Author: Cleveland Benefits Partners
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Compliance Risks in Open Enrollment: 5 Mistakes and How to Avoid Them
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: By proactively addressing these areas, employers can help…
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Breaking Barriers: Increasing Employee Utilization of Mental Health Benefits
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…
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Empowering the Next Generation: Making Benefits “Easy” for Young Employees
Health Insurance today is significantly more complex for young workers than it was just a decade ago. This complexity is driven in large part by healthcare costs that have outpaced inflation, pushing premiums, copays, and other out-of-pocket expenses to comprise substantial portions of their budgets. For many younger employees, navigating this landscape is confusing –…
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Compliance Recap | September 2025
UNDERSTANDING AND DISTRIBUTING MLR REBATES Insurance carriers must issue Medical Loss Ratio (MLR) rebates by September 30 when too much of the prior year’s premiums went to administrative costs or profit instead of claims and quality improvements. Employers who received MLR rebate checks will need to determine how much—if any—belongs to the plan and its…
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Mastering Open Enrollment: A Step-by-Step Guide
Open enrollment doesn’t have to be a stressful administrative task. When planned well in advance, it becomes a valuable opportunity to review and enhance your benefits offerings, demonstrating your commitment to your team’s physical, mental, and financial well-being. A well-executed open enrollment can boost employee morale, improve retention, and ensure your workforce is supported. Use…
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Compliance Recap | August 2025
NORTH CAROLINA PASSES NEW PBM LAW On July 10, 2025, North Carolina Governor Josh Stein signed into law the Act Supporting Community Retail Pharmacies and Improving Transparency (“the SCRIPT Act”). The sweeping law regulating pharmacy benefit managers (PBMs) in North Carolina is designed to improve transparency, strengthen consumer protections, and support community pharmacies. While most…
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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.…
