March 5, 2001 Today's sponsor: The ERISA Health and Welfare Handbook: Questions and Answers on ERISA Compliance (click) Offers guidance on more than 30 key issues involving ERISA and employee welfare plans, including benefits entitlement, HIPAA, plan document language, discrimination issues and employer obligations under managed care plans. 2d edition; 350 pages; written by veteran benefits consultant Terry Humo, Esq., of Intermountain Administrators. $102.50. Cafeteria Plan for Federal Workers Under Study in Congress Excerpt: "The House civil service subcommittee has started work on a proposal to create 'cafeteria plans' for federal employees as a way to let them design their own benefits packages and perhaps allow the government to pull together employee benefits programs under one structure." (Washington Post) Gross Misconduct Under COBRA Excerpt: "Should employers pay to continue the health plans of employees fired for committing serious, or even criminal, offenses? Part of the solution is a clear, universal definition of gross misconduct, but 15 years of COBRA experience shows clarity is elusive." (Michael Greve, FLMI, CEBS of William M. Mercer, Inc.) Summary: IRS Issues Final Rules Under COBRA (PDF) March 2001 Client Action Bulletin. (Milliman & Robertson) Florida Judge Partly Grants HMO Suit Dismissal Excerpt: "A federal judge in Florida on Friday handed a partial victory to the managed care industry by throwing out racketeering and other charges in lawsuits filed by doctors who say HMOs have exploited their services. The ruling, which came in response to a motion filed by managed care companies to dismiss the lawsuits, partly helped lift stocks of Health Maintenance Organizations, or HMOs on Friday." (Reuters, via Yahoo! Finance) Managed Care Loses Key Bid in South Florida Court Action Excerpt: "The managed care industry lost a key bid to make a lawsuit by the nation's doctors disappear when a federal judge eliminated only one of several claims that the companies use fraud and extortion to control costs. U.S. District Judge Federico Moreno found fault with the legal underpinnings of several claims offered by 600,000 physicians against seven major health care providers, but gave doctors extra time to revise their complaint." (New York Times; free registration required) Judge Partly Grants HMO Suit Dismissal Excerpt: "A federal judge in Florida on Friday partly granted a motion by the managed care industry to dismiss lawsuits filed by physicians against several HMOs, according to a clerk in the judge's office." (New York Times; free registration required) Fact Sheet: The Uninsured and Their Access to Health Care (KaiserNetwork.org) Jump In Medical Malpractice Jury Awards Hits Hard Excerpt: "Jury awards for medical malpractice claims jumped 76 percent from 1996 to 1999, and the aftershocks of the increase are hitting physicians and their patients in some states particularly hard." (insure.com) Opinion: HMOs Get Conflicting Consumer Demands Excerpt: "The most obvious conflict is between what health consumers want and what health purchasers are willing to pay for. The state Legislature and California consumers are demanding a great deal more from managed care than they were several years ago." (Sacramento Bee) Virtual HR Department Spells Out Benefits Online Excerpt: "Small-business owners who've struggled with questions about insurance and 401(k) plans can take their hats off to Jerry Peter, founder of 4myBenefits Inc. He and his son, Jason, developed a virtual human resources department that can be customized to any company and each individual employee." (Cincinnati Business Courier; free registration required) Plaintiff's Claim Under Terms of SPD Fails Without Detrimental Reliance; Estoppel Claim Fails Too Gary B. Mauser v. Raytheon Company Pension Plan for Salaried Employees (1st Cir. 2001). Excerpt: "Because we have already established an avenue for relