Category: ACA
ACA Update: IRS Announces 2027 Cost-Sharing Limit
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On January 29, 2026, the U.S. Department of Health and Human Services (HHS) officially released the maximum cost-sharing limits for the 2027 plan year. These figures represent a significant 13.2% increase over the 2026 limits, marking a substantial shift in potential out-of-pocket expenses for plan participants. 2027 Maximum Out-of-Pocket Limits For 2027, the maximum annual…
2026 ACA Reporting Guide: Key Deadlines and Compliance Requirements
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Employers must prepare for Affordable Care Act (ACA) reporting covering the 2025 calendar year. Staying ahead of these deadlines is critical for Applicable Large Employers (ALEs) and providers of self-insured health plans. Who is Required to Report? Reporting obligations under Internal Revenue Code Sections 6055 and 6056 fall into two main categories: Note for Self-Insured…
Pay-or-Play Affordability Percentage Will Increase for 2026
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On July 18, 2025, the IRS released Revenue Procedure 2025-25 to index the contribution percentage in 2026 for determining the affordability of an employer’s health plan under the Affordable Care Act (ACA). For plan years beginning in 2026, employer-sponsored coverage will be considered affordable under the ACA’s “pay-or-play” rules if the employee’s required contribution for…
ACA Update: Enhanced No-Cost Cancer Screenings for Women Coming in 2026
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Big changes are coming to women’s preventive care coverage! Starting with plan years on or after December 31, 2025, group health plans and health insurance issuers must expand their no-cost coverage for women’s preventive care. This expansion includes additional breast cancer imaging or testing needed to complete an initial mammogram, as well as patient navigation…
ACA Reporting Deadlines for 2025: What You Need to Know
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For employers subject to the Affordable Care Act (ACA), staying compliant with reporting requirements is non-negotiable. With 2025 due dates just around the corner, now is the time to prepare for distributing Forms 1095-C to employees and filing with the IRS. These forms provide essential information about health coverage offered to employees and are critical…
The Pay or Play Percentage Increase for 2025
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The Affordable Care Act (ACA) requires large employers to offer affordable health insurance coverage to their full-time employees or face a penalty known as the “Pay or Play” tax. This tax is based on the employer’s average monthly wage (AMW) and the number of full-time employees. The affordability rate for employer-sponsored health coverage will increase from 8.39% to…