by admin | Nov 12, 2025 | Employee Benefits, Hot Topics
Federal regulators—specifically, the Departments of Labor, Health and Human Services, and the Treasury—issued joint guidance on October 16, 2025, making it significantly easier for employers to offer fertility benefits outside of their traditional group health plans.
This action was driven by an Executive Order focused on protecting in vitro fertilization (IVF) access and reducing the high out-of-pocket costs associated with fertility treatment. The guidance effectively creates compliant pathways for employers to offer fertility coverage as an excepted benefit.
Key Takeaways for Offering Fertility Coverage
The new guidance provides clear, compliant options for employers to offer fertility support:
- Standalone Excepted Benefit: Employers may offer fertility benefits through a separate, fully insured policy that is not coordinated with the main group health plan. This is a crucial distinction, as individuals enrolled in this separate coverage may still contribute to a Health Savings Account (HSA).
- Excepted Benefit HRA: Employers can use an Excepted Benefit Health Reimbursement Arrangement (HRA) to reimburse employees for out-of-pocket fertility expenses, provided the HRA meets all applicable regulatory standards.
- Limited EAP Services: Benefits for fertility coaching and navigator services (to help employees understand their options) can be offered under an Employee Assistance Program (EAP), as long as the EAP qualifies as a limited excepted benefit and does not offer significant medical care benefits.
What’s Next?
The Departments have indicated they plan to release future rulemaking to explore even more ways to offer fertility benefits as a limited excepted benefit, which could offer employers additional flexibility in the future.
by admin | Nov 4, 2025 | Custom Content, Employee Benefits, Health & Wellness
The future of healthcare is rapidly evolving, with a clear trend toward integrating health interventions directly into employee benefits packages. As employers face rising healthcare costs—projected to increase by over 8% in 2025—they are rethinking how to deliver value to their workforce while managing expenses. This integration is reshaping not just what benefits are offered, but how employees access, use, and experience healthcare.
From Reactive to Proactive: A Paradigm Shift
Historically, employee benefits have largely been reactive, focusing on covering costs after an illness or injury occurs. While essential, this model often overlooks the power of prevention, early intervention, and continuous support. The modern workforce, increasingly diverse in its needs and health goals, demands more. They seek benefits that empower them to manage their health proactively, rather than merely responding to sickness.
Integrating health interventions directly into benefits packages represents a pivotal move towards a proactive, holistic model. This means weaving in tools and programs that actively promote wellness, manage chronic conditions, and address the root causes of health challenges before they escalate.
What Do “Integrated Health Interventions” Look Like?
This new era of benefits goes beyond basic wellness programs. It encompasses a wide array of specialized, often technology-driven, interventions designed to meet specific health needs:
- Personalized Digital Health Platforms: These platforms leverage AI and data to offer tailored recommendations for fitness, nutrition, sleep, and stress management. They can connect employees with virtual coaching, mental health resources, and even provide smart device integration for continuous health monitoring.
- Specialized Chronic Condition Management Programs: For employees managing conditions like diabetes, hypertension, or asthma, integrated benefits offer dedicated support. This might include virtual health coaching, remote monitoring devices, personalized nutrition plans, and direct access to specialists, all aimed at improving adherence, outcomes, and quality of life.
- Mental Health & Well-Being Solutions: Recognizing the escalating importance of mental health, benefits packages are increasingly including access to online therapy platforms, meditation apps, stress reduction programs, and resilience training. These are often integrated with EAPs (Employee Assistance Programs) for a comprehensive support system.
- Preventive Care & Early Detection Initiatives: Beyond standard physicals, this could involve access to advanced health screenings, genetic testing (with proper counseling), smoking cessation programs, and vaccination clinics, all designed to identify risks early and prevent disease.
- Family-Building & Parental Support: Expanding beyond traditional maternity benefits, interventions now include fertility support, adoption assistance, lactation consulting, and comprehensive parental leave policies, acknowledging the full spectrum of family health needs.
The Multi-Layered Benefits of Integration
For employers, the strategic integration of health interventions yields substantial advantages:
- Improved Employee Health Outcomes: Proactive management leads to healthier employees, reducing the incidence and severity of chronic conditions.
- Reduced Healthcare Costs: Early intervention and better management of health issues can significantly lower claims costs, emergency room visits, and long-term medical expenses.
- Enhanced Talent Attraction & Retention: A comprehensive, forward-thinking benefits package is a powerful differentiator in a competitive job market, signaling a true investment in employee well-being.
- Increased Productivity & Engagement: Healthier, less stressed employees are more focused, engaged, and productive, leading to a more vibrant workplace culture.
- Stronger Organizational Culture: Prioritizing employee health fosters a culture of care, support, and appreciation, boosting morale and loyalty.
Challenges and the Path Forward
While the benefits are compelling, integration comes with its challenges, including data privacy concerns, ensuring equitable access, and effectively communicating complex offerings. The future of healthcare within employee benefits is not just about providing access to care, but about actively cultivating health. By seamlessly weaving targeted health interventions into benefits strategies, organizations can build a healthier, more resilient workforce, ultimately contributing to a more sustainable and prosperous business.
by admin | Oct 30, 2025 | Custom Content, Employee Benefits, Health Care Costs
No doubt about it, prescriptions are expensive. While this may not be a big worry when you’re young and healthy, the costs can add up quickly if you’re diagnosed with a chronic condition or need an expensive drug. Whether you take medications regularly or for an occasional illness, it pays to know how to save money on prescriptions.
Did You Know?
Drug costs are a primary driver of rising healthcare expenses for both employers and employees. Prescription drug spending is consistently growing at a faster rate than overall healthcare costs, with a steady increase of 6.8%. As the fastest-growing part of benefits plans, these costs will continue to climb with new pharmaceutical innovations.
