NFP's Insights from the Experts

In this episode, Chase Cannon and Suzanne Spradley discuss a recent HHS Office for Civil Rights settlement showing that self-insured employer-sponsored group health plans are not outside the reach of HIPAA enforcement — especially when ransomware, electronic PHI, and incomplete risk analysis are involved.

In this episode, Suzanne Spradley and Chase Cannon revisit the history and importance of the tax exclusion for employer-sponsored insurance (ESI) coverage. Suzanne takes us back to the 1940s to understand how the tax exclusion began. The two discuss the reasons for the longevity and stability of the ESI model and how it has impacted the accessibility and affordability of health insurance in the U....

In this episode, Chase Cannon and Suzanne Spradley look at some common blind spots that employers, as plan sponsors, should review with respect to compliance. Chase outlines the first two blind spots that relate to the application of COBRA and COBRA initial notice distribution. Chase and Suzanne then discuss how employee counts can trip up employers when it comes to how certain compliance laws app...

In this episode, Suzanne Spradley and Chase Cannon discuss two recent circuit court decisions and their impact on employer-sponsored group health plans. Suzanne first discusses a Sixth Circuit decision involving a state law that attempts to regulate PBMs. Suzanne and Chase walk through Supreme Court precedent that appears to be driving states to enact PBM laws, and they explain how ERISA preemptio...

In this episode, Chase Cannon and Suzanne Spradley review three important upcoming compliance-related deadlines. Chase highlights the three requirements, including ACA reporting, an April 15 deadline related to HSA contributions and distributions, and RxDC reporting. Chase and Suzanne discuss some practical approaches to each of those deadlines and conclude with a summary of how recent DOL enforce...

In this episode, Suzanne Spradley and Chase Cannon review the outlook of health policy in the current Washington, DC environment. Suzanne leads off, setting the stage with a description of the narrow House Republican majority and its impact on enacting legislation. Suzanne and Chase discuss several pieces of legislation focused on transparency, including site-neutral payment reform and drug pricin...

In this episode, Chase Cannon and Suzanne Spradley review a recent DOL announcement that outlines the agency’s enforcement priorities for group health plans. Chase provides some background on DOL enforcement and the DOL’s efforts to increase employee benefit plan compliance, address abusive practices, and protect the rights of participants and beneficiaries. Chase and Suzanne go deeper on four of...

In this episode, Chase Cannon and Suzanne Spradley discuss a recent wave of litigation centered on ERISA’s fiduciary obligations for health and welfare plan sponsors. Suzanne begins with an explanation of the lawsuits and how the voluntary benefit plan exception from ERISA is core to the lawsuit allegations. Suzanne and Chase continue with a close look at the exception and the criteria employers s...

In this episode, Chase Cannon and Suzanne Spradley discuss recently released guidance on fertility benefits. Chase provides the background on how employers might be able to offer fertility benefits as “excepted” or “independent, non-coordinated" benefits, which may ease some compliance burdens. Suzanne and Chase discuss the cost aspects of fertility benefits and how an excepted benefit Health Reim...

In this episode, Chase Cannon and Suzanne Spradley discuss recent and noteworthy guidance from the IRS despite the federal government shutdown. Chase and Suzanne dive into the recently announced IRS inflation-adjusted amounts for benefits-related items in 2026 and their impact on employer plans. The podcast winds down with a discussion on what employers should consider and a preview of the next po...

In this episode, Suzanne Spradley and Chase Cannon discuss a September 2025 presidential announcement regarding tariffs on pharmaceutical products. Suzanne provides some background on the announcement and what it might mean for the U.S. and other countries. Suzanne and Chase explore the potential benefits and drawbacks of a new website relating to prescription drugs. Suzanne closes the podcast by...

In this episode, Chase Cannon and Suzanne Spradley discuss a few HIPAA lessons that employers can glean from recent Health and Human Services (HHS) enforcement settlements. Chase begins with an outline of HIPAA’s obligations in the group health plan context and HHS enforcement trends. Chase and Suzanne discuss three different cases that resulted in monetary penalties, highlighting the importance o...

