Effective January 1, 2025, Kentucky has new law regulating pharmacy benefit managers (“PBMs”). Earlier this year, the Governor of Kentucky signed SB 188 into law, making Kentucky the latest state to pass legislation regulating PBMs. The new law applies to PBM contracts issued, renewed, extended, or amended on or after January 1, 2025.
SB ...
By: Sherry Porter
The Department of Labor, Department of Treasury and Department of Health and Human Services (the “Departments”) issued 536 pages of guidance last week to help plan sponsors comply with the nonquantitative treatment limitations (NQTLs) rules under the Mental Health Parity and Addiction Equity Act (MHPAEA). The main goal ...
For the first time in four years, the IRS adjusted the affordability percentage used for the shared responsibility penalties. The IRS recently announced that the affordability percentage for 2025 will be 9.02%. This is up from 8.39% in 2024. For employers this means that if you set your employee premium costs from last year right at the ...
By: Sherry Porter
The Employee Benefits Security Administration (EBSA) of the U.S. Department of Labor has jurisdiction over the enforcement and interpretation of the Employee Retirement Income Security Act of 1974 (ERISA). ERISA governs most private employer sponsored employee benefit plans, like group health plans, retirement plans ...
By: Sherry Porter
The Patient Protection and Affordable Care Act (ACA) made many changes to the way the American health care system worked. One such change requires insurers to use a certain amount of insurance premiums to provide medical care (at least 80% in the small group market, 85% in the large group market) effectively limiting the ...