Going Beyond Wellbeing to Combat Rising Medical Rates

Wellbeing programs were once the answer to controlling healthcare costs, but today, they’re only part of the solution. With medical rates climbing faster than ever, employers are shifting their focus from simple wellness initiatives to comprehensive health strategies that drive real results. Going beyond well-being means integrating prevention, data analytics, and smarter plan design to create healthier employees and healthier financial outcomes.

Understanding the Impact of Rising Medical Rates

The surge in rising medical rates isn’t just a budgeting concern; it directly affects company competitiveness and employee satisfaction. Premiums continue to climb due to chronic conditions, high-cost prescriptions, and delayed preventive care. While traditional wellness initiatives like fitness challenges and health screenings are beneficial, they only address the surface. Businesses need deeper, data-driven approaches to truly control spending and create long-term value in their insurance plans.

Smarter Plan Design for Sustainable Savings

One of the most effective ways to manage healthcare costs is through smarter plan design. This involves analyzing employee demographics, claims data, and utilization patterns to build benefits that encourage proactive health management. Employers can reduce unnecessary spending by introducing tiered networks, telehealth access, and incentives for preventive care.
Health insurance brokers for small businesses play a major role here. They can guide employers through plan customization, ensuring the benefits align with workforce needs while maintaining cost efficiency. By strategically structuring insurance coverage, companies can minimize waste, avoid duplicate coverage, and make healthcare more accessible.

Leveraging Data-Driven Insights

Data is the key to unlocking real cost control. Employers who track utilization trends, chronic disease management, and claims behavior gain valuable insights into where money is being spent and how to reduce those expenses.
With data analytics, it’s possible to pinpoint high-cost drivers and identify opportunities for early intervention. For example, targeted disease management programs can help employees manage conditions like diabetes or hypertension before they lead to costly hospitalizations. This proactive approach helps stabilize rising medical rates while improving employee well-being.

Engaging Employees in Smarter Health Choices

Cost control isn’t only about plan design; it also depends on employee engagement. When employees understand their healthcare benefits and how to use them effectively, they make better, more cost-conscious decisions.

Educational initiatives that explain deductibles, in-network care, and prescription options empower employees to take ownership of their health. Encouraging preventive care visits and routine screenings can also reduce claims long-term.

Working with experienced insurance advisors can help implement communication strategies that boost participation and accountability.

The Bottom Line: Strategic Action Over Simple Solutions

Wellness programs remain an important part of the equation, but true progress demands more. Employers must go beyond step challenges and annual screenings to create programs that connect with employees on a deeper level — guiding them toward healthier behaviors, supporting mental and physical wellbeing, and empowering them to take ownership of their health journey.

By combining smarter plan design, advanced data analytics, and authentic engagement, organizations can do more than slow rising medical rates, they can foster a culture where health is part of the company’s DNA. That’s not just good for employees; it’s good for business. The future of benefits belongs to those who see wellbeing not as a program, but as a strategic advantage.

Tooher-Ferraris Insurance Group offers expert guidance and comprehensive insurance solutions to help businesses take control of their healthcare costs. From plan analysis to long-term cost management, our team of experienced health insurance brokers for small businesses ensures every client gets tailored, results-driven strategies.

Contact Tooher-Ferraris Insurance Group today to discover how you can protect your business and your employees, while keeping healthcare costs in check.

Employee Benefits

October 18, 2025

Five Ways to Increase the ROI of Your Benefits Strategy with Technology

Businesses are constantly seeking smarter ways to manage employee benefits while maintaining strong financial performance.

Tooher-Ferraris Insurance Group helps organizations strengthen their benefits strategy with technology by providing insights, analytics, and coverage solutions that safeguard both employees and company assets.

From improving efficiency to securing sensitive data, technology plays an important role in maximizing return on investment.

1. Use Data Analytics to Optimize Benefit Offerings

Modern benefits strategies thrive on data. Advanced analytics tools can identify which benefits employees value most and which ones are used the least. For example, an employer might discover that a high-cost dental plan has low enrollment, while telehealth and wellness stipends are in high demand.

