DSP Insurance Insights

Overview of the New Requirement

Illinois House Bill 1697 introduces a new annual fee tied to prescription drug benefits, and many employers will begin seeing this charge in 2026. Most Blue Cross Blue Shield of Illinois (BCBS of IL) health plans use BCBS of IL’s subsidiary, Prime Therapeutics, as its pharmacy benefit manager (PBM), and this update applies directly to those plans. Under the Prescription Drug Affordability Act, PBMs are required to pay the State of Illinois fifteen dollars per covered individual who is enrolled in pharmacy benefits and lives in Illinois. This includes both employees and dependents. BCBS of IL & Prime Therapeutics will pay the fee to the state fund, and BCBS of IL will pass the cost through to employer groups that fall under the law.

The IRS has announced new inflation-adjusted limits for flexible spending accounts (FSAs) beginning in 2026, giving employees more room to set aside pre-tax dollars for medical and dependent care expenses. These updates, along with a major legislative change from the One Big Beautiful Bill (OBBB) Act, make 2026 an important year for benefit planning. For employees, these changes translate to greater flexibility and potential tax savings. For employers, they mean updated plan limits, new communication needs, and an opportunity to highlight valuable benefits.

Running a school is hard work. Every dollar matters. Every staff member matters even more.

In early childhood education, whether practiced like Montessori, Waldorf or others, benefits are not just a nice-to-have. They are the difference between keeping great teachers and losing them to other jobs. The right benefits strategy helps you manage costs, keep your people, and give families the consistency they expect.

What Is Individual Disability Insurance?

Disability insurance pays a portion of your income if you cannot work due to an illness or injury. Employer-sponsored plans often have limits on benefits and an “Individual Disability Insurance” (IDI) policy can provide a more comprehensive level of income protection on their own or layered with an employer policy. IDI policies are:

• Owned by you and stay with you no matter where you work.

• Fills in the benefit gap an employer plan may have.

• Typically provides additional benefit enhancements for catastrophic illness/injury.

If you run payroll anywhere from The Loop to Lake County, you’re paying too much for the same care your people could get safely, often better, outside the hospital campus. Not because you’re careless. Because our market is wired to push routine services into the most expensive settings and then send the bill to employers.

Here’s the blunt version: consolidation plus misaligned incentives = inflated unit prices and the wrong site of care. And it’s costing your plan millions that should be going to wages, growth, and retirement matches...not “facility fees” and parking garages.

On May 22, 2025, the U.S. House of Representatives narrowly passed the “One Big Beautiful Bill Act” (H.R. 1). The “One Big Beautiful Bill Act” aims to promote economic growth, simplify the tax code, and give individuals greater control over their financial and healthcare decisions.

When it comes to employee benefits, one thing hasn’t changed: people still don’t understand them.

On September 9th, 2024 the Departments of Labor, Treasury, and Health and Human Services released the final rule changes regarding the Mental Health Parity and Addiction Equity Act. 

Introduction to ICHRAs

Introducing Level Funding: