Health Plan Deductibles and OOPMs – Key Concepts for Employers (May)
Deductibles and out-of-pocket maximums (OOPMs) are important costsharing parameters for health plans. A deductible is the amount an individual must pay in covered health care expenses each year before the health plan starts paying. An OOPM is the overall limit on an individual’s annual out-ofpocket spending on covered health care expenses. Once an individual reaches their OOPM, their health plan pays 100% of covered expenses for the rest of the year. Generally, health plans with higher cost-sharing limits have lower monthly premiums than health plans with lower deductibles and OOPMs.
Wellness In the News – Spring Allergy Season Expected to Be Longer and More Severe (May)
As the weather warms up, millions of people are experiencing spring allergies. According to the Centers for Disease Control and Prevention (CDC), more than 1 in 3 adults and 1 in 4 children suffer from seasonal allergies. If the spring allergy season has felt longer and more severe, that’s because it is. Public health organizations, including the CDC and the Asthma and Allergy Foundation of America, are citing climate change as a possible contributing factor to worsening allergy seasons.
Benefits Breakdown May
1 in 4 Workers Unaware of Mental Health Benefits. An annual survey by the National Alliance on Mental Illness (NAMI) found that 1 in 4 workers are unaware whether their employers offer mental health benefits, employee assistance programs, flexible work arrangements or sick days for mental health. Only half understand how to access these benefits through their employer-sponsored health insurance. NAMI found that, similar to last year’s findings, only about a fifth of employees have received training on mental health conditions or symptoms, despite more than three-quarters expressing interest in learning about mental health benefits and receiving general education about mental health. Furthermore, this report demonstrates that stigma and judgment surrounding mental health persist in many workplaces. NAMI data shows that more than half of employees are comfortable discussing their mental health with a close friend or manager, while only 39% would feel comfortable discussing their mental health with HR.
Overview of State Pay Transparency Laws
There is currently no federal law that requires employers to disclose salary information to job applicants or employees. However, a growing number of states have enacted legislation that requires employers to disclose wage or other compensation information to applicants or employees under pay transparency laws. Colorado’s pay transparency law, which took effect in 2021, was the first such law. Since then, 14 additional states (including the District of Columbia) have passed pay transparency laws. Currently, pay transparency laws have been enacted in the following states: Click the link below.
MAINTAINING YOUR WELL-BEING AMID TARIFFS AND ECONOMIC UNCERTAINTY
Americans have become familiar with a fluctuating economic state. In the last few years, the United States has faced a pandemic, disrupted supply chains and high inflation. Now, you may be concerned about impending tariffs, a shifting stock market and speculation over whether the country may enter a recession. This kind of economic uncertainty can take a toll on your well-being.
Keeping Up with Compliance Quarterly
Keeping up with compliance developments can be difficult and time-consuming. This quarterly update highlights recent legal developments to help your organization stay on top of new requirements and minimize compliance risks.
For more information on these topics, please contact Evolution of Benefits.
Supreme Court Ruling May Lead to More Fiduciary Lawsuits under ERISA
On April 17, 2025, the U.S. Supreme Court ruled that a group of employees may challenge their employer’s fee arrangement with a retirement plan service provider under the Employee Retirement Income Security Act (ERISA). In its unanimous decision, the Supreme Court took an employee-friendly view of statutory text and simplified the requirements for alleging a violation of ERISA’s prohibited transaction rules.
Form 5500 Deadline Is July 31
Each year, employers that are subject to the Employee Retirement Income Security Act of 1974 (ERISA) must electronically file an annual report (Form 5500) for each employee benefit plan they maintain unless a filing exemption applies.
Employee Compensation and Benefits During Layoffs and Furloughs
During periods of economic or business uncertainty, employers may need to downsize their workforce. Such reductions can take a variety of forms but frequently include employee layoffs or furloughs. Employers who take these measures must ensure that they are in compliance with laws governing compensation and employee benefits. Some key benefits and compensation issues to consider include:
Voluntary Benefits – ERISA Compliance Exemption
Voluntary benefits are optional benefits that employers may offer to enhance their traditional benefits packages. Offering voluntary benefits allows an employer to include a variety of benefits that are attractive to employees in their benefits package without adding to their organization’s costs. While voluntary benefits are typically employee-paid, payments can be automatically deducted from employees’ paychecks and remitted to the insurance carrier.
Client and Employee Resources
The more your employees understand your benefit plans the more they become educated, empowered consumers. The programs you provide will also gain an enhanced value.
As your strategic partners in employee benefits, we can provide multiple avenues of ongoing support, including:
- Employee Meetings (English and Spanish)
- Webcasts
- Payroll Stuffers
- Poster Campaigns
- Newsletters
Carrier Directories
E-Verify is a web-based system that allows enrolled employers to confirm the eligibility of their employees to work in the United States. Click the image below to begin.