By analyzing participation rates, claim data, and employee demographics, HR teams can refine benefit packages to better match workforce needs. This targeted approach eliminates waste, reallocates dollars to high-impact benefits, and enhances employee satisfaction. Over time, data-driven decisions contribute to stronger engagement and reduced turnover — both critical drivers of return on investment (ROI).

Tip: Use integrated HR and benefits platforms to combine data from multiple sources, giving you a holistic view of utilization trends and predictive cost modeling for the upcoming plan year.

2. Automate Administrative Processes

Manual benefits administration is not only inefficient but also prone to costly errors. Automation tools streamline processes like open enrollment, eligibility verification, COBRA notifications, and compliance reporting — ensuring accuracy while freeing up valuable HR time.

Automated systems can send real-time reminders, flag compliance gaps, and sync data across payroll, HR, and carrier systems. This eliminates duplicate entry and reduces the risk of missed deadlines or data mismatches.

Beyond efficiency, automation provides scalability. As your workforce grows or remote work expands, a digital benefits administration platform ensures seamless communication and consistent employee experiences across locations.

ROI impact: Automation reduces administrative costs, minimizes compliance risk, and enables HR professionals to focus on strategic initiatives such as workforce planning and culture-building.

3. Strengthen Cyber Protection for Benefits Platforms

With the majority of benefit systems now operating in the cloud, cybersecurity has become a critical element of any benefits strategy. Sensitive employee data — including Social Security numbers, dependent information, and health details — is a prime target for cybercriminals.

Integrating cyber insurance coverage into your overall benefits and risk management program provides a financial safety net against data breaches, ransomware attacks, and other cyber threats. Beyond the insurance protection itself, Tooher-Ferraris partners with organizations to identify vulnerabilities and implement proactive measures such as multifactor authentication, encryption, and employee training.

Why it matters: A breach not only results in direct financial loss but also erodes employee trust and can trigger costly regulatory penalties. Robust cyber protection ensures business continuity and maintains confidence in your digital benefits ecosystem.

4. Enhance Employee Engagement with Digital Tools

A well-designed benefits program is only as effective as its utilization. Digital engagement tools — such as mobile apps, AI-driven chatbots, and interactive self-service portals — empower employees to access and understand their benefits anytime, anywhere.

These platforms deliver personalized communications, reminders, and recommendations based on individual needs. For instance, an employee approaching a major life event, like the birth of a child, might automatically receive information on dependent coverage or flexible spending accounts.

Engaged employees who clearly understand their benefits are more likely to appreciate their total compensation package, leading to improved retention, satisfaction, and productivity — all of which directly enhance ROI.

Tip: Encourage employees to download your benefits app and use it regularly by integrating gamification elements or small incentives for completing wellness or benefits education activities.

5. Leverage Predictive Insights for Cost Control

Predictive analytics uses historical and real-time data to forecast future trends in healthcare costs, absenteeism, and employee health risks. Employers can use these insights to implement targeted wellness initiatives, negotiate better rates with carriers, or identify early signs of rising costs.

For example, predictive modeling might reveal a spike in chronic conditions such as diabetes or hypertension within the workforce. Proactively introducing preventive care programs or disease management resources can reduce long-term claims and improve overall well-being.

When combined with cyber insurance and robust risk management strategies, predictive tools offer organizations a powerful framework for achieving both financial efficiency and workforce resilience.

Drive Greater Value with a Tech-Enabled Strategy

The most successful organizations don’t just offer benefits — they optimize them. A technology-driven benefits strategy combines automation, analytics, and cybersecurity to deliver measurable results across cost control, compliance, and employee experience.

Tooher-Ferraris Insurance Group provides comprehensive insurance services, including advanced cyber insurance coverage and employee benefits solutions tailored to your organization’s goals. Contact us today to learn how we can help you increase the ROI of your benefits strategy through smart technology and trusted protection.

Employee Benefits

October 13, 2025

IRS Adjusts Health Flexible Spending Account and Other Benefit Limits for 2026

The Internal Revenue Service (IRS) recently released Revenue Procedure 2025-32, which increases the health flexible spending account (FSA) salary reduction contribution limit to $3,400 for plan years beginning in 2026, an increase of $100 from 2025. Thus, for health FSAs with a carryover feature, the maximum carryover amount is $680 (20% of the $3,400 salary reduction limit) for plan years beginning in 2026. When carrying over funds from 2025 to 2026, 20% of the $3,300 salary reduction limit for 2025 is $660.