In this episode, Suzanne Spradley and Carol Wood discuss the role of pharmacy benefit managers (PBMs) and the recent proliferation of state laws that regulate PBMs. Next, Suzanne explains how these state PBM laws interact with federal laws, which are supreme. Suzanne reviews ERISA preemption and the U.S. Supreme Court Rutledge case, and how state lawmakers continue to test the boundaries of their...

In this episode, Suzanne Spradley and Chase Cannon discuss the No Surprises Act (NSA) and its impact on out-of-network (OON) billing, with the independent dispute resolution (IDR) process at its core. Suzanne starts with an outline of the NSA and OON billing, how surprise bills arise, and how the IDR process is meant to help with carrier and provider disputes on bill payment amounts. Suzanne and C...

In this episode, Suzanne Spradley and Chase Cannon break down the Senate’s version of the One Big Beautiful Bill, released on June 16, 2025. Suzanne outlines the budget reconciliation process and how the so-called “Byrd Rule” comes into play. Suzanne and Chase discuss the similarities and differences between the House and Senate versions of this bill and how the two can align on those differences....

In this episode, Chase Cannon and Suzanne Spradley outline the latest proposed bill from the U.S. House of Representatives, potentially up for a vote in the coming weeks. Chase outlines a key element missing from the proposed bill ‒ caps, cuts, or elimination of the so-called employer tax exclusions for health insurance ‒ and explains why it’s important for employer health plan sponsors. Chase and...

In this episode, Suzanne Spradley and Chase Cannon review a recent industry focus-study on the economic impact of capping or eliminating the tax benefits associated with employer-provided health plans. Suzanne begins by providing a background on the employer-sponsored insurance tax breaks, their impact on employers and employees, and why Congress is considering a potential cap or elimination of th...

In this episode, Chase Cannon and Suzanne Spradley discuss some interesting questions relating to health savings accounts (HSAs), including basic eligibility, impermissible coverage, and employer responsibility when determining an individual employee’s HSA eligibility. Chase jumps in on a response to a question about HSA eligibility regarding a health FSA grace period. Chase and Suzanne conclude w...

In this episode, Suzanne Spradley and Chase Cannon discuss recently published proposed regulations relating to HIPAA’s Security Rule. Suzanne leads off with an overview of the HIPAA privacy and security rules generally, focusing on security — the usage of personal health information in electronic form. Suzanne and Chase discuss potential changes in definitions under HIPAA’s Security Rule, how the...

In this episode, Suzanne Spradley and Chase Cannon discuss the debate relating to employer-sponsored group health plan coverage and insurance tax exclusion. Suzanne describes what is meant by employer-sponsored insurance (ESI) and the background on the tax breaks that employers and employees receive when it comes to ESI. Suzanne and Chase walk through the two sides of the debate on keeping or remo...

In this episode, Chase Cannon and Suzanne Spradley discuss the recent revival of vendor-promoted pre-tax wellness arrangements that promise large tax savings for employers and employees with little employer investment. Chase leads off with a brief description of these programs and their purported claims on employment tax savings for both employees and employers. Chase and Suzanne review the variou...

In this episode, Suzanne Spradley and Chase Cannon review the current state and federal regulation of pharmacy benefit managers (PBMs), focusing on litigation surrounding recent state-enacted PBM rules. Suzanne starts off with a high-level description of PBMs and the role they play in the group health plan context. Suzanne and Chase discuss the plethora of state laws (proposed and enacted) focused...

In this episode, Suzanne Spradley and Chase Cannon discuss the US importation policies and rules aimed at lowering domestic prescription drug costs. Suzanne walks through the legalities of drug importation generally and then outlines the specific programs by which states can develop importation plans. Chase and Suzanne discuss several state importation proposals and how they could potentially brin...

In this episode, Chase Cannon and Suzanne Spradley remind employers about important ACA employer mandate reporting deadlines with the IRS, including a change in electronic reporting in 2024 for smaller employers. Chase also outlines some updated numbers relating to the federal poverty line (FPL), ACA affordability calculations and ACA penalty amounts, which are all adjusted annually. Suzanne and C...

In this episode, Suzanne Spradley and Chase Cannon give an overview of the No Surprises Act (NSA) — a consumer health protection law that places certain requirements on providers and payers (insurers and group health plans). Suzanne describes the main requirements under the NSA and introduces the Independent Dispute Resolution (IDR) process, which is an integral part of the NSA’s implementation. S...