also covers the standardized text file that tells users where the machine-readable files live, backed by a monitored contact email. If a plan limits telephone requests, the limit must allow cost information for at least 20 providers per operational day. Sponsors should spell out vendor duties in their contracts. Self-funded plans remain responsible even when a vendor does the work.

Falcon Rappaport & Berkman traces how the Marketplace subsidy proposal reaches employer plans. Tighter eligibility verification can generate more coverage inquiries to employers, employees who lose subsidies may migrate toward employer coverage, and repayment of excess credits becomes full for tax years after 2025. The firm recommends keeping offer and affordability records in order and updating employee communications, while noting the proposal’s several implementation schedules. Comments are due November 30, with a hearing set for December 8.

The revised Transparency in Coverage rules put accuracy and accountability alongside public access to health-plan prices. Mintz explains the move to quarterly updates to in-network and out-of-network pricing files, more standardized rate information and an accuracy attestation by a senior official. Different provisions take effect on different schedules, so plans need a requirement-by-requirement implementation calendar. For self-insured employers, assigning the work to an administrator doesn’t make oversight disappear. Vendor agreements should identify who prepares, validates and posts the information.

Groom’s analysis of the revised Transparency in Coverage rules focuses on who stands behind the numbers. The [final rule](https://www.govinfo.gov/content/pkg/FR-2026-10-06/pdf/2026-20447.pdf) requires an accuracy attestation and identification of a responsible senior official. A plan can arrange in writing for its administrator to make the attestation using the administrator’s designated official. For self-insured plans, however, the plan remains responsible if the administrator fails to comply. Employers should check who prepares, validates and posts the pricing files, and who corrects errors. Quarterly updates to in-network and out-of-network pricing files follow a different schedule from changes to participants’ cost-comparison tools.

Federal agencies have finalized changes intended to make public health-plan pricing information smaller, cleaner and easier to use. PLANADVISER describes quarterly file updates, improved validation and added responsibility for accuracy, alongside changes affecting consumers’ cost-comparison tools. Reducing the volume of published data doesn’t eliminate the work of producing it. Plans need to identify which party performs each task and which deadlines apply to the particular disclosure or tool.

Davis Wright Tremaine looks at the revised health-price transparency rules from the provider’s side. More usable files can help hospitals compare negotiated rates, evaluate payer proposals and understand how contracts differ across networks. Standardization won’t make every price directly comparable, since service definitions and contract arrangements still matter. The analysis gives employer purchasers a view of how providers may use the same information in negotiations, and why a posted rate alone doesn’t settle the value of a deal.

Hawaii employers should obtain 2027 Form HC-5 from employees who qualify to waive the employer’s health coverage, Aon explains. The annual process requires attention even when an employee’s reason for declining coverage hasn’t changed. The bulletin recommends completing the forms by December 31, 2026, and retaining them for at least two years. Employers generally keep the completed forms rather than routinely sending them to the state, but must provide them when requested.

Employees need help understanding their benefits before open enrollment begins. Employee Benefit News highlights employers that provide education throughout the year, giving workers more time to weigh their choices. The need is substantial. Alera Group reports that 84 percent of employers saw premium increases, while Prudential found that only 38 percent of employees feel confident navigating enrollment. Solidarity Health Network’s CEO projects per-employee premium increases above 8 percent for 2027, with increases of 15 to 22 percent in some markets.

The number that frames the season comes from Alera Group’s annual employer benchmark. 84 percent of employers reported premium increases, up from 81 percent last year, and 34 percent of those saw spikes of 11 to 20 percent, making this one of the steepest renewal cycles in years. Alera’s Nicole Negvesky says the notable pattern is employers absorbing the increase rather than passing it to employees, then layering on supplemental products, accident, critical illness, cancer and long-term care coverage, to blunt out-of-pocket exposure under higher-deductible designs. Her warning is that those products only earn their premium if employees know they exist and when to use them, which argues for year-round communication instead of a two-week enrollment sprint, and for communications that say plainly how each program pays off and how to reach it.

