DPC + HSA: What Plan Sponsors Need to Know

DPC + HSA: What Plan Sponsors Need to Know

A significant regulatory shift is reshaping how employers can design consumer-directed health strategies. Starting January 1 of this year, employees were able to enroll in Direct Primary Care (DPC) arrangements alongside a High Deductible Health Plan (HDHP) and still maintain Health Savings Account (HSA) eligibility—provided specific IRS criteria are met. (more…)

Lessons for Employer-Sponsored Health Plans After Ransomware Settlement

Lessons for Employer-Sponsored Health Plans After Ransomware Settlement

On April 23, 2026, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a notable HIPAA enforcement action against a self-funded employer-sponsored group health plan following a ransomware attack that compromised electronic protected health information (ePHI). The settlement required the plan’s sponsor to pay $245,000 and adopt a two-year corrective action plan (CAP). Although OCR frequently enforces HIPAA against healthcare providers and insurers, actions directly targeting employer-sponsored group health plans are relatively uncommon, underscoring the significance of this case for plan sponsors. (more…)

Can Fertility Benefits Qualify as Excepted Benefits?

Can Fertility Benefits Qualify as Excepted Benefits?

On October 16, 2025, the Departments of Treasury, Labor, and Health and Human Services jointly released FAQs About Affordable Care Act Implementation Part 72, clarifying how employers may offer fertility benefits as HIPAA excepted benefits under existing federal regulations. The agencies also announced their intent to pursue future rulemaking to create additional pathways for offering fertility coverage as excepted benefits — including possible revisions to the rules governing supplemental excepted benefits. (more…)

New Law Expands Benefits for Employers and Employees

New Law Expands Benefits for Employers and Employees

Signed into law on July 4, 2025, the “One Big Beautiful Bill Act” delivers sweeping changes aimed at enhancing employer-sponsored health and welfare benefits. This landmark legislation includes several provisions that are particularly favorable to employers and employees, making many pandemic-era measures permanent and introducing new tax-advantaged options.

Among the most significant changes is the permanent reinstatement of telehealth relief for High-Deductible Health Plans (HDHPs). Effective retroactively to January 1, 2025, HDHPs can now permanently cover telehealth and remote care services before deductibles are met, without jeopardizing employees’ Health Savings Account (HSA) eligibility. This also applies to standalone telehealth services outside of the HDHP. (more…)