Welfare Plans Edition
October 23, 2000
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7th Cir.: No ERISA Preemption of Illinois Law Requiring Independent Review of HMO Claim Denials
Moran v. Rush Prudential HMO (7th Cir., 10/19/2000). Excerpt: "Posner, Circuit Judge, with whom Circuit Judges Coffey, Easterbrook, and Diane P. Wood join, dissenting from denial of hearing en banc. This case is well worth the attention of the full court. The panel's decision creates a square conflict with another circuit, is very probably unsound, and will affect an enormous number of cases." (United States Court of Appeals for the Seventh Circuit)
IRS Info Letter: Kindergarten is Not an Eligible Employment-Related Expense for Dependent Care
Excerpt: "The IRS confirmed that only expenses that are primarily for custodial care qualify for the credit, and that kindergarten expenses are generally for education, not custodial care." (EBIA Weekly)
Whether Costs of Purchase and Adaptation of Vehicles for Disabled are Medical Expenses
Henderson v. Commissioner, T.C. Memo 2000-321 (2000). Excerpt: "This decision provides some guidance for administrators deciding whether to pay health FSA claims for purchase and adaptation of vehicles for use by handicapped persons." (EBIA Weekly)
Self-Insured Health Plan's Exclusion of Fertility Treatment Coverage Did Not Violate ADA
Excerpt: "On the merits, the court held that the plan's exclusion of surgical impregnation did not violate the ADA because it provided the same insurance coverage to all employees. 'It does not offer infertile people less pregnancy and fertility-related coverage than it offers to fertile people.'" (EBIA Weekly)
Inspector General Report: Tough Penalties Needed For Data Match Noncompliance
Excerpt: "The Health Care Financing Administration should be more aggressive in punishing employers who refuse to comply with the Data Match program's request for information about employees who are covered under both Medicare and another plan, according to a report from the U.S. Department of Health and Human Services' Office of Inspector General." (Thompson Publishing Group)
The Health Care Consequences of Smoking and its Regulation
Link to a Working Paper available for downloading from the National Bureau of Economic Research. Excerpt: "This paper extends the literature by examining whether cigarette tax increases lead to lower health care costs." (National Bureau of Economic Research)
Drug Benefits Costs to Jump 20% in 2001
(Medscape; free registration required)
Law Requires Inmates to Chip in for Healthcare
Excerpt: "Federal prison inmates who have money will have to pay part of the cost of their doctor visits under legislation signed by President Clinton." (DrKoop.com)
A Discussion About Excess Loss Coverage
Excerpt: "The excess loss market has noticeably tightened this year. Stop-loss carriers are fussier about accepting new business and are scrutinizing claims like never before. We discussed aspects of the excess loss market with Bob Baisden, president, International Assurance of Tennessee, Inc. (IAT), a managing general underwriter based in Franklin, Tennessee." (Sungard Corbel)
Europe's Cheaper Rx for Health
Excerpt: "As the U.S. presidential candidates debate reforming Medicare, similar systems in France and Italy top a U.N. survey. Apart from their cost, their most important difference is offering citizens freedom from uncertainty." (Los Angeles Times)
Enhancing Employer-Sponsored Health Coverage: State and Community Efforts (Audio Presentation)
(Alliance for Health Reform)
Survey: Hatred of HMOs May Be Based In Part On Biases
(Modern Healthcare)
Another Question is Answered in the Cafeteria Plans Q&A Column
If an employee has unused money in a dependent care assistance plan (DCAP) at the end of a plan year, will the employee be taxed on the unused money in that account that is forfeited? (BenefitsLink.com)
(Following also appears in Retirement Plans Edition)
EFAST-C: EFAST Participant Acceptance Testing Procedures (PDF)
October 6, 2000; 12 pages. (U.S. Department of Labor)
EFAST-B: Elec/Mag Media File Specs for Validation Criteria for Forms 5500 and 5500-EZ for 1999 (PDF)
October 6, 2000; 196 pages. (U.S. Department of Labor)
| Pension Administrator | for Ingham Group, 401(k) & Retirement Plan Service Provider (Coral Gables) in FL |
| Executive Compensation & Benefits Consultant | for Clark Bardes Consulting/Compensation Resource Group, Inc in CA, DC, GA, IL, NY, OH, TX |
| Director Product Development | for Emplanet in MA |
| Marketing Assistant | for Investment/Financial Firm in TX |
| Vice President of Sales | for The GlobalQuest Group in ALL STATES |
| ERISA Employee Benefits Lawyer | for Lawson & Fields P.C. in TX |
| Plan Consultant | for Diversifed Investment Advisors in NY |
| 401(k)/Pension Administrator | for Great Lakes Pension Administrators, Inc. in MI |
| 401(k) / Retirement Plan Administrator | for Sentinel Benefits Group, Inc. in MA |
| Retirement / Health & Welfare Actuarial Sr. Consultants | for Unifi Network/PricewaterhouseCoopers in GA, IL |
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