Understanding 2026 Health Insurance Compliance Changes

Health insurance compliance is not getting simpler in 2026. For employers, the biggest risk is not usually one major mistake — it is small reporting, affordability, or plan-administration issues that get overlooked until deadlines hit.

Here are a few areas employers should be watching closely.

1. ACA reporting still matters

Applicable Large Employers generally must continue reporting offers of coverage to the IRS on Forms 1094-C and 1095-C. For 2025 calendar-year reporting, the filing deadlines fall in March 2026, so preparation should start well before year-end.

2. Affordability changed for 2026

For 2026, the ACA affordability percentage increased to 9.96%. That makes affordability testing an important part of employer planning, especially for businesses monitoring contribution strategy and employee eligibility.

3. Electronic filing rules are broader now

Many employers who once filed on paper may now need to file electronically. In general, if you are filing 10 or more information returns in the aggregate, electronic filing rules can apply.

4. Mental health parity deserves attention

Mental health parity compliance remains an active area for employer-sponsored plans. Federal final rules already apply in part, and certain additional standards apply for plan years beginning on or after January 1, 2026. Employers should make sure their plans and partners are keeping pace.

5. Compliance is bigger than forms

Good compliance is not just about filing paperwork. It also includes plan documentation, employee notices, contribution strategy, and working with the right partners to keep your benefits program aligned and defensible.

Staying ahead of compliance changes helps reduce disruption, lower risk, and create a smoother experience for both the employer and employees.

Fusion Benefits Group helps employers review benefits strategy, renewal structure, and compliance touchpoints before small issues turn into bigger ones.