Federal Regulations Updates & Impacts

One Big Beautiful Bill Act Enhances HSAs & FSAs

H.R.1, commonly referred to as the One Big Beautiful Bill (OBBB), recently passed Congress and was signed into law on July 4, 2025. While most of the content focuses on tax provisions, other changes include improvements to Health Savings Accounts (HSAs), permanent extension of the telehealth relief for high-deductible plans (HDHPs), and an increase in the annual contribution limit for dependent care Flexible Spending Accounts (FSAs). These items are outlined below: 

Dependent Care Flexible Spending Accounts (FSAs)
For plan years starting on or after January 1, 2026, the dependent care FSA limit has increased to $7,500.00/year (or $3,750.00 for married couples who file taxes separately). This new limit is not indexed for inflation.

Telehealth Services Permanently Allowed to be Covered by HSA 
In general, individuals with High-Deductible Health Plans (HDHPs) are required to meet their deductible before receiving any benefits under the plan. Congress had previously provided temporary relief, allowing HDHPs to offer telehealth services prior to meeting an HDHP deductible. This relief has now become permanent, effective retroactively to January 1, 2025. In addition, individuals will have the flexibility to receive telehealth services from a vendor outside of their High-Deductible Health Plan (HDHP). This coverage will not affect an individual's ability to contribute to or receive contributions to their HSA, ensuring that they can continue to save for their healthcare expenses while also taking advantage of convenient telehealth services.

Favorable Treatment for Coverage Under Direct Primary Care Service Arrangements (DPCSA)
HSA-eligible individuals enrolled in DPCSAs can contribute or receive HSA contributions and may use HSA funds to pay for certain DPCSA services. A DPSCA is medical care provided by primary care practitioners in exchange for a fixed recurring fee of no more than $150.00 per month, per employee ($300.00 if multiple individuals are covered). Fees paid under a DPCSA are treated as medical expenses rather than insurance premiums, allowing them to be paid for with an HSA. The DOL and HHS will propose and finalize regulations.

2026 Women's Preventive Services Expansion

Effective January 1, 2026, the Women's Preventive Services Initiative (WPSI) introduced or updated several preventive services guidelines that are being supported by the Health Resources & Services Administration (HRSA). These guidelines determine what preventive services are required to be covered by non-grandfathered group health plans under the ACA. WebTPA will be prepared to administer these benefits.

Screening Now Extended to Intimate Partners
The WPSI recommends screening adolescents and adult women for intimate partner and domestic violence, annually, and providing or referring them to intervention services as needed. Intimate partner and domestic violence includes physical and sexual violence, stalking and psychological aggression, any type of coercion including reproductive coercion, neglect, and the threat of violence, abuse, or both. Intervention services include, but are not limited to, counseling, education, harm reduction strategies, and appropriate supportive services.

Additional Breast Cancer Imaging for Woman at Average Risk 
Current breast cancer preventive services included the following:

• Women at average risk of breast cancer (those without high risk factors) should start mammography screening between the ages of 40 and 50.
• Screening should occur at least every 2 years (biennially) and may be done as frequently as every year.
• Screening should continue until at least age 74.
• Age alone should not be the reason to stop screening.
• Women at increased risk of breast cancer should undergo periodic mammography screening, but recommendations for additional services are not included in this guideline. 

Now, in addition to the preventive services listed above, any imaging (such as MRI, ultrasound, or a second mammography) and pathology evaluation necessary to complete the screening process or to investigate findings on the initial screening mammography should be covered under preventive services. 

Patient Navigation Services for Breast & Cervical Cancer Screening
The WPSI recommends patient navigation services for breast and cervical cancer screenings and follow-ups, based on an assessment of the patients’ needs for navigation services. Patient navigation services involve personalized one-on-one (e.g., in person, virtual, hybrid) contact with the patients. Services include, but are not limited to, assessments and planning, navigating health care access and health systems, and providing referrals to appropriate support services such as language translation, transportation, social services, and patient education. Patient navigation services aim to increase the number of patients who receive breast and cervical cancer screenings, by addressing any barriers or challenges patients may face in accessing care. 

ACA Employer Shared Responsibility Penalties Increased

The IRS has announced changes to the penalty amounts that large employers may face under the Affordable Care Act (ACA) for not providing adequate health insurance to their employees. These changes will take effect in 2026.

As background, large employers (those with 50 or more full-time employees) are required to offer minimum essential coverage to at least 95% of their full-time employees and their dependents (excluding spouses). If they fail to do so, they may be subject to a penalty. There are two types of penalties: 

1. 1. If an employer doesn't offer minimum essential coverage to enough employees, they may face a penalty of $3,340 per full-time employee (minus a 30-employee reduction) for failures occurring in 2026. This is a $440 increase from the 2025 penalty amount.
      
      
   2. If an employer offers minimum essential coverage, but it's not affordable or doesn't provide minimum value, they may face a penalty of $5,010 per full-time employee who receives subsidized coverage through a health insurance exchange. This is a $660 increase from the 2025 penalty amount.

These penalty amounts are adjusted annually for inflation, and the IRS provides a list of current and previous penalty amounts on their website.