Understanding Health Insurance Contract Negotiations: Your FAQ for Peace of Mind
As a Benefits Advisor, I’ve seen a noticeable uptick in members receiving letters from their health insurance plans about hospital contract negotiations. These notices often arrive with urgent-sounding language and can trigger unnecessary panic. The good news? Most of these…
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Exploring GLP-1 Weight-Loss Medication Options When Insurance Doesn't Cover Them
Medications known as GLP-1s (glucagon-like peptide-1 receptor agonists) have gained attention for helping people manage weight and related health conditions. Many health plans, including BCBS, Priority Health and UHC in Michigan, do not cover GLP-1 drugs when prescribed specifically for weight loss, which can…
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Employers No Longer Need to Automatically Distribute ACA Reporting 1095 to Employees
We all know healthcare costs increase annually. Medical trend increases are based on higher costs for prescription drugs, advancement in medical technologies, reinsurance costs and regulatory changes. So, what are the reasons for the higher than normal premium rates as we approach…
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ACA Subsidies Update: Pending Legislation and What Employers Should Know
As employers continue to field questions about rising ACA Marketplace premiums, there is a new development worth watching closely. On January 8, 2026, a bill was introduced in Congress aimed at addressing the expiration of enhanced ACA subsidies. If the…
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Understanding Full-Time Equivalents (FTEs) Under the Affordable Care Act (ACA)
Understanding Full-Time Equivalents (FTEs) Under the Affordable Care Act (ACA): A Guide for Employers What is a Full-Time Equivalent (FTE)? A Full-Time Equivalent (FTE) is a unit of measurement that represents the workload of an employee in a way that…
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Understanding the Affordable Care Act
Understanding the Affordable Care Act: What Employers Need to Know when Moving Above or Below 50 FTEs The Affordable Care Act (ACA) has specific regulations that impact employers based on the size of their workforce. One of the most critical…
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Tracking Variable Hour Employees: Understanding Measurement and Administrative Periods
Tracking Variable Hour Employees: Understanding Measurement and Administrative Periods Employers with variable hour employees face unique challenges when it comes to tracking hours and determining health insurance eligibility. Under the Affordable Care Act (ACA), businesses must use specific methods to…
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New Benefits, Big Changes: What the OBBA Means for HDHPs, Telehealth, FSAs, HSAs & More
New Benefits, Big Changes: What the OBBBA Means for HDHPs Telehealth, FSAs, HSAs & More The recently passed One Big Beautiful Bill Act (OBBBA) brings a wave of important updates that will directly impact health plan administration, tax-preferred accounts, and…
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Health Savings Account (HSA) FAQs
Health Savings Account (HSA) FAQs: Everything You Need to Know A Health Savings Account (HSA) is a powerful tool that helps individuals save for medical expenses while enjoying tax advantages. If you're considering opening an HSA or want to maximize…
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Understanding PCORI Fees: What They are and Who is Required to Pay Them
Understanding PCORI Fees: What They Are and Who is Required to Pay Them The Patient-Centered Outcomes Research Institute (PCORI) fee is a federal fee established under the Affordable Care Act (ACA) to fund research that helps patients, healthcare providers, and…
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HSA/HDHP Limits for 2026
The IRS has released the updated inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2026. Annual contribution limits, minimum deductibles for HDHPs, and maximum out-of-pocket expenses will see an increase. However, the additional catch-up…
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Understanding Non-FMLA Leave and Health Coverage: Employer Responsibilities
Understanding Non-FMLA Leave and Health Coverage: Employer Responsibilities When an employee takes leave that is not covered under the Family and Medical Leave Act (FMLA), employers often have questions about how to handle health insurance coverage. Unlike FMLA leave, which…
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Understanding RxDC Reporting: What is it, why do we need it, and what are my employer’s responsibilities
What is RxDC Reporting? RxDC (Prescription Drug Data Collection) reporting is a requirement under the Consolidated Appropriations Act (CAA) of 2021. The purpose of this reporting is to provide the Centers for Medicare & Medicaid Services (CMS) with data on…
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Defined Contributions for Employee Benefit Plans
Employers looking for more predictability in their costs, more equity in their contributions and perhaps even more flexibility for their employees are increasingly exploring the idea of Defined Contribution strategies for their employee benefit plans. Defined Contribution (or DC) plans come…
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Top 4 Reasons Healthcare Costs are Rising for 2025
We all know healthcare costs increase annually. Medical trend increases are based on higher costs for prescription drugs, advancement in medical technologies, reinsurance costs and regulatory changes. So, what are the reasons for the higher than normal premium rates as we approach…
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PCORI Fees – What Are They and When Do I Pay Them?
