The Starling Group

08/27/2026

The Fifth Circuit has ordered major changes to the No Surprises Act’s payment rules, finding that insurers may not use “ghost rates” or categorically exclude applicable bonus and incentive payments when calculating the Qualifying Payment Amount. The ruling could reshape out-of-network reimbursement and the federal dispute-resolution process while patient protections remain in place. The Starling Group will continue monitoring implementation guidance and its impact on employers, brokers, providers, and health plans.

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08/27/2026

Rising health care costs, changing regulations, and rapid AI adoption are reshaping employee benefits. For employers, the path forward requires more than controlling expenses it demands data-informed planning, responsible technology governance, flexible benefits, and clear employee communication. The Starling Group helps organizations align benefits strategy with compliance requirements, workforce needs, and long-term sustainability. Learn more in this timely BenefitsPRO article.

08/14/2026

New York Updates Its Surprise Medical Billing Dispute Resolution Process

New York is moving forward with significant changes to the state’s Independent Dispute Resolution (IDR) process for out-of-network health care billing disputes.

The reforms are designed to improve efficiency while continuing to protect patients from the financial consequences of payment disputes between health insurers and out-of-network providers. Among the changes, Medicaid Managed Care will be excluded from the state IDR process, while the Empire Plan and Student Employee Health Plan will be added. The reforms also modify dispute-processing requirements and payment procedures for insurers, providers, and IDR entities.

For employers with fully insured, New York-regulated health plans, this is an important compliance and cost-management development.

At The Starling Group, LLC, we continue to monitor regulatory changes that affect employee benefits, health plan administration, employer costs, and the people those plans are designed to protect.

The new law takes effect August 26, 2026, with NYDFS also moving forward with implementing regulations.

Employers are hoping the changes will hold down the cost of the awards made to doctors and hospitals.

08/01/2026

Federal policy changes affecting Medicaid eligibility and hospital reimbursement demand careful attention. When hospitals, particularly rural and safety-net facilities, face declining revenue and rising uncompensated care, entire communities risk losing access to essential services. The Starling Group urges employers, healthcare leaders, and policymakers to prepare strategically, protect vulnerable populations, and pursue sustainable solutions. Financial stability and patient access must remain shared priorities as these reforms take effect across the nation while protecting patients, employees, and local economies.

"Hospitals are facing a host of serious financial headwinds, which for some will have existential implications," said Katherine Hempstead, senior policy advisor at the Robert Wood Johnson Foundation.

08/01/2026

AI is transforming health care, but technology should support, not replace, human judgment. As states establish safeguards for automated insurance decisions and AI-provided therapy, The Starling Group welcomes policies promoting transparency, accountability, patient safety, and meaningful human review. Innovation must improve access and efficiency without sacrificing fairness, compassion, or individualized care.

New laws restrict automated insurance decisions and AI-provided therapy, with several major requirements taking effect in 2027.

07/30/2026

A proposed House bill could change employer-sponsored health coverage by allowing ERISA plans to move outside the Affordable Care Act’s essential health benefits framework. Supporters may view this as flexibility for employers to design more affordable plans. However, flexibility without adequate safeguards could leave workers facing narrower coverage, greater out-of-pocket costs, or gaps in services such as prescriptions, maternity care, mental health treatment, and hospitalization. Employers could still voluntarily cover these benefits, but access to comprehensive care should not depend solely on voluntary choices. Policymakers must balance cost control with protection for employees and families who rely on workplace coverage.

A new House bill would free employer coverage from the standard Affordable Care Act health plan template.

07/11/2026

"No one should have to skip buying groceries or half their retirement savings to cover medical expenses," said Nancy Brown, chief executive officer of the American Heart Association. "The American Heart Association is committed to addressing health care affordability in our efforts to build a world of longer, healthier lives. Employers are important allies in this work – their influence is critical to prioritizing more affordable, accessible care for all."

New American Heart Association research finds workers are motivated to improve their wellbeing, but financial pressures, time constraints and workplace demands continue to stand in the way.

07/10/2026

Rising care costs are forcing nearly half of U.S. workers to reduce or stop savings, a troubling reminder that and benefits go hand in hand. Employers and advisors must help employees navigate these challenges with smarter planning and stronger benefits strategies.

New American Heart Association research finds workers are motivated to improve their wellbeing, but financial pressures, time constraints and workplace demands continue to stand in the way.

07/07/2026

Exciting news! Trump Accounts made their debut in July 2026, opening up fantastic opportunities for children! If your child is under 18 and has a Social Security number, they might just qualify for a Trump Account.

Here’s the amazing part: children born between January 1, 2025, and December 31, 2028, who are U.S. citizens can receive a generous $1,000 government deposit into their account!

Additionally, up to 25 million children aged 10 or younger from eligible ZIP codes can enjoy a special $250 charitable gift deposit from the Michael & Susan Dell Foundation. It’s a wonderful way to support families!

Please note that while funds will be invested according to strict regulatory guidelines during the "growth period," they will remain accessible after December 31 of the year the child turns 17. It’s an incredible opportunity to help our children thrive!

Trump Accounts launched in July 2026 for certain children under the age of 18. Some newborns may even be eligible for a $1,000 government deposit. Learn how these accounts work and how they compare to other investing options.

05/26/2026