Under the Patient Protection and Affordable Care Act (PPACA), aka Healthcare Reform, health insurance companies are required to spend a minimum of their premium dollars for health care. This percentage, called medical loss ratio (MLR), is 80% of premiums for groups under 100 employees or 85% for groups with 100 or more employees. If an insurer does not meet this standard, it is required to rebate the excess to employers by August 1, 2012. Employers need to become familiar with the MLR rebate rules and if receiving a rebate, know what needs to be done to be compliant with the law.

The Supreme Court affirmed the constitutionality of the Affordable Care Act. By a 5-4 vote, the individual mandate requiring most Americans to maintain "minimum essential" health insurance coverage, 26 U.S.C. 5000A, is affirmed as an exercise of Congress's taxing power.

The IRS announced the inflation-adjusted increases for thresholds applicable to HSAs and High-Deductible Health Plans (HDHPs) for 2013.