Winter 2025
Stay up to date with the latest trends, regulations, and insights shaping the employee benefits landscape. Explore our curated collection of articles, covering everything from expanded preventative care in HDHPs to the growing adoption of ICHRAs. Let TPSC be your trusted guide to navigating the evolving world of employee benefits.
HDHP Preventative Care Expanded to More Contraceptives
The IRS Expands Preventative Care Coverage for HDHPs
The IRS has announced important updates for high-deductible health plans (HDHPs) that will allow more preventive services to be covered before meeting the deductible. Key changes include the addition of over-the-counter oral contraceptives, like the “minipill” and emergency contraception, along with male condoms. These changes, retroactive to December 2022, help expand access to vital preventive care while ensuring that Health Savings Account (HSA) eligibility remains intact. Additionally, this guidance clarifies that services like breast cancer screenings and continuous glucose monitors may also be covered before the deductible is met.
Ozempic Price Reduction Brings Hope to Patients Nationwide
A New Era for Diabetes and Weight Management?
Big news in the world of GLP-1 medications—Ozempic’s average net price has dropped 33% since 2021, now sitting at around $290 per month. Thanks to aggressive negotiations and increasing competition from alternatives like Mounjaro and Victoza, affordability is improving for diabetes and weight management treatments. With similar price trends for Wegovy and Rybelsus, could this signal a turning point for anti-obesity drugs?
26% Plan to Include GLP-1 Meds in 2025 Goals, Led by 37% of Gen Z
The Growing Popularity of GLP-1 Medications in 2025 Wellness Resolutions
Tebra’s latest survey reveals that 26% of Americans plan to incorporate GLP-1 medications, such as Ozempic and Wegovy, into their 2025 wellness resolutions, with Gen Z leading the charge at 37%. These medications, widely used for weight loss, are gaining popularity, though concerns about high costs, potential side effects, and long-term effectiveness remain. Many users, however, feel that the benefits outweigh the risks. This shift emphasizes the growing demand for wellness-driven healthcare solutions and highlights the role of independent healthcare practices in addressing both the medical and financial aspects of this treatment.
The Shift from Traditional Employer-Sponsored Coverage to ICHRA: The Health Plan Perspective
ICHRA: A Growing Solution for Employers Seeking Cost-Effective Health Coverage
As healthcare costs continue to rise, more employers are turning to Individual Coverage Health Reimbursement Arrangements (ICHRA) as a way to manage expenses while providing flexible, ACA-compliant health coverage for their employees. ICHRA allows employers to contribute fixed amounts toward employees’ individual health insurance plans, offering greater cost predictability and flexibility. Health plans are also supporting ICHRA due to its potential to expand their membership base and stabilize ACA risk pools. The model’s flexibility is particularly attractive to businesses seeking alternatives to traditional employer-sponsored coverage, and its adoption is expected to continue growing.
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