group health plans Archives - Word on Benefits

What Group Health Plans Should Know About Additional Breast Cancer Screening Coverage in 2026

Amanda Wilke, CEBS

04 Dec 202504 Dec 2025

Employers should prepare now for expanded breast cancer screening and navigation coverage requirements applicable to group health plans in 2026, as the new requirements impact plan participants, administration and costs.

Health Care Prescription Drugs Regulatory U.S.

Executive Order on Drug Discounts Has Uncertain Impact on Employers’ Price Negotiations

Jenny Gartman, CEBS

19 Nov 202519 Nov 2025

Today’s blog highlights uncertainties for employers and plan sponsors to consider as they await further developments on TrumpRx.

Affordable Care Act (ACA) Compliance Employee Benefits Health Care Insurance Regulatory U.S. Voluntary Benefits

Fertility Treatment Benefits as Excepted Benefits Coming for Employers

Anne Newhouse, CEBS

28 Oct 202529 Oct 2025

A new fact sheet from the White House discusses a “New Benefit Option” for employers to offer fertility benefits to employees in the future as a standalone plan, regardless of if benefits for fertility treatments are also included under an employer health plan.

Communication Compliance Employee Benefits Health Care Prescription Drugs Regulatory U.S.

CMS Creditable Coverage Updates for Group Health Plans

Anne Newhouse, CEBS

17 Jun 202517 Jun 2025

One of the annual reporting obligations for both fully insured and self-funded health plans is the Centers for Medicare & Medicaid Services (CMS) Medicare Part D Creditable Coverage notice. The reporting requirement for plan sponsors has two components: the first is to […]

Open pharmacy pill containers on a pile of 20 dollar bills.

Compliance DOL Employee Benefits ERISA Health Care Legislative Prescription Drugs U.S.

What the Executive Order Increasing PBM Fee Transparency Means for Employers

Amanda Wilke, CEBS

29 May 202529 May 2025

On April 15, 2025, President Trump signed the executive order (EO) “Lowering Drug Prices by Once Again Putting Americans First,” which includes specific actions to be taken by federal agencies to reduce prescription drug costs, improve transparency and increase competition in the […]

Employee Benefits Regulatory U.S.

President-Elect Trump Regulatory Outlook

Jenny Gartman, CEBS

21 Nov 202408 Jan 2025

What do the election results mean for employer-sponsored benefits? That’s a tough question to answer. Aside from occasional mentions of Medicare and Social Security, benefits-related topics weren’t prominent in the 2024 presidential campaigns. President-Elect Trump’s health messaging focused on making health care […]

Affordable Care Act (ACA) DOL Health Care Legislative U.S.

ACA Litigation Update: Preventive Services Requirements Upheld

Jenny Gartman, CEBS

12 Jul 202412 Jul 2024

What’s new? On June 21, 2024, the Fifth Circuit Court of Appeals ruled in Braidwood v. Becerra that the lower court had overreached when it struck down the Affordable Care Act (ACA) preventive services mandate nationwide. The Fifth Circuit held that federal […]