{"id":259376,"date":"2025-05-27T07:54:22","date_gmt":"2025-05-27T07:54:22","guid":{"rendered":"https:\/\/peraltafinancing.com\/business\/insurance\/top-health-plan-compliance-issues-for-2025\/"},"modified":"2025-05-27T07:54:22","modified_gmt":"2025-05-27T07:54:22","slug":"top-health-plan-compliance-issues-for-2025","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=259376","title":{"rendered":"Top Health Plan Compliance Issues for 2025"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div>\n<div data-breakout=\"normal\">\n<div class=\"_2gdJs\" id=\"viewer-u1wb13032\">\n<div class=\"-Zu58 T998g\">\n<figure class=\"_--iF3\" data-hook=\"figure-IMAGE\">\n<div data-hook=\"image-viewer\" class=\"n8j-U\">\n<div style=\"--dim-height:415;--dim-width:1037;--ricos-image-default-border-color:unset\" id=\"u1wb13032\" class=\"soNkr k0QAQ HKd75\" data-hook=\"image-viewer-u1wb13032\"><wow-image id=\"a219ed_2e187529e241402386836d0fdede36c8~mv2.jpg\" class=\"undefined uCZui\" data-image-info=\"{&quot;containerId&quot;:&quot;u1wb13032&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;isLQIP&quot;:true,&quot;isSEOBot&quot;:false,&quot;lqipTransition&quot;:&quot;blur&quot;,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;imageData&quot;:{&quot;width&quot;:1037,&quot;height&quot;:415,&quot;uri&quot;:&quot;a219ed_2e187529e241402386836d0fdede36c8~mv2.jpg&quot;,&quot;name&quot;:&quot;&quot;,&quot;displayMode&quot;:&quot;fill&quot;}}\" data-motion-part=\"BG_IMG\" data-bg-effect-name=\"\" data-has-ssr-src=\"https:\/\/www.chinsurance.cc\/post\/true\" data-animate-blur=\"\"><img decoding=\"async\" alt=\"\" style=\"width:100%;height:100%;object-fit:cover;object-position:50% 50%;max-width:100%\" src=\"https:\/\/www.chinsurance.cc\/post\/top-health-plan-compliance-issues-for-2025\" data-pin-media=\"https:\/\/static.wixstatic.com\/media\/a219ed_2e187529e241402386836d0fdede36c8~mv2.jpg\/v1\/fill\/w_1037,h_415,al_c,q_85\/a219ed_2e187529e241402386836d0fdede36c8~mv2.jpg\" draggable=\"false\"\/><\/wow-image><\/div>\n<p><button class=\"-d0kF\" type=\"button\" data-hook=\"image-expand-button\" aria-label=\"Expand image\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewbox=\"0 0 19 19\" class=\"_34eAR\"><path d=\"M15.071 8.371V4.585l-4.355 4.356a.2.2 0 0 1-.283 0l-.374-.374a.2.2 0 0 1 0-.283l4.356-4.355h-3.786a.2.2 0 0 1-.2-.2V3.2c0-.11.09-.2.2-.2H16v5.371a.2.2 0 0 1-.2.2h-.529a.2.2 0 0 1-.2-.2zm-6.5 6.9v.529a.2.2 0 0 1-.2.2H3v-5.371c0-.11.09-.2.2-.2h.529c.11 0 .2.09.2.2v3.786l4.355-4.356a.2.2 0 0 1 .283 0l.374.374a.2.2 0 0 1 0 .283L4.585 15.07h3.786c.11 0 .2.09.2.2z\" fill=\"#000\" fill-rule=\"nonzero\"\/><\/svg><\/button><\/div>\n<\/figure>\n<\/div>\n<\/div>\n<\/div>\n<div data-breakout=\"normal\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"auto\" id=\"viewer-6hf72237\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>In 2025, the Affordable Care Act (ACA) reporting saw a simplification with Form 1095-C only needing to be distributed upon request.\u00a0.\u00a0The telemedicine exception for\u00a0<\/span><\/span><span style=\"color:#222222;background-color:white;text-decoration:inherit\"><span>High Deductible Health Plans (HDHPs)\/Health Savings Accou<\/span><\/span><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>nt (HSA) plans was also eliminated.\u00a0Furthermore, new HIPAA privacy rights regarding lawful reproductive health care were established.\u00a0<\/span><\/span><\/span><\/p>\n<\/div>\n<div data-breakout=\"normal\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"auto\" id=\"viewer-x072k241\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>Simplified ACA Reporting:<\/span><\/span><\/span><\/p>\n<\/div>\n<div data-breakout=\"normal\">\n<ul class=\"ICCsA feWr-\">\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-ptgwq245\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>Form 1095-C, which details employer-provided health coverage, no longer needs to be automatically sent to employees.\u00a0<\/span><\/span><\/span><\/p>\n<\/li>\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-2m17a248\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>Instead, it is now only required to be furnished upon specific request from the individual.