By: HUB’s EB Compliance Team

If perhaps you were married to your general news feed in 2024 (Japan landing a probe on the moon, the Summer Olympics, King Charles’ cancer diagnosis, astronauts stuck in space, and something about an election maybe?), here are the compliance stories that you may have missed in 2024 and their potential impacts in 2025:

  1. Something(s) Old. As is common in an election year, there was not much in the way of new earth-shattering laws or rules. While there were definitely some changes (see below), 2024 was a good time to shore up knowledge of the basics such as:
    1. ACA Employer mandate, including issues around employee types and measurement periods, value and affordability, some affordability myths, and what effect an opt-out payment might have on your plan.
    2. Getting ACA reporting in order, especially in those states that require separate reporting, among other deadlines.
    3. For employers who allow employees to pay their premiums pre-tax (as most do), this was also a good year to brush up on various change in status issues, like changes in the number of dependents, changes in dependent eligibility and adoption assistance, change in marital status, and the effects of mid-year contribution changes.
    4. There are also the reminders of existing rules, like what it means to grandfather employees, whether or not to allow independent contractors on your plan (spoiler alert: don’t), that food really is not a reimbursable medical expense under a health FSA, that Title VII still applies to health plans even if the Section 1557 rules do not, and that Mental Health Parity rules require disclosure of information, like medical necessity criteria.
    5. Then there was making explicit what was always implicit, namely that the DOL’s cybersecurity guidance applied to health and welfare plans as well.
    6. Finally, as every year, 2024 brought its standard fare of dollar adjustments like:
      1. DOL Civil Monetary Penalties
      2. The Federal Poverty Guildeine for ACA Affordability
      3. The ACA Affordability Percentage
      4. HIPAA, Medicare, & SBC Penalties
      5. 2025 HDHP/HSA Figures
      6. The 2025 Employer Mandate Penalties
      7. 2026 Out of Pocket Maximums (and Projected Employer Mandate Penalties
      8. New York’s 2024 update to its Health Care Reform Act charges
      9. San Francisco’s increase in its Health Care Security Ordinance expenditure rates
  1. Something(s) New. However, 2024 was more than just a year for treading water. There were some new items from a compliance perspective, starting with:
    1. Florida’s Approval to Get Canadian Drugs,
    2. adding a new Florida PBM law with indirect effects on employer plans,
    3. moving on to updates to the Gag Clause Attestation,
    4. adding some finalized rules on fixed indemnity plans (although the notice requirement has been set aside by a court),
    5. throwing in updates to Medicare Part D (and the simplified method for determining if employer coverage is creditable, which could impact the notice an employer is required to send in 2025 in particular),
    6. also seeing HIPAA privacy changes related to reproductive healthcare, including a model attestation, which will have impacts on plan administration in 2025,
    7. receiving finalized Mental Health Parity rules that gave more detail on the comparative analysis requirements, which will likely start being enforced in 2025,
    8. getting additional various preventive service guidance on contraceptives and other preventive items,
    9. being reminded of the potential cyber risks associated with social engineering,
    10. California mandating infertility treatment for large insured plans covering individuals in the state, and
    11. taking some things that were old and making them new again, like the 1557 rules and the end of first dollar telehealth coverage relief for employees who want to make HSA contributions.
  1. Something Borrowed (from the Retirement World). The biggest surprise, perhaps, of 2024 was the lawsuit against J&J alleging potential fiduciary breaches related to their prescription drug plan management. It was not a secret that ERISA’s fiduciary rules applied to health and welfare plans; other litigation over life insurance conversion notices demonstrated the fiduciary exposure related to ERISA’s disclosure rules. However, the expansive approach taken by the J&J plaintiffs is something to watch in 2025 and beyond as more lawsuits are likely to be filed.
  1. Something (Seemingly Out of the) Blue. There was other litigation that could also cast an even longer shadow. The Supreme Court overturned prior precedent that will make it easier for plaintiffs to challenge rules issued by administrative agencies. It will hopefully lead to more precise legislation by Congress and more thoughtful rulemaking, but it will likely lead to more litigation, especially in the near term. In addition, one court ruled that the United States Preventive Services Task Force did not have sufficient political accountability to issue rules that bind health plans.  There will likely be more to come on this in the upcoming year.

While 2024 was not as busy as some years for new guidance, there was still plenty to focus on from a compliance perspective. Those new rules and 2024 litigation results will have effects felt reaching into 2025 and beyond. Additionally, a second Trump Administration will likely issue new rules that will change some of the existing regulatory landscape. As always, HUB will keep you updated on the latest in compliance.

If you have any questions, please contact your HUB Advisor. View more compliance articles in our Compliance Directory. 

NOTICE OF DISCLAIMER

Neither Hub International Limited nor any of its affiliated companies is a law or accounting firm, and therefore they cannot provide legal or tax advice. The information herein is provided for general information only and is not intended to constitute legal or tax advice as to an organization’s or individual's specific circumstances. It is based on Hub International's understanding of the law as it exists on the date of this publication. Later developments may result in this information becoming outdated or incorrect, and Hub International is not obliged to update it. You should consult an attorney, accountant, or other legal or tax professional regarding the application of the general information provided here to your organization’s specific situation in light of your or your organization’s particular needs.