Businessolver® Client Newsletter
01/20/2026
Businessolver Ushers in the Anticipation Era for Benefits in 2026
Empathy meets intelligence:
Redefining the benefits experience
For years, benefits technology has been largely reactive—waiting for employees to click, call, or navigate complexity after a need arises. That approach often leads to missed deadlines, confusion, and unnecessary stress.
In 2026, we’re changing that.
Introducing Anticipatory Benefits Experiences
Businessolver is moving beyond personalization to a new standard: anticipation.
Anticipatory benefits experiences use intelligence and real-time signals to identify what’s coming and act early—before employees, HR teams, brokers, or partners even know to ask. That means guidance arrives sooner, decisions feel clearer, and issues are addressed before they escalate.
What does this mean for you?
Smarter, Ecosystem-Wide Support
Sofia is evolving from an assistant into an intelligence layer that supports the entire benefits ecosystem. In addition to helping employees, Sofia will increasingly support client administrators, brokers, advisors, and partners—surfacing insights in tools like the Benefits Insights Dashboard, helping users navigate data, and delivering faster, more contextual answers across roles.
Anticipatory Communication
Communication is increasingly driven by our anticipation engine—delivering alerts, reminders, and insights based on early signals rather than after-the-fact events. Employees and administrators receive the right information earlier, helping them act confidently and avoid last-minute surprises.
An Enhanced Experience
A refreshed MyChoice Benefits App and enrollment experience make it easier for employees to take the right action at the right time.
This evolution reflects our continued commitment to empathy, innovation, and delivering benefits experiences that support people consistently and proactively. You’ll also begin to see updates to our visual identity—including refreshed logos and interfaces—rolling out over the coming months.
We’ll walk through all the details at today’s Product Update in the Learning Hub.
Join us at 11 a.m. CT or 2 p.m. CT.
If you miss one of these sessions, be sure to head to the Training and Updates: Benefitsolver Updates page for an on-demand replay in the Learning Hub.
Product Update:
New ACA Report Enhancement Simplifies State Mandate Compliance
New columns will provide a better user experience
To reduce manual work and improve accuracy, the ACA 1095 Employee Statement Eligibility Report now includes five new columns: Employment Status, plus indicators for CA, NJ, DC, and RI reporting. These columns show “Yes” if a member had applicable coverage for that state in any month, eliminating the need to cross-reference multiple reports.
This update supports clients who opt out of printing 1095s under the Paperwork Burden Reduction Act while still meeting state-specific mailing requirements.
What’s New in Compliance?
Covered Entities may need to update Privacy Notices by February 16
In February 2024, the Department of Health and Human Services (HHS) updated requirements for the use and disclosure of substance use disorder (SUD) patient records. These rules apply to records maintained by health care programs that provide SUD diagnosis, treatment, or referral for treatment and meet one of the applicability criteria outlined in the 2024 Final Rule amending 42 CFR Part 2 under federal law.
What’s new?
The updated HIPAA Notice of Privacy Practices must now explicitly explain:
- How SUD treatment records received from Part 2 programs may be used and disclosed.
- That Part 2 limits certain uses or disclosures otherwise permitted under HIPAA, including:
- Use in civil, criminal, administrative, or legislative proceedings against the patient without the patient’s written consent or a qualifying court order.
For more context, review the regulations. To review the requirements for Part 2 Privacy Notices, visit this site.
Action needed: Plan sponsors and covered entities should review this information to determine if an update to their privacy notice is required.
The Departments issued updated guidance related to Transparency in Coverage final rule
The Centers for Medicare & Medicaid Services (CMS), along with the Departments of Labor and Treasury, have proposed amendments to the Transparency in Coverage Final Rule to improve healthcare price transparency for consumers. The goal is to make payer pricing information more accessible, standardized, and reliable.
The proposal includes several key changes:
- Machine-readable files: Streamlined to reduce file size and duplication, exclude unlikely provider-service combinations, and shift in-network rate reporting from the plan level to the provider-network level.
- Alignment with hospital price transparency: Payer disclosures would be standardized to match hospital reporting requirements for consistency.
Additional enhancements focus on out-of-network pricing transparency, requiring greater aggregation, lowering claims thresholds, extending reporting periods, and adding contextual data elements such as product type, enrollment counts, and network names. A new public change-log file would also be introduced to track updates.
The Departments also propose updates to participant-facing disclosure rules:
- Cost-sharing information available through online transparency tools must also be provided by phone upon request.
- Notices would be updated to reflect current federal balance-billing protections.
Most amendments would apply to plans beginning on or after January 1, 2027.
Review the CMS news release on the proposed rule to learn more.
Upcoming Sessions:
TODAY at 11 a.m. & 2 p.m. CT: Businessolver Update // Q1 Product Update
We’re sharing some exciting news at our Product Update today! Don’t miss this opportunity to hear all about how Sofia and Benefitsolver are changing for the better in 2026. Plus, we’ll run through a recap of annual enrollment, take a look at key enhancements from Q4, preview our 2026 product roadmap, and more.
If you can’t join us live at 11 a.m. CT, check out our live replay at 2 p.m. CT, where we’ll watch alongside you and answer Q&A.
We’ll see you soon!
Join us at 11 a.m. CT
Join our live replay at 2 p.m. CT
Thurs., Jan. 22, at 11 a.m. CT: Businessolver Training // ACA Data Review
Join our experts as they take you behind the scenes of Businessolver’s ACA process to explore the keys to success. This session will cover best practices for data validation, verification, and code management, ensuring you understand your role in building an efficient ACA workflow.
With insights into how Businessolver drives your data through ACA compliance, you’ll leave equipped with the knowledge to confidently navigate every step of the process.
Add to schedule
Tues., Jan. 27, at 11 a.m. CT: MyChoice Accounts Update // Q1 Product Update
Join our first MyChoice Accounts Product Update of the year to learn about what we have planned for 2026. We’ll showcase some newly released features, explore our roadmap, and look at how our enhancements are streamlining account management and elevating the member experience.
Add to schedule
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A Peek at Our Pinnacle Partners:
Simplifying Health Care for Your Members
Smart Technology and Human Touch for Health Care Success
Rightway is transforming how members navigate health care by combining cutting-edge technology with empathetic, high-touch support. Through its care navigation platform and mobile app, members gain access to live clinical health guides who assist with everything—from finding top doctors and managing care plans to resolving billing issues and understanding benefits.
Our partnership ensures a seamless, simplified experience backed by deep analytics for smarter decisions and better outcomes. For employers, Rightway delivers secure integrations, turnkey implementation, and higher ROI, while empowering employees to make confident, informed health choices. Together, we’re creating a better way to do health care—one that prioritizes quality, ease, and employee well-being.
