This email shared the latest employer insights on drug pricing trends and ACA regulatory developments from The Council's research and government affairs teams. The update covered the impact of the Inflation Reduction Act's drug pricing provisions, ongoing ACA marketplace subsidy extensions, and employer health plan cost management strategies. The briefing helps member firms stay current on fast-moving healthcare policy issues affecting employer-sponsored benefits.
New Drug Pricing Executive Order Targets PBM Transparency
On April 15th, President Trump issued an executive order titled Lowering Drug Prices By Once Again Putting Americans First. It is largely focused on Medicare and Medicaid drug pricing but includes several provisions that could impact employer-sponsored plans, including directing the Department of Labor to issue regulations to improve transparency and disclosure of pharmacy benefit manager (PBM) compensation. PBM transparency is a top legislative priority for The Council and this executive order indicates the Trump Administration is likely to focus on this
issue.
Read the memo outlining the executive order and the potential implications for employer-sponsored plans.
District Court Case May Impact Employer Penalty Assessment Under Affordable Care Act
A federal court in Texas recently struck down the government’s process for assessing employer penalties under the Affordable Care Act (ACA). The court ruled in Faulk Co. Inc. v. Xavier Becerra that the IRS lacked the authority to impose penalties on the plaintiff for failing to offer its employees coverage as required under the ACA.
Although just a district court ruling and subject to appeal, if the Trump administration chooses not to appeal, there may be questions about its general applicability regarding employers’ liability under the ACA’s employer shared responsibility rules.
Massachusetts Dental Loss Ratio Rule to Impact Broker Commissions
A Dental Loss Ratio (DLR) regulation was passed into law on April 12, 2024, in Massachusetts, requiring dental insurers to spend at least 83% of premium dollars on patient care. This law is the first of its kind with over 15 states now considering similar legislation. The National Association of Dental Plans published research on the DLR rule’s impact to broker commissions and small group coverage.
Read insights from Small Employer Interviews.
Examine the NADP Broker Commissions Research.
Leader’s Edge May Features
Global Hotspotting
Political Risk Starts at Home
Data Failures and Lawsuits Are Piling Up
Unlocking Strategic Potential: Key Takeaways from the COO Working Group
Join us for Operations Working Group Forum November 5-7 | San Antonio, TX
The recent COO Working Group session offered valuable insights into the evolving role of the CIO and the strategic importance of technology. Led by Kate Bang of USI, the discussion highlighted the shift from traditional IT management to CIOs becoming core business strategists driving digital transformation.
Key takeaways included the necessity for CIOs to possess both business and technical acumen, the importance of defining problems before deploying tools, and building cross-functional teams for sustainable change. Leaders were also encouraged to personally experiment with AI to unlock its strategic potential.
Read the full COO Working Group recap.
Read more about this topic in The Human Side of Digital Transformation in Leader’s Edge.
Spring Learning Circles: Limited Seats Still Available
Register today to secure your spot
The Council’s Learning Circles are virtual, small-group discussions designed to help insurance professionals build cultures of inclusion and belonging. Over six bi-weekly, 90-minute sessions, professional facilitators lead important discussions to help attendees recognize and “unlearn” dominant cultural norms.
Learning Circles are a safe space to navigate challenging topics in a supportive setting. Attendance at all six sessions is highly encouraged and there is no cost to register.
Put your Future Leaders to the Test at the Broker Smackdown Competition this July
Register today to send a team of four emerging leaders to compete in 2025 Broker Smackdown events is July 15-17 in Phoenix, AZ. Don’t delay – spots are filling fast for this popular program.
Broker Smackdown is a 2.5-day competitive simulation that gives emerging leaders a broader perspective on how the business operates. Participants compete in teams, running a computer-simulated insurance brokerage and making strategic decisions that impact financial, operational, and sales outcomes. Winners will go on to compete at the National Broker Smackdown in October.
Paula Staley, Senior Vice President, Meetings
Need REAL ID in a hurry? Here are some alternative options outside the DMV
Fox News
Audra Jackson, Director, Government Affairs
Democrats Plan to Capitalize as G.O.P. Begins Outlining Spending Cuts
New York Times
Andrea De Bono, Director, International
What Canada’s election results mean for Canadians, Trump and U.S. tariffs
The Washington Post
