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End-of-Year HR Compliance Checklist: What Your Business Needs to Wrap Up

Fri, 16 Oct 2026 19:50:45 GMT

Essential Compliance Responsibilities to Finalize Before the Close of 2026

As 2026 comes to a close, HR and benefits administrators face more than holiday planning a nd budget forecasting. Year-end compliance responsibilities are critical to avoid penalties, ensure smooth operations, and set your business up for a successful new year.

It can be daunting, but we're here to help, and the practical checklist below is a great place to start. Tackle one section at a time, and reach out to us if you get stuck. We'll go over ERISA, COBRA, Section 125, ACA reporting, creditable coverage notices, and handbook updates.

ERISA Plan Year-End Tasks

If your company offers health, dental, vision, life or disability benefits, you're likely subject to the Employee Retirement Income Security Act (ERISA). Before year-end, verify the following:

Wrap Plan Documents and Summary Plan Descriptions

Ensure your plan documents and wrap documents are current. If your plan has changed during the year, you need to update your Summary Plan Description (SPD) to reflect those changes. That can include coverage levels, eligibility rules, or benefits. An outdated SPD creates a compliance risk and can confuse employees about what's actually covered.

Verify Form 5500 Filings

If you filed a Form 5500 extension earlier in the year, your extended deadline is October 15, 2026. This requirement applies to employers with 100 or more participants in self-insured or ERISA-covered plans. Small welfare plans (fewer than 100 covered participants) that are fully insured or unfunded are generally exempt from this filing requirement.

Missing the Form 5500 deadline can result in significant Department of Labor penalties—up to $2,739 per day of noncompliance. Take a moment to verify that you filed or make arrangements to do so.

Finalize Plan Year Closeout Documentation

Complete all compliance documentation for plan-year reporting and maintain it in your ERISA file for audit protection. This includes testing results, nondiscrimination certifications, and any amendments made during the year.

Issue COBRA Notices

COBRA (the Consolidated Omnibus Budget Reconciliation Act) requires employers with 20 or more employees to offer continuation of health coverage after qualifying events such as termination of employment or reduction in hours. Each year, you need to communicate next year's rates to employees by November.

Conduct a COBRA Audit

Review all required notices to ensure they've been issued properly and within required timelines. If you missed a deadline, address it now before an employee files a complaint. Verify that notices are being sent on time, that premium billing is accurate, and that records are in order.

Update COBRA Rates for 2027

COBRA premiums for the next calendar year should be calculated and communicated to participants by November. Determine your plan's 102 percent rate (the COBRA premium cap) and ensure notices are distributed to covered beneficiaries.

Review Section 125 (Cafeteria Plan) Compliance

Section 125 plans allow employees to pay for benefits using pre-tax dollars. If benefits or eligibility rules have changed during the year, your plan document and summary must reflect those changes. This includes changes to FSA limits, dependent care FSA availability, or any shift in benefit offerings.

Conduct Nondiscrimination Testing

Highly compensated employees should not receive a disproportionate benefit under your pre-tax plans. Conduct nondiscrimination testing now to ensure compliance, particularly if any plan design changes were made during the year.

Clarify Carryover and Grace Period Rules

For health care and dependent care FSAs, determine your approach to unused balances. You can offer carryover (up to $680 in 2026), a grace period (up to 2.5 months into the following plan year), or a runout period. Communicate your policy clearly to employees so they understand how to use remaining FSA balances before year end.

Confirm ACA Reporting Requirements

Under the Affordable Care Act, Applicable Large Employers (ALEs), or those with 50 or more full-time or full-time equivalent employees, face specific reporting obligations.

Gather Data for Forms 1094-C and 1095-C

You must file Forms 1094-C and 1095-C with the IRS and distribute 1095-C forms to all full-time employees who had coverage during 2026. Verify that your payroll or benefits platform can accurately track full-time status, hours of service, and plan affordability.

Understand 2027 Filing Deadlines

For the 2026 calendar year:

Distribute 1095-C forms to employees by March 2, 2027
E-file Forms 1094-C and 1095-C with the IRS by March 31, 2027 (March 2 if filing paper returns, though most ALEs must file electronically)

Start gathering data now so you're not scrambling in the first quarter.

Track Full-Time Status Accurately

Ensure your records clearly show which employees were full-time for each month in 2026. The ACA's definition of "full-time" is 30+ hours per week. Misclassification is one of the most common ACA reporting errors.

Confirm Affordability Thresholds

The 2026 affordability rate is 9.96 percent of household income (up from 9.02 percent in 2025). Use this threshold when evaluating whether your lowest-cost self-only health plan meets affordability requirements.

Distribute Creditable Coverage Notices

If your business offers a group health plan that includes prescription drug coverage—whether fully insured or self-funded—you must notify Medicare-eligible individuals each year whether your coverage is creditable or non-creditable under Medicare Part D guidelines.

Understand Creditable vs. Non-Creditable Coverage

"Creditable coverage" means your plan's prescription drug benefits are expected to pay at least as much, on average, as standard Medicare Part D. If your plan does not meet this standard, it's classified as non-creditable. This distinction matters because Medicare-eligible individuals may face late-enrollment penalties if they delay signing up for Part D without having creditable coverage in place.

Identify All Required Recipients

You must provide this notice to anyone eligible for your plan's prescription drug coverage, whether or not they're currently enrolled. This includes:

Active employees
COBRA beneficiaries
Covered spouses and dependents
Any Medicare-eligible individual eligible for coverage under your plan

Do not assume someone is not Medicare-eligible based on age or employment status. When in doubt, issue the notice.

Meet Annual Deadline

The Creditable Coverage Notice must be provided annually before October 15.

