by admin | Dec 28, 2025 | Compliance
The Internal Revenue Service (IRS) has issued Notice 2025-61, announcing a significant increase to the Patient-Centered Outcomes Research Institute (PCORI) fee amount. Employers with self-insured health plans and health insurance issuers must take note of the new rate and upcoming compliance deadlines.
What is the New PCORI Fee Amount?
The PCORI fee is increasing to $3.84 per covered life. This new rate applies to plan years that end on or after October 1, 2025, and before October 1, 2026.
For comparison, the previous fee amount (for plan years that ended on or after Oct. 1, 2024, and before Oct. 1, 2025) was $3.47 multiplied by the average number of lives covered under the plan.
Background and Applicability
The PCORI fee was originally established by the Affordable Care Act (ACA) to fund comparative effectiveness research. Though initially set to expire in 2019, federal legislation extended the fee for an additional 10 years. The PCORI fee is now scheduled to apply through the plan or policy year ending before October 1, 2029.
The fee is imposed on:
- Health insurance issuers
- Sponsors of self-insured health plans
The fee is calculated based on the average number of covered lives under the plan, which generally includes employees, their enrolled spouses, and dependents (unless the plan is an HRA or FSA).
Reporting and Payment Deadlines
The PCORI fee must be reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return).
The fee is always due by July 31st of the year following the last day of the plan year.
Action for Self-Insured Plans: Employers with self-insured health plans should ensure they use the correct rate and meet the upcoming July 31st deadline corresponding to their plan year end.
Additional Resources:
PCORI Fee Overview Page
PCORI Fee FAQs
by admin | Dec 10, 2025 | Compliance, HIPAA
The U.S. Department of Health and Human Services (HHS) has issued a final rule that requires covered entities—including many health plans—to update their Notice of Privacy Practices (Privacy Notice). This change enhances privacy protections for highly sensitive Substance Use Disorder (SUD) treatment records.
Why the Update is Necessary
The HIPAA Privacy Rule already mandates that covered entities provide a Privacy Notice to explain how an individual’s Protected Health Information (PHI) is used.
However, the April 2024 final rule specifically addresses patient records involving SUD treatment from federally assisted programs (often referred to as “Part 2 programs”). Any covered entity that receives or maintains these Part 2 records must now update their Privacy Notice to reflect these additional, heightened protections.
The mandatory deadline for updating and distributing these notices is February 16, 2026.
Required Employer Actions by Plan Type
Employers sponsoring health plans must determine their level of responsibility based on their plan’s funding structure and access to PHI.
Next Steps for Employers: Employers with self-insured health plans, or fully insured plans that manage PHI, must immediately begin the process of updating their Privacy Notices to incorporate the new requirements for SUD treatment records. It is currently uncertain if HHS will release updated model privacy notices before the deadline.
by admin | Dec 9, 2025 | Custom Content, Health & Wellness
The transition into winter and the busy holiday season often brings two things: cold weather and packed calendars. While the shorter days and festive cheer are welcome, they also present unique challenges to our health, including managing stress, fighting off seasonal illnesses, and maintaining an active routine.
Staying healthy this winter isn’t about grand gestures; it’s about small, consistent habits that protect your body and mind. Here is your guide to winter wellness.
- Boost Your Immune System and Sleep
The fight against winter colds and the flu starts with strengthening your natural defenses. This season, prioritize three foundational pillars of immunity:
Mind Your Vitamin D
With less sunlight exposure, many people become deficient in Vitamin D, which is crucial for immune function and mood regulation. If you can’t get 10–15 minutes of midday sun exposure, consider speaking to your doctor about a supplement. This small adjustment can make a big difference in fighting off sickness.
Stay Hydrated (Yes, Even in Winter)
The dry winter air and indoor heating dehydrate us faster than we realize, weakening the protective mucous membranes that fight germs. Keep a water bottle within reach and aim to drink herbal tea or warm water throughout the day. Dehydration contributes to fatigue, which makes you more susceptible to illness.
Make Sleep Non-Negotiable
Sleep is your body’s most effective time for immune repair. With holiday parties and deadlines looming, it’s easy to sacrifice an hour of sleep, but this can significantly compromise your health. Aim for 7-9 hours of quality sleep nightly. Stick to a consistent bedtime, even on weekends, to regulate your body’s natural rhythms.
- Managing Holiday Stress and Mental Load
The holidays bring a mix of joy and unique pressures—financial strain, travel headaches, and social commitments. Protect your mental health by applying these strategies:
Practice Proactive Planning
Instead of letting tasks pile up, dedicate 15 minutes each Sunday evening to look at your calendar and budget your energy. Schedule time blocks not just for work meetings, but also for “recharge time” and “boundary setting.”
Set Realistic Boundaries
It’s okay to say no to extra commitments. Whether it’s an optional holiday event or taking on another project before year-end, know your limits. Communicate clearly and politely: “That sounds lovely, but I can’t commit right now.” Protecting your time is vital for preventing burnout.
Embrace Micro-Mindfulness
Use small moments throughout the workday to check in with yourself. Before answering an email or joining a meeting, take two deep, slow breaths. This simple action can lower your heart rate, reduce the stress hormone cortisol, and reset your focus.
