As 2025 comes to a close, employers are facing a compliance environment that is more complex and closely monitored than in previous years. Whether or not you were able to join CBIZ’s Q4 compliance conversation webinar, several themes emerged that are especially important for HR and benefits leaders to keep in focus.
Read on to discover a high-level look at the developments that matter most as you prepare for the year ahead.
Government Shutdown & Marketplace Tax Credit Uncertainty
The government shutdown, which began on Oct. 1, 2025, and concluded on Nov. 12, 2025, highlighted the downstream effects that federal funding decisions can have on both individual and employer-sponsored coverage. The pivotal issue driving the shutdown was the upcoming expiration of tax credits available for the purchase of health coverage through the Marketplace.
This expiration, set for Dec. 31, 2025, raised concerns that healthier individuals may exit the Marketplace, potentially driving up uncompensated care, overall healthcare costs, and ultimately, employer plan costs.
Currently, the government is considering a variety of proposals to address these concerns, including:
- A temporary extension of the expanded premium tax credit
- Returning the premium tax credit to the pre-extension levels
- Curtailing or eliminating premium tax credits in favor of contributions to consumer-driven arrangements, such as HSAs
Employers should continue to monitor the government’s decision regarding Marketplace tax credits.
Transparency Rules: Continued Momentum & More Scrutiny
Healthcare data transparency remains a top federal and state-level priority. Employers must continue complying with monthly machine-readable file posting, price comparison tool availability, and hospital and provider price transparency standards. Legislation currently under consideration could further tighten rules around spread pricing, rebate pass-through, and disclosure of PBM compensation.
One Big Beautiful Bill Act: Key Provisions
The One Big Beautiful Bill Act (OBBBA) introduced several important changes, some already accompanied by early guidance and others awaiting full regulations.
HSA Compatibility
Telehealth
Telehealth may continue to be offered pre-deductible without jeopardizing HSA eligibility — now on a permanent basis. Employers should review plan documents, amend plan language if planning to maintain or expand low- or no-cost telehealth, and clearly communicate changes to plan participants.
Bronze & Catastrophic Plans
Bronze or catastrophic Marketplace plans will be treated as HSA-compatible — even if they do not meet traditional high-deductible criteria. This most directly impacts employers offering individual coverage HRAs (ICHRAs).
Direct Primary Care (DPC) Arrangements
The OBBBA allows limited-fee direct primary care (DPC) arrangements to be paid with HSA funds, but only if they meet strict criteria. Employers should evaluate whether DPC could be an employee-benefit strategy, confirm that any DPC arrangement meets fee caps and service limitations.
Additional OBBBA Provisions
Dependent Care Assistance
Amounts are increasing for tax years beginning after Dec. 31, 2025. Employers should determine whether to adopt the increased limits and amend their plan accordingly. However, it’s important to be aware of and test for potential discrimination challenges, such as the 55% average benefits test.
Educational Assistance Programs
Employers offering educational assistance programs should determine whether the plan will cover qualified student loan repayments and consider amending the plan to incorporate cost-of-living adjustments.
Tax Credits for Family Leave
Employers offering paid family leave are entitled to a tax credit. This credit is only available for employers who go above and beyond state-mandated leave in applicable states.
Trump Accounts
This IRA-type savings account will become available in July 2026, specifically for children under age 18. Contributions of up to $5,000 are allowed annually (after tax), and the pilot project provides a one-time $1,000 contribution for children born between Jan. 1, 2025, and Dec. 31, 2028. Employers can contribute up to $2,500 per employee, not per child, all or a portion of which could be through cafeteria plan salary reduction.
ACA Preventive Update
The Advisory Committee on Immunization Practices is continuing to review immunization schedules. Recently, the committee recommended individual-based decision-making on whether to give the hepatitis B vaccine to infants born to women who test negative for the virus. Decisions may have implications for coverage of vaccines by insurers, and it’s unclear how insurers may respond.
Fiduciary Rule Revisited
Fiduciary compliance is moving to the forefront — especially with rising litigation in both retirement and health plan arenas. Recent DOL activity suggests increased employer-friendly positions in some cases, but the overall trend still leans toward heightened scrutiny.
Annual Compliance Updates
2026 Cost-of-Living Adjustments: Cost-of-living adjustments (COLAs) affect HSA contribution limits, deductible minimums, out-of-pocket maximums, and retirement plan deferrals. See 2026 COLAs here.
Employer Shared Responsibility (ESR): ESR requirements remain unchanged, subject to COLAs, but rising plan costs and evolving Marketplace dynamics may affect affordability strategies.
Annual Notice Requirements: SBC updates, CHIPRA notices, Medicare Part D disclosure, WHCRA, and transparency disclosures remain foundational components of compliance.
Prepare to Maintain Compliance With CBIZ
As employers prepare for 2026, the compliance themes closing out this year offer a clear roadmap for where to focus attention: stronger documentation, deeper oversight, more structured governance, and proactive engagement with vendors.
Together, these priorities will help employers navigate an evolving regulatory landscape with greater confidence.
See how CBIZ helps employers stay ahead of complex compliance issues.
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