Welfare Plans Edition
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October 4 - 5, 2000
Court Rejects IRS's Proposed Cafeteria Plan Rules Regarding Reimbursement From An FSA
Excerpt: "An IRC Sec. 125 flexible spending account (FSA) was required to reimburse an employee for amounts actually paid for health care expenses in a plan year, even though the medical services that gave rise to the expenses took place during the prior plan year. This ruling by the U.S. District Court for the Southern District of Indiana in Grande v. Allison Engine Company." (Spencernet)
Reasonably Average Man Standard? Group Policy to be Interpreted in "Ordinary, Popular Sense"
Excerpt: "We believe the average person would not under- stand the term 'tissue transplant' to encompass [high dose chemotherapy with peripheral stem cell rescue], because she would not understand stem cells to be 'tissue.' Instead, the average person would focus on the fact that stem cells in this procedure are a component of the patient's blood." (United States Court of Appeals for the Ninth Circuit)
Domestic Partner Benefits Proposed for Hennepin County Minnesota Employees
Excerpt: "Hennepin County Commissioner Peter McLaughlin wants to provide same-sex domestic-partner benefits to the county's 11,000 workers and is seeking a change in state law to make that possible." (StarTribune.com)
Concord CA Considers Domestic Partner Benefits
Excerpt: "A decade ago, Concord was ground zero for anti-gay legislation. From being the first city in the nation to overturn a law barring discrimination against people with AIDS to refusing to acknowledge Gay Freedom Week, the city got a national reputation for its inhospitality toward homosexuals." (San Francisco Chronicle)
Supervisors Hold Firm on Domestic Partners' Benefits Vote
Excerpt: "Despite pleas to rescind a vote granting benefits for the gay and unmarried partners of county employees, the Board of Supervisors on Tuesday refused to back down from a decision that one supervisor called 'fair and just.'" (Los Angeles Times)
6th Cir.: Insured May Have Changed Beneficiary Under "Undue Influence" Common Law Doctrine
Excerpt: "The Sixth Circuit U.S. Court of Appeals has ruled that an insured may have changed the designated beneficiary of his life insurance benefits as a result of "undue influence." The ruling came in Tinsley v. General Motors Corporation and Metropolitan Life Insurance Company." (Spencernet)
Medical Saving Accounts Program Never Fulfilled Its Promise
MSA (Knight-Ridder / Tribune, via International Foundation of Employee Benefit Plans)
Most Insurers Will Cover Abortion Pill
Excerpt: "Most insurers and pharmacy benefit managers say they will cover the newly approved RU-486 abortion pill, but they are leaving it up to employers to decide whether to extend the benefit to their employees." (insure.com)
Coverage Can Be Tailored to Suit Workers, Employers
Excerpt: "Consumer-choice health purchasing groups split costs between owners and employees, let create plans that meet their needs.... Health insurers aren't ready to say so publicly yet, but they know that the cost-containment benefits of managed care have just about run their course.... The good news [is] something relatively new to the insurance industry but not widely known among employers--consumer-choice health purchasing groups, or CHPGs, of which two now operate in California." (Los Angeles Times)
Spending on Health Care -- A Three-Decade Perspective on Current Costs
Excerpt: "For employers struggling to evaluate their own health costs, the historical perspective may offer some context of the overall health market for using more recent data to compare and project employers' health costs." (Deloitte & Touche)
Massachusetts Voters to Decide on Universal Healthcare
(DrKoop.com)
HMOs Under Pressure from States to Speed Payment of Claims
Excerpt: "Doctors, hospitals and other providers in California might find that health plans that have been the slowest and most inadequate in paying claims suddenly are among the first to put checks in the mail. Lawmakers recently passed a bill that would allow the state to make plans with a pattern of slow payment pay future claims within a shorter time span than mandated for other plans. Under California's current prompt-pay law, HMOs have to pay or deny claims within 45 days ..." (Managed Care Executives Online)
Pittsburgh-Area Health Insurance Firm Drops Controversial Flat Fee Compensation Plan
Excerpt: "Under the compensation plan that was abandoned, Highmark would have begun making flat payments to cover each patient that a specialist treated. The payments would have varied with the patient's diagnosis. Currently, the specialists receive fees for each service they provide." (Knight-Ridder / Tribune)
(Following also appears in Retirement Plans Edition)
EEOC Publishes Compliance Manual on Employee Benefit Plans
Excerpt: "The section provides guidance and instructions for investigating and analyzing issues [under ADEA, the ADA, Title VII of the Civil Rights Act of 1964 or the Equal Pay Act] ... with regard to life and health insurance benefits, long-term and short-term disability benefits, severance benefits, pension or other retirement benefits, and early retirement incentives.... [A]ll employee benefits must be provided in a non-discriminatory manner unless a statutory exception provides otherwise." (Equal Employment Opportunity Commission)
Court-Approved Plan Language Seeks To Guarantee Safe Harbor for Sponsor Discretion
Excerpt: "[T]he U.S. Court of Appeals for the Seventh Circuit laid down safe harbor language for SPD deferential standard of review [in] Herzberger v. Standard Insurance Co.... The issue was whether language in plan documents to the effect that benefits shall be paid when the plan administrator upon proof (or satisfactory proof) determines that the applicant is entitled to confers upon the administrator a power of discretionary judgment..." (Corbel)
Chart of Currently Pending Employee Benefits Issues in Washington
Describes issues, bill numbers, and status. Nice! (Deloitte & Touche)
| Implementation Specialist | for Towers Perrin - Benefit Administration Services in NJ, PA |
| 401(k) Consultant | for Louis Kravitz & Associates, Inc. in CA |
| Senior Compliance Specialist | for Putnam Investments in MA |
| Employee Benefits Tax Manager/Senior Manager | for Deloitte & Touche, Leading Professional Services Firm in MN |
| Trust Administrator | for Fifth Third Bank, Kentucky, Inc. in KY |
| CONVERSION SPECIALIST | for TEAMVEST - CHARLOTTE in NC |
| Senior Benefit Plan Analyst | for Marriott International, Inc. in MD |
| Part Time Defined Contribution Administrators | for Ceridian Retirement Plan Services in CO |
| Retirement Administrator | for Delaware Investments in PA |
| Daily Valuation Administrator | for WESPAC Plan Services, Inc. in CA |
| Senior Paralegal- Retirement Consultant | for William M. Mercer in NY |
| Defined Benefit Conversion Programming Specialist | for New York Life Benefit Services LLC in MA |
| Defined Benefit Conversion Specialist | for New York Life Benefit Services LLC in MA |
| Director of TSA Sales | for Security Benefit Group of Companies - Topeka, KS in KS |
| Compliance Administrator | for The Vanguard Group in PA |
| Operations Manager | for Summit Bank in NJ |
| HR Generalist | for Hewitt Associates in IL |
| Pension Plan Administrator | for Thomas F. Barrett, Inc. in MD |
| Defined Contribution Account Administrator | for The Vanguard Group in PA |
| ERISA Attorney | for Watson Wyatt Worldwide in OH |
| Trust Account Manager (Employee Benefits) | for The Northern Trust Company in IL |
| Nonqualified Plan Account Manager | for Benefit Plan Services, Inc. in GA |
| Regional Account Representative | for Insurance Company Providing 401(k) and Other Retirement Plans in TX |
| Assistant Benefit Consultant | for Buck Consultants, Inc. in NJ |
| Legal Assistant II - ERISA | for American Century Investments in MO |
| ERISA - Benefits Attorney | for William M. Mercer in NY |
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