Additional timing requirements include:

Before an individual's initial Medicare Part D enrollment
Before coverage begins for new hires or newly eligible individuals
Within 30 days of any change in your plan's creditable status
Upon request from a plan participant

File With CMS

In addition to notifying participants, you must report your plan's creditable coverage status to the Centers for Medicare & Medicaid Services (CMS) annually. Submission must occur:

No later than 60 days after the start of your plan year
Within 30 days of any change in status
Upon termination of the plan

This filing is completed electronically through the CMS Creditable Coverage Disclosure Portal. Failure to submit on time can result in penalties.

Update Employee Handbooks and Policies

The end of the year is an ideal opportunity to review and refresh your employment policies.

Review for State and Local Law Changes

Employment law is constantly evolving. Review your handbook and policies for compliance with updated state or local laws, including minimum wage requirements, paid leave mandates, harassment prevention policies, and any new local employment rules that took effect during 2026.

Update Schedules and Policies

Refresh holiday schedules, paid time off policies, benefits summaries, and any procedures that changed during the year. Inconsistencies between your handbook and actual practice create compliance risk and employee confusion.

Incorporate New Requirements

Depending on your jurisdiction, ensure your handbook addresses emerging topics such as remote work guidelines, artificial intelligence use disclosures, pregnancy accommodation policies, or any other regulatory changes affecting your workforce.

Looking Forward

Year-end HR compliance is essential to keeping your business legally sound and your employees protected. Close out the year properly to prevent headaches, fines, and missed deadlines in the months ahead.

As you work through the checklist above, if you have questions about any of these requirements, reach out to us. We can help you navigate the details specific to your situation and industry.

Breast Cancer Awareness Month: Turn Awareness Into Action

Wed, 07 Oct 2026 02:03:44 GMT

The Pink Ribbon Is a Reminder, Not the Finish Line

Every October, pink ribbons bring breast cancer into public view. And while awareness certainly matters, a more us eful purpose to these cute little ribbons is personal action. To anyone with breasts, this means understanding your risk, paying attention to changes, talking with a healthcare professional about screening, and knowing how your insurance works before you need it.

Breast cancer can affect people with very different backgrounds and risk profiles. Women are affected most often, but men can develop breast cancer too. Some people have a strong family history or an inherited genetic change, while many people diagnosed have no obvious family history. No checklist can tell you with certainty who will or will not develop the disease.

Know What Is Normal for You

Breasts can naturally change with age, hormones, weight, pregnancy, and medications. Because of that variability of risk and of factors throughout life, it's crucial to become familiar with how your own breasts normally look and feel. That can be the key to making an unusual change easier to notice. Warning signs could include a new lump in the breast or underarm, thickening or swelling of tissue, skin dimpling or irritation, changes in size or shape, nipple changes, unusual discharge, or persistent pain.

If you do notice something, don't panic. Many breast changes are not cancer. Still, a new change is worth discussing with a healthcare professional, even if a recent mammogram was normal. Do not wait for a symptom to become severe before speaking up and asking a question.

Make Screening a Conversation

Mammogram can find some signs of breast cancer before symptoms appear. Recommendations about when to begin and how often to get these screenings depend on age, personal history, family history, breast density, genetic risk, and guidance from your healthcare team. Someone at higher risk may need more frequent mammograms or additional tests.

General rules, such as getting a mammogram once a year after the age of 40, are a good starting point, but you should also ask your doctor what is appropriate for you. Useful questions include when you should begin screening, how often you should return, whether you have risk factors that change the plan, and where to schedule the test.

Risk Information May Help You Plan

Some risk factors, including age and inherited genetic changes, cannot be controlled. Others may relate to health history or lifestyle. Gathering information can help guide conversations and provide context. Ask relatives what they know about cancers on both sides of the family, including the type of cancer and age at diagnosis. Share that history with your healthcare professional. If the pattern suggests increased risk, the next step might include a more detailed assessment or a discussion about genetic counseling. Be aware of lifestyle risk factors that you may need to change.

Understand Screening and Diagnostic Care

Insurance often treats a routine screening mammogram differently from a diagnostic mammogram ordered to evaluate a symptom or follow up on a finding. The services may look similar, but network rules and out-of-pocket costs can differ. Additional imaging, such as an ultrasound or MRI, may also have separate requirements regarding timing and referrals.

Before an appointment, consider asking your insurance company whether the facility is in network, whether an order or prior authorization is needed, and what costs may apply if the visit becomes diagnostic. You can also reach out to us for help understanding the terms of your policy. Coverage varies by plan, age, risk level, and the reason for the service, so confirm the details rather than assuming every test will be handled the same way.

Review the Rest of Your Financial Safety Net

A cancer diagnosis can affect more than medical bills. Time away from work, travel for treatment, household help, and other everyday expenses can put pressure on a family. Health insurance is central to treatment, but it may not address every financial consequence.

This month can be a useful time to review your health plan's deductible, out-of-pocket limit, prescription coverage, provider network, and care-management resources. Depending on your situation, you may also want to understand disability, critical illness, cancer coverage, hospital indemnity, or life insurance already in place. These products have limitations and exclusions, and they should not be treated as substitutes for major medical coverage.

Support Can Be Practical as Well as Emotional

If someone you care about is dealing with breast cancer, specific offers are often easier to accept than a general request to call if anything is needed. A ride, a meal, a fun activity, help with errands, childcare, or simply listening can reduce the weight of a difficult week. Respect the person's privacy and follow their lead about what they want to share.

Choose One Step This October

Awareness is truly meaningful when it leads to action. This month, take at least one action to help stop breast cancer. Schedule an overdue appointment, write down your family history, ask your doctor about a screening, or review your coverage. If you have questions about how your insurance may handle mammograms, diagnostic testing, prescriptions, or specialist care, contact our office. We can help you understand the plan language and prepare more informed questions for your healthcare team.

