The IRS has released a private letter ruling (No. 202434006) approving an employer’s program that gives employees the option to direct employer contributions toward several different offered benefits. A private letter ruling, or PLR, is a written statement issued to a taxpayer in response to a written request that interprets and applies tax laws to the taxpayer’s represented set of facts. While a PLR may not be relied on as precedent by other taxpayers, the PLR provides important insight into how the IRS might view similar employer programs.

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On Oct. 17, 2024, the IRS issued Notice 2024-75 (the Notice) to expand the list of preventive care benefits permitted to be provided by a high deductible health plan (HDHP) without a deductible (or with a deductible below the minimum deductible) to include:

• Over-the-counter (OTC) oral contraceptives, including OTC birth control pills and emergency contraceptives, for individuals potentially capable of becoming pregnant, regardless of whether they are purchased with a prescription; and
• Male condoms, regardless of whether they are purchased with a prescription and regardless of the gender of the individual covered by the HDHP who purchases them.

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As a reminder, the deadline to distribute Part D notices and the extended Form 5500 filing deadline for calendar year plans is Oct. 15, 2024. This deadline applies to employers with group health plans that provide prescription drug coverage and those with calendar year employee benefit plans that previously requested an extension of time to file their Form 5500, respectively.

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On Oct. 9, 2024, the U.S. Equal Employment Opportunity Commission (EEOC) released litigation data for fiscal year (FY) 2024, which covers Oct. 1, 2023,through Sept. 30, 2024. The data shows an overall decrease in litigation;however, of the lawsuits filed, the EEOC focused on emerging issues, such as pregnancy discrimination, and advancing the rights of underserved and vulnerable workers

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On Oct. 8, 2024, the Centers for Medicare and Medicaid Services (CMS) released the maximum limits on cost sharing for 2026 under the Affordable Care Act(ACA). For 2026, the maximum annual limitation on cost sharing is $10,150 for self-only coverage and $20,300 for family coverage. This represents an approximately 10.3% increase from the 2025 limits of $9,200 for self-only coverage and $18,400 for family coverage.

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Employers offering fixed indemnity coverage must comply with a new notice requirement for plan years beginning on or after Jan. 1, 2025. The new notice is designed to explain the limitations of fixed indemnity coverage and help prevent employees from mistakenly selecting such coverage as an alternative to or replacement for traditional health coverage.

Employers with fixed indemnity policies should ensure that enrollment,application and marketing materials for the 2025 plan year include the required notice.

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In July 2024, the IRS released draft 2024 forms for reporting under Internal Revenue Code Sections 6055 and 6056. Thereafter, on Sept. 4, 2024 and Sept.13, 2024, respectively, the draft instructions for the B series forms and C series forms were released.

• The 2024 draft Forms 1094-B and 1095-B (and related draft instructions) are draft versions of forms and instructions that will be used by providers of minimum essential coverage—including self-insured plan sponsors that are not applicable large employers (ALEs)—to report under Section 6055.
• The 2024 draft Forms 1094-C and 1095-C (and related draft instructions) are draft versions of forms that will be used by ALEs to report under Section 6056 as well as for combined Section 6055 and 6056 reporting by ALEs that sponsor self-insured plans.

No major changes were made to the draft forms or instructions for 2024 reporting. However, certain changes may be made once the forms and instructions are finalized.

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On Sept. 11, 2024, in Mayfield v. U.S. Department of Labor, the U.S. Court of Appeals for the 5th Circuit held that the U.S. Department of Labor’s (DOL)authority to define and delimit the terms of the executive, administrative and professional (EAP) exemptions includes the power to set a minimum salary for exemption under the Fair Labor Standards Act (FLSA).

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Through Compliance Assistance Release No. 2024-01, the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) is confirming that the cybersecurity guidance it issued in April 2021 generally applies to all employee benefit plans, including health and welfare plans.

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On Sept. 9, 2024, the Departments of Labor, Health and Human Services, and the Treasury (Departments) released a final rule to strengthen the requirements of the Mental Health Parity and Addiction Equity Act (MHPAEA). According to the Departments, the final rule is designed to achieve MHPAEA’s purpose of ensuring individuals with private health coverage do not face greater restrictions to obtaining mental health and substance use disorder (MH/SUD) benefits than they would face for medical/surgical (M/S) benefits.

Significantly, the final rule adds protections against more restrictive non quantitative treatment limitations (NQTLs). For example, the final rule requires group health plans and health insurance issuers to collect and evaluate data related to the NQTLs they place on MH/SUD care and make changes if the data shows they are providing insufficient access.

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