- Keep Moving, Inside and Out
When it’s cold and dark, the couch can be a powerful magnet. Counter this by adapting your fitness routine to the season:
Take a “Walking Meeting”
If you are working from home or have an internal call, suggest a walking meeting outside. Even 15 minutes of brisk outdoor walking can boost your mood and provide light exposure to aid Vitamin D production. Remember to layer up!
Find Your Indoor Outlet
Don’t rely solely on outdoor activities. Explore simple indoor options: use resistance bands while watching TV, follow a 15-minute yoga session online, or simply do some stretching and bodyweight exercises before starting your workday. The goal is consistency, not intensity.
Fuel with Focus
The holidays often mean sugary treats, which can lead to energy crashes and sluggishness. Balance celebratory foods with nutrient-dense options. Focus on protein, fiber, and healthy fats to keep your energy stable, especially during peak work hours.
By taking small steps each day – and listening to your body – you can enjoy the winter season, stay healthy, and start the new year feeling your best.
by admin | Dec 2, 2025 | Compliance, ERISA
Employers with insured health plans may have received a Medical Loss Ratio (MLR) rebate from their health insurance carrier this year. Rebates were required for plans not meeting the 2024 MLR standards and had to be issued by September 30, 2025, either as premium credits or lump-sum payments.
If any part of the rebate qualifies as a plan asset under ERISA, it must benefit plan participants and beneficiaries exclusively. Employers can fulfill this requirement by distributing the plan asset portion using a fair and reasonable allocation method. Alternatively, if direct payments aren’t practical, the rebate can be used for other allowable plan purposes, such as future premium reductions or benefit enhancements.
ERISA generally requires that plan assets be kept in trust, but this is waived if any rebate amount considered a plan asset is used within three months of receipt, so employers must pay careful attention to the timeline. For example, rebates received on September 30, 2025, must be used by December 30, 2025.
Key points:
- Under the Affordable Care Act, health insurers must spend a minimum percentage of premiums on medical care and quality improvements; if not, rebates are required.
- Employers must determine if any rebate portion qualifies as a plan asset under ERISA.
- Plan assets must only benefit plan participants and beneficiaries and generally must be used within three months of receiving the rebate to remain ERISA-compliant.
Employers should review current obligations to ensure any rebate qualifying as a plan asset is properly allocated and used in accordance with federal requirements.
by admin | Nov 24, 2025 | Custom Content, Health & Wellness
The phrase “attitude of gratitude” is more than a simple rhyme—it’s a powerful reminder to intentionally practice thankfulness in our daily lives. Consistently acknowledging what we appreciate not only enhances our own mental and physical health but also positively affects those around us.
What Is Gratitude?
Gratitude means being thankful and ready to show appreciation and return kindness. While saying “thank you” is a common expression of gratitude, it also includes reflecting on positive moments from your day or life and genuinely feeling grateful.
The Profound Health Benefits
The benefits of gratitude extend far beyond simply making someone feel appreciated. Research has consistently demonstrated measurable psychological and physiological advantages for those who practice it regularly.
Mental and Emotional Well-being
Consciously practicing gratitude has been proven to act as a direct counter to stress and anxiety.
- Increased Happiness: Studies show that a single, thoughtful act of gratitude can produce an immediate increase in happiness and a 35% reduction in depressive symptoms.
- Improved Outlook: It fosters greater optimism for the future, improved mental well-being, and greater overall satisfaction with life.
- Reduced Toxic Emotions: Gratitude helps diminish feelings of envy, frustration, resentment, and regret.
- Character Development: It encourages the development of valuable traits like patience, humility, and wisdom.
Physical Health Advantages
The positive effects of gratitude are so deep that they manifest physically:
- Better Health Outcomes: Individuals who focus on gratitude have even reported fewer visits to the doctor.
- Improved Rest: It is linked to better sleep quality and less fatigue.
- Cellular Resilience: Perhaps the most surprising benefit is its effect on the body’s internal state. Regular gratitude is associated with lower levels of cellular inflammation. Since chronic inflammation is a root cause for numerous diseases, this suggests that thankfulness plays a role in long-term disease prevention and better physical health overall.
Simple Ways to Cultivate Gratitude
Building a habit of thankfulness is easy and requires minimal time. Here are practical exercises to strengthen your gratitude muscles every day:
- Daily Acknowledgment: Make it a point to sincerely say “thank you” to people throughout your day.
- Journaling: Keep a dedicated gratitude journal or use a physical gratitude jar to record specific things you are thankful for each day.
- Handwritten Notes: Take the time to write personalized, handwritten thank-you notes.
- Mindful Reflection: Set aside a few minutes daily to think or meditate on positive events.
- Create Rituals: Incorporate thankfulness into a daily routine, such as sharing a high point of the day at the dinner table.
- Visual Reminders: Use sticky notes around your home or workspace to prompt you to pause and appreciate what you have.
The evidence is clear: cultivating an “attitude of gratitude” is not a luxury, but a necessity for optimal health. By committing to mindful reflection and simple daily practices—whether through journaling, enjoying time spent with a loved one, or simply saying thank you—you invest directly in your psychological resilience and physical longevity. Start today to experience the transformative power of thankfulness.
