Health Insurance

Multiple Sclerosis (MS) is a chronic medical condition that is characterized by brain fog, fatigue, muscle weakness, and many other debilitating symptoms that limit a person’s ability to function on a daily basis1. For many people living with MS, the hardest part can often be the uncertainty that follows. While symptoms can vary from person to person, these symptoms can often make sustained employment difficult. When that happens, employer-provided short- and long-term disability benefits plans may be necessary to
Continue Reading Multiple Sclerosis and the Difficult Road to Long-Term Disability Benefits

When a loved one begins to need help with daily activities, families often face difficult decisions about care. Long-term care is not limited to nursing homes—it includes a wide range of services that help individuals manage daily living when age, illness, disability, or cognitive decline makes independent living difficult.

Long-term care may include help with bathing, dressing, eating, mobility, toileting, medication management, meal preparation, and supervision for individuals with memory loss or cognitive impairment. 

For many families, staying at
Continue Reading What is Long Term Care?

On May 29, 2026, the IRS announced the Health Savings Account limits for 2027.  With respect to contribution limits, and reflecting the inflationary environment, the limits are higher than the ones for 2026 and the required deductible and out-of-pocket maximums have increased as well.  As a reminder, these inflation adjusted amounts are effective for calendar year 2027.

HSA/HDHP Requirement
Cost-of-Living Adjustments

Limit on HSA Contributions – Self-only HDHP

2026 – $4,400

2027 – $4,500

Limit on HSA Contributions –
Continue Reading 2027 HSA Limits Are Announced

If your business has more than 16 employees in Illinois, a new law—the Family Neonatal Intensive Care Leave Act—requires you to provide additional job-protected leave for parents with a newborn or newly adopted child in the neonatal intensive care unit (NICU).

The Illinois Neonatal Intensive Care Leave Act (NICLA) takes effect June 1, 2026. Here’s what you need to know.
What Is NICLA?
NICLA is a new Illinois law that gives employees the right to take unpaid, job-protected leave
Continue Reading Understanding the New Illinois Neonatal Intensive Care Leave Act (NICLA)

If you have had a chronic condition that recently worsened, you might be wondering if your long-term disability (LTD) claim could be denied on the basis that your condition was pre-existing. Or, you might have already received a denial because the insurance company is saying your condition is pre-existing.

Many LTD policies do have pre-existing condition exclusions and they are a common reason used by insurance companies to deny claims. Being aware of these provisions can help you determine
Continue Reading Can My Long-Term Disability Claim be Denied Because My Condition is Pre-Existing?

Why the Compliance Answer You’re Getting May Not Be the Answer You Need

If your company offers health benefits, someone has probably asked about GLP‑1 coverage in the last six months. The drugs work, employees want access, and the sticker price through traditional pharmacy channels can run north of $1,000 per month per employee.

Direct‑to‑consumer platforms like TrumpRx.gov, Hims, Lilly Direct, and NovoCare now offer the same medications between $149 and $449 per month, cash pay. The obvious question:


Continue Reading GLP‑1s, Direct‑to‑Consumer Pricing, and the HRA Opportunity Most EmployersAre Missing

On January 1, 2026, Minnesota officially launched its state-administered Paid Family and Medical Leave (PFML) program, triggering an immediate surge of over 25,000 benefit applications in the first two weeks alone. As many Minnesotan employers are quickly discovering, the post-PFML workplace poses significant operational challenges. As the legal landscape continues to evolve in Minnesota (and those benefit applications keep rolling in), employers must become intimately familiar not only with administering the program but also with the variety of pitfalls
Continue Reading Thousands Apply for Minnesota PFML: What Employers Should Do Now

The U.S. Department of Labor (DOL) recently released a new set of opinion letters addressing recurring questions under the Fair Labor Standards Act (FLSA) and the Family and Medical Leave Act (FMLA).

While opinion letters are based on specific fact patterns, they provide valuable insight into how the DOL analyzes common compliance questions and foreshadow DOL enforcement priorities, and they are often relied upon by courts and investigators.

