Welfare Plans Edition
January 5, 2001
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Supreme Court Will Not Hear ERISA Preemption Case re Subrogation Rights
Excerpt: "The Supreme Court backed out of deciding whether health-care plans can sue to enforce some plan requirements. The court dismissed a California dispute over health benefits paid to a man severely injured in a car accident. The case was dismissed Tuesday on request of both sides in the case under a rule generally invoked when a case has been settled." (Associated Press, via Excite!)
ERIC Amicus Brief Asks Supreme Court to Reconsider and Reverse 3d Circuit Erie Case (PDF)
From ERIC's web site: "ERIC filed January 3, 2001 a brief amicus curiae ... in Erie County vs Erie County Retirees' Association. ERIC's brief argues that retirees are not and were never intended to be covered by the Act. Moreover, ERIC argued, the employer in Erie was not making a distinction on the basis of age but legitimately on the availability of an alternative source of health insurance not available to younger retirees." (ERISA Industry Committee)
Benefit Costs for Private Employers Jump Six Percent in 2000
Excerpt: "Private employers' benefit costs increased by a dramatic 6 percent during the one-year period ended in September 2000, according to the Bureau of Labor Statistics' most recent version of its Employment Cost Index (ECI). Wages and salaries paid by private employers grew by 4.1 percent over the same one-year period." (Deloitte & Touche)
Disease Management Targeting Is Key to a Cost-Effective Program: A Case Study
Excerpt: "A client developing Disease Management services knew that to distinguish its product it needed to develop more cost-effective interventions to manage chronically ill patients ... [we] recognized that the low cost-effectiveness ratio in disease management programs is due not to the significant expense of many interventions, but rather to inefficient attempts to manage all patients. A successful program must be able to predict those patients at high risk for future poor outcomes ..." (Deloitte & Touche)
More Big Companies End Perks; Critics Say Cutbacks Sap Morale
Excerpt: "The trend, which surfaced among struggling dot-coms last year, is now spreading among bigger businesses. Aetna Inc., the nation's biggest health insurer notified approximately 4,000 staffers in Bluebell, Pa., Wednesday that they must pay for their currently free coffee and tea after Feb. 2-- a move expected to save $400,000 a year." (Wall Street Journal)
Resource Site: Long-Term Care Insurance for Federal Employees
Excerpt: "With President Clinton's signing of the Long-Term Care Security Act during a White House ceremony on September 19, long-term care insurance became a reality for federal workers, members of the military, retirees and their families. It is the first new benefit offered to federal employees since the inception of the Federal Employees Retirement System, with its Thrift Savings Plan component, in June 1986." (Office of Personnel and Management, U.S. Government)
Federal Employees' Long-Term Care Insurance: Questions & Answers (PDF)
Excerpt: "When will long-term care insurance be available to Federal employees? The new law provides that the program must be effective no later than the first pay period of the fiscal year that begins 18 months after enactment, that is, by October 2002 at the latest. Implementing this new long-term care program will take a lot of work, but we will strive to make it available as quickly as possible." (Office of Personnel and Management, U.S. Government)
HHS Publishes Online Preamble to New Health Information Privacy Standards
Reading the preamble is a good way to get an overview of the purpose, history and highlights of both the proposed and the final regulations. (U.S. Department of Health and Human Services)
Massachusetts' New Patients' Rights Bill Takes Effect
Excerpt: "Subscribers to most health plans in Massachusetts now have the right to appeal the denial of medical treatment under a law that went into effect Jan. 1. Emergency regulations were filed Friday by the state Department of Public Health, which will implement the new patients rights law along with the Department of Insurance." (Boston Herald)
Why Does The Number Of Uninsured Americans Continue To Grow? (PDF)
Excerpt: "Gains in employer overage, caused by workers shifting into higher-paying jobs, have not offset declines in Medicaid coverage." (John Holahan and Johnny Kim, in Health Affairs)
Long-Term Care Insurance Is An Option for Middle-Income Families
Excerpt: "If you fall somewhere between very wealthy and low-income, it probably makes sense to consider long-term care insurance. That's because federal health care insurers Medicaid and Medicare don't pick up all the costs of nursing home care for people in all income brackets." (Pittsburgh Post-Gazette)
Another Question is Answered in the Cafeteria Plans Q&A Column
An employer has a self-insured medical reimbursement plan with a $1,000 annual limit. The plan is not part of the employer's Section 125 cafeteria plan. The plan reimburses employees' out-of-pocket medical expenses, up to $1,000 per year. The employer permits employees to carry over any unused amounts from one year to the next. Is this legal? (BenefitsLink.com)
(Following also appears in Retirement Plans Edition)
Graef Crystal: Pfizer's Steere Shows How Well Drugmakers Pay
Excerpt: "[D]rugmakers understand, if dimly, that lower prices could also mean fewer miracle pay packages for chief executives. The case of Pfizer Inc.'s William Steere, who just ended an almost decade-long tenure as CEO, shows just how much they have to lose." (Graef Crystal, on Bloomberg.com)
IRS Issues Proposed Regs on Minimum Cost Requirement Under Code Section 420
Excerpt: "[Section 420] permits the transfer of excess assets of a defined benefit pension plan to a retiree health account ... these proposed regulations provide that an employer who significantly reduces retiree health coverage during the cost maintenance period does not satisfy the minimum cost requirement of section 420(c)(3) ... [these rules] clarify the circumstances under which an employer is considered to have significantly reduced retiree health coverage ..." (Internal Revenue Service)
| Director Of Operations, Deerfield,IL | for ADP, INC in IL |
| Benefits Administrator | for Broadvision Inc; in CA |
| Healthcare Consultants & Analysts | for William M. Mercer, Inc (Phoenix) in AZ |
| Client Consultant | for Invesmart, Austin, Texas in TX |
| Consultants - Benefits Administration & Communication | for Towers Perrin in CA, GA, PA |
| 401(k)/DC Plan Administrator | for Federation Pension Bureau, Inc. in NY |
| Pension Administrator | for TPA Firm in MD |
| Manager, Benefits Administration | for University Hospitals Health System in OH |
| ERISA Attorney | for ADP, Inc in NJ |
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