Prudential’s 2026 Retirement Pulse Survey asked 3,023 pre-retirees and retirees age 50 and up about spending their own money, and only 14 percent were comfortable using retirement savings each month on things they enjoy. Forty percent would rather leave money behind than risk running short, 29 percent take pride in a bank balance that never moves, and wealth doesn’t cure it: among respondents with at least $500,000 saved, 61 percent still weren’t comfortable spending on themselves. The reasons given are Social Security uncertainty, inflation and health costs, and a third don’t know how long the money has to last. One Prudential planner summed up the job: “I have to give my clients permission to spend.”

An eHealth survey of more than 500 small and midsized business owners and managers finds 54 percent of those offering group coverage facing double-digit premium increases for 2027, and 73 percent actively weighing whether to drop the benefit altogether. The options discussed run from raising deductibles to reimbursement arrangements that give employees money to buy their own individual coverage, with the caveat that savings from cutting coverage tend to leak back out through higher wages and harder hiring.

KFF's refreshed polling lands as open enrollment season starts, and the numbers explain what employees are feeling. Health care costs top the list of family financial worries, ahead of housing, food, and utilities, with 27 percent of adults very worried about affording care. About 28 percent skipped or postponed care in the past year because of cost, 22 percent had problems paying medical bills, and 43 percent did not take medication as prescribed for cost reasons, including 19 percent who cut pills in half or skipped doses. For benefits teams writing open enrollment communications, this is the context employees bring to every premium and deductible number.

A fight over who is inflating hospital bills, with plan dollars in the middle. The Blue Cross Blue Shield Association says AI-assisted coding tools added about $942 million to its costs over two years without a matching rise in treatment. It points to more anemia diagnoses without more transfusions. PwC analysts separately attribute 9 percent of next year's increase in insurer medical costs to AI billing tools. Billing companies, whose coding platforms reach most U.S. hospitals, say the tools identify patient conditions and treatment complexity that hospitals previously failed to document fully. Employers that pay their own health claims should ask their claims administrator how it checks higher charges generated by AI-assisted billing.

The U.S. fell three places to 24th in Natixis Investment Managers' annual Global Retirement Index, down from 14th a decade ago, with public debt, healthcare costs, and uneven access to workplace savings doing the damage. One number in the coverage says where the pressure lands: 81 percent of investors now say funding retirement is increasingly their own responsibility, up from 63 percent a decade ago. Rankings are blunt instruments, but the direction matches what plan sponsors see in participant behavior, with more expected of the workplace plan every year.

Employers with San Francisco headcount will be required to spend roughly 9 percent more on health care next year under the city's Health Care Security Ordinance, which sets a minimum amount employers must spend for each hour a covered employee works in the city. The 2027 rates are $4.49 an hour for employers with 100 or more workers worldwide and $2.99 for those with 20 to 99 (nonprofits, 50 to 99). The exemption threshold for managers and supervisors rises to $131,763 a year on January 1. The ordinance counts the whole worldwide workforce to determine coverage but charges only for San Francisco hours, and telecommuters outside the city currently don't trigger the expenditure. The annual report on compliance is due around April 30.

Aon's alert on the new assessment fills in what the headline version leaves out. Employers aren't charged for employees or dependents with a developmental, intellectual, or permanent physical disability. Starting July 1, 2027, short-tenure, part-time, per diem, temporary, and seasonal employees are excluded too, and an employer charged for one of them before then can seek a credit or refund. The law bars using Medicaid enrollment information in hiring, promotion, or retention decisions. And the open questions are real. The state hasn't said what data it will use to calculate the fee, how employers can verify an assessment, or how people who work for more than one employer will be counted. Aon's advice is to track the litigation and watch for implementing guidance.

New federal Medicaid and CHIP eligibility restrictions for lawfully present immigrants take effect October 1. The eligible immigration categories narrow to green-card holders, Cuban and Haitian entrants, people living in the U.S. under Compacts of Free Association, and lawfully residing children and pregnant people in states that cover them. Refugees and asylees without green cards are among those losing eligibility. KFF warns that confusing notices and paperwork requirements could also cause people who remain eligible to lose coverage. Employers may receive enrollment questions from workers whose families lose public coverage.

