Group health plans are prohibited from entering into agreements containing contractual 'gag clauses' which operate to restrict access to provider cost, quality, or de-identified claims data. Most employer-sponsored group health plans must annually attest to compliance with these requirements via the Gag Clause Prohibition Compliance Attestation portal hosted by the Centers for Medicare and Medicaid Services (CMS).

The One Big Beautiful Bill Act (OBBBA) created a new employer-sponsored benefit opportunity through Internal Revenue Code §128. Employers may now make tax-favored contributions of up to $2,500 annually to the Trump Account of an employee or an employee's dependent through a Trump Account Contribution Program (TACP).

Applicable large employers (ALEs) are subject to §4980H offer of coverage requirements and §6056 employer reporting requirements on Form 1094-C and Form 1095-Cs. ALEs who fail to comply with §4980H offer of coverage requirements may face penalties (i.e., employer shared responsibility payments) for full-time employees who enroll in subsidized coverage through a public Marketplace.

In 2012, a class action lawsuit was filed against the Blue Cross Blue Shield Association (BCBSA) and its member companies, alleging that they violated federal antitrust laws by limiting competition in the market for commercial health insurance and administrative services. 

The IRS has begun issuing Letter 5699 (for failure to report) and Letter 226J assessments (with proposed §4980H penalties) for the 2024 tax year.