HR & Payroll

Why your U.S. health insurance costs are rising, and how to control them

Aaron Mongerson

HR Manager

Jan 14, 2026

4 minutes

Aaron_HR_Group_Benefits

Table of Contents

Financial oversight: The benefits audit processCompliance requirements for U.S. health benefitsAbout the author

The cost of U.S. Group Health Insurance is now a primary driver of the Total Cost of Employment (TCE). For international companies, healthcare is no longer just a line item; it is a strategic challenge that affects your budget, your ability to hire, and your ability to keep top talent.

Financial oversight: The benefits audit process

A proactive audit identifies where your current plan is inefficient. This process focuses on:

Vendor Value: Are your insurance carriers and pharmacy managers actually delivering value?
Plan Design: Balancing your contributions with employee cost-sharing to keep the plan attractive but sustainable.
Prevention: Investing in wellness programs to reduce long-term claims.
Education: Teaching employees how to use healthcare efficiently (e.g., choosing urgent care over the Emergency Room).

Compliance requirements for U.S. health benefits

Navigating U.S. renewals requires strict adherence to federal laws. TABS specializes in helping foreign-owned entities manage these requirements.

Our audit and compliance support includes:

ALE Status: Annually verifying if you are an "Applicable Large Employer" under the Affordable Care Act (ACA).
Communication: Reviewing all legal notices and cost-sharing disclosures sent to employees.
Affordability Testing: If using an ICHRA, ensuring your contribution meets ACA standards to avoid heavy penalties.
Ready to de-risk your U.S. expansion? Learn more about our Payroll & HR services.

About the author

Aaron Mongerson is a dedicated HR Manager and licensed broker specializing in general lines of health and ancillary benefits. She partners with European companies expanding into the United States, offering clear, actionable guidance across the full spectrum of U.S. HR and benefits requirements.

 

Disclaimer: This article provides general information and does not constitute legal, tax, or accounting advice. To evaluate your specific situation and ensure full compliance, contact TABS today. We will assess your equity plan, handle all operational execution, and connect you with the appropriate specialized U.S. tax attorneys and CPAs within our trusted network.