Creating an Eye-Friendly Workplace

Wed, 30 Sep 2026 06:00:04 GMT

Your employees spend one-third of their lives at work. Their workplace environment directly impacts many aspects of their wellbeing: their productivity, mood, and quali ty of life. Many leaders are aware of environmental health risks related to ergonomics, but one area that is often overlooked is eye health.

The Environmental Health Crisis You’re Likely Missing

Here’s some data you might want to take in: 72% of employees report struggling with environmental eye issues that reduce focus and productivity. But HR leaders estimate that less than half their employees are affected.

This gap between perception and reality is costing companies like yours. Employees with unmanaged eye strain are less productive, more likely to take time off, and more likely to leave for employers who demonstrate greater care about their wellbeing. That’s a significant opportunity to improve culture and retention.

Three Environmental Threats to Your Employees’ Vision

1. Seasonal Eye Discomfort

Pollen, allergens, and seasonal environmental changes trigger itchy, red, burning, watery eyes and blurred vision for roughly 7 out of 10 workers. These symptoms aren’t necessarily minor—they can reduce focus, increase errors, and lead to personal time off.

The problem worsens in both spring and fall when allergens are high. But employees can experience seasonal eye discomfort year-round due to changes in climate and weather patterns, humidity shifts, and indoor environmental factors.

What you can do:

Educate employees about causes, symptoms, and treatments
Provide resources from reputable sources like the American Optometric Association
Install HEPA air filters in your workplace
Post reminders about washing hands and avoiding eye rubbing
Share information about OTC treatments and when to see an eye doctor

2. Workplace Climate, Air Quality, and Lighting

Your workplace environment directly affects your employees’ eyes. Hot summer air combined with aggressive air conditioning creates dryness and irritation. Cold winter heating has the same effect. In more severe cases, poor indoor air quality from cooking oils, pesticides, and volatile organic compounds (VOCs) can contribute to ocular surface disease, glaucoma, and conjunctivitis.

Lighting matters enormously. Dim conditions cause 45% of employees to report eye strain, stress, and anxiety. On the other hand, overly bright settings could also trigger strain and plus headaches. Screens compound the problem, with two-thirds of employees reporting screen-related eye issues.

What you can do:

Install humidifiers to maintain balanced indoor humidity
Evaluate workplace lighting: ensure it’s adequate without being excessive
Advise employees to follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds
Recommend screen filters and blue light settings on devices
Address poor air quality by using low-odor cleaning products and understanding building material VOCs

3. Workplace Eye Safety

Nearly 25,000 workplace eye injuries occur annually in the U.S., resulting in lost productivity, high medical costs, vision impairment, and mental health issues. But here’s what’s alarming: the fastest-growing number of eye injuries now occur at home—the new workplace for many employees.

Common workplace eye hazards include blunt force trauma, flying debris, chemical splashes, radiation, and dust. Yet only 56% of employees feel their workplace is eye-friendly. While 81% of HR leaders say their company promotes protective eyewear, only 45% of employees agree.

What you can do:

Regularly inspect work areas and equipment for eye hazards
Remove or reduce hazards where possible; clearly mark those that can’t be removed
Enforce the use of OSHA-approved safety glasses or face shields
Educate employees with literature, signage, videos, and presentations
Provide guidance for remote workers on home office eye safety

Vision Insurance: A Benefits Strategy That Supports Culture and Retention

Vision insurance covers regular eye exams, which catch vision problems and eye health issues before they become serious or affect work performance. Employees with access to vision care get prescription glasses, contact lenses, and lens treatments that reduce eye strain and improve productivity. They’re more likely to seek preventive care rather than waiting until problems impact their work.

More importantly, employees who have vision benefits feel valued. They’re more likely to stay with your company, more engaged in their work, and more satisfied overall. In a competitive labor market, comprehensive benefits—including vision—matter to recruitment and retention.

What to Watch Out For

Employee education gaps: Many employees don’t know what treatments are available for eye issues. They don’t understand the connection between their environment and their eye health. Make sure your benefits communication includes eye health education, not just enrollment information.

Perception vs. reality: Don’t assume your HR team knows how employees are really experiencing the workplace. Conduct surveys or focus groups specifically about eye health and environmental comfort. The disconnect between what leadership thinks and what employees experience is real.

Remote and hybrid workforce challenges: Eye safety doesn’t end when employees leave the office. Many work from home or switch between locations. Provide guidance on home office setup, lighting, screen positioning, and break strategies.

Preventive care adoption: Not all employees will use their vision benefits. Promote regular eye exams as preventive care, not just for getting glasses. Highlight the benefits of early detection and the connection between eye health and overall wellbeing.

Foster a Culture That Cares

Make sure your benefits package includes vision insurance that supports preventive eye care. The payoff is measurable: improved productivity, higher engagement, better retention, and a workplace culture where employees know their employer values their wellbeing.

When you invest in protecting their vision, you’re investing in your organization’s vision as well.

How Much Life Insurance Do You Actually Need?

Fri, 25 Sep 2026 16:54:46 GMT

Skip the Generic Formula and Build Your Own Number

Ask an online calculator how much life insurance you need and it will probably suggest a million dollars. Ask a se cond one and you will likely get the same answer. That is the problem with generic formulas. They do not know whether you have three kids or none, a mortgage or a paid-off house, a working spouse or a single income.

Rules like "buy ten times your salary" are only a starting point. A married couple with three children and twenty years left on a mortgage is in a completely different position than a couple with no children and no debt. Even with the same income, the needs are very different.

What follows is a more customized approach. Work through four categories, add them up, then adjust for your situation.

1. Debts and Mortgages

Add up everything you owe. Mortgage balance, auto loans, student loans, credit cards, personal loans — anything with a monthly payment attached to it.

