If your fully insured group health plan filed a Form 5500 by July 31, you have until September 30 to distribute the Summary Annual Report to participants. Here's what it must include and who's actually required to send it.
Most self-funded employers set reserves by gut feel, not by modeling IBNR lag, claims fluctuation exposure, and stop-loss timing gaps. Here's how to calculate what you actually need.
An ICHRA removes your group carrier but not your compliance obligations. Here's the full compliance stack: 90-day notice, ACA affordability calculations, ERISA plan documents, and monthly premium substantiation.
The Big Three PBMs still process 80% of U.S. prescriptions, but 52% of employers are considering a switch. Here's who's earning that business, what the CAA 2026 changes, and the five contract clauses that separate real transparency from marketing.
The FDA has approved 83 biosimilars, but less than 10% of eligible biologic prescriptions are filled with one. PBM rebate structures keep branded biologics preferred. Here's what's driving the gap and what employers should demand at renewal.
DIR fees grew 107,400% in a decade and peaked at $9.5 billion. CMS reformed them out of Medicare. Your employer plan still has them. Here's where the money goes and what to do before the CAA catches up in 2029.
Your TPA handles administration, but ERISA fiduciary liability stays with you. With 155 ERISA lawsuits in 2025 and new CAA disclosure mandates, here's what to check in your ASA before renewal.
Healthcare costs are jumping 10% in 2026. A disengaged broker isn't neutral, they're a cost. Here's how to fire them, what to gather first, and how a Broker of Record change actually works.
The Transparency in Coverage rules require your health plan to post three machine-readable files every month. Most employers have no idea whether their vendor is actually doing it.
Your broker's carrier shortlist isn't built around your best premium. It's built around their easiest workflow. Here's what's actually driving those repeat recommendations.
Most PBM rebate guarantees protect the PBM, not your plan. Here's the specific contract language, audit rights, and reconciliation clauses that actually ensure rebates flow back to you.
