Welfare Plans Edition
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September 26, 2000
Employer Was Proper Defendant on Severance Claim Although Board of Managers Was Plan Administrator
Excerpt: "[M]any skirmishes over the identity of the proper parties to a lawsuit are little more than litigation tactics. But a case like this one, in which the litigants can seriously argue that the ERISA plan itself is not a proper party, demonstrates the rather confused state of the law regarding who is the ERISA plan administrator and who can be a proper defendant in an ERISA benefits lawsuit." (EBIA Weekly)
3d Circuit Dismisses RICO Claims Against Aetna And Its 24 Subsidiary HMOs
Excerpt: "The Third Circuit U.S. Court of Appeals has dismissed a class action lawsuit alleging that Aetna and 24 of its regional subsidiary health plans violated the Racketeer Influenced and Corrupt Organizations Act (RICO) by failing to disclose its internal policies regarding physician incentives and other practices. The case is Maio, et al. v. Aetna, Inc., et al." (Spencernet)
6th Cir.: ERISA Did Not Preempt Kentucky's "Any Willing Provider" Statutes
Excerpt: "The Sixth Circuit U.S. Court of Appeals has ruled that ERISA did not preempt the state of Kentucky's 'any willing provider' laws because the statutes were saved from preemption as laws that regulate insurance. The ruling came in Kentucky Association of Health Plans, Inc., et al. v. Nichols." (Spencernet)
Achieving A Balance: Meeting Work And Family Obligations (PDF)
Excerpt: "In response to Congressional concern that agencies are not making family-friendly workplace arrangements available to employees, the Office of Personnel Management (OPM) reviewed these programs ... Family-friendly programs studied included: part-time employment, job sharing, telework, alternative work schedulesCflexible and compressed, resource and referral services for child and elder care, and on-site or near site child care centers." (U.S. Office of Personnel Management, Office of Merit Systems Oversight and Effectiveness)
A New Solidarity: Unions Look to Pick Up Members During Dot-Com Shakeout
Excerpt: "'If you read some recent headlines, a lot more dot-com companies are starting to lay off workers,' [AFL-CIO spokesman Ed] Sills said. 'The day of unlimited prosperity seems to coming to an end for some of these. And that's the point where it's more likely that workers will start looking at the hours they worked and the stock options that are now worthless.'" (San Jose Mercury News)
Company Shares $18 Million With Employees
Excerpt: "Many bosses say they value their employees. Charlie Butcher backed up his words last week with a grand gesture, distributing $18 million among 325 workers after selling the floor-care products and cleaning supplies company his family had owned for 120 years. 'It was like Christmas on Tuesday,' said Cindy Hanam, human resources manager of The Butcher Co., which is headquartered in Marlboro, Mass." (Las Vegas Sun)
Internet Workforce Compensation Study 2000
(TheStandard.com)
"Critical Condition" -- PBS Special on October 18 Will Address U.S. Health Coverage, Quality
Excerpt: "More than 100 million Americans are chronically ill — How are health plans handling them?" Includes a "companion web site" intended to be "a patient-friendly source crammed with useful information for the health care consumer. It digs in detail into the issues of health care that are most important to patients and their families: quality, access, insurance coverage, and different kinds of health plans." (PBS.org)
It's Prudent to Check Up on Your Health Plan
Excerpt: "For information on whether a health plan (or provider) is accredited, rated or reviewed, you may contact the plan itself, your state's insurance department, or contact these organizations ..." (Neil Downing, in the Providence Journal)
American Benefits Council Membership Survey (PDF)
Excerpt: "From the perspective of members of the American Benefits Council, there are opportunities to improve both the quality and accuracy of policy discussions about the employer-sponsored benefits system. They believe Congress is receptive to, though not necessarily well informed about, issues related to employer-sponsored benefits. They are also concerned about the accurate and fair presentation of benefits policy issues in the media." (American Benefits Council)
Managed Care and the Imperative for a New Professional Ethic
Excerpt: "In this paper David Mechanic argues ... that medicine is being pulled in one direction by members of the old guard, who rail against managed care and its effects on traditional notions of medical professionalism, and in another by broader trends that call out for a new professional ethic that takes account of a broader set of responsibilities for physicians." (Medscape; free registration required)
Who Really Wants Price Competition in Managed Care?
