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The BenefitsLink Newsletter -
Welfare Plans Edition

October 16, 2000
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Partners HMO Going Online-- Patients Can Access Own Medical Info on Web Site
Excerpt: "Partners of Indiana, a South Bend-based HMO, knows what test and treatments its members have received. It knows whether they've filled their prescriptions. Now the company is making that information--and treatment suggestions based on it--available to members in a private Web site. Partners has joined with California-based Resolution Health Strategies to use a Web site--www.wellpatient.com--to give its members access to their own medical information." (South Bend [Ind.] Tribune)

4th Cir.: Insurer Wrongfully Refused To Pay Death Benefits To Insured's Husband
Excerpt: "The Fourth Circuit U.S. Court of Appeals has ruled that an insurance company violated ERISA by wrongfully refusing to pay death benefits to a beneficiary's husband because the beneficiary was covered by the life insurance policy at the time of her death. The ruling came in Tester v. Reliance Standard Life Insurance Company." (Spencernet)

Full Plate of Fringe Benefits
Excerpt: "Employers are offering a soup-to-nuts array of non-traditional benefits to increase flexibility and choice for their workers." (Employee Benefit News)

Gore and Bush Health Proposals Fall Short of Counterparts' Plans 8 Years Ago
Excerpt: "The issue of the uninsured has flared anew in the presidential campaign, with a fierce exchange in the last debate and a new round of charges and countercharges about the Bush record in Texas." (New York Times; free registration required)

Seniors Choosing Work Over Retirement
Excerpt: "As early retirements, downsizing, computers and the Internet change the nature of work, policy makers and employers say it is hard to predict what role a growing pool of older workers will play in the economy. Telecommuting, automation of manufacturing processes, and globalization all are pieces of this still-incomplete equation." (Boston Globe)

Proposed Patient Bill of Rights in Congress Worries Small-Business Owners
Excerpt: "[Diane] Symms, owner and chief executive officer of the Lombardi's chain, joined more than a dozen other small-business owners and advocates at her Ballard restaurant yesterday to say medical lawsuits from employees would cripple them financially. At the least, the threat of lawsuits would discourage small businesses from offering health-care benefits at all, because increased liability increases insurance premiums, Symms said." (Knight-Ridder / Tribune)

Opinion: HMOs Give Big Money to Fight Massachusetts Universal Coverage Proposition
Excerpt: "Days after slamming seniors with a 320 percent price hike, Blue Cross and Blue Shield pumped nearly $500,000 into a political campaign aimed at halting plans for universal health coverage. The influx of cash into the 'No on 5 Coalition' followed a series of large contributions from Bay State HMOs that are slashing benefits, raising premiums and trying to stave off regulators who are keenly focused on the industry's shaky finances." (Boston Herald)

Representative Coburn Resumes Last-Minute Run for HMO Bill
Excerpt: "U.S. Rep. Tom Coburn launched a last-ditch effort Tuesday to break a congressional impasse on legislation designed to give patients more power over their managed care plans.... It appears that the compromise pushed by Coburn and Rep. John Shadegg, R-Ariz., first needs an endorsement by House Speaker Dennis Hastert, R-Ill., and other key players. Shadegg said Hastert supports their 'effort' but apparently not their proposal." (Tulsa World)

Opinion: How GOP Defused Democrats on Health Care Issues
Excerpt: "One of the most striking things about the political scene today is the apparent failure of Democrats to make much headway with what they clearly hoped would be a cutting edge issue: health care." (Detroit News)

Buyers and Nonbuyers of Long Term Care Insurance (10/12/2000 Powerpoint Presentation)
(Don Charsky, FSA)

Who Buys Long-Term Care Insurance In 2000? A Decade Of Study Of Buyers And Nonbuyers (PDF)
(Health Insurance Association of America)

Another Question is Answered in the COBRA Q&A Column
A COBRA premium payment was received from a payment processing center using an envelope that is presorted, first class mail, postage paid, with a permit number. These types of envelopes are not processed with a postmark. Is there any way to determine when premiums have been mailed on a timely basis under such circumstances? (BenefitsLink.com)

Another Question is Answered in the COBRA Q&A Column
A self-insured employer sends a COBRA notice to a qualified beneficiary (QB) indicating that the QB is eligible for 18 months of COBRA coverage. During the 18-month period, the employer realizes that it made a mistake and qualified the QB for up to 29 months of COBRA coverage. The new COBRA administrator has identified the error in communicating a COBRA extension to the affected QB. Does the employer have to offer the extended COBRA coverage? (BenefitsLink.com)

(Following also appears in Retirement Plans Edition)

E-Signatures: Don't Shred All The Paper Yet
Excerpt: "... while the business community has been clamoring for the legislation, its impact on human resource and benefits administrators is somewhat unclear." (Employee Benefit News)

9th Cir.: District Court Couldn't Order Embezzler to Pay Over His ERISA Plan Benefits
U.S. v. Jackson (9th Cir., 10/12/2000). Excerpt: "This case presents the question whether, as part of a criminal sentence, a district court may order that undistributed funds from a pension plan covered by the Employee Retirement Income Security Act (ERISA) be used to make immediate payment of restitution. We hold that unless the crime involved the ERISA pension plan in question and restitution is ordered to that plan, undistributed funds are not available for such payment." (FindLaw.com)

Plan Not Required to Inform Claimant of Right to Review Pertinent Documents During Benefit Appeal
Simpson v. Ameritech Corp., Inc. (E.D. Mich. 2000). (EBIA Weekly)

Employer's Error on Benefit Statement Does Not Create Estoppel or Fiduciary Breach Claims
Hofsas v. Montgomery Hosp. Medical Ctr. (E.D. Pa. 2000). (EBIA Weekly)

Supreme Court Denies Review Of Two Employee Benefits Cases
Excerpt: "The U.S. Supreme Court has denied a petition to review the decision of the Sixth Circuit U.S. Court of Appeals in Western Atlas, Inc. v. Pennington ... In that case, the Sixth Circuit upheld a jury award in the total amount of $483,092 in favor of two plaintiffs who were terminated by their employer in violation of ERISA. Separately, the Court denied a petition to review the decision of the Seventh Circuit U.S. Court of Appeals in Gallegos v. Mt. Sinai Medical Center." (Spencernet)

Insurers Watch Two Cases Before High Court
Excerpt: "[T]wo cases now pending before the United States Supreme Court ... could have a significant impact on the [life insurance] industry. [In the Egelhoff v. Egelhoff case], which will be decided during the court's 2000-2001 term, ... [the] specific issue is whether a Washington state law that automatically revokes entitlement of a former spouse to plan benefits upon divorce, even though the former spouse remains the named beneficiary, is preempted by ERISA." (National Underwriter Company)

Job Openings Newly Posted or Reposted on EmployeeBenefitsJobs.com

401(k) Client Account Managerfor New York Life Benefit Services LLC
in MA
Client Relationship Managersfor Leading Search Firm
ERISA Attorneyfor Riordan & McKinzie
in CA
Pension Systems Supervisor - Palm Beach Gardens, Floridafor Philips Electronics - Personal Access Center for Employees (PACE)
in FL
Pension Plan Administratorfor The Angell Pension Group, Inc.
Total Benefit Outsourcing Project Managerfor Unifi Network a division of PricewaterhouseCoopers
in NJ
Benefits Adminstrator - Walnut Creek, CAfor Brown and Caldwell
in CA
Benefits Supervisorfor Jet Propulsion Laboratory
in CA
Benefits Accountantfor Catholic Archdiocese of Seattle
in WA

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