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Welfare Plans Edition


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August 3, 2000

E.D. Pa.: Whether Arrest Constituted Gross Misconduct for Purposes of COBRA Was a Question for Trial
Excerpt: "The plaintiff, a teacher, was charged with criminal sexual assault against a former student. The charges were later dismissed. The plaintiff was fired and brought suit against the school district for, among other things, penalties related to a failure to provide a COBRA election notice." (EBIA Weekly)

Participant Entitled to Medical Coverage Despite Employer's Failure to Pay Health Insurance Premiums
McFadden v. R&R Engine & Machine Co. (N.D. Ohio 2000). Excerpt: "This case involved a group health insurance policy that was retroactively canceled due to an employer's late payment of premiums.... A former employee, whose significant medical costs for cancer treatment were not covered as a result of the policy's cancellation, sued the ex-employer, claiming that the employer breached its fiduciary duty when it failed to timely forward the premium payments." (EBIA Weekly)

Limitations Period for ERISA Disability Claim is Based on State Contract Law, Not Insurance Code
Wetzel v. Lou Ehlers Cadillac Group Long Term Disability Insurance Program (9th Cir. 2000) (en banc). Excerpt: "The trial court dismissed ... on statute of limitations grounds, looking to a California Insurance Code provision that required a disability policy to contain certain claims language, which, in turn, required a covered individual to bring a lawsuit for disability benefits within three years after the written proof of loss was required to be furnished." (9th Circuit Case, reported in EBIA Weekly)

American Health Care and the Law-- We Need to Talk!
Excerpt: "Duke University's Clark Havighurst describes the evolution and current confused state of the law governing the health care enterprise and its directions. Important changes in health care law often occurred more by chance than by design, and policy incoherence is the rule rather than the exception. Moreover, a single entity exercising plenary authority over health care law and policy, the legal system cannot easily set a constant, clear, or wisely charted course." (Medscape; free registration required)

Association of American Physicians and Surgeons Position Paper on Genetic Testing
Excerpt: "Medical tests can now identify genetic traits in people not showing symptoms or external signs. Some of these conditions can produce disease later in life, or in some offspring. In the context of risk assignment for health insurance, these genetic tests have recently become controversial. AAPS finds that genetic testing is not fundamentally different from other tests or examinations used to assign people to insurance risk categories." (Association of American Physicians and Surgeons, Inc.)

(Following also appears in Retirement Plans Edition)

Base Salaries for 505 U.S. CEOs
Excerpt: "The following table lists base salaries for chief executives of the 500 largest U.S. companies by market value as of May 31, 2000 ..." (Graef Crystal, on Bloomberg.com)

Base Pay Distinguishes Risk-Taking CEOs
Excerpt: "A salary is the one component of pay that you'd think every chief executive would have. Bonuses and stock options may vary, but a cushy monthly paycheck seems as natural for the American CEO as an officious secretary and a country-club membership. Natural maybe, but no longer a given. Just as some CEOs are ditching their corner office for a democratic cubicle, others are abandoning the idea of a base salary." (Graef Crystal, on Bloomberg.com)

Gimme, Gimme! Dealing With Some Workers' Entitlement Mentality
Excerpt: "Many employees have come to regard benefits as a right. With costs soaring, employers are taking a hard look at how they can combat this entitlement mentality." (Benefits Canada)


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