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The BenefitsLink Newsletter -
Welfare Plans Edition
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February 20, 2001
Today's sponsor: EmployeeBenefitsJobs.com (click)


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Individual Health Policies Through Employer Can Constitute Employee Welfare Plan Subject to ERISA
Strange v. Plaza Excavating, Inc. (N.D. Ill. 2001). Excerpt: "The plaintiff in this case sued her prior employer for sexual harassment and for failing to offer her COBRA coverage. The employer moved for summary judgment, arguing on the COBRA claim that it had no responsibility to offer COBRA coverage because the plaintiff had been covered during her employment by an individual health insurance policy not by a group health plan subject to COBRA." (EBIA Weekly)

Expenses Not Covered by Plan Where Services Were Custodial in Nature, Not Skilled Nursing Care
Pawlowski v. Blue Cross and Blue Shield of Western New York (W.D.N.Y. 2001). Excerpt: "[L]itigation over what constitutes custodial versus nursing care is on the rise, so if your medical plan addresses those concepts, check that the language accurately captures your intent." (EBIA Weekly)

Sole Proprietor's Claims For LTD Benefits Not Preempted By ERISA, Ninth Circuit Holds
Excerpt: "ERISA did not preempt a sole proprietor's state law claims for long term disability benefits because the LTD policy was not an 'employee benefit plan' covered by ERISA. This was the decision of the Ninth Circuit U.S. Court of Appeals in LaVenture v. The Prudential Insurance Company of America." (Spencernet)

Firm Did Not Breach Its Fiduciary Duty By Failing To Disclose A Potential Severance Package
Excerpt: "An employer did not breach its fiduciary duty under ERISA by failing to disclose to an employee its plan to adopt an involuntary severance package because the plan was not under 'serious consideration' at the time the employee voluntarily retired. This was the ruling of the Tenth Circuit U.S. Court of Appeals in Winkel v. Kennecott Holdings Corp." (Spencernet)

Group Participation Rules May Not Be Used to Prevent Small Employers from Obtaining Health Insurance
Excerpt: "In this [November 2000] Program Memorandum, the Health Care Financing Administration (HCFA) addresses several issues with respect to the above rules and how they are affected by state law. First, HCFA clarifies that a state law definition of 'small employer' cannot be more restrictive than HIPAA's definition, as that would have the effect of removing from HIPAA's protection some 'small employers' as defined by HIPAA." (EBIA Weekly)

"Individual" Health Insurance Coverage Under State Law May Be Subject to HIPAA's Group Plan Rules
Excerpt: "In [HCFA Program Memorandum, Transmittal No. 00-06, issued in November 2000], the Health Care Financing Administration (HCFA) clarifies the responsibilities of insurers who issue individual policies in connection with a group health plan.... HCFA points out that whether a group health plan exists in connection with individual policies depends on the facts and circumstances of the arrangement, including how much the employer is involved in the program." (EBIA Weekly)

Opinion: Texas-style HMO Reforms Serve Up Model for Nation
Excerpt: "Talk about playing a weak hand. Faced with growing support for legislation to protect patients from abusive health plans, the HMO industry is trying to convince the public that such a law would be dangerous." (USA Today)

GE Launches New Long Term Care Policy
Excerpt: "GE Financial Assurance has launched a long term care insurance policy that provides in-home health care without the 'elimination period,' or waiting period, required by traditional long term care policies. The new policy, Long Term Care Choice, allows policyholders to choose among in-home care, adult day care facilities, assisted living facilities, or nursing homes." (insure.com)

(Following items also appear in Retirement Plans Edition)


Washington State Lawmaker Skirts Governor Locke Over Benefits to Domestic Partners
Excerpt: "The legality of out-of-state gay marriages and taxpayer-funded domestic partner benefits would be decided by voters under a measure sponsored by Rep. Joyce Mulliken. The Ephrata Republican is pushing for a referendum to kill the benefits made available last year to unmarried partners of state employees." (Yakima [Wash.] Herald-Republic )

Forfeiture-For-Competition Provisions Under Employer Stock Plans
Excerpt: "Employers have devised several means of discouraging employers from leaving to work for a competitor. Covenants-not-to-compete are one end of the strategic spectrum. These absolutely prohibit any work for a competitor provided, of course, that a court enforces them.... At the other end of the spectrum, we find provisions permitting the departing employee to compete to her/his heart's content, but at a price." (Nixon Peabody LLP)




Newly Posted or Renewed Job Openings (Post Yours!)
Pension Consultants/Administrators; F/T & P/T for Northern NJ Mid-Size Pension Consulting Firm
in NJ, NY
Sales Executive for Evolution Health, Inc.
in ALL STATES
Manager - Benefits Administration for Towers Perrin
in NY
Team Leader - Benefits Administration for Towers Perrin
in NY
VP/Director Of Operations, Deerfield, IL for ADP, INC
in IL
Client Consultant for Invesmart, Austin, Texas
in TX
Executive Director for WEB Worldwide Employee Benefits Network (WEB, Inc.)
in ALL STATES
Pension Administrator for The Allied Companies
in MI
Death & Disability Coordinator for Fire & Police Pension Association
in CO
Death & Disability Assistant Benefits Rep for Fire & Police Pension Association
in CO



Newly Posted Conferences (Post Yours!)
Managing Flexible and Work/Life Benefits in GA on March 5, 2001
presented by WorldatWork
Managing Flexible and Work/Life Benefits in TX on June 18, 2001
presented by WorldatWork
Managing Flexible and Work/Life Benefits in CO on August 20, 2001
presented by WorldatWork
Managing Flexible and Work/Life Benefits in CA on November 26, 2001
presented by WorldatWork
Managing Flexible and Work/Life Benefits in NY on December 10, 2001
presented by WorldatWork
Integrated Disability Management in CA on May 21, 2001
presented by WorldatWork
Integrated Disability Management in IL on September 12, 2001
presented by WorldatWork
Integrated Disability Management in NY on November 12, 2001
presented by WorldatWork
International Benefits in MI on April 2, 2001
presented by WorldatWork
International Benefits in IL on July 23, 2001
presented by WorldatWork
International Benefits in CA on September 10, 2001
presented by WorldatWork
International Benefits in NY on October 8, 2001
presented by WorldatWork
Vendor Management: How to Select and Manage Employee Benefits and Other HR Service Providers in IL on March 12, 2001
presented by WorldatWork
Vendor Management: How to Select and Manage Employee Benefits and Other HR Service Providers in NY on April 23, 2001
presented by WorldatWork
Vendor Management: How to Select and Manage Employee Benefits and Other HR Service Providers in TN on May 4, 2001
presented by WorldatWork
Vendor Management: How to Select and Manage Employee Benefits and Other HR Service Providers in CA on May 21, 2001
presented by WorldatWork
Vendor Management: How to Select and Manage Employee Benefits and Other HR Service Providers in CA on September 24, 2001
presented by WorldatWork
Vendor Management: How to Select and Manage Employee Benefits and Other HR Service Providers in IL on December 18, 2001
presented by WorldatWork
WorldatWork's 2001 Annual Conference and Exhibition: Rhythm of Rewards in TN on May 6, 2001
presented by WorldatWork
Fourth Annual Employee Benefits Law Conference in VA on May 2, 2001
presented by McGuire Woods LLP
Fourth Annual Employee Benefits Law Conference in VA on May 9, 2001
presented by McGuire Woods LLP
Behavioral Approaches to Disability Management in CA on March 16, 2001
presented by Disability Management Employers Coalition, Silicon Valley Chapter

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