These balances do not disappear if you pass away, and they can become a real burden for the people you leave behind. Keep in mind that your family may want to stay in the house rather than sell it. If that matters to you, make sure there is enough money to make staying possible.

2. Final Expenses

A traditional funeral can reach several thousand dollars once you account for the service, burial or cremation, and related costs. Prices vary quite a bit by region and by the choices a family makes.

Pre-planning helps, because it takes decisions off your family's plate during a hard time. But planning and paying are two different things. Set aside a realistic amount in your coverage so the bill is not an extra burden.

3. Income Replacement

This is the part people tend to overestimate and underestimate at the same time.

Your family probably does not need one hundred percent of your paycheck replaced. Some of that income goes to taxes, to your own expenses, and to debts you already counted above. A common approach is to plan on replacing roughly half of your pretax income for the years until you would have retired.

How that translates into a lump sum depends on how long the money needs to last and what a reasonable withdrawal rate looks like. An agent can run that math with you in a few minutes rather than leaving you to guess.

4. Education Costs

If you have children, tuition also needs to be calculated. College costs have been climbing steadily for years, and the number on a school's website today is not the number your family will face in a decade.

Look at the kinds of schools you would realistically be planning for, then account for years of increases on top of the current price.

Adjusting Your Total

Add the four categories together. That figure is your baseline, not your final answer. A few things could nudge it up or down:

A spouse with a substatial income of their own may reduce how much coverage you need
No pension or employer survivor benefit is a reason to increase the total
A family member with ongoing medical or special needs usually calls for some added cushion
Existing savings, investments, and any group coverage through work can offset part of the number

Most people land somewhere in the high six figures or above. Yours may be higher or lower, and that is fine. The point is that the number is based on the particulars of your life, not just a slider on a website.

Choose a Policy You Can Actually Keep

Coverage only helps if you keep paying for it. If you choose a death benefit that's too large for your budget, you may end up lowering it later, which means losing money already paid at that rate and losing the ground you gained by locking in coverage while you were younger and healthier. Run the numbers before you commit to an amount, so you choose one you can keep.

Timing matters too. Buying life insurance while you're young and healthy generally means locking in a lower rate for the life of the policy, so it costs less to keep long-term. Some term policies also include a conversion option, letting you move to permanent coverage later without a new health review. That's worth knowing, since term premiums climb as you age, and converting to a whole or universal policy down the road is a common way to keep coverage affordable for good.

Revisit Your Plan When Life Changes

Marriage, a new baby, a new career, a new home, a business, a divorce, retirement... Each major life event changes the math. A policy you set up eight years ago may not match the family or the needs you have now.

If you're not sure whether your coverage still fits, give us a call. We will walk through the four categories with you and see where you stand.

Employers Should Make Employee Health Care Literacy a Top Priority

Wed, 23 Sep 2026 16:44:25 GMT

For many U.S. workers, health insurance is confusing, intimidating, and underused. Despite the billions employers spend on benefits each year, a large share of employee s don't fully understand how their benefits work or how to use them effectively.

The Cost of Confusion

According to Aflac's 2026 Employee Benefits Trends report, only 38% of employees say they understand everything about their benefits. That means most workers need more guidance on what coverage they actually have and how to use it. This is called health care literacy: the ability to find, understand, and use health information and services.

When employees lack health care literacy, they're more likely to delay care, make poor medical decisions, and rack up unnecessary costs. For employers, that translates into higher claims costs, lower productivity, and frustration with benefit programs that were supposed to help.

The scale of the problem is significant. The Centers for Disease Control and Prevention estimates that better health literacy nationwide could prevent nearly 1 million hospital visits annually and save more than $25 billion in health care costs each year.

What Happens When Employees Don't Understand Their Benefits

Employees who don't understand their coverage often make choices that cost everyone more:

They use out-of-network providers unnecessarily, paying higher costs than they would in-network
They choose expensive care settings, like emergency rooms, for non-emergencies that urgent care or telehealth could handle
They skip preventive care that could catch and treat conditions before they become serious and costly
They misinterpret medical bills or fail to challenge incorrect charges

These behaviors impact more than just the employees themselves. They drive up costs across your entire benefits plan and contribute to absenteeism, as well as 'presenteeism,' when employees show up to work but are too distracted or unwell to be productive.

Adding to the pressure is the fact that health insurance premiums rose 7% last year, and the increase is expected to more than double in 2026. As costs climb, the price of employee confusion climbs with them.

Open Enrollment Alone Isn't Enough

Many employers concentrate their communication efforts on open enrollment. That makes sense, since it's the moment employees choose their plans. But a once-a-year push isn't quite enough to build true health care literacy.

Employees make health care decisions all year long, like when they schedule a test, fill a prescription, or decide where to seek care for a sudden illness. Without ongoing education, even a well-designed benefits package can go underused, and employees may end up making costly choices simply because they didn't know a better option existed.

Employers that take a continuous approach to benefits education are more likely to see employees engage with their coverage and make well informed decisions throughout the year.

Practical Ways to Build Health Care Literacy

You don't need to overhaul your entire benefits strategy to make progress. Small, consistent steps can have a meaningful impact:

Use plain language. Rewrite benefit materials to eliminate jargon. Explain key terms like deductibles, copays, and coinsurance in simple terms, aiming for a sixth- to eighth-grade reading level. After all, even employees with post-graduate degrees may not have the expertise to understand the health care and insurance industry!

Educate year-round. Provide monthly or quarterly communications focused on one topic at a time, such as preventive care, telehealth, or how to read an explanation of benefits statement.

Show real-world examples. Compare costs for common scenarios, like an urgent care visit versus an emergency room visit, so employees can see the financial impact of their choices.