The Revenue Procedure also contains the cost-of-living adjustments that apply to dollar limitations in certain other sections of the Internal Revenue Code.

Qualified Commuter Parking and Mass Transit Pass Monthly Limit
For 2026, the monthly limits for qualified parking and mass transit are increased to $340 each, an increase of $15 from 2025.

Adoption Assistance Tax Credit Increase
For 2026, the credit allowed for adoption of a child is $17,670 (up $390 from 2025). The credit begins to phase out for taxpayers with modified adjusted gross income in excess of $265,080 (up $5,890 from 2025) and is completely phased out for taxpayers with modified adjusted gross income of $305,080 or more (up $5,890 from 2025).

Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) Increase
For 2026, reimbursements under a QSEHRA cannot exceed $6,450 (single) / $13,100 (family), an increase of $100 (single) / $300 (family) from 2025.

Reminder: 2026 HSA Contribution Limits and HDHP Deductible and Out-of-Pocket Limits
Earlier this year, in Rev. Proc. 2025-19, the IRS announced the inflation-adjusted amounts for HSAs and high-deductible health plans (HDHPs).

	2026 (single/family)	2025 (single/family)
Annual HSA Contribution Limit	$4,400 / $8,750	$4,300 / $8,550
Minimum Annual HDHP Deductible	$1,700 / $3,400	$1,650 / $3,300
Maximum Out-of-Pocket for HDHP	$8,500 / $17,000	$8,300 / $16,600

The ACA’s out-of-pocket limits for in-network essential health benefits have also been announced and have increased for 2026. Note that all non-grandfathered group health plans must contain an embedded individual out-of-pocket limit if the family out-of-pocket limit is above $10,600 (2026 plan years). Exceptions to the ACA’s out-of-pocket limit rule are available for certain small group plans eligible for transition relief (referred to as “Grandmothered” plans). While historically CMS has renewed the transition relief for Grandmothered plans each year, it announced in March 2022 that the transition relief will remain in effect until it announces that all such coverage must come into compliance with the specified requirements.

	2026 (single/family)	2025 (single/family)
ACA Maximum Out-of-Pocket	$10,600 / $21,200	$9,200 / $18,400

ACA Reporting Penalties (Forms 1094-B, 1095-B, 1094-C, 1095-C)
The table below describes late filing penalties for ACA reporting. The 2027 penalty is for returns filed in 2027 for calendar year 2026, and the 2026 penalty is for returns filed in 2026 for calendar year 2025. Note that failure to issue a Form 1095-C when required may result in two penalties, as the IRS and the employee are each entitled to receive a copy.

Penalty Description	2027 Penalty	2026 Penalty
Failure to file an information return or provide a payee statement	$340 for each return with respect to which a failure occurs	$340 for each return with respect to which a failure occurs
Annual penalty limit for non-willful failures	$4,191,500	$4,098,500
Lower limit for entities with gross receipts not exceeding $5M	$1,397,000	$1,366,000
Failures corrected within 30 days of required filing date	$60	$60
Annual penalty limit when corrected within 30 days	$698,500	$683,000
Lower limit for entities with gross receipts not exceeding $5M when corrected within 30 days	$244,500	$239,000
Failures corrected by August 1	$130	$130
Annual penalty limit when corrected by August 1	$2,095,500	$2,049,000
Lower limit for entities with gross receipts not exceeding $5M when corrected by August 1	$698,500	$683,000
Failure to file an information return or provide a payee statement due to intentional disregard	$690 for each return with respect to which a failure occurs (no cap)	$680 for each return with respect to which a failure occurs (no cap)

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About the Author. This alert was prepared for Tooher-Ferraris by Barrow Weatherhead Lent LLP, a national law firm with recognized experts on the Affordable Care Act. Contact Stacy Barrow or Nicole Quinn-Gato at sbarrow@marbarlaw.com or nquinngato@marbarlaw.com.

