Author: Cleveland Benefits Partners
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2026 Medical Cost Outlook
PwC’s latest annual analysis forecasts that group health insurance costs will increase by 8.5% in 2026—the third straight year at this elevated trend. This sustained rise means health care expenses are now similar to those seen 15 years ago, after a brief dip post-pandemic. Researchers gathered data from actuaries at 24 major U.S. health plans,…
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Benefits 101: A Guide to PPO Plans
When navigating the world of health insurance, you will likely encounter the term PPO (Preferred Provider Organization). A PPO plan – whether medical or dental – is about balancing the cost and convenience of care. With a PPO plan, you get the flexibility to see a wide range of doctors. You’ll save money by staying…
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What Brokers Should Be Doing Now to Get Clients ACA-Ready
How to position yourself as a trusted ACA compliance advisor For brokers and benefits advisors, Q4 planning doesn’t start in October. It starts now. September marks a critical moment in the annual ACA compliance cycle, when employers begin thinking about year-end strategies, benefits renewals, and how to avoid last-minute reporting panic. That makes now the perfect…
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Navigating Your Health Plan: A Guide to Your Explanation of Benefits (EOB)
Ever found a confusing document in your mailbox after a doctor’s visit, wondering if it’s a bill, especially with an “amount you owe” at the bottom? You’re not alone! That document is most likely an Explanation of Benefits (EOB) from your health insurance company. It’s crucial to remember: an EOB is NOT a bill. Think…
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Compliance Recap July 2025
THE ONE BIG BEAUTIFUL BILL ACT IMPACT ON EMPLOYEE BENEFITS The One Big Beautiful Bill Act of 2025 (OBBBA) introduces permanent changes to a range of employee benefits, creating a more stable and generous framework for employers and employees. HDHPs and HSAs Telehealth Services: High-deductible health plans (HDHPs) can now permanently cover telehealth before deductibles…
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Health Insurance Terms You Should Know
Health care terms, medical bills, and forms can be hard to understand. Here are some common health care terms, and what they mean. Allowed Amount This is the maximum payment the plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.” For example, if…
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Upcoming Changes for Employee Benefits
Employers will see several changes to their health and welfare benefits due to comprehensive new tax and spending legislation. This includes notable improvements to Health Savings Accounts (HSAs), Dependent Care Flexible Spending Arrangements (DCFSAs), and employer-provided student loan payments, as well as the introduction of some new fringe benefit choices. These updates introduce significant changes…
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ACA Update: Enhanced No-Cost Cancer Screenings for Women Coming in 2026
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…
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Compliance Recap June 2025
SUPREME COURT AFFIRMS PREVENTIVE CARE PROTECTIONS UNDER THE ACA The U.S. Supreme Court has upheld a critical component of the Affordable Care Act (ACA), reinforcing the requirement that health insurers provide coverage for preventive services recommended by a federal expert panel. The decision ensures that Americans will continue to have access to early detection and…
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Supporting Your Workforce: The Value of Dependent Care Assistance Programs (DCAPs)
Want to attract and keep top talent? Your benefits package is crucial! Think beyond just health and retirement. Fringe benefits like Dependent Care Assistance Programs (DCAPs) offer real, meaningful support, especially for employees caring for kids or dependent adults. What is A DCAP? A DCAP – also known as a dependent care flexible spending account…
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The Truth About FSAs: Facts, Myths, and Tips
Flexible Spending Accounts (FSAs) offer unique advantages for managing health and dependent care expenses, but they operate differently from standard savings or spending accounts. Below are five essential facts about FSAs, along with common myths and clarifications to help you make the most of this benefit. Key FSA Facts: Tax Advantages: A major perk of…
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Breaking Down Your Benefits: Understanding Key Terms
Selecting the right health insurance plans for your family is a critical process that requires careful attention from start to finish. Navigating health insurance becomes much simpler when you understand its terminology. Making sense of these terms empowers you to better understand your costs, benefits, and even estimate the price of a doctor’s visit. Premium:…
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Compliance Recap | May 2025
CONSOLIDATED APPROPRIATIONS ACT 2024 RXDC REPORTING DEADLINE The Centers for Medicare & Medicaid Services (CMS) has reaffirmed that the instructions for reporting 2024 Prescription Drug Data Collection (RxDC) remain unchanged from 2023. The deadline for employers and plan sponsors to submit 2024 data is Sunday, June 1, 2025. Overview of RxDC Reporting Requirements Each year, employers sponsoring…
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Form 5500 Filing Requirements: Deadlines, Penalties, and Compliance Options
If your company provides an employee benefit plan governed by the Employee Retirement Income Security Act (ERISA), you are likely obligated to file Form 5500. This annual report discloses key details about your organization’s benefit offerings, such as welfare benefit plans (including medical, dental, life, and disability coverage), retirement plans, fully insured plans, and self-funded…
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Benefits 101: What Is Cancer Insurance?
The word “cancer” carries a weight that extends far beyond its medical implications. Beyond the physical and emotional toll, a cancer diagnosis can bring significant financial strain. While your primary health insurance will cover many treatment costs, there are often substantial out-of-pocket expenses that can quickly add up. This is where cancer insurance comes in.…
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The Clock is Ticking: Don’t Miss the EEO-1 Report Deadline
The annual EEO-1 Report, mandated by the Equal Employment Opportunity Commission (EEOC), is a cornerstone of workplace diversity and anti-discrimination efforts in the United States. This data collection provides a demographic snapshot of America’s workforce, helping to monitor for discrimination and promote equal employment opportunity. Missing the deadline can lead to serious consequences, making it…
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Disability Insurance Explained: Long-Term Disability
Your most valuable asset isn’t your house, car or retirement account. It’s the ability to make a living. Long-term disability insurance (LTD) provides financial protection by replacing a portion of your income—typically 50% to 70%—if you become unable to work due to a prolonged illness, injury, or accident. This benefit is paid directly to you…
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Compliance Recap | April 2025
MARYLAND DELAYS PAID FAMILY AND MEDICAL LEAVE IMPLEMENTATION Originally approved in 2022, the state-regulated family and medical leave insurance (FAMLI) program mandates that all Maryland employers provide qualified employees up to 12 weeks of paid family and medical leave, and potentially another 12 weeks for parental leave—totaling up to 24 weeks of paid leave. Qualified…
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From Anxiety to Action: Managing the Impact of Doomscrolling on Your Well-Being
In stressful or uncertain times, it’s easy to get caught in an endless cycle of scrolling through negative news and social media. This behavior, known as doomscrolling, is increasingly common—but it can take a serious toll on your mental and physical health. This article explores the risks of doomscrolling and offers practical tips to help…
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Mind Matters: Supporting Employee Mental Health at Work
Every year, millions of people experience mental health challenges with limited access to care. According to the World Health Organization, 1 in 8 people globally are affected. Conditions like anxiety and depression significantly reduce productivity, costing the global economy around $1 trillion annually. Despite the rising demand for support, more than two-thirds of those who…
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Compliance Recap | March 2025
ACA REPORTING Affordable Care Act (ACA) reporting for applicable large employers (those with 50 or more employees) was due for the 2024 plan year in March. Reporting to Employees – due March 3, 2025 Form 1095-C: For Applicable Large Employers (ALEs) to report health coverage offered to full-time employees. Form 1095-B: For employers with self-funded…