Excerpt: "There is much policy talk about making Medicare more competitive, like private markets. But when reform proposals near implementation, local opponents of competition are often able to stop reform experiments. This paper reports on one recent example, the Competitive Pricing Advisor Committee, created by the 1997 Balanced Budget Act (BBA) to bring competitive bidding to Medicare+Choice plans." (Medscape; free registration required)
Opinion: Ghastly Gore-Care
Excerpt: "My purpose in writing is not to be self-indulgent or elicit sympathy, but to send a warning that Vice President Al Gore's constant disparagement of America's health care system threatens to destroy the greatest health care system in the world. The dirty little secret is that the vast majority of Americans receive the health care they need, when they need it, whether or not they can afford insurance." (Washington Times)
Opinion: Gore's Aims, Lieberman's Record At Odds on Prescription Drug Issue
Originally published August 27, 2000. Excerpt: "Lieberman has accepted more campaign money from insurance companies in the current election cycle than any other senator, and has taken the third-highest amount of drug company contributions, according to the Center for Responsive Politics." (Boston Globe)
Opinion: On Two Big Issues - Spending and Health Care - Democrats are Strong
Excerpt: "Managed care has entered the popular culture as a term of abuse. Last week's New Yorker magazine ran a cartoon of a campfire at a girls' summer camp, with the counselor saying, 'Very scary, Jennifer-- does anyone else have an HMO horror story?' The Republicans, with close ties to the insurance and pharmaceutical industries, have managed to put themselves on the unpopular side of this issue." (Boston Globe)
Prescription Drugs, Patients Rights Bills Not Likely to Become Law This Year
Excerpt: "... the White House has shown no interest in a modest, Senate-passed Republican HMOreform bill that would widen access to emergency room care but permit patient suits only after an independent review, while still disallowing punitive damages and class-action claims. On prescription drugs, a GOP House-passed measure to provide limited subsidies to the poorest elderly for buying private coverage has been pronounced dead by its sponsors." (StarTribune.com)
Healthcare Emerges on Top in Presidential Election Battlegrounds
Excerpt: "In a new national poll by the Pew Research Center, nearly two-thirds of voters say they're very concerned about affording care when a family member gets sick, up from 58 percent a year ago. Those who expressed concerns are firmly in Gore's camp. Nearly one-third of voters in Illinois, Michigan, Ohio and Pennsylvania cited 'making quality health care accessible to everyone' as their top issue in a recent poll. Education was a distant second." (DrKoop.com)
HCFA Issues Guidance on Eligible Individuals Under HIPAA's Individual Market Rules
Excerpt: "This Program Memorandum clarifies HCFA's position that the following types of coverages are recognized as coverage under a group health plan for purposes of determining who is an eligible individual entitled to guaranteed-issue coverage ... This Program Memorandum does not break new ground, although it is helpful to see HCFA's position formally clarified." (EBIA Weekly)
HCFA Issues Guidance to Insurers Offering Coverage in Small Group Market
Excerpt: "This Program Memorandum reflects the prevailing view on how ERISA preemption would effect inconsistent state laws related to small group markets." (EBIA Weekly)
Eyes Are On New California HMO Regulatory Agency
Excerpt: "Early next month, Daniel Zingale will mark his 100th day in office as head of a new state agency charged with policing HMOs and protecting the nearly 23 million Californians who belong to such plans. The task in front of him is a daunting one. Polls show that public dissatisfaction with HMOs still runs high." (Los Angeles Times)
Family Circle/Kaiser Family Foundation Survey on Health Care and Other Elder Care Issues
Excerpt: "... 43% say they feel they know next to nothing or nothing at all about health insurance to help their parent and 45% of those who say their parent has a regular doctor say they do not know who that doctor or health care provider is. The survey also found a lack of knowledge about Medicare, the primary health insurance program for those 65 and older, and about Medicaid, which is an important source of supplemental and long-term care coverage for low-income seniors." (Henry J. Kaiser Family Foundation)
Hawaii Gives State Workers Long-Term Care Program
(National Underwriter Company)
Another Question is Answered in the HIPAA Q&A Column
I represent a non-federal governmental employer. The employer has a fully-insured, stand-alone, limited scope dental plan and a self-insured, stand-alone, limited scope dental plan. Are either or both plans subject to the coverage or certification requirements of HIPAA? (BenefitsLink.com)
(Following also appears in Retirement Plans Edition)
New issue online of the Pension & Benefits Update email newsletter by Tax Analysts: 9/25/2000
(Tax Analysts, Inc.--see www.taxbase.org)
Advocacy Organization Reports Number of Companies Offering Domestic Partner Benefits Is Up 25%
Excerpt: "The firms that offer these benefits include more than 100 companies on the Fortune 500 list, a 46 percent increase over the previous 12-month period for that group, according to the HRC, the largest homosexual political organization in the United States." (Boston Globe)
FASB Emerging Issues Task Force September Agenda Appears Clear of Nonqualified Plan Items
Excerpt: "... the September (fall) agenda of the Emerging Issues Task Force (EITF) appears clear of any items that would directly impact on nonqualified deferred compensation plans." (Magner Financial Network)
Graef Crystal: Executive Pay Hall of Shame & Fame Class of 2000
(Graef Crystal, on Bloomberg.com)
| Balance Forward Allocation Specialist | for The Nyhart Company, Inc. in IN |
| Manager of Marketing Intelligence and Research | for INVESCO Retirement and Benefit Services in GA |
| Defined Benefit Plan Administrator | for The Nyhart Company, Inc. in IN |
| Defined Benefit Best Practices Leader | for Hewitt Associates in IL |
| Plan Consultant | for Transamerica Insurance and Investments - The Winning Organization in CA |
| 401(K) Employee Benefits Consultant | for Fidelity Investments in ALL STATES, TX |
| 401(k) Plan Administrator | for Polycomp Administrative Services, Inc. in CA |
| Benefits Auditor | for Boston Scientific Corporation in MA |
| Pension Plan Services Consultant | for American United Life Insurance Company in IN |
| Compensation and Benefits Manager | for KPMG in CO, TX |
| Client Service Consultant | for Diversified Investment Advisors in NY |
| Retirement Consultant | for Invesmart - Cleveland Office in OH |
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