\u00a0<\/span><\/span><\/span><\/p>\n<\/li>\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-imujx251\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>Employers must still provide a notice informing employees of their right to request the form.\u00a0<\/span><\/span><\/span><\/p>\n<\/li>\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-wef14254\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>This change is expected to reduce the burden on employers associated with ACA reporting.\u00a0<\/span><\/span><\/span><\/p>\n<\/li>\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-9o41w257\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>The IRS is providing guidance on how to implement this change, including the required notice.\u00a0<\/span><\/span><\/span><\/p>\n<\/li>\n<\/ul>\n<\/div>\n<div data-breakout=\"normal\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"auto\" id=\"viewer-nchr1261\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>End of Telemedicine Exception:<\/span><\/span><\/span><\/p>\n<\/div>\n<div data-breakout=\"normal\">\n<ul class=\"ICCsA feWr-\">\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-3o07g265\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>The previous exception allowing telemedicine to be offered in conjunction with HDHP\/HSA plans has been removed.<\/span><\/span><\/span><\/p>\n<\/li>\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-hqp06268\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>This means that telemedicine will now need to comply with the same requirements as other healthcare services offered under HDHP\/HSA plans.\u00a0<\/span><\/span><\/span><\/p>\n<\/li>\n<\/ul>\n<\/div>\n<div data-breakout=\"normal\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"auto\" id=\"viewer-jhmg1272\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>HIPAA Privacy Rights for Reproductive Health Care:<\/span><\/span><\/span><\/p>\n<\/div>\n<div data-breakout=\"normal\">\n<ul class=\"ICCsA feWr-\">\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-vhvte276\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>New HIPAA privacy protections strengthen the confidentiality of protected health information (PHI) related to lawful reproductive health care.<\/span><\/span><\/span><\/p>\n<\/li>\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-uhjqm279\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>These protections prohibit the use or disclosure of PHI for investigations or proceedings related to lawful reproductive health care.<\/span><\/span><\/span><\/p>\n<\/li>\n<li dir=\"auto\" aria-level=\"1\" class=\"fU9RR\" style=\"margin-inline-start:1.5em;list-style-type:disc\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"\" id=\"viewer-wyiza282\"><span class=\"lEnMT\"><span style=\"color:rgb(0, 29, 53);background-color:white;text-decoration:inherit\"><span>This change aims to protect individuals&#8217; privacy related to their reproductive healthcare choices.\u00a0<\/span><\/span><\/span><\/p>\n<\/li>\n<\/ul>\n<\/div>\n<div data-breakout=\"normal\">\n<p class=\"_8QQRx d9zr0 feWr- gGGrL\" dir=\"auto\" id=\"viewer-xpd85613\"><span class=\"lEnMT\"><span>If you have any questions our benefits team is here and in your corner. You can reach us at 315-234-7500<\/span><\/span><\/p>\n<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>In 2025, the Affordable Care Act (ACA) reporting saw a simplification with Form 1095-C only needing to be distributed upon request.\u00a0.\u00a0The telemedicine exception for\u00a0High Deductible Health Plans (HDHPs)\/Health Savings Account (HSA) plans was also eliminated.\u00a0Furthermore, new HIPAA privacy rights regarding lawful reproductive health care were established.\u00a0 Simplified ACA Reporting: Form 1095-C, which details employer-provided health [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":259377,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[94],"tags":[15442,597,15332,10933,213],"dealstore":[],"offerexpiration":[],"class_list":["post-259376","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-insurance","tag-compliance","tag-health","tag-issues","tag-plan","tag-top"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - 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