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Health Insurance

Track health insurance costs and employee benefits

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11 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
17 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1847/H.R. 2528) would expand pooling with two-year association and nondiscrimination safeguards after the 2018 rule was rescinded in 2024.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
8 min read

The Self-Employed Health Insurance Deduction in 2026: Navigating the Return of the ACA Subsidy Cliff

The enhanced ACA premium tax credits expired January 1, 2026, restoring the 400% FPL subsidy cliff — about $60,240 for a single filer — and roughly doubling net premiums for the average subsidized enrollee. Here's how self-employed workers can use the 100% above-the-line health insurance deduction, Form 7206, HSA contributions ($4,400 individual / $8,750 family), and MAGI timing strategies to soften the hit.

Mike Thrift

health-insuranceself-employmenttax-deductions
7 min read

PBM Reform 2026: What Rebate Pass-Through Means for Small Employer Health Plans

Congress's February 2026 PBM reform mandates 100% rebate pass-through, bans spread pricing, and requires transparency reporting by August 2028. In West Virginia, an early rebate pass-through approach cut average 2026 group plan rate increases to 12.6% versus 19.5% under the old system. Here's what small employers should do before the 2029 enforcement date.

Mike Thrift

healthcarehealth-insurancesmall-business
9 min read

Small Business Health Insurance in 2026: Why Premiums Are Up 11% and What Your Options Are

Small-group health insurance premiums are rising a median 11% for 2026, with single coverage averaging $703 a month and family coverage near $2,000 per employee. Here's why costs are spiking, how level-funded plans, QSEHRA, and ICHRA compare to traditional group coverage, and a five-question framework for deciding before your renewal deadline.

Mike Thrift

small-businesshealth-insuranceemployee-benefits
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