Newsroom

Clients often need to access Rx benefits before receiving their health plan ID Cards. Our handy Small Group Rx BIN and PCN table can provide the information they need.

Big changes are coming to California group health plans. Effective for plans issued or renewed on or after 7/1/25, state law will require IVF coverage in Large Group and make it a new plan option in Small Group. Paul Roberts explains what’s in the law, who it impacts, and what brokers need to know.

The 6/1 deadline for RxDC reporting is approaching; group health plans must submit data on drug costs and healthcare spending. While carriers handle reporting for fully insured plans, employers still have responsibilities. For self-funded plans, the employer is responsible. Learn what’s required.

We break down the San Francisco HCSO – a local health care spending law that can apply to employers both inside and outside California. Whether fully insured or self-funded, employers with even one SF-based employee are generally subject to HCSO’s spending, reporting, & compliance requirements.

Paul Roberts breaks down ACA IRS reporting requirements for Applicable Large Employers (ALEs) and all employers with self-funded plans, California’s individual mandate reporting, reporting relief for employers impacted by LA fires, and new federal laws designed to ease reporting burdens.

Paul Roberts outlines key annual compliance responsibilities for 2025, including ACA employer mandate requirements, IRS reporting, COBRA compliance, and more. Learn how to navigate these complexities and leverage resources to ensure your clients stay informed and compliant throughout the year.

In his latest column, Paul Roberts breaks down the gag clause attestation requirements for health plans under the Consolidated Appropriations Act, outlining what both fully insured and self-funded plan sponsors need to know about the upcoming December 31st compliance deadline.