The BenefitsLink Newsletter -
Welfare Plans Edition
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September 14, 2000
Recent Case Forces a Fresh Look At Retiree HMO Plans and Medical Benefits
Excerpt: "A recent case raises troubling questions about an employer's ability to provide different retiree medical benefits to various classes of retirees. In particular, it challenges the common practice of offering Medicare-eligible retirees only an HMO option while offering younger retirees a wider range of health care options." (Kilpatrick Stockton LLP)
Texas Regulators Lose Case Against HMO -- Denial of Care Was ERISA-Preempted Coverage Issue
Excerpt: "A federal judge delivered a blow Tuesday against Texas' effort to exert more regulatory authority over HMOs ... [ruling that]a UnitedHealthcare medical director's decision on treatment for a 13- year-old boy was a benefit decision [regulated by ERISA]. 'We're pleased the court reached the decision it did ... coverage decisions made by medical directors are governed by federal laws and not state regulators or agencies,' said David Lubben, general council of UnitedHealth Group." (Fort Worth Star-Telegram)
Costs, Employer Misperceptions Affect Health Care Coverage At Small Companies, Survey Finds
Most State Insurance Departments Underfunded
HIAA Supporting State and Federal Long-Term Care Insurance Consumer Protections
(Health Insurance Association of America)
(Following also appears in Retirement Plans Edition)
Another Question is Answered in Our ERISA Q&A Column
Are there rules in ERISA with respect to an employer's obligation to respond within a certain time frame to an employee's inquiries about benefit-related issues (incorrect coverage category, payroll refunds, etc.)? (BenefitsLink.com)
Employee Inquiry Is Key to Employer's Fiduciary Disclosure Obligation, Court Rules
Excerpt: "An employer is required to provide 'complete and truthful information' about potential plan changes if a plan participant inquires about these changes, but the employer is not required to volunteer this information prior to final adoption of new provisions, according to a recent ruling by the full 9th U.S. Circuit Court of Appeals. The case is Bins v. Exxon Company U.S.A." (Thompson Publishing Group)
Blair Brininger's Summary of Principal ERISA Cases in the U.S. Courts of Appeal - June 2000 Update
(Blair Brininger, P.C.)
PWBA Seeks Public Comment on ERISA Fiduciary Duty to Disclose -- More Regs, Laws Needed?
Excerpt: "This document requests information from the public concerning disclosure obligations of fiduciaries of employee benefit plans governed by ERISA ... [particularly] the effect on employee benefit plans and employers of recent rulings of the United States Supreme Court and federal circuit courts regarding the extent of an ERISA fiduciary's duty to disclose information to participants and beneficiaries in addition to the specific disclosure requirements imposed under ERISA." (U.S. Department of Labor)
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