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The BenefitsLink Newsletter -
Welfare Plans Edition

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July 25, 2000

Interim Regulations on Cafeteria Plan for Federal Employees
Excerpt: "The Office of Personnel Management (OPM) has issued Interim Regulations that enable federal employees who participate in the Federal Employees Health Benefits (FEHB) Program to pay their health insurance premiums, for the first time, with pre-tax dollars under a cafeteria plan." (EBIA Weekly)

New Legislation Creates Protected Status Under Certain State Insurance Laws for Church Welfare Plans
Church Plan Parity and Entanglement Prevention Act of 1999. Excerpt: "Congress has acted to protect church welfare plans from being treated as insurance companies under state insurance law. Furthermore, under the Act, a church welfare plan will be deemed to be sponsored by a single employer rather than by a multiple employer arrangement." (EBIA Weekly)

9th Cir: Administrator Failed to Apply Plan's Definition of "Disability" in Claim for Benefits
Excerpt: "This case amplifies the need to read a plan's definitions (such as 'disability') carefully and to apply the correct definition in denying benefits. In addition, DOL regulations require that claim and appeal denial letters must cite the plan provisions on which any denial is based." (EBIA Weekly)

Death Caused by Intoxicated Driving Was Not Covered by AD&D Plan
Excerpt: "The issue in this case was whether the insurer for an employer-sponsored accidental death and disability (AD&D) plan was required to pay benefits to the beneficiary of a participant who was killed in a one-car accident. At the time of the accident, the participant had a blood alcohol level four times the legal limit." (EBIA Weekly)

Daryl Cagle's Collection of Editorial Cartoons on Health Care
(Daryl Cagle, Cartoonist)

Life on the Hill for Healthcare Lobbyists, Including Karen Ignagni of the AAHP
June 2000 cover story. Excerpt: "Washington doesn't merely represent a regulatory and legislative challenge. The government is also, of course, healthcare's biggest customer--spending hundreds of billions of dollars annually through Medicare, Medicaid and various other health entitlement programs. Set against this backdrop are the healthcare folks on the frontlines, the men and women who advocate for their corner of the healthcare universe--the healthcare lobbyists." (HealthcareBusiness)

New Virginia Commission Handles HMO Complaints from Insureds
Excerpt: "The program, which has not yet handled its first case, offers an alternative to consumers who tangle with their managed care company over whether a medical procedure is necessary or covered. Although many insurers will review denials of coverage at the consumer's request, the company's word is final, even if a doctor says the procedure should be covered." (Knight-Ridder / Tribune Business News)

(Following also appears in Retirement Plans Edition)

HR-XML Consortium Works to Standardize Payroll Transactions
Excerpt: "Payroll Providers Invited to Participate in Standardization Effort" (HR-XML.org)

Subscribe to the Retirement Plans Edition, too (click)
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