Written for construction employers, useful to any sponsor. A significant share of health plan cost is driven by who else is covered. Dependent-eligibility audits catch ineligible dependents whose claims an insurer or stop-loss carrier may refuse. Spousal surcharges and carve-outs raise consistency, Medicare and TRICARE questions. Opt-out payments must be structured through the cafeteria plan and counted in ACA affordability math. Each approach asks employers to weigh potential savings against administration, documentation and compliance obligations, and Saul Ewing's four-question checklist (clear eligibility definitions, administrative feasibility, interaction with other requirements, workforce impact) is the useful takeaway.

An argument that menopause is a benefits design problem, not an awareness problem: $1.8 billion a year in lost productivity, roughly 6,000 U.S. women reaching menopause daily, and a Mayo Clinic finding that 13 percent experienced an adverse work outcome from symptoms. With the FDA's removal of the warning that long discouraged hormone therapy now driving demand—and a shortage of estrogen patches—direct to consumer vendors are rushing into the gap, some initiating hormone therapy without a physical exam or mammogram. The prescription is integrated primary care built into the plan rather than point solutions, with Rhode Island's first-in-the-nation menopause accommodation mandate a sign of where this is heading.

The opener of a three-part KFF video essay series on where the premium dollar actually goes, and the answer is mostly upstream of the insurer. National health spending reached $5.3 trillion in 2024, and hospitals alone have driven 40 percent of the growth in recent years, and one or two health systems controlled inpatient care in nearly half of U.S. metro areas. Insurers largely pass those costs through, and consolidation plus employers' own demands for broad networks leave them little negotiating leverage.

Written for self insured organizations, large deductible programs, and captives, the point is that a reserve increase is not by itself bad news. Three complementary diagnostics—actual versus expected development, a reserve walk between evaluation dates, and frequency and severity analysis—turn the periodic reserve review into a tool for spotting emerging trends and supporting funding decisions.

Robert Andrews, the former congressman who leads the Health Transformation Alliance, tells EBN the question for employers is not how much they spent but what they got for the money. With nearly all employers covering GLP-1s for diabetes, the hard decision is obesity coverage for patients who are not diabetic, and Andrews describes a turn toward clinically driven coverage decisions built on claims and health record data, watching whether weight stays off and A1C improves. Before cutting benefits, he argues, employers should chase the waste first, the billing errors, ineligible claims, and payments that should never have gone out the door.

Marsh's national survey of more than 1,800 employers projects health benefit costs rising 8.2% in 2027, the sharpest annual jump since 2003, and 11% for employers who take no action. Some 59% plan cost-reduction moves such as raising deductibles, and GLP-1 coverage alone accounts for about a percentage point of the increase.

An opinion piece from the founder of Empower Healthcare Insights argues that moving beyond traditional healthcare options opens the door to a better experience for employers and employees alike.

With employer health costs expected to jump 11.1% in 2027 by WTW's count, finance chiefs are moving into territory HR used to own. WTW's Tim Stawicki says employers are mostly avoiding drastic benefit cuts and instead scrutinizing vendors, hunting fraud and waste, steering employees to lower-cost providers, and looking at spousal surcharges and waiting periods. Big employers have largely locked their 2027 strategies; midmarket companies are deciding now.

New projections released this week put next year's employer health benefit cost increase at the highest level in more than two decades, adding pressure on plan sponsors heading into 2027 renewals and budget season.

MetLife's president of U.S. business makes the case that improving employees' benefits literacy leads to smarter choices for their health and financial wellness, an argument for personalized decision support as employers look for ways to get more from every premium dollar.

UnitedHealthcare published the list of roughly 1,700 codes that will no longer require preapproval starting in October, part of its pledge to cull 30% of its utilization management controls. The codes span a broad range of services, and plan sponsors should expect the change to surface in network and claims conversations this fall.

