(If this message looks garbled to you or if the headlines in this message don't connect you to Web pages when you click on them, please request the "plain text" version of this newsletter (Welfare Plans Edition) by emailing your request to publisher Dave Baker at davebaker@benefitslink.com)
The BenefitsLink Newsletter -
Welfare Plans Edition

Today's sponsor is EmployeeBenefitsJobs.com
Please support our advertisers
(Would your company like to sponsor an issue?)

June 8, 2000

Insurer Not Liable For Bad Faith in Not Informing COBRA Qualified Beneficiary of Conversion Option
Excerpt: "The group health plan in this case provided an option to enroll in a conversion policy upon expiration of COBRA coverage. One month before the qualified beneficiary's COBRA coverage was about to expire, the plaintiff and the plan administrator made separate inquiries to the insurer ..." (EBIA Weekly)

7th Cir: Former Executive Can't Force Ex-Employer to Pay Same Severance Benefits Paid to Other Exec
Excerpt: "The acquiring corporation paid severance benefits to only one of the executives, and the other one sued to obtain the same benefits, on the grounds that the payments created an informal severance plan." (EBIA Weekly)

2d Cir: During 24-Month STD Period, LTD Plan Can Be Amended to Change Definition of Total Disability
Excerpt: "[T]he plan determined that [the plaintiff] did not meet the definition of 'total disability,' which showing was necessary to continue benefits after an initial 24 months of benefits. The plaintiff challenged this decision on the grounds that the plan's termination decision relied on plan language that was adopted after the plaintiff became disabled ..." (EBIA Weekly)

E. D. Wash: Native American Tribal Pension Plan Is A Government Plan Exempt from ERISA
Excerpt: "ERISA is silent as to whether its provisions apply to Native American tribal governments. However, it appears that courts are willing to extend the governmental plan exemption to Native American tribal government plans under the factors analyzed in this case." (EBIA Weekly)

Texas Attorney General Sues HMO Over Authority to Challenge Denial of Care for Patient
Excerpt: "The Texas attorney general's office told [a] U.S. District Judge ... that the state should be able to regulate health maintenance organization officials who make decisions about patient treatment. The state is asking [the court] to dismiss a lawsuit by United Healthcare, which objects to a state medical board review of ... its North Texas medical director. The state launched the review after the director denied home nursing care to a 13-year-old boy with respiratory problems." (Associated Press)

DOL Sues Plan Administrator and Trustees for Overpaying $906,621 in Administrative Services
Excerpt: "The DOL lawsuit alleges that an employer welfare association, a plan administrator and plan trustees breached their fiduciary duty and engaged in prohibited transactions by overcharging and not seeking competitive bids." (Thompson Publishing Group)

Lifetime Perks Become the Rage As CEOs Extend Their Benefits
Excerpt: "For a growing number of chief executives, a new batch of benefits promises a lifetime of care. They are 'permanent perks,' good for the life of the fortunate executive, and often his or her spouse ... Probably the most welcome of the new lifetime perks is company-paid long-term-care insurance." (Wall Street Journal)

Are Childless Employees Being Discriminated Against?
Excerpt: "At a time when most companies are working diligently to come up with expanded family-friendly benefits to help attract and retain qualified workers, two revolutionary demographic trends--the movement of mothers into the workplace and the dramatic rise in the number of voluntarily childless adults--are colliding ... Childless employees feel that corporations and universities are getting a free ride at their expense." (Scripps Howard News Service)

National Survey on Consumer Experiences With Health Plans
Excerpt: "[This is a] national survey of 2,500 insured adult Americans on their experiences with health plans--[it] documents problems people have experienced with their plans, the impact of those problems, and how people resolve their disputes with their health plans." (Kaiser Family Foundation)

State-by-State Database of Mandated Coverage Laws, Other Health Insurance Consumer Protection Laws
Excerpt: "Confused about what benefits your health plan must include? Use this comprehensive guide to find your rights to specific coverages. Plus, see your rights regarding guaranteed-issue plans, pre-existing medical conditions, and external grievance review panels." (insure.com)

HCFA Says Non-Confinement Provisions in Group Health Plans Violate HIPAA
Excerpt: "[Prior to HIPAA, non-confinement] provisions generally provided that dependent coverage would not become effective for individuals who were in a hospital or other medical institution on the coverage effective date--i.e., coverage would be delayed until the individual was released from the institution." (EBIA Weekly)

IRS Issues Updated Publication 969, Medical Savings Accounts
Excerpt: "Changes to the new version include the 1999 and 2000 limits for annual deductibles and for the maximum out-of-pocket expenses for high-deductible health plans. Additionally, Publication 969 now covers the Medicare+Choice Medical Savings Accounts that were initiated effective January 1, 1999." (EBIA Weekly)

Arbitration Squabble Breaks Out At Kaiser
Excerpt: "An arbitrator selected to settle a patient's dispute with Kaiser is angry that the HMO's attorney disqualified him after he insisted that the case begin with a face-to-face meeting, leading him to question the fairness of this private dispute resolution process." (Foundation for Taxpayer and Consumer Rights)

HealthINFLATION (tm) News Summaries
Monthly summary of information about costs of medical services and commodities, published online by Price Index Communications. (Price Index Communications)

The Problems with Punitive Damages in Lawsuits against Managed-Care Organizations
Excerpt: "Studdert and Brennan (Jan. 27 issue) raise the possibility that subjecting managed-care organizations to tort liability and punitive damages might cause litigation to become widespread and disrupt 'the economics of managed care for the insurer.' Although the liability system is far from perfect, the authors fail to mention countervailing considerations, and their proposal is therefore incomplete." (New England Journal of Medicine; Letters to the Editor)

Kellogg Foundation's Devolution Initiative Interested in Health Policy, Long-Term Care Issues
Excerpt: "Known as 'devolution,' this complex shifting of responsibility and accountability [for many health and human services programs] from the federal government to the state governments has continued to evolve, with increasing transference to local governments." (W. K. Kellogg Foundation)

Subscribe to the Retirement Plans Edition, too (click)
Copyright 2000 BenefitsLink.com, Inc.

Feel free to forward this email to friends, colleagues or clients, if no fee is paid to you and the email is forwarded in its entirety. Thanks!

BenefitsLink is a trademark of BenefitsLink.com, Inc., published by Dave Baker with much help from Mary Hall and lots of friends.

To subscribe (free): visit https://benefitslink.com/newsletter - or the person desiring to subscribe can send an email to listmanager@postmastergeneral.com, with this as the subject of the email: subscribe BLwelfare

We have an online archive of prior issues at
BenefitsLink logo
Looking for a speaker for your benefits group? Want to throw your hat into the ring? Free.

Need personnel? It's like fishing in a barrel here.

Need a benefits job? Sort the openings by their distance away from you.

Exchange questions and tips with colleagues. Co-sponsored by us and several employee benefits organizations.

Promotions and new personnel in the employee benefits community.

Experts field questions online, submitted by readers via email.

View by location, by sponsoring organization, or by date.

Largest listing of benefits software on the net: descriptions, downloads.

Ads are our sole source of support. No subscription fees!


Copyright 2000 BenefitsLink.com, Inc. All rights reserved. BenefitsLink is a trademark of BenefitsLink.com, Inc.