Coverage made HUMAN.

In July the IRS set the 2027 ACA affordability threshold at 10.22% — the first time it has ever passed 10%. That gives you room, but it resets every safe harbor calculation. The federal poverty line safe harbor lands at $135.92 per month, and penalties climb to $3,780 and $5,670 per employee for 2027. If you're building renewal contribution tiers this quarter, build them off the new number — not last year's.

Every plan must tell Medicare-eligible employees whether its drug coverage is creditable — before October 15. Two things make this year different. The Part D redesign has pushed some employer plans out of creditable status entirely. And on January 1, CMS retires the old simplified determination method: plans must cover 73% of prescription drug costs or produce an actuarial analysis. If nobody has re-run your plan's numbers under the new math, now is the time.

The 2024 mental health parity regulations sit under a non-enforcement policy while the agencies rewrite them, and plenty of employers have read that as a reprieve. It isn't. The CAA's requirement to document an NQTL comparative analysis is statutory — and still fully in force. Regulators are still opening investigations and still issuing violation findings. If your analysis was never finished, the pause didn't help you.

Insurers have filed for a median 14% increase on fully insured small group plans for 2027 — most land between 10% and 20% — and employers overall project a second straight year of 10% cost trend, led by GLP-1s and specialty drugs. Part of what's driving it: healthier groups keep leaving for level-funded and self-funded arrangements, and everyone who stays pays more. If your renewal came in ugly, it's not just you — but you don't have to accept it without looking at the alternatives.