Promote in-network savings. Use visuals or simple tools that show employees how much they can save by staying within their plan's network.

Leverage multiple channels. Combine email newsletters, intranet content, webinars, and short videos to meet employees wherever they're most likely to engage.

Offer decision support. Provide access to benefits counselors, in person or virtually, who can help employees choose plans and understand their coverage.

Encourage preventive care. Regular reminders about screenings, vaccinations, and annual checkups reinforce healthy behaviors and help reduce long-term costs.

Build Trust and Engagement

Employers who invest in health care literacy can become a trusted source of information for their workforce. That trust can increase participation in wellness programs, improve satisfaction with benefits, and strengthen retention.

Workers increasingly expect guidance and want help navigating a complex system. And as the employer, you are well positioned to provide that guidance.

Health care literacy isn't just a nice-to-have. It's a bottom-line investment that pays off in lower costs, healthier employees, and a workforce that trusts you to help them make sense of a system that often seems confusing by design. Start small, stay consistent, and your benefits program will work harder for everyone.

Medicare Part D Notices Are Due Before October 15

Wed, 16 Sep 2026 16:41:24 GMT

What Employers Must Send, and What's New for 2026

If your business offers health insurance that includes prescription drug coverage, there's an important annual dead line coming up. Before October 15, you need to tell your Medicare-eligible employees whether your drug coverage counts as “creditable.” It's a short notice, but skipping it can cost your employees real money down the road. Here's what you need to know, including an important change that may affect you this year.

What is the Creditable Coverage Notice?

Each year, employers that offer prescription drug coverage must let Medicare-eligible plan members know whether that coverage is creditable or non-creditable. Creditable means your drug coverage is expected to pay, on average, at least as much as standard Medicare Part D coverage. Non-creditable means it pays less.

This matters because of timing. If someone delays enrolling in Medicare Part D while they have creditable coverage through you, they avoid paying a late enrollment penalty later. But if they go 63 days or more without creditable coverage and don't realize it, they can face higher Part D premiums for the remainder of their plan years. The notice gives them the information they need to make the best decisions regarding their plan.

Who Needs to Send One

The requirement is broad. It applies to employers of all sizes that offer prescription drug coverage to Medicare-eligible individuals, whether your plan is fully-insured or self-funded, and regardless of grandfathered status. In other words, if your health plan includes drug coverage and any of your members could be eligible for Medicare, this applies to you.

Who Should Receive It

You must provide the notice to all Medicare-eligible individuals covered under your plan, regardless of whether they are actually enrolled in Medicare or not. That includes active employees, retirees, and COBRA participants who qualify for Medicare, along with their covered spouses and dependents. They may qualify according to age (65 and up), disability, or by having end-stage renal disease.

Because you may not always know which of your members are Medicare-eligible, a common best practice is to send the notice to everyone on the plan. It's simpler and helps ensure no one is missed.

What Changed for 2026

Recent Medicare Part D updates under the Inflation Reduction Act have made drug coverage more generous, including a new annual cap on out-of-pocket costs. This has raised the bar for what counts as creditable coverage.

CMS introduced a stricter method for testing creditable status for 2026. While some plans may still use older standards for now, the new test will eventually become the rule. Consequently, some plans that were creditable in previous years, particularly high-deductible health plans, may no longer qualify as creditable.

The main lesson here is: Don't assume your plan's status from last year still holds. It's best to confirm it every year.

How to Confirm Your Plan's Status

If your plan is fully insured, your insurance carrier usually determines creditable status and shares it with you, often around the time of renewal. If your plan is self-funded or level-funded, the responsibility generally falls to you, working with your third-party administrator, pharmacy benefit manager, or an actuary.

Once you know your status, CMS offers free sample notices in English and Spanish that you can adapt and use, so you don't have to draft it from scratch. You can also fold the notice into your open enrollment materials, as long as members receive it within the prior 12 months.

Don't Forget the Separate CMS Disclosure

The October 15 notice to employees is distinct from the requirement to disclose your plan's status to CMS via an online form. This CMS disclosure is due within 60 days of the plan year's start (March 1 for calendar-year plans). It's a good idea to keep both dates on your compliance calendar to ensure full alignment.

What to Do Now

With the October 15 deadline approaching, now is the time to confirm your plan's status and notify Medicare-eligible members. While employers must provide this notice before October 15, keep in mind that licensed agents can begin assisting beneficiaries with plan comparisons as early as October 1. If you are unsure how the 2026 changes affect your business, we are here to help you navigate the requirements and avoid costly surprises for your employees.

New Study Links Processed Foods and Weight Gain

Thu, 16 Jul 2026 06:00:04 GMT

Findings From a Landmark Study Confirm Dietary Impact

Many Americans rely on packaged and convenience foods to save time, but research suggests that diets high in ul tra-processed foods make it easier to consume excess calories and gain weight.

A widely discussed study conducted by researchers at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) examined how processed foods affect eating habits and body weight. The findings provided some of the strongest evidence to date that the type of food we eat can influence how much we eat, even when calories and nutrients appear similar on paper.

Inside the Study

The study followed 20 adults who lived in a research facility for four weeks. Participants spent two weeks eating a diet rich in ultra-processed foods and two weeks eating a diet centered on minimally processed foods.

Importantly, both meal plans were designed to provide similar amounts of calories, fat, carbohydrates, sugar, sodium, and fiber. Participants were free to eat as much or as little as they wanted during each phase.

Examples of ultra-processed foods included packaged breads, sweetened cereals, flavored yogurts, and ready-made meals. The minimally processed diet emphasized foods such as fruits, vegetables, whole grains, eggs, nuts, and freshly prepared meals.

What the Researchers Found

The results were striking.

