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Welfare Plans Edition

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July 21 - 24, 2000

Promotion of the Fittest: Genetic 'Discrimination' by Employers and Insurers Is Rational
Excerpt: "When you first think about it, it's a no-brainer. When the final stages of mapping the human genome were hyped last month, both President Bill Clinton and Prime Minister Tony Blair called for a swift, extensive ban on using genetic information to discriminate in employment or insurance ... What's not to like? Well, quite a lot, actually. Like most notions that command almost universal assent, the proposed ban on genetic discrimination makes far less sense the more you think about it." (New York Times; free registration required)

Study Shows Online Health Insurance May Offer Significant Benefits for Small Businesses and Consumer
Excerpt: "This report describes each [online health insurance site's] effectiveness in delivering useful information and plan comparison tools, its business model, and its policies and practices with regard to consumer privacy. We use the term 'current state' advisedly, since health insurance sites, like the rest of e-commerce, are evolving rapidly." (California Healthcare Foundation)

Employer's Firing of Employee After Stop Loss Policy Changed May Be ERISA Violation
Excerpt: "A federal district court ruled that substantial evidence existed that could reasonably indicate that a self-funded employer violated both ERISA and the Americans With Disabilities Act (ADA) when it fired an employee whose wife incurred significant medical expenses as the result of a liver transplant." (Thompson Publishing Group)

Woman Sues Employer Over Lack of Contraception Coverage
Excerpt: "A Seattle woman has filed an unprecedented lawsuit alleging that her employer, a local drug company, discriminates against female employees by not covering contraception in its health insurance plan, The Washington Post reported Saturday." (United Press International)

Opinion: Stop Blaming HMOs
Excerpt: "And yet, in our attempt to regulate and litigate HMOs and other health insurance plans into submission, we have once again side-stepped the two real U.S. health-care issues: the more than 40 million Americans who have little or no access to services and--election promises and contingency fees aside--that health-care resources are finite. Neither of these two issues are the HMOs' fault. In fact, quite the opposite is true." (Jonathan P. Weiner, in the Baltimore Sun)

Sample Letter Requesting Documents Used by HMO in Denial of Benefits
Excerpt: "Under ERISA, (29 CFR 2560.503-1(g)(1)(ii)) I have a right to copies of pertinent documents that [HMO] relied on in making its decision to deny my [Long Term Disability claim] benefits. I am hereby formally requesting copies of all such records used or referred to by, or influencing your in making that decision, including ..." (Health Administration Responsibility Project)

Your Kids Are Their Problem: Backlash from Childless Employees
Excerpt: "From where I sit, the increasing insistence by employees that employers accommodate their lives has been a welcome revolution ... Although things like flex time, telecommuting, adoption assistance and emergency day care are hardly ubiquitous, they are at least a part of the national conversation about what workers might need ... [But Elinor Burkett, author of The Baby Boon: How Family-Friendly America Cheats the Childless] sees ... examples of perks the childless are not getting." (New York Times; free registration required)

'Phased Retirement' Allows People To Ease Out Of Work
Excerpt: "According to a survey last year by benefits consulting firm Watson Wyatt Worldwide, 16 percent of 586 large companies offered phased retirement and another 28 percent were interested in starting a program in the next few years. With a shortage of skilled workers, a strong economy and a smaller generation coming on the heels of baby boomers, employers are eager to keep experienced employees from walking out the door and into retirement." (Baltimore Sun)

California HMO Will Cover Acupuncture Visits
Excerpt: "In addition to offering discount programs for complementary therapies, as some other health maintenance organizations do, Health Net's acupuncture and herbal supplements coverage allows members with HMO benefits to self-refer to an acupuncture provider for up to a $15 co-payment, depending on the plan." (New York Times Syndicate)

Stronger Ties Needed Between Employers, Managed Health Care Providers
Excerpt: "Faced with rising health care costs and growing dissatisfaction among workers, employers must become more active managers of their health plans if they want to address both issues. That's the message of a new national survey of 175 large employers, conducted by Watson Wyatt consultants. Employers can achieve both cost savings and improved satisfaction by developing longer and stronger relationships with their health plan and providers, the report concludes." (Medscape; free registration required)

Florida Warns Eager-Beaver Health Plans
Excerpt: "Current Florida law guarantees sole proprietors ... and other businesses with up to 50 employees the right to buy a small-group health plan year-round, regardless of their health history--a practice known as 'guaranteed issue.' That will change next summer [when an open enrollment system becomes effective]. Open enrollment is a brief, specified period of time annually when eligible individuals and businesses have the right to buy a health plan regardless of their health." (insure.com)

Plaintiffs' Health Lawyer: Fight Back and Win!
Excerpt: "Legal tips to follow if your claim is denied." (William Shernoff Esq., published by Health Administration Responsibility Project)

Opinion: Time to Rethink Healthcare 'Reform'
Excerpt: "In the current health care debate the media have decided that the 'reformers' are those who support a larger government role, such as the advocates for a patients' bill of rights or single-payer universal health insurance. Because there can be only one anointed reform position, anyone who disagrees with these proposals or offers alternative solutions is tagged as a defender of the status quo, or worse yet, a pawn of special interests. Wrong." (Boston Herald)

Experts Urge Congress to Ban Genetic Discrimination in the Workplace
Excerpt: "Further progress on the Human Genome Project could be jeopardized unless Congress makes it illegal for insurers and employers to discriminate on the basis of genetic information, the project's director told a Senate Committee on Thursday." (Medscape; free registration required)

Patient Advocates Warn New Massachusetts HMO Law May Not Fit the Bill
Excerpt: "One of the toughest HMO laws in the nation took effect in Massachusetts [on Friday, July 21, 2000], but patient activists warned the long-awaited 'patients bill of rights' could be sapped by weak rules implementing it. Advocates took their cue from Gov. Paul Cellucci, who praised lawmakers yesterday for sending the bill to him but said it 'might be a little excessive.'" (Boston Herald)

(Following also appears in Retirement Plans Edition)

Opinion: Adobe's Warnock Benefits From Weak-Kneed Moments
Excerpt: "The way I see it, Adobe Systems Inc.'s chief executive, John E. Warnock, is a man of little faith in his company. Ironically, his excellent performance has proven him wrong. Still, it would be nice if he would return the $2.8 million in extra stock option profits he has accumulated -- profits that were predicated on his lack of faith." (Graef Crystal, on Bloomberg.com)

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