Consolidated Appropriations Act 2026

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The Consolidated Appropriations Act of 2026 (CAA 26), which was signed by the President on February 3, 2026, reshapes how pharmacy benefit managers (PBMs) will operate in the employer group health plan market. The statute creates new federal transparency, reporting, rebate remittance, and fiduciary compliance requirements across the Public Health Service Act (PHSA), ERISA, and Internal Revenue Code, thereby broadly affecting all group health plans.

The legislation aims to:

  • Increase transparency into drug pricing, spreads, and rebate flows;
  • Ensure that 100% of drug rebates and remuneration are passed back to plans; and
  • Expand fiduciary oversight and enforcement mechanisms.

Most provisions take effect for plan years beginning 30 months after enactment (e.g., January 2029 for calendar year plans) and will apply to contracts entered into or renewed after that time. For employers and brokers, these changes may affect PBM contracting, fiduciary oversight, and compliance responsibilities well before the effective date as contracts are reviewed and renegotiated. Read more

The Rising Cost of Health Insurance: What Employers Can Control in 2026

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Employer-sponsored health coverage is entering another year of significant cost pressure. Medical costs are projected to rise 8.5% this year, with overall increases ranging from 6.5% to 10% per employee, one of the steepest hikes in over a decade.

More than half of employers plan to raise deductibles or annual out-of-pocket limits to offset those increases.

Meanwhile, employees have seen their share of premiums climb dramatically over the past two decades—up 272% for individual coverage and 243% for family coverage.

For business leaders, these are significant numbers that affect operating budgets, with health insurance often among the top three expenses. While national trends are outside an individual employer’s control, plan strategy and design, as well as employee engagement, can influence long-term outcomes. Read more

Zoom In, Zoom Out: The Alignment Habit That Keeps Work Moving

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Our workdays often start in third gear, with back-to-back meetings, emails, and Slack notifications, leaving people tired and exhausted by the end of the day.

Disjointed work and miscommunications are all too common. A project moves fast for a week, then hits a wall. A deliverable gets built and then rebuilt because it wasn’t what the business needed.

That’s why in many workplaces, the problem is a lack of perspective.

People spend long stretches either executing tasks without context or talking strategy without turning it into clear next steps. The result is misalignment, constant re-prioritization, and a steady drip of frustration and rework.

A simple habit clears things up: Zoom In, Zoom Out (ZIZO)—a repeatable way to reconnect daily execution to direction, and direction back to concrete action. Read more

Forming, Storming, Norming, Performing: A Practical Way to Lead Teams Through Growth

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Growing a company means living with change. Teams shift as the business evolves, and roles tend to stretch before they are fully redefined. It can also create pressure that shows up in day-to-day work.

Most employers recognize the signs quickly. Communication takes more effort. Decisions slow down. Accountability feels less clear across teams. In many cases, leaders focus on fixing the issue right in front of them without stepping back to assess how the team is developing.

The Forming, Storming, Norming, Performing model offers a useful way to zoom out. Developed in the mid-1960s by Bruce W. Tuckman, it provides employers with a simple framework for assessing their team, understanding how teams evolve over time, and why certain challenges tend to resurface as organizations grow.

Used as a reference point, this model helps leaders respond with intention. It also creates shared language that makes team challenges easier to discuss without immediately assigning blame.

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