An opinion piece argues that benefit advisers, who spend most of their time on medical trend, pharmacy costs, and renewals, should treat leave strategy as core advisory work rather than a topic to hand off, given how much absence management now shapes the employer benefits conversation.

Leveraging pharmacies for medical care and incentivizing employees to seek preventive care are among the ways plan sponsors are trying to keep cost hikes in check.

Groom situates the new tri-agency FAQ relief against the litigation wave that produced it: by the firm's count, the HIPAA wellness program rules have drawn more than 80 putative class actions claiming that premium surcharges for tobacco use violate ERISA. The relief addresses the midyear reward-timing and notice-disclosure questions; the broader surcharge fights, including the pending Sixth Circuit appeal in the Progressive case, remain in the courts.

Employers are nearing double-digit health cost increases, but many won't be able to take drastic cost-cutting measures until 2028 at the earliest, the Business Group on Health's president and CEO told HR Dive.

Employers are expecting a median 9.2% increase in medical spending next year, according to a new survey. But they’ve underestimated actual cost growth for the past three years, so even that figure may be too optimistic.

Accelerating dispute volumes and sky-high award amounts are inflating how much independent dispute resolution is costing the U.S., according to new Georgetown research. Patients could pay the price with higher premiums.

The employer advocacy group warned that litigation challenging wellness program incentives could discourage employers from offering health-related premium discounts.

A new risk analysis released by leading insurance broker Aon this week projected that employer health costs in the U.S. will rise by roughly 10 percent in 2027.

A federal court in Tennessee denied Cracker Barrel's motion to dismiss in its entirety in a putative class action challenging the tobacco-user premium surcharge in its self-insured health plan, on claims that the plan failed to offer a compliant reasonable alternative standard and failed to give adequate notice of it, both required under the wellness-program nondiscrimination rules. Three days earlier, a Maryland federal judge reached a similar result in a class action over Marriott's $15-per-week tobacco surcharge, letting through a claim that plan communications named a smoking-cessation program without explaining how to enroll or whether enrolling would avoid the fee. Two courts in three days is the pattern worth watching: sponsors running a tobacco surcharge should treat “we offered an alternative” as necessary but not sufficient: notice design, placement, and reimbursement mechanics are now live issues in both cases. (The broader split runs both ways: earlier dismissals went the other way in Williams v. Target and Spencer v. Campbell Soup, so treat this as an emerging, unsettled pattern, not a rule.)

Medical and pharmacy trends remain high at 7.7% overall. Learn what's driving healthcare costs and what employers should expect moving forward.

Groom surveys the tobacco-surcharge docket after the trio of July decisions favoring employers, including the Target and Campbell Soup dismissals covered here this week, and asks whether the 75-case wave has crested or is merely regrouping.

the second consecutive year of double-digit projected trend, and the number that will anchor this fall's renewal conversations.

Bricker Graydon on the health-premium recovery question every employer eventually faces: what happens to premiums the employer advanced during FMLA leave when the employee never comes back.

Groom unpacks Notice 2026-28, the first guidance on the now-permanent section 45S paid-leave credit since the OBBBA amendments, including how to calculate the credit when an employer funds PFML through insurance premiums rather than paying wages directly. The notice led the Digest on August 6; this is the first full firm analysis.

Segal examines what the early end of the Medicare Part D Demonstration program means for premiums and retiree health plans.

Segal's survey report reveals that health plan cost trends for employer-sponsored benefits are approaching their highest levels in 15 years.

Revenue Procedure 2026-26 provides the 2027 indexing adjustments for the ACA premium tax credit applicable percentage table and sets the required contribution percentage at 10.22 percent, up from 9.96 percent for 2026. That figure drives the employer affordability safe harbors, so sponsors should have it in hand before setting 2027 employee contributions.

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC.

More people get health coverage through their job than from any other source. The deduction workers see in each paycheck for their share of the premium is only a fraction of the total cost.

The expiration of the ACA’s enhanced premium tax credits at the start of 2026, combined with rising insurer premiums, put a spotlight on health care affordability that extends beyond Marketplace enrollees.