Welfare Plans Edition
January 16, 2001
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Patient Files Opened to Marketers, Fundraisers
Excerpt: "New federal medical privacy regulations, touted by the Clinton administration as a landmark of patient protection, will for the first time explicitly permit doctors, hospitals, other health services and some of their business associates to use personal health records for marketing and fundraising." (Washington Post)
HealthInsurance.com Gives Small Businesses Health Insurance Options
Excerpt: "HealthInsurance.com, an Internet-based health insurance brokerage and administration company based in Los Angeles, Calif., offers small businesses the opportunity to research and apply for group health insurance online. The company launched its new Web site on Jan. 9, 2001." (insure.com)
Opinion: The Independent Medical Examination/Transferable Skills Analysis Swindle
Excerpt: "[I]n the field of ERISA law, things are not always what they seem to be. Moreover, words tend to lose their meaning. Two such examples are the 'Independent Medical Examination' (IME) and the 'Transferable Skills Analysis' (TSA) ... IME's are seldom 'independent,' and TSA's almost never contain any kind of an 'analysis.' These are fictions, but they're fictions that insurance companies are allowed to create and rely upon in the context of ERISA-governed claim denials." (Michael A. McKuin, Esq.)
Opinion: The Stop-Loss Shuffle of Some Self-Insured Health Plans
Excerpt: "The provision of 'stop-loss' coverage to a self-funded ERISA plan, by an entity or by persons, who are in control of the Plan and its assets, is the purest example of a 'conflict of interest' one can think of. But some [multiple employer trusts] did exactly that in the 1970s and 80s and many of the insurance industry giants are pulling the exact same scam today." (Michael A. McKuin, Esq.)
Opinion: Under Firestone, The Exception Becomes the Rule and the Rule Becomes the Exception
Excerpt: "Plan attorneys usually argue that the 'Firestone exception' to the de novo rule applies, so as to try to take advantage of the deferential standard of review in Federal Court. Participants' attorneys usually try to argue the opposite. Much of ERISA litigation involves this technical debate over the standard of review." (Michael A. McKuin, Esq.)
Voluntary Benefits Programs Help Employers Compete
Excerpt: "Employers who want to be more competitive but cannot afford to incur added costs are investigating, and increasingly adopting, what is known as voluntary benefits programs. Voluntary benefits plans allow employers to offer their employees a cafeteria line of benefits choices. Employers may, but usually do not, subsidize these benefits." (Kansas City Star)
Opinion: The Legacy of the Multiple Employer Trusts of the 1970s and 1980s
Excerpt: "[I]t is not clear whether anybody, in 1974, knew precisely what an 'employee welfare benefit plan' was or what it would be.... The intent was apparently to allow certain larger employers or unions to 'self-insure' their employee benefits plans. But by the late 1970s, just a few years after ERISA's enactment, the concept of an 'employee welfare benefit plan' was given new meaning by the proprietors of the 'Multiple Employer Trusts.'" (Michael A. McKuin, Esq.)
Mental-health Advocates Demand Parity In Washington State
Excerpt: "Thwarted for the past two years, supporters of legislation to boost health-insurance coverage for the mentally ill returned to the Capitol in force yesterday. About 200 people, mostly people with mental illnesses or their family members, converged on the Legislature to push for improvements in the state's mental-health system, including a law requiring health insurers to cover treatment of mental illnesses at the same level they cover other maladies." (Seattle Times)
Humana Debuts PPO Plan for Small Businesses
Excerpt: "Humana Inc. is offering a new line of Preferred Provider Organization (PPO) health insurance plans designed for small businesses. HumanaPPO 2001 plans encourage members to seek care within a specific network of preferred providers, while allowing them to visit out-of-network providers if they so choose." (insure.com)
Opinion: Canada's Burning! Media Myths About Universal Health Coverage
Excerpt: "Foreign experience thoughtfully portrayed would help Americans participate intelligently in the great debate about how to reform our medical care arrangements that still leave over 44 million Americans uninsured." (Washington Monthly)
Agents Put It Bluntly: Get Serious About LTC, Or Don't Bother
Excerpt: "'It's not just product and features education that's needed,' stresses Susan Nastasi, regional sales manager in the Orlando, Fla., office of ACSIA Insurance Services, a LTC specialist firm. LTC agents also need to know how to get appointments, what happens during the appointment, how to do an LTC needs assessment, and how to sell to each client's needs and risk concerns." (National Underwriter Company)
(Following also appears in Retirement Plans Edition)
Commentary on IRS Split-Dollar Ruling
Excerpt: "In general, the Notice provides a kind of 'check-the-box' approach to the taxation of split-dollar arrangements. The parties have the option of characterizing it as either a loan transaction or as a transaction in which the employer acquires an interest in the policy and provides current life insurance protection and, in equity arrangements, an interest in the cash surrender value of the policy, to the employee." (Michael A. Swirnoff, Esq., for the Magner Financial Network)
| Asset Reconciliation Coordinator | for Zurich Scudder Investments in NH |
| Employee Benefit Trust Officer | for BankFirst Trust Company in TN |
| DIRECTOR OF PENSION OPERATIONS | for MBM Advisors Inc. in TX |
| Benefits Analyst Senior | for Jet Propulsion Laboratory in CA |
| Analyst - Benefits Consulting | for Towers Perrin, a leading global management consulting firm in CA |
| 401k Compliance Testing Analyst | for Automatic Data Processing- Retirement Services in NJ |
| Director, Quality Assurance | for Automatic Data Processing- Retirement Services in NJ |
| 401(k) Pension Administrator/Entrepreneur | for an independent small plan administrator in ALL STATES |
| Consultant, Employee Benefit | for The Standard Insurance Company in |
| 401(k) Administrator | for Benefit Management Inc. in MA, RI |
| 401(k) Plan Administrator | for Polycomp Administrative Services, Inc. in CA |
| Compensation & Benefits Analyst | for PTI Technologies, Inc. in CA |
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