Employee Benefits Compliance

Grandfathered health plans under the ACA allow certain existing plans to bypass some ACA requirements, but maintaining this status requires strict adherence to regulations, including limited benefit changes and mandatory participant notices.

Gain insights into the latest updates on RxDC reporting, key challenges, and strategies for meeting compliance obligations.

Maine has finalized its Paid Family and Medical Leave rules, requiring employers to prepare for new payroll taxes starting in 2025.

The Department of Labor’s new guidance on the Gag Clause Prohibition clarifies that no agreements can restrict plan sponsors or their business associates from accessing critical health claims data, ensuring greater transparency and compliance.

Group health plan sponsors offering prescription drug coverage must submit their annual creditable coverage disclosure to CMS by March 1, 2025, for calendar year plans to ensure compliance and avoid penalties.

Illinois employers are required to provide employees with a written comparison of their health plan’s benefits. An updated model disclosure forms was recently released for 2025.

The DOL increased ERISA penalties for 2025, emphasizing the need for employers to prioritize compliance to avoid significant penalties.

Starting January 1, 2025, New York employers must provide 20 hours of paid prenatal leave, with clear guidelines outlined by the NYS Department of Labor.

New Jersey has updated 2025 rates and benefit for Temporary Disability Insurance and Family Leave Insurance programs, including increased benefit caps and employee contribution rates.