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Health Insurance

Track health insurance costs and employee benefits

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11 min read

The $120,000 Fertility Benefit: How to Account for America's Newest Standalone Employee Benefit

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.

Mike Thrift

employee-benefitshealth-insurancepayroll
9 min read

Medicare Part D Creditable Coverage Notices: What Employers Must Send Before October 15

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.

Mike Thrift

compliancehealth-insurancehealthcare
8 min read

Ski Instructor Taxes: What Seasonal Pay, Tips, Unemployment, and Benefits Gaps Mean for Your Return

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.

Mike Thrift

taxpersonal-financeseasonal-business
10 min read

The $15 Dispute: What the No Surprises Act's New IDR Rules Mean for Your Practice's Out-of-Network Revenue

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.

Mike Thrift

healthcarehealth-insuranceaccounts-receivable
13 min read

2026 HSA Limits Rise to $4,400 and $8,750: The Small Business Owner's Pre-Open-Enrollment Playbook

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.

Mike Thrift

small-businessemployee-benefitspayroll
16 min read

Association Health Plans in 2026: How Small Businesses Can Pool Together for Affordable Group Coverage

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.

Mike Thrift

health-insurancesmall-businessemployee-benefits
16 min read

The ACA Subsidy Cliff Returns in 2026: How Self-Employed Filers Near $63,840 Use a SEP IRA to Keep the Premium Tax Credit

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.

Mike Thrift

health-insurancetax-planningself-employment
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