The information provided in this alert is not, is not intended to be, and shall not be construed to be, either the provision of legal advice or an offer to provide legal services, nor does it necessarily reflect the opinions of the agency, our lawyers, or our clients. This is not legal advice. No client-lawyer relationship between you and our lawyers is or may be created by your use of this information. Rather, the content is intended as a general overview of the subject matter covered. Tooher-Ferraris and Barrow Weatherhead Lent LLP are not obligated to provide updates on the information presented herein. Those reading this alert are encouraged to seek direct counsel on legal questions.

Business Insurance

October 13, 2025

5 Strategies to Help Avoid Workers’ Compensation Claims Litigation

Workers’ compensation claims can be one of the most complex and costly challenges an employer faces. Beyond the financial impact, litigation can damage morale, strain employer-employee relationships, and consume valuable time and resources. Fortunately, the best defense against disputes is a proactive, well-structured approach that combines prevention, communication, and partnership.

At Tooher-Ferraris Insurance Group, we help businesses manage risk and protect their teams through comprehensive workers’ compensation insurance services. Beyond securing the right coverage, proactive steps can significantly reduce the chance of disputes and costly litigation.

Here are five proven strategies to help employers minimize litigation risk while fostering a culture of safety, accountability, and trust.

1. Build a Strong Workplace Safety Program

Avoiding workers’ compensation litigation begins long before an incident occurs. It starts with creating a genuine culture of safety that permeates every level of the organization. Go beyond compliance by engaging employees in safety discussions, recognizing teams for maintaining best practices, and providing regular, role-specific training.

Establish clear protocols and ensure they evolve with changing workplace conditions, technologies, and regulations. Regular audits and leadership involvement demonstrate commitment, signaling to employees and regulators alike that safety isn’t optional—it’s part of your company’s DNA.

When safety is woven into everyday operations, accidents decline, and so does the potential for costly litigation.

2. Document Everything Thoroughly

In the world of workers’ compensation, documentation is your strongest defense. Every report, medical evaluation, and corrective action should be recorded promptly and accurately. Consistent documentation helps ensure claims are handled transparently and can be easily verified if questions arise.

Employers that maintain well-organized records can respond quickly to inquiries, provide clear evidence of due diligence, and minimize disputes that often stem from uncertainty or incomplete information. Think of documentation as both a shield and a roadmap—it protects your business and guides your claims process toward fair, efficient resolution.

3. Communicate Openly with Employees

When an injury occurs, an employee’s first impression of how the situation is handled can determine whether the issue escalates or resolves peacefully. Communication and empathy are critical.

Ensure employees feel heard, supported, and respected throughout the claims process. Provide clear explanations, set expectations, and offer consistent updates. A compassionate, transparent approach builds trust and reduces the likelihood of litigation born from frustration or misunderstanding.

Ultimately, an informed and respected employee is far less likely to seek legal counsel—and far more likely to remain engaged and loyal.

4. Partner with Reliable Insurance Experts

Workers’ compensation insurance is not a one-size-fits-all product. Partnering with seasoned insurance professionals who understand your industry and state regulations is vital.

A knowledgeable advisor can assess your current program, identify coverage gaps, and provide risk management guidance to prevent future claims. They also serve as a strategic ally when claims arise—helping navigate complex processes, coordinate with adjusters, and advocate for efficient, fair outcomes.

Choosing the right partner ensures you’re not just insured—you’re protected, compliant, and strategically prepared.

5. Conduct Regular Claims Reviews and Risk Assessments

A proactive risk management mindset is essential for long-term success. Regularly review past claims and conduct risk assessments to uncover patterns and potential vulnerabilities.

Ask: Are certain roles, locations, or procedures associated with higher injury rates? Are there recurring claims that signal deeper operational issues?

By addressing these root causes and investing in ongoing improvement, employers can prevent repeat incidents, control costs, and strengthen compliance. Combined with a robust workers’ compensation policy, these efforts lay the groundwork for sustainable protection and peace of mind.

Protect Your Business with the Right Support

While no employer can eliminate risk, the right prevention strategies and insurance solutions can greatly reduce exposure. Tooher-Ferraris Insurance Group provides comprehensive workers’ compensation insurance services designed to protect your employees and safeguard your business from costly disputes.

Contact Tooher-Ferraris Insurance Group today to learn how we can help you strengthen workplace safety and minimize the risk of workers’ compensation litigation.

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