When participants followed the ultra-processed diet, they consumed about 500 additional calories per day on average. Over the two-week period, they gained roughly two pounds.

During the minimally processed diet phase, participants tended naturally to eat fewer calories, and they lost a similar amount of weight.

Researchers also observed changes in hormones that help regulate hunger and fullness. Participants eating the minimally processed diet experienced increases in hormones associated with feeling satisfied and decreases in hormones linked to hunger.

Why Might Processed Foods Lead to Overeating?

The study was not designed to identify a single cause, but researchers noted several possible explanations.

One factor was eating speed. Participants tended to eat processed foods more quickly than minimally processed foods. Foods that require more chewing may help slow down eating, giving the body more time to recognize fullness signals.

Texture, flavor combinations, and convenience may also play a role. Many ultra-processed foods are engineered to be highly appealing and easy to consume, making it easier to eat large portions before feeling satisfied.

What Counts as Ultra-Processed Food?

Not all processed foods are unhealthy. Frozen vegetables, canned beans, plain yogurt, and whole-grain bread are technically processed but can still be nutritious choices.

Ultra-processed foods are generally products that contain multiple ingredients, additives, flavorings, or preservatives and are far removed from their original form.

Examples include:

Sugary breakfast cereals
Packaged snack foods
Candy and desserts
Sweetened beverages
Many frozen dinners
Processed meats such as hot dogs and some sausages
Packaged baked goods

Practical Ways to Eat Less Processed Food

You do not need to eliminate processed foods entirely to improve your diet. Small changes can make a meaningful difference.

Consider these strategies:

Fill half your plate with fruits and vegetables.
Choose whole grains more often, such as oatmeal, brown rice, or quinoa.
Include lean protein sources like fish, poultry, eggs, beans, or nuts.
Prepare simple meals at home when possible.
Keep nutritious snacks on hand, such as fruit, yogurt, nuts, or vegetables.
Slow down during meals and pay attention to hunger and fullness cues.

Takeaways

This study suggests that diets high in ultra-processed foods may encourage people to eat more calories and gain weight, even when meals contain similar amounts of nutrients. While no single food determines your health, emphasizing whole and minimally processed foods may help support healthy weight management and overall well-being.

The goal is not perfection. Making gradual shifts toward more whole foods and fewer heavily-processed options can be a sustainable way to improve your eating habits over time.

Employers with Health Plans: PCORI Fee Due July 31

Mon, 06 Jul 2026 15:49:06 GMT

Who Owes It, How Much It Is, and How to Pay on Time

If you sponsor a health plan, you’ve probably seen “PCORI fee” show up on a compliance calendar and wondered whet her it applies to you. Here’s some relief up front. For many employers it takes very little work, and some don’t have to do anything at all. Let’s walk through what the fee is, who actually owes it, and what to do before July 31.

What the PCORI Fee Is

The PCORI fee was created under the Affordable Care Act. It helps fund the Patient-Centered Outcomes Research Institute, which studies how well different medical treatments and care options work. Insurers and certain employers pay it once a year to support that research. The fee is currently scheduled to stay in place for plan years ending before October 2029.

Who Owes It

This is the part worth getting right, because it splits employers into two groups.

If you have only fully insured health plans , your insurance carrier handles the fee. You don’t file anything. The cost is built into your premium, so there’s nothing more for you to do.

If you sponsor a self-insured health plan , the responsibility is yours. That includes level-funded plans and most health reimbursement arrangements (HRAs), such as ICHRAs and QSEHRAs. You file and pay the fee directly to the IRS.

A few things are not subject to the fee, including standalone dental and vision coverage, most health FSAs, and HSAs.

How Much It Is

The fee is your average number of covered lives multiplied by a per-person rate that the IRS adjusts each year. For the filing due July 31, 2026, which covers plan years that ended in 2025, the rate depends on your plan year end date:

Plan years ending January through September 2025: $3.47 per covered life
Plan years ending October through December 2025: $3.84 per covered life

So a calendar-year plan that ended December 31, 2025, uses the $3.84 rate.

How to Count Covered Lives

The IRS allows a few methods to find your average covered lives, including the actual count method, the snapshot method, and the Form 5500 method. For an HRA, you generally count only covered employees, not their dependents.

Your third-party administrator can usually pull these numbers for you, though the fee itself stays your responsibility as the plan sponsor.

How to File

You report and pay the fee on IRS Form 720, the Quarterly Federal Excise Tax Return. A few details to keep straight:

File it on the second-quarter Form 720, even though PCORI is an annual fee
Use the most current version of the form, which the IRS updates each spring
If PCORI is your only excise tax, you file Form 720 just once for the year

One more note: The fee comes out of your company’s general assets. This means you can’t pay it from plan assets or employee contributions.

If the Deadline Sneaks Up on You

Unlike Form 5500, there’s no extension available for the PCORI fee, so July 31 is the date to circle. If you do file late, the IRS can apply failure-to-file and failure-to-pay penalties plus interest, though you may be able to request relief if you had reasonable cause.

The bottom line is simple. If your plan is fully insured, you can likely relax and let your carrier take care of it. If you’re self-insured or you offer an HRA, set aside a little time before the end of July to run your numbers and file. And if you’re not sure which group you fall into, that’s exactly the kind of question we’re glad to help you sort out.

This article is for general informational purposes only and is not legal or tax advice. The rules and rates can change, and your situation may differ. Confirm your obligations with a qualified benefits advisor, third-party administrator, or tax professional, and check the latest guidance at IRS.gov.

How to Have a Safe 4th of July Celebration

Mon, 29 Jun 2026 18:51:44 GMT

Simple Safety Tips to Help Protect Your Family, Friends, and Property During Your Fourth of July Festivities

Fourth of July is one of America's favorite holidays and it's a time to enjoy Independence Day with your family and friends.

