#health-insurance
Track health insurance costs and employee benefits
Medicare's IRMAA surcharge sets your 2026 Part B and Part D premiums from your 2024 tax return, and crossing a bracket by one dollar triggers the full tier — up to roughly $14,000 a year above standard premiums for a couple. Here is how business sales, Roth conversions and RMDs trigger it, the 2026 thresholds, and how to file Form SSA-44 after retirement or another qualifying life-changing event.
Insurers have filed a median 14% small-group premium increase for 2027, following an 11% rise for 2026, while Mercer projects employer health costs up 8.2% per employee even after cost controls. This guide explains what is driving the increases, how to model the renewal in per-employee-per-month terms, and five levers (competitive bids, level-funded and ICHRA/CHOICE comparisons, plan redesign, defined contributions, and early communication) that can shrink the hit before open enrollment.
USERRA covers every US employer with no headcount minimum. When an employee is called to military service, you must reemploy them promptly at the "escalator" position they would have reached, continue health coverage for up to 24 months, credit seniority and pension benefits as if they never left, and honor return deadlines of 14 or 90 days depending on service length. This guide lays out the five reemployment conditions, the anti-discrimination rules, what federal law does not require, and a before-during-after bookkeeping checklist for small employers.
A proposed federal rule would let employers offer fertility coverage as a standalone excepted benefit — like dental or vision — capped at a combined $120,000 lifetime maximum per participant and covered beneficiaries, for plan years beginning on or after January 1, 2027. Here is how the fully insured and self-funded options differ on the books, and the ledger accounts, payroll deduction codes and accumulator reports to set up before the first enrollment.
Employers with prescription drug coverage owe two annual disclosures — a creditable-coverage notice to Medicare-eligible participants before October 15, and an electronic filing to CMS within 60 days of the plan year start. Missing the notice can leave an employee paying a lifetime Part D penalty of 1% of the national base premium per uncovered month.
Most ski instructors are seasonal W-2 employees, and for 2025–2028 the no-tax-on-tips deduction lets workers in qualifying occupations deduct up to $25,000 a year in reported tips. This guide covers withholding across multiple W-2s, the 2026 Form W-2 Box 12 code TP tip reporting, filing for unemployment between seasons, bridging the spring health-coverage gap through ACA special enrollment or COBRA, and the daily tip log that substantiates the deduction.
The No Surprises Act's Federal IDR administrative fee fell from $115 to $15 per party for disputes filed on or after June 11, 2026, with the rest of the operations rule effective August 3, 2026. This guide walks a small medical practice through the arbitration timeline, why low-dollar out-of-network underpayments are now worth disputing, and how to book disputed receivables, dispute fees and awards so contested claims stop leaking revenue.
IRS Rev. Proc. 2025-19 raises 2026 HSA limits to $4,400 self-only and $8,750 family, with a $1,000 catch-up at 55+, and lifts HDHP minimum deductibles to $1,700/$3,400. This guide explains how small businesses must update cafeteria plans, payroll caps, and bookkeeping before open enrollment to capture the triple tax benefit and avoid overcontribution and comparability penalties.
Association health plans could let small businesses and self-employed owners pool as a single large group under ERISA — median small-group premiums are proposed up 11% for 2026 and family coverage averages $26,993, while the Association Health Plans Act (S. 1847/H.R. 2528) would expand pooling with two-year association and nondiscrimination safeguards after the 2018 rule was rescinded in 2024.
Small-group health insurance faces a median 11% proposed increase for 2026 based on 318 insurer filings — the sharpest in over 15 years. This guide shows small employers how to translate that median into dollars, understand the cost drivers, and evaluate renewal, plan design, and ICHRA alternatives before signing.
An ICHRA lets employers reimburse employees tax-free for individual health insurance instead of buying a group plan. Covers the 2026 affordability threshold of 9.96%, QSEHRA vs ICHRA rules, the 11 allowable employee classes, required notices, and how to book reimbursements without losing the tax advantage.
The enhanced ACA subsidies expired December 31, 2025, so in 2026 a single filer one dollar above roughly $63,840 in MAGI loses the entire premium tax credit while Marketplace rates rise a median 18%. Deductible SEP IRA, solo 401(k), traditional IRA and HSA contributions are above-the-line, so they lower the MAGI the credit uses — and the repayment cap on excess advance credits is gone for tax years after 2025, making every dollar of the excess repayable.