The latest batch addresses employee classification, overtime calculations, collective bargaining agreements,


Continue Reading U.S. Department of Labor Issues New FLSA and FMLA Opinion Letters: Key Compliance Takeaways for Employers

A Florida district court (the “Court”) in United States v. AIMA Business and Medical Support, LLC held that a third-party medical billing company can be held liable under the False Claims Act (“FCA”) for pushing medically unnecessary genetic tests, even though it did not provide care directly to patients. This decision is important because it underscores that companies advising or facilitating health care providers’ billing practices can be targeted by the government if they knowingly encourage false claims, expanding
Continue Reading Court Finds the Government Adequately Pleaded Its False Claims Act Complaint Against Third-Party Medical Billing Company

When Compassion Costs You: A Young Manager’s Injury, Walmart’s Silence, and the System That Failed Her
In the American workplace, we’re taught to be team players — to show up, follow the rules, look out for our coworkers, and do what’s right, even when it’s inconvenient. We’re taught that if we work hard, stay loyal, and lead with integrity, we’ll be protected and valued in return.

But what happens when that promise is broken?

Let me tell you a


Continue Reading When Compassion Costs You & Walmart

The Wisconsin Department of Health Services (DHS), Division of Quality Assurance (DQA), Bureau of Assisted Living (BAL), released updated guidance regarding the use of electronic recording, video monitoring, and filming equipment (collectively, “Monitoring Devices”) in assisted living settings. The goal of this guidance is to balance the use of emerging technologies with residents’ rights to privacy in their homes. This guidance applies to Wisconsin Adult Family Homes (AFHs), Community-Based Residential Facilities (CBRFs), and Residential Care Apartment Complexes (RCACs).

Key
Continue Reading Wisconsin DHS Issues Updated Guidance on Use of Electronic Monitoring in Assisted Living Facilities

On May 19th of 2025, the legislature introduced a bill that gives drivers for Uber, Lyft, Instacart, and similar app-based companies the possibility of self-funded health insurance (in portable benefit accounts that could possibility also receive contributions from the companies if a company, for some reason, decides to help pay for such health insurance coverage) in return for losing their status as employees under current Wisconsin law.

The legislature rushed the hearings and passage of this bill and sent
Continue Reading Network drivers pretense

On May 1, 2025, the IRS announced the Health Savings Account limits for 2026.  With respect to contribution limits, the limits are slightly higher than the ones for 2025 and the required deductible and out-of-pocket maximums have increased as well.  As a reminder, these inflation adjusted amounts are effective for calendar year 2026.

HSA/HDHP Requirement
Cost-of-Living Adjustments

Limit on HSA Contributions – Self-only HDHP

2025 – $4,300

2026 – $4,400

Limit on HSA Contributions – Family HDHP

2025 –
Continue Reading 2026 HSA Limits Are Announced

Over the past year, numerous class actions have been filed against large employers claiming their health plan surcharge for tobacco use is not in compliance with HIPAA nondiscrimination rules. With yet another lawsuit filed on March 3, 2025 against LHC Group (a large home health care company), these cases show no signs of slowing down.

Several recognizable employers have faced similar class actions, including 7-Eleven, Inc. Walmart Inc., Target Corp., PepsiCo Inc., Tractor Supply Co., Whole Foods Market Inc.,
Continue Reading Refusing to Quit: Class Actions on Tobacco Surcharges in Health PlansContinue

Healthcare fraud is a serious offense that can result in significant penalties for medical providers. In addition to criminal charges that may lead to fines or imprisonment if a person is convicted, accusations of fraud can lead to the loss of a professional license, loss of provider status with Medicare and Medicaid, and damage to a provider’s personal reputation. If you are facing healthcare fraud charges, it is crucial to understand your rights and options for defense.
Continue Reading How Can Medical Providers Defend Against Healthcare Fraud Charges?

There is understandable confusion among employees and their employers about an employee’s access to disability insurance coverage after termination of the employee/employer relationship.

Disability insurance coverage is an employee benefit, and some assume that when employment ends, employee benefits – including disability insurance – end. However, that is not always the case.

In fact, the termination of employment generally should not affect ongoing short-term disability (STD) or long-term disability (LTD) benefits or even prevent employees from applying for benefits
Continue Reading Disability Benefits: When Terminated Employees Are Still Eligible