Articles

• Impact for Telehealth Benefits– Retroactive to January 1, 2025, High-Deductible Health Plans (HDHPs) may cover telehealth services before the deductible without impacting Health Savings Account (HSA) eligibility.
• Expanded HSA Eligibility – Beginning in 2026, ACA Marketplace Bronze and Catastrophic plans will qualify as HDHPs, making more employees HSA-eligible.
• Direct Primary Care (DPC) – Starting in 2026, HSA funds may be used for DPC membership fees, up to a maximum of up to $150 per month for an individual or $300 per month for a family. This maximum will adjust annually with inflation.
• Dependent Care FSA Limit Increase – Effective January 1, 2026, the annual limit increases from $5,000 to $7,500 ($3,750 if married filing separately), indexed for inflation. Employers offering Section 125 cafeteria plans should update plan documents accordingly.
• Educational Assistance Programs (IRC §127) – Permanently extends the provision allowing repayment of qualified student loans. Employers may provide up to $5,250 annually in tax-free educational assistance to employees. Employers offering this benefit should update their program documents to reflect the permanent inclusion of student loan repayment.
   

2. State Spotlight: Delaware PFML

The Delaware Paid Family and Medical Leave (PFML) program begins paying claims January 1, 2026

• Opt-Out/Renewal Window for Private Plans – From October 1 to December 1, 2025, employers will have the opportunity to apply for an exemption from the state PFML program by offering a private plan that meets or exceeds all state requirements. This opt-out period will recur annually, and applications must be submitted through the LaborFirst portal during the open window to secure exemption status for the following year.
• Employee Notice Requirement – PFML program details must be provided at least 30 days before contributions begin or before any change in coverage.
• Private Plan Commitment – Small employers who voluntarily opt in must remain for at least three years and provide notice of termination at least 12 months in advance.

3. Preparing for Open Enrollment: 2026 Required Notices & Compliance Updates

Annual Required Notices

• • Employer CHIP Notice – Notices were updated by the DOL and must be distributed annually, at renewal if any covered participants live in states offering premium assistance subsidies.
  • ACA Marketplace Notices – Updated in 2024 to reflect affordability thresholds, Marketplace special enrollment period details, and optional employer coverage tool data.
  • Creditable Coverage Notices (Medicare Part D) – Must be sent annually by October 15 to Medicare-eligible active employees, dependents, COBRA participants, retirees, and disabled individuals. Your Employee Benefits Consultants should proactively confirm your plan’s creditable status ahead of your renewal each year.

Plan Document Updates

If any of the following apply to your benefit offerings, your plan documents will require updates to remain compliant:

• • Section 125 Cafeteria Plan – Amend to reflect the increased Dependent Care FSA limit and any new HSA-eligible plan options for 2026.
  • Educational Assistance Programs – Update documents to reflect the permanent inclusion of student loan repayment under IRC §127.
  • PFML Private Plans – Ensure the private plan document meets Delaware requirements and is approved during the October opt-out window.

4. Key Compliance Dates

• 2026 HSA and HDHP Limits: IRS.GOV HSA 2026
• ACA Marketplace Coverage Notices: CMS Creditable Coverage
• CHIP Model Notice (July 31, 2025 Update): DOL.gov
• Delaware Department of Labor – Paid Family and Medical Leave Regulations: DE Paid Leave Regulations
• IRS – Employer Educational Assistance Programs under Section 127: IRS.gov