Federal Court Vacates DOL's Final Overtime Rule Nationwide
Survey: Employees Struggling with Drug Prescription Costs
The latest Patient Experience Survey by Pharmaceutical Research and Manufacturers of America (PhRMA) revealed that more than half (51%) of Americans with health insurance can’t anticipate what they’ll pay for prescription medications. Meanwhile, 38% of patients reported increasing out-of-pocket costs for these medicines. This means that employees are struggling to pay for prescriptions, even when they are covered by group health insurance. These costs directly impact workers covered under employer-sponsored plans of small businesses.
“If facing a major medical event or chronic condition, many insured Americans report that their out-of-pocket costs would be expensive or more than they could afford—even with insurance.”
- PhRMA Patient Experience Survey
Rising health care costs have left a significant number of insured Americans struggling to afford out-of-pocket expenses, with nearly half (46%) finding their out-of-pocket costs either expensive or unaffordable. Key contributors to this strain include high deductibles, as cited by nearly half (43%) of respondents, with another 20% saying they can’t afford copays. Moreover, 19% said their insurer won’t cover necessary services or medicines, while 16% cited unaffordable coinsurance.
According to the survey, 1 in 3 patients reported difficulty adhering to prescriptions because they could not afford drug costs. Many resorted to skipping doses, delaying taking medicines, or cutting pills in half to save on costs. Some did not complete the full prescribed course, while others avoided taking the medicine altogether.
The report highlighted other widespread challenges insured Americans face in navigating health care coverage and affordability:
- Only about a quarter of Americans (28%) believe that insurance currently provides everyone with affordable access to health care when it’s needed.
- More than half (52%) worry about their ability to pay for out-of-pocket costs and insurance premiums over the next 12 months.
Takeaway
The PhRMA survey showed that health care costs remain a top concern for workers. Small businesses should stay informed about the evolving prescription drug market and evaluate how their health care plan design choices might affect their workforce.
If you have an employee struggling with high prescription costs, reach out to us at assist@foresitebenefits.com.
Sign Up for Motion Connected's Upcoming Great Culture Webinar!
Motion Connected, Forsite's sister company, is kicking off this year’s Great Culture Webinar Series with an exciting first episode! As a leader in employee engagement and wellbeing, this episode will be packed with valuable insights, thought-provoking conversations, and actionable strategies to help organizations create thriving workplace cultures.
Join us as Alysia, a passionate wellness advocate with over 14 years of experience in mental health and holistic wellness, shares SNHU’s innovative strategies for creating a thriving workplace culture. From unique program designs to holistic wellbeing approaches and effective communication tactics, this webinar is a must for anyone looking to elevate their organizational culture.
Mark your calendar:
📅 Date: Wednesday, February 12th
⏰ Time: 11:00 AM CST
🔗 Click here to sign up for this insightful webinar!
Register today to reserve your spot. See you there!
Key Drivers of 2025 Health Care Cost Increases
5 Insurance Policies for Small Businesses
With so many different types of insurance to choose from, it can be overwhelming to determine what type is best for your small business. Understanding the following five insurance policies can help your business make decisions to financially protect employees and the business’s bottom line.
1. Commercial Property Insurance
In the case of a catastrophic event such as a fire, explosion, burst pipe, storm or theft, commercial property insurance may compensate you for losses or damage to your building, leased or owned equipment, and other property on the premises. In fact, commercial property insurance can cover items such as furniture, inventory, computers, and anything that would be considered necessary for performing normal business operations.
Commercial property insurance is typically purchased as a stand-alone policy or as part of a comprehensive business owner’s policy that includes property and general liability coverage.
Commercial property insurance is offered on either a replacement cost or actual cash value basis:
- Replacement cost: Pays the cost to replace or repair the damaged property with materials of like kind and quality without any deduction for depreciation.
- Actual cash value: Pays the cost to repair or replace the damaged property minus depreciation.
