Bulletins

This month the IRS released 2027 penalty amounts assessed when applicable large employers (ALEs) - those with at least 50 full-time employees, including full-time equivalent (FTE) employees - fail to comply with coverage and affordability requirements of the Affordable Care Act (ACA). 

In April, Kansas Governor Laura Kelly signed into law the Consumer Protection and Accountability Act (SB 20), allowing regulation of pharmacy benefit managers (PBMs) operating in the state. Effective July 1, 2026, the law gives the state more oversight of PBMs, including licensing, rebate...

The Consolidated Appropriations Act (CAA) requires insurance companies and employer-based plans to submit information regarding prescription and health care spending to the Centers for Medicare and Medicaid Services (CMS) by June 1 of each year. 

Cigna is in active negotiations with HCA Midwest Health ahead of their expiring contract. HCA Midwest Health providers were recently sent a letter notifying them of the potential impact of failed negotiations. The current contract is set to expire on May 1, 2026. Members will receive a letter...

Language addressing substance use disorder protections has been added to the Notice of Privacy Practices (NPP). Gravie released a template today containing the new requirements and advises employers to provide a copy to group health plan participants by the April 17 deadline.

Sponsors of self-funded health plans must update their Notice of Privacy Practices (NPP) by February 16, 2026*. Actual distribution to plan participants must be within 60 days of that date or April 17, 2026. The last mandatory NPP update was in 2013 under the HIPAA Omnibus Rule. To assist...

The IRS recently released Notice 2025-62 granting penalty relief for employers and payors required to report cash tips and overtime compensation on 2025 tax forms. The relief applies to Forms W-2 and 1099 that workers must receive by January 31, 2026. The relief only applies to the 2025 tax year.

The Consolidated Appropriations Act (CAA) gag clause prohibitionrequires issuers and plan sponsors to attest that any agreements they enter with health care providers, third-party administrators or other service providers will not contain language restricting access to cost and quality-of-care...

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) released a revised simplified determination that can be used by most employer groups* to evaluate the creditable coverage status of their prescription drug coverage. (Note: For fully insured and most level-funded plans,...

In a move to curb the impact of high-cost drug utilization on members and plan sponsors, Blue Cross Blue Shield of Kansas City (Blue KC) is launching a new drug discount program.