PCORI Fees - What are They and When Do I Pay Them? One of the many requirements in the Affordable Care Act (ACA) is the Patient-Centered Outcomes Research Institute (PCORI) fee, an often overlooked but essential aspect of compliance. The…
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Spousal Incentive Opt-Out HRA Plans
Spousal Incentive Opt-Out HRA Plans What is a Spousal Incentive Opt-Out HRA Plan? While many organizations have a taxable cash opt-out or waiver incentive that is offered to employees who are covered by health insurance coverage elsewhere, a spousal incentive…
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Employer Guide: Navigating ACA Compliance as an Applicable Large Employer (ALE)
employer Guide: navigating aca compliance as an applicable large employer In today’s dynamic employment landscape, staying compliant with healthcare regulations is crucial for employers. The Affordable Care Act (ACA), signed into law in 2010, brought significant changes to the healthcare…
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Top 3 Reasons you need (and want) a Summary Plan Description (SPD)
Top 3 reasons you need (and want) a summary plan description (spd) Employee benefits are a critical component of talent retention, and providing clear information about these benefits is a legal requirement for employers. The Summary Plan Description (SPD) serves…
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Virtual Health Care in Michigan
Virtual health care in Michigan In today’s benefits advisor blog, we’ll briefly touch on the types of virtual health care and how each of the primary health insurance carriers in SW Michigan are providing solutions. Virtual health care is primarily…
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Why Do You Need an Employee Benefits Advisor/Agent/Broker?
WHY DO YOU NEED AN EMPLOYEE BENEFITS ADVISOR/AGENT/BROKER? An employee benefits agent or broker is a great resource for both employers and employees. An advisor, agent or broker manages a number of different areas of employee benefits, including: •…
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What Has Your Broker Done for You Lately?
With a slight adjustment to the Janet Jackson classic… “what has your broker done for you lately?” How might you rate your most recent benefits open enrollment on a scale of 1-10? What could be improved upon? There’s a laundry…
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CAA & Transparency Regulations - The "Man" Behind the Curtain
Transparency Regulations were issued by the Departments of Labor, Health and Human Services and the Treasury (Departments) in November 2020. A month later, the Consolidated Appropriations Act, 2021 (CAA) was signed into law. Following in August 2021, the Departments released…
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Save The Trees!
Save The Trees! Why Using Employee Benefits Technology Matters... Throughout the day. I easily open my phone hundreds of times to buy something, read an article, respond to a message, watch a video for a good laugh or look up…
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What’s an SPD?!
What’s an SPD?! Space Patrol Delta? Super Perfect Day? Special Person Driver? Spinning Pile Driver?! Summary Plan Description? Oh yeah, that’s it, at least in the context of benefit plans! So, what is a Summary Plan Description, or SPD, who…
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Let Us (Re)Introduce Ourselves | Rose Street Advisors Team
Let Us (Re)Introduce Ourselves To the many friends of Rose Street Advisors, As we embrace this new year, we are more committed than ever to living out our core values and our mantra "What We Do and How We Do It…
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Employee Retention Credit (ERC)
Employee Retention Credit (ERC) On December 27, 2020, the Consolidated Appropriations Act of 2021 was signed. This provided updates and extensions to Employee Retention Credits (ERC). Employers that received Paycheck Protection Program (PPP) loans can also qualify for the ERC…
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