How Health Insurers Are Trying to Rein in Costs Without Cutting Value
Employers are grappling with another year of steep increases in group health plan premiums due to medical cost inflation, higher utilization and rising drug prices. At the same time, health insurers can no longer shift additional costs to employers and employees
Voluntary Benefits Lawsuits Add Fiduciary Concerns for Employers
Plaintiff's lawyers are breaking new ground by suing employers for allegedly failing in their fiduciary duties to manage their voluntary benefit plans, including dental, vision, accident insurance, critical illness, cancer and hospital indemnity benefits. These class action lawsuits typically allege that
Employers Experiment with Direct-to-Consumer Access for GLP-1s
Employers grappling with the cost and complexity of GLP-1 drugs are increasingly testing a workaround: steering certain employees to direct-to-consumer (DTC) arrangements that operate outside the company's health plan. The shift reflects a growing tension for benefits executives: how to manage
Model Law Could Spur States to Rein in Prior Authorization
A new model law adopted by the executive committee of the National Council of Insurance Legislators (NCOIL) could spur more states to adopt legislation to regulate health insurers' use of prior authorization. While prior authorization remains an important tool for managing
‘Stealth’ Health Plan Cost Drivers Employers Can’t Ignore
As employers face rapidly rising health insurance costs for their employees, industry pundits are increasingly urging benefit leaders to confront "stealth" cost drivers that quietly inflate spending year after year. While headline issues like premium increases draw the most attention, some
Seven Tips for Avoiding High Medical Bills
When people sign up for a new health insurance plan, be that an employer-sponsored plan or one purchased on the Affordable Care Act (ACA) exchange, they can often be confused about when coverage starts, what is covered and whether they
Get ACA Reporting Right and Avoid Fines
Applicable large employers face a familiar but unforgiving task each winter: reporting their group health coverage details to the IRS. With key ACA Affordable Care Act filing deadlines falling in early 2026, employers with 50 or more full-time equivalent employees
ACA Subsidy Expiration Could Ripple Through Group Health Plans
The expiration of enhanced premium subsidies that have helped millions of Americans afford individual health insurance through the Affordable Care Act exchanges at the end of 2025 will be felt by employers offering group health plans.As exchange coverage becomes less
Health Benefit Trends to Watch in 2026
Employers are heading into what may be one of the most challenging years for managing group health costs. The new "Trends to Watch in 2026" report by Business Group on Health (BGH) outlines developments that will shape next year's benefits environment. Rising medical
How to Avoid the ‘Ghost Network’ Issue in Your Health Plans
For your group health plan enrollees, finding a doctor who accepts their plan should be straightforward since each plan typically has a network of physicians available for enrollees. However, enrollees regularly learn that a doctor that is clearly listed in their