For years in the U.S., cost has been a significant obstacle to sticking with medications with up to 3 in 10 people reporting that they do not take their medications as prescribed.
The Rising Cost of Prescriptions
Historically, prescription drug costs have outpaced total healthcare costs. The following chart highlights this trend from 2019 to 2024. 
Prescription drug costs can put a strain on your budget, but with a little research and the right questions, you can reduce expenses without sacrificing your health.
Here are expert-backed strategies to help you save on your medications:
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- Ask About a Generic Drug – Get the same quality and active ingredient as you’d find in a brand name, for less money.
- Save Money with a Pill Splitter – If your prescription comes in a higher dose that can be safely split, you get 2 doses for the price of 1.
- Consider a Combo Pill – Combining two drugs into one pill can help you avoid paying separate copays or coinsurance. Ask if a combo pill is an option for you.
- Buy in Bulk – Opt for a mail-order pharmacy to get a 90-day supply of your meds instead or a 30-day supply. This can often reduce your copay and overall cost.
- Make a List and Check it Twice – Check the list of preferred medications (a.k.a. “the formulary”), which tend to cost less.
- Find Out if You Still Need That Medication – If you’ve been taking the same medication for years, it’s worth checking in with your doctor to see if you still need it. Or if you’ve made a lifestyle change, it may reduce your need for certain medications. It never hurts to ask your doctor.
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The medicines prescribed by your doctor are essential to your good health. With some savvy shopping, you can use the money you save on the things you enjoy!
by admin | Oct 21, 2025 | Employee Benefits, Open Enrollment
Open enrollment is a hectic and critical period for employers that often brings a risk of compliance errors. These mistakes can confuse employees and cause missed benefits, while also exposing employers to legal risks.
This article highlights five common compliance pitfalls to avoid during open enrollment:
- Ineffective Communication of Benefit Changes – Benefit offerings often change annually due to plan design updates or regulatory mandates. Employers must clearly notify employees of any changes, including cost-sharing adjustments and new benefits, well before open enrollment. Using multiple communication channels and simple explanations helps employees make informed choices. Updates should also be reflected in required plan documents like the Summary Plan Description (SPD) or Summary of Material Modifications (SMM).
- Overlooking Election Deadlines
– Open enrollment periods should end well before the new plan year to allow orderly processing and compliance with tax laws. Employees’ benefit elections under Section 125 cafeteria plans are typically irrevocable for the plan year unless a qualifying life event occurs. Clear communication and encouraging early enrollment help prevent late or mistaken elections, which are difficult to correct.
- Failing to Distribute Required Health Plan Notices
– Employers must provide various health plan notices during open enrollment, such as the Summary of Benefits and Coverage (SBC), COBRA notices, CHIP notices, WHCRA notices, Medicare Part D disclosures, and HIPAA privacy notices. These notices ensure employees are informed of their rights and plan details and must be delivered in timely fashion. Electronic delivery is often permitted with proper safeguards.
- Not Providing Materials to All Eligible Individuals – It’s crucial to distribute open enrollment information not only to active employees but also to eligible individuals on leave, furlough, or COBRA continuation. A multi-channel approach with diligent tracking of distribution reduces the risk of missed communications and potential disputes.
- Neglecting Disclosure of Reasonable Alternatives in Wellness Programs – Wellness programs that impose surcharges or provide rewards based on health standards must offer reasonable alternative ways to meet requirements, per HIPAA rules. Employers need to disclose these alternative standards and provide contact information and assurance that personal physician recommendations will be accommodated. Compliance reduces legal risks related to premium surcharges and discrimination claims.
By proactively addressing these areas, employers can help employees confidently choose benefits while reducing compliance risks and administrative challenges.
by admin | Oct 14, 2025 | Health & Wellness
Over the past several years, mental health in the United States has steadily declined. Growing concerns about this issue have increased the pressure on employers to provide stronger mental health benefits. Although many organizations have expanded their mental health offerings, utilization among employees remains low. When these resources go unused, employees who could benefit miss out on vital support, and employers face potential downsides such as reduced well-being, lower morale, declining productivity, more frequent absences, and higher turnover.
To improve utilization, employers must first understand the barriers preventing employees from accessing mental health benefits. Common challenges include:
- Lack of communication – Many employees are simply unaware of the resources their workplace provides.
- Limited education – Workers may not have adequate information about how to access available benefits.
- Time constraints – Some employees don’t set aside time to learn about their options.
- Mental health stigma – Ongoing stigma may discourage individuals from seeking help.
- Cost concerns – Employees may be uncertain about expenses, unaware of discounted or free resources, or discouraged by deductibles and out-of-pocket costs. Some also lack clarity on what their plans cover.
Simply offering benefits is not enough to address these barriers. Employers can encourage greater use of mental health resources through strategies such as:
- Training managers – Managers often serve as the first point of contact for employees. By equipping them with knowledge of available benefits, they can promote resources, answer questions, and normalize their use.
- Educating employees regularly – Mental health benefits should be communicated throughout the year, not just during open enrollment. Multi-channel communication, including emails, newsletters, and meetings, can raise awareness.
- Fostering a supportive culture – Promoting open conversations around mental health and encouraging use of available resources can reduce stigma and create a more supportive environment.
- Clarifying access – Clear guidance on how to use benefits can make employees more comfortable seeking care.
- Gathering employee feedback – Anonymous surveys allow employers to learn which benefits employees value most and make adjustments accordingly. Communicating any resulting changes helps employees feel heard.
Although the availability of mental health benefits has grown in recent years, significant barriers still limit employee engagement with these resources. By addressing obstacles directly and implementing supportive strategies, employers can boost utilization, improve employee well-being, strengthen engagement, and enhance organizational outcomes.