Unfortunately, every year more than 11,000 people are sent to the emergency room for fireworks-related injuries, and in a typical year about eight to 10 people are killed by fireworks.

On top of that, fourth of July fireworks start an average of 18,500 fires every year, including 1,300 structure fires, 300 vehicle fires, and 16,900 outside fires, according to the National Fire Protection Association.

But you can take steps to protect your family and your property so that you don't have to be one of those statistics. It all comes down to common sense and respecting the power of the fireworks.

Mind the Sparklers

Usually these are known as "kiddie" fireworks, but you may be surprised to know that they cause one-quarter of the house fires and emergency room fireworks injuries on Fourth of July.

Sparklers are best handled by people aged 12 and older. Children younger than 12 require extreme supervision.
Everyone handling sparklers should wear closed-toe shoes, and not flip-flops or sandals, to protect their feet from sparks.
Keep a bucket of water to place sparklers in after they finish sparkling; they are still hot and dangerous.

Adult Supervision

Always have an adult vigilantly supervise fireworks activities and never allow children to play with or ignite fireworks.

Keep a Safe Distance from Your Home

If you are going to use fireworks at home, be sure you're lighting them in a safe area. A “safe area” means away from homes, buildings, trees, and bushes.

If your gutters have accumulated leaves, pine needles, or other flammable material, clean them before using fireworks near your home. If you're leaving town for the holiday, ask a neighbor to keep an eye on your house.

Be Prepared for the Worst

If you set off fireworks, keep a bucket of water handy in case of malfunction or fire. A fire extinguisher should be kept nearby in case of an emergency, especially if you are lighting fireworks on your street.

Follow Instructions

Always follow instructions for lighting fireworks. If fireworks malfunction, don't relight them! Douse and soak them with water, then throw them away. Also, never ignite fireworks in a container, especially one that is glass or metal.

Stay Away from Others

Don't aim fireworks at other people. They can cause severe injury.

By taking a few simple precautions and using common sense, you can enjoy a fun, memorable, and safe Fourth of July while helping protect your loved ones, your neighbors, and your property.

Rethinking Your Soft Drink Habits

websitehelp@agencybloc.com (Agency Bloc) — Tue, 01 Jul 2025 15:35:31 GMT

As the summer sun beckons and thirst levels rise, it's tempting to reach for a cold, fizzy beverage. But before you pop open that soda can, consider this: your drink choice has long-term implications for your health.

The Hidden Risks in Your Glass

A comprehensive study by the International Agency for Research on Cancer (IARC) analyzed data from over 451,000 individuals across 10 European countries over a 16-year period. The findings revealed that consuming two or more 250 ml glasses of soft drinks daily—whether sugar-sweetened or artificially sweetened—was associated with a higher risk of all-cause mortality compared to those who drank less than one glass per month.

Delving deeper:

Artificially Sweetened Beverages : Individuals consuming two or more glasses daily had a 26% higher risk of death compared to those who consumed less than one glass per month. Specifically, there was a 52% increased risk of death from circulatory diseases.
Sugar-Sweetened Beverages : Those consuming one or more glasses daily faced a 59% higher risk of death from digestive diseases.
All Soft Drinks : A notable association was found between soft drink consumption and increased mortality from Parkinson's disease.

Alternatives That Aren’t Any Healthier

Think fruit juice or energy drinks are a safer bet? A study involving 13,440 U.S. adults aged 45 and older found that each additional 12-ounce serving of sugary beverages, including 100% fruit juice, was linked to an 11% higher risk of all-cause mortality. Specifically, each additional 12-ounce serving of fruit juice was associated with a 24% increased risk. Watch the sugar content of iced coffee beverages and alcoholic cocktails as well.

Lifestyle Factors Matter, Too

It's essential to note that high soft drink consumption often correlates with other unhealthy lifestyle choices. The IARC study observed that individuals who drank more soft drinks typically had higher body mass indexes and were more likely to smoke. Even after adjusting for factors like diet, physical activity, smoking, and education, the association between soft drink consumption and increased mortality risk remained significant.

Refreshing Alternatives for the Season

Looking to quench your thirst without compromising your health? Here are some delightful, healthier options:

Infused Water : Add slices of citrus fruits, cucumbers, or berries to your water for a refreshing twist.
Herbal Iced Teas : Brew teas like hibiscus or mint, chill them, and enjoy over ice.
Sparkling Water with a Splash : Mix sparkling water with a splash of 100% fruit juice for a fizzy treat.
Homemade Lemonade : Use fresh lemons, water, and a touch of natural sweetener like honey or stevia.
Coconut Water : A natural source of electrolytes, perfect for rehydration.

Final Thoughts

Summer is a time for relaxation and enjoyment. By making informed beverage choices, you can savor the season while prioritizing your health. So, the next time you're reaching for a drink to beat the heat, consider these healthier alternatives. Your body will thank you!

7 Healthy Travel Tips

websitehelp@agencybloc.com (Agency Bloc) — Tue, 01 Jul 2025 15:35:31 GMT

Whether you’re planning a weekend getaway or a long-awaited international adventure, setting off on a trip is always exciting—but can also be unpredictable. That’s why preparing for the unexpected, especially when it comes to your health, is essential. Knowing what your medical coverage includes (and doesn’t) while traveling can help you stay healthy, avoid costly surprises, and soak up the unforgettable moments on your journey.

Let’s walk through some proactive steps you can take before packing your bags—from vaccinations and insurance to emergency planning and fraud protection.

1. Know What Your Health Plan Covers—And Where

Medical surprises aren’t on anyone’s itinerary—but it’s best to be prepared. Start by knowing how your insurance policy covers (or doesn’t) the region you’re traveling to.

