IRS Announces 2026 Limits for HSAs, HDHPs & EBHRAs
The IRS has released the 2026 contribution limits for Health Savings Accounts (HSAs) and High Deductible Health Plans (HDHPs). Individuals with self-only coverage can contribute up to $4,300, while those with family coverage may contribute up to $8,750. The minimum deductible and out-of-pocket limits for HDHPs have also increased. Additionally, the 2026 employer contribution limit for Excepted Benefit Health Reimbursement Arrangements (EBHRAs) will rise to $2,200. EBHRAs remain exempt from certain federal health care regulations but must meet nondiscrimination and compliance requirements.
Trump Executive Order Targets Drug Prices, PBM Transparency, and Reform
On April 15, 2025, President Trump issued an executive order aimed at lowering prescription drug costs by increasing transparency, reforming pharmacy benefit managers (PBMs), and enhancing competition. The order directs federal agencies to evaluate PBM practices, propose ERISA regulations to disclose PBM compensation, and expand pricing transparency for health plans and Medicare. It builds on prior initiatives like the Inflation Reduction Act and Transparency in Coverage rules. Employers should prepare for potential changes affecting PBM disclosures and plan cost reporting requirements.
Upcoming July 2025 Changes to IBX Premium Formulary for Self-Funded Groups
Starting July 1, IBX updates the Premium formulary, favoring biosimilars like Wezlana over Stelara, excluding Sprycel and Pitavastatin for cheaper alternatives. Step therapy protocols and quantity limits for drugs such as Motegrity and Eliquis will also change. Members will be notified in advance. Click here to read more.
IBX Updates Select & Value Formularies Starting July 1, 2025
IBX will update its Select and Value formularies on July 1 with drug additions/removals, tier changes, and updated prior authorization and quantity limits. Approved by the Pharmacy & Therapeutics Committee, these changes promote safe and cost-effective prescribing. Affected members and providers will get advance notice. Click here to read more.
Urgent: Update ACH Bank Codes to Avoid Payment Delays
Clients enrolled in automatic ACH payments may need to update their bank authorization settings due to new company codes issued by IBX as part of a platform transition. The change affects both self-funded and fully insured groups, but only if their bank requires authorization for “push” and “pull” payments. Clients should add the new IBX BLUE CROSS Company Names and IDs based on their line of business, while retaining the old HIGHMARK ID for runout claims. Prompt updates are advised to avoid payment disruptions.
Compliance Corner! PCORI Fees: What Self-Insured Plans and HRAs Must Know
Under the ACA, plan sponsors of self-insured health plans—including HRAs and level-funded arrangements—must pay annual PCORI fees to support health research. These fees apply to plan years ending between October 1, 2012, and September 30, 2029, and must be reported using IRS Form 720 by July 31 each year. The fee is based on the average number of covered lives, calculated using one of three IRS-approved methods. Stand-alone HRAs and those integrated with insured plans require separate reporting and payment by the plan sponsor.