News & Analysis as of

Employer Group Health Plans Out-of-Pocket Expenses Employee Benefits

Woodruff Sawyer

IRS Releases 2026 HSA Contribution Limits and HDHP Deductible and Out-of-Pocket Limits

Woodruff Sawyer on

In Rev. Proc. 2025-19, the IRS released the inflation adjusted amounts for 2026 relevant to Health Savings Accounts (HSAs) and high deductible health plans (HDHPs).  In Rev. Proc. 2025-19, the IRS released the inflation...more

Seyfarth Shaw LLP

Agencies Release 2026 Out-of-Pocket Limits and 2025 Limits for Health FSAs

Seyfarth Shaw LLP on

Recently HHS issued a memorandum announcing the maximum annual limitation on cost sharing (a/k/a out-of-pocket maximum) for 2026 and the IRS issued Rev. Proc. 2024-40 announcing the cost-of-living adjustments to certain...more

McAfee & Taft

RADICAL new transparency rules likely to apply to your health plan in one year

McAfee & Taft on

New rules published last month likely require your employer health plan to phase-in certain disclosures over a three-year period beginning in one year: 1. January 1, 2022 (three files must be disclosed): For plan years...more

Foley & Lardner LLP

Is an Employer’s Health Plan Required to Count the Value of Drug Manufacturer Coupons Towards an Employee’s Out-of-Pocket Maximum?

Foley & Lardner LLP on

Background. These days, almost all employer-sponsored group health plans require an employee (and any dependents) covered under the plan (each are referred to as a “member”) to pay “out-of-pocket” for covered expenses in the...more

Snell & Wilmer

Preventive Care Can Now Be Covered for Specified Chronic Conditions Before HDHP Deductible

Snell & Wilmer on

On July 17, 2019 the IRS released Notice 2019-45 resolving a preventive care problem that has been plaguing many high deductible health plans (“HDHPs.”). The Affordable Care Act’s free preventive care mandate appears to be...more

Fisher Phillips

Reference-Based Pricing: Another Self-Insured Option for Employers

Fisher Phillips on

As health care costs increase, employers have been exploring new types of health coverage options, one of which is reference-based pricing (RBP). This method typically does not involve a traditional insurance carrier or...more

Proskauer - Employee Benefits & Executive...

Reminder: Non-Grandfathered Plans Must Implement Embedded Out-of-Pocket Maximums

As employers and plans prepare for 2016 open enrollment, they must be sure to address in their benefit design and with their third party vendors the new embedded out-of-pocket maximum limitations on individuals that were...more

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