2025 Year-End EB Compliance Round-Up

By Karen Hooper | Published December 2, 2025

Question: What compliance action items do employers need to keep in mind as we near the start of 2026?

Short Answer: Upcoming deadlines and considerations as we reach the end of 2025 include OBBB changes to employee benefit options, the Gag Clause Prohibition Compliance Attestation (Dec. 31), ACA reporting via Forms 1094-C and 1095-C (Mar. 2 and Mar. 31 deadlines), and a number of state paid leave benefits taking effect in 2026.

With year-end approaching, many employers are focused on navigating a challenging health insurance renewal and preparing for the year ahead. The One Big Beautiful Bill Act (OBBB) also introduced new employee benefits options to consider. As we approach the start of a new year (and for many, a new plan year), we have compiled an overview of the compliance action items to address.

OBBB Changes to Employee Benefits

Dependent Care FSA Limit Increases to $7,500

The dependent care FSA limit has been stuck at $5,000 for 40 years. The OBBB changes this starting in 2026 by setting a new $7,500 ($3,750 married filing separately) limit. This new limit is not indexed for inflation.

What Does This Mean for Employers? Employers may need to work with their FSA TPA to amend the Section 125 plan document prior to the start of the new plan year to reflect the new $7,500 limit.

Employers with a highly paid workforce will also need to be diligent about running nondiscrimination pre-testing early to monitor whether the dependent care FSA will pass 55% average benefits test.

First-Dollar Telehealth Coverage Revived and Made Permanent

The OBBB now makes this first-dollar telehealth option permanent effective January 1, 2025.

What Does This Mean for Employers? First-dollar telehealth coverage is an optional plan design feature. Employers wishing to incorporate first-dollar (or reduced cost) telehealth into their HDHP will need to work with their insurance carriers, TPAs, and/or telehealth providers.

Direct Primary Care is Not Disqualifying Coverage (and a New HSA-Eligible Expense)

As of 2026, the OBBB specifically excludes DPC arrangements from being a form of disqualifying coverage, thereby allowing the DPC approach to be HSA-compatible.

Student Loan Repayment Assistance Made Permanent (and Indexed for Inflation)

The OBBB now makes permanent the ability to offer tax free student loan repayment assistance under a §127 educational assistance program, indexed starting in 2027.

Trump Accounts – A New Savings Option for Children

The OBBB establishes Trump Accounts (TAs) as a new way to help families save for their children’s future.

Gag Clause Prohibition Compliance Attestation (GCPCA): Due December 31, 2025

Plans must annually submit an attestation via the CMS Health Insurance Oversight System (HIOS) Portal that they have not entered into any of the prohibited contractual restrictions.

What Does This Mean for Employers? For employers sponsoring fully insured medical plans, the insurance carrier is directly responsible for completing the GCPCA.

Year-End ACA Reminders

Deadlines for ACA Reporting in 2026

Form 1095-C Paper Copies: Due Date: March 2, 2026

Form 1094-C (+Copies of Form 1095-C): Due Date: March 31, 2026

ACA Reporting No Longer Requires Furnishing of Forms 1095-C to All Full-Time Employees

Employers must post a clear notice of availability on their benefits website by March 2, 2026, that employees may request a copy of the Form 1095-C.

HIPAA Notice of Privacy Practices Update Required by February 16, 2026

Employers need to update the Notice of Privacy Practices for the new substance use disorder treatment protections by February 16, 2026, and provide the updated notice to employees.

Section 125 Cafeteria Plan Nondiscrimination Testing

All cafeteria plans must undergo annual nondiscrimination testing, which often poses challenges for employers.

New State Paid Leave Benefits Effective 2026

Delaware Paid Leave: Starts January 1, 2026.
Maine Paid Family Medical Leave: Effective May 1, 2026.
Minnesota Paid Family and Medical Leave: Starts January 1, 2026.

Summary

The tangled web of employee benefits compliance requirements continues to expand and increase in complexity each year. This post is only a shorthand overview for some of the items requiring attention heading into 2026, but keep in mind that there are many more employee benefits compliance items employers should consider that are not tied to these specific year-end deadlines.

The Author

Karen Hooper
VP, Senior Compliance Manager
Karen Hooper, CEBS, CMS, Fellow, is a Vice President and Senior Compliance Manager working closely with the Lead Benefit Counsel in Newfront's Employee Benefits division. She works closely with internal staff and clients regarding compliance issues, providing information, education and training.