Individual health policyholders, review your insurer’s network coverage. Some plans only cover in-network or state-specific services, while others offer broader emergency coverage or travel-specific riders. Consult your insurance agent to get help reviewing your policy.

Medicare beneficiaries, Original Medicare (Parts A & B) typically doesn’t cover medical care outside the U.S., except in limited circumstances. If you have a Medicare Advantage Plan, it may include emergency and urgent coverage abroad, but this varies by provider. Check your plan’s Evidence of Coverage or speak to your plan representative before traveling.

2. Consider Supplemental Insurance

If you're a frequent traveler or heading abroad, look into some options to help cover you. Some options include:

Travel Medical Insurance : Plans offer emergency coverage during trips outside the U.S. and tend to be affordable.
Evacuation Insurance : This covers transport to a qualified medical facility if the nearest care is inadequate. An evacuation clause is often, but not always, included in a travel insurance plan.
Medicare Supplement Insurance (Medigap) : Some Medigap policies cover emergency care abroad, typically up to plan limits and with a deductible.
Critical Illness Insurance : A lump-sum payout can provide financial flexibility in case you’re diagnosed with a covered condition like a heart attack or stroke during travel.

Be sure to read the fine print—some policies require you to be under a certain age, and preexisting conditions may not be covered. Your licensed insurance agent can help talk you through your options.

3. Keep Your Medical Info Handy

Consider using a secure health app or digital wallet to access all your health records quickly. But just in case your phone is inaccessible, bring physical copies of these important documents as well:

Your insurance or Medicare cards
Emergency contact numbers (include the country code +1 if you’re traveling abroad)
A medication list with dosages
Allergy and medical condition alerts

Pack all essential paperwork together in a waterproof sleeve in your luggage, and leave a second copy with someone back home.

4. Schedule Preventive Care Before Departure

Most insurance plans cover preventive care services like wellness visits, vaccinations, and screenings. Before your trip, check these tasks off your list:

Get vaccinated : Make sure you’re up to date on your flu, COVID-19, and tetanus shots. If traveling internationally, check the CDC recommendations for the region you’re visiting, which may include Hepatitis A/B, typhoid, or yellow fever vaccinations.

Scammers Are Targeting Grandparents—Here’s How to Stay One Step Ahead

websitehelp@agencybloc.com (Agency Bloc) — Tue, 01 Jul 2025 15:35:31 GMT

Imagine getting a call in the middle of the night from someone claiming to be your grandchild, panicked and in trouble. They say they’ve been in an accident or arrested—and they desperately need money. Your heart races. You’d do anything to help. That’s exactly what scammers are counting on.

The Federal Communications Commission (FCC) has recently issued a warning about a rise in what's known as the “grandparent scam” —a sneaky and heartless scheme targeting older adults with urgent, emotional phone calls meant to trick them into sending money.

What Is the Grandparent Scam?

These scams usually start with a phone call from someone pretending to be your grandchild (or another close relative). They’ll say they’re in trouble—maybe stuck in jail or in a hospital—and they need money fast for bail, legal fees, or emergency expenses.

To make things even more convincing, they may hand the phone off to someone pretending to be a lawyer or a police officer. And they’ll likely ask you not to tell anyone—saying it’s a “private” or “sensitive” situation.

That sense of urgency is key to the scam. It’s meant to bypass your instinct to double-check and make you act fast—before you have time to think it through or talk to someone else.

Why It Works—and Why It’s Dangerous

These calls often come late at night or early in the morning, when you’re more likely to be caught off guard. The scammer might not even say who they are—just “Grandma, it’s me”—and hope you fill in the blank for them. From there, they use that information to sound more convincing.

Some victims have been asked to send money via wire transfer, cryptocurrency, gift cards, or even in cash via courier—all methods that are difficult or impossible to trace or reverse. According to the FCC, scammers using this method have stolen tens of millions of dollars from seniors across the U.S.

Watch for These Warning Signs

If you or someone you love receives a call like this, here are some red flags that it could be a scam:

High pressure and urgency – You’re told to act immediately

Vague or strange details – They may not identify themselves clearly, or hope you’ll say the grandchild’s name for them

Unverifiable location or story – They say they’re in jail overseas or in a place where you can’t easily check on them

Unusual payment requests – Gift cards, Bitcoin, wire transfers, or cash deliveries

Calls at odd hours – Scammers try to catch you when you’re less alert

What To Do If You Get a Suspicious Call

If something doesn’t feel right, trust your gut. Here’s what you can do to stay safe:

✅ Hang up and verify – Call your grandchild or their parent using a phone number you know is theirs

✅ Talk to someone you trust – A second opinion from a friend or family member can make all the difference

✅ Don’t rely on caller ID – Scammers often “spoof” numbers to make it look like someone you know is calling

✅ Block the number – Use your phone’s settings to block suspicious calls

✅ Report the scam – Contact the National Elder Fraud Hotline at 833-FRAUD-11 and file a complaint with the FCC

What If You’ve Already Sent Money?

First of all, don’t panic—and know that you’re not alone. Scammers are incredibly convincing, and even smart, cautious people have been tricked.

Here’s what to do:

Call your bank or payment service right away – They may be able to stop or reverse the transaction if it's recent
Report it – Contact the FCC, your local police, and the FBI’s Internet Crime Complaint Center at ic3.gov
Let your family know – They can help protect you and others from future attempts

Help Protect Others, Too

The more people know about this scam, the harder it becomes for criminals to succeed. Please share this information with friends, neighbors, and especially your older loved ones. A quick conversation now could prevent a heartache later.

And remember—if you ever get a call like this and aren’t sure what to do, don’t rush. Take a breath, hang up, and check in with someone you trust. Real family emergencies don’t come with secret demands or payments via gift cards.