2. Employment Practices Liability
Employment practices liability insurance (EPLI) is a form of insurance that covers wrongful acts that occur during the employment process. The most frequent types of claims covered under an EPLI policy include claims of discrimination, wrongful termination, sexual harassment, and retaliation.
These policies may reimburse your company against the costs of defending a lawsuit in court and for judgments and settlements. EPLI may cover legal costs, regardless of whether your company wins or loses the suit. However, these policies typically do not pay for punitive damages or civil or criminal fines.
3. Workers’ Compensation
Workers’ compensation is important in the event that an employee suffers a work-related injury or illness. This type of insurance is required in most states and is used to cover medical bills or wage replacements for employees who experience a work-related injury.
For example, if a worker pulls a back muscle at work and is unable to perform their duties, workers’ compensation may help cover any physical therapy costs as well as compensate the employee for any lost wages.
Having workers’ compensation insurance can also protect your business from civil suits made by employees against your company related to their injuries.
4. Commercial Auto
Commercial auto insurance helps cover the costs of an auto accident if you or an employee is at fault. This coverage can help pay for damaged property and medical expenses.
Your business should consider a commercial auto policy if any of the following are true:
- Your business owns, leases, or rents vehicles such as cars, trucks, or vans.
- Your business has employees who drive their own vehicles to conduct business.
- Your business has employees who operate leased, rented, or owned company vehicles.
5. Professional Libility Insurance
Professional liability insurance, also known as errors and omissions insurance, can protect your business against claims that a service you provided caused a client to suffer due to a mistake on your part or because you failed to perform a service.
Professional liability insurance can cover the cost of defending your business in a civil lawsuit for an alleged error or omission. Depending on your industry, professional liability insurance may be required by law.
While many types of businesses need professional liability insurance, you should especially consider this type of insurance if your business works directly with customers to provide services.
More Information
Contact us today to help you analyze your needs and decide on the right coverage for you and your growing business.
Forms 1094 & 1095: forms, Instructions, & Deadlines
The Affordable Care Act requires applicable large employers (ALEs)—generally those with 50 or more full-time employers—to report information to the IRS and to their full-time employees about their compliance with the employer shared responsibility (pay or play) provisions and the health care coverage they have offered (or did not offer). Self-insured employers (regardless of size) have additional reporting responsibilities that apply to health coverage providers.
Forms & Instructions
The following Internal Revenue Service (IRS) forms and instructions are available for 2024 calendar year reporting:
- Minimum Essential Coverage (MEC) Reporting (Section 6055)
- Large Employer Reporting (Section 6056)
| Action | Fully Insured ALEs | Self-Insured ALEs | Self-Insured Employers That Are Not ALEs (Fewer Than 50 Full-Time Employees) |
| Provide Form 1095-C to Full-Time Employees | March 3, 2025 | March 3, 2025 | Not Applicable |
| Provide Form 1095-B to Responsible Individuals (may be the primary insured, employee, former employee, or other related person named on the application) | Not Applicable | ALEs providing self-insured coverage to non-employees may use either Form 1095-B or Form 1095-C to report coverage for those individuals and other family members covered under the plan, by March 3, 2025. | March 3, 2025, if not using the alternative method of furnishing. Under this method, a reporting entity must post a clear and conspicuous notice on its website by this date, stating that responsible individuals may receive a copy of their statement upon request, and retain the notice in the same location on its website through Oct. 15, 2025. |
| File Forms 1094-C & 1095-C with the IRS | March 31, 2025* | March 31, 2025* | Not Applicable |
| File Forms 1094-B & 1095-B with the IRS | Not Applicable | ALEs providing self-insured coverage to non-employees may use either the B series Forms or the C series Forms to report coverage for those individuals and other family members covered under the plan, by March 31, 2025* | March 31, 2025* |
* This is the deadline for electronic filing. Reporting entities that file at least 10 returns during the calendar year must file electronically. Reporting entities must aggregate most information returns, such as Forms W-2 and 1099, to determine if they meet the 10-return threshold for mandatory electronic filing.