Beware of Risky FICA Tax Savings Schemes
A growing number of vendors are promoting FICA savings schemes disguised as wellness or EAP programs, but these arrangements raise serious tax concerns. They involve employees making pre-tax contributions through a Section 125 plan, completing a simple activity, and then receiving tax-free reimbursements from a fixed-indemnity policy. However, the IRS has clarified that reimbursements are only nontaxable if used for qualified medical expenses under Section 213(d). Without such expenses, payments are taxable, exposing employers and employees to significant risk.
Kelly Munson Named CEO of Independence Health Group
Independence Health Group has named Kelly A. Munson as its next President and CEO, effective October 1, 2025, succeeding Gregory E. Deavens, who announced his retirement earlier this year. Munson currently leads AmeriHealth Caritas, a subsidiary of Independence, and will maintain oversight there while stepping into her new role. With over 25 years of experience in both commercial and government health programs, Munson brings national expertise and a strong commitment to affordable, high-quality care as she guides the organization into its next chapter.
IBX Fully Insured Members Can Now Access EOBs Online
Independence Health Group has introduced a paperless option for Explanation of Benefits (EOBs) as part of its upgraded operating platform. Fully insured commercial members can now opt out of mailed EOBs and securely access them online, with notifications sent as soon as documents are available. The new format features a clearer design, faster availability, and consolidated information for easier use. Adult dependents can also view their own EOBs digitally, while minor dependents follow the subscriber’s preference.
OBBB Act May Boost Group Health Plan Enrollment
The recently signed One Big Beautiful Bill Act (“OBBB Act”) rolls back key ACA subsidies, likely driving up individual marketplace premiums and reducing affordability. As costs rise, more employees may migrate back to employer-sponsored group health plans. For HR, finance leaders, and company owners, this shift underscores the need to reassess benefit strategies, model potential enrollment changes, and highlight the value of group coverage to attract and retain talent.
2024 MLR Rebates to be Issued by Sept. 30
IBX will issue 2024 medical loss ratio (MLR) rebates by September 30, as several segments fell below federal minimums. Eligible customers include Independence Assurance Company, Keystone Health Plan East, and QCC small/large groups, individual subscribers, and student health plans. Impacted groups and individuals will receive rebate checks with CMS-required notices, cover letters, and FAQs.
Under the Affordable Care Act, health insurers must spend a minimum percentage of premiums on medical care—80% for Small Group and Individual (IFP) Plans and 85% for Large Group Plans. If insurers fall short, subscribers and employer groups may be eligible for rebates. Employers have 90 days to decide how to distribute these rebates, which can be applied toward future premiums or refunded as cash to employees. Employers should consult with professionals to ensure compliance with tax and labor laws.
Medicare Part D Notices Due by Oct. 15, 2025
Employers sponsoring group health plans must provide Medicare Part D disclosure notices to Medicare-eligible individuals by Oct. 15, 2025, ahead of the annual enrollment period. The notice informs participants whether their prescription drug coverage is creditable and helps them avoid late enrollment penalties. Employers must also submit disclosure to CMS. Model notices are available from CMS to simplify compliance.
Updated AmeriHealth Billing Guides & Policy Changes
AmeriHealth has updated its billing guides for client advisors and fully insured clients, adding new sections on provisioning, terminations/reinstatements, and notifications within the Group Portal. In addition, the company has reinstated its standard policy, terminating accounts past 45 days with a 30-day grace period.
Compliance Corner! IRS Updates ACA Employer Penalties for 2026
The IRS has announced updated Affordable Care Act (ACA) employer shared responsibility penalties for 2026. Applicable Large Employers (ALEs) face a $3,340 “A” penalty if they fail to offer minimum essential coverage to at least 95% of full-time employees and dependents. The “B” penalty, set at $5,010, applies if coverage offered is unaffordable or does not provide minimum value, and a full-time employee receives a premium tax credit. Both penalties are assessed monthly, based on the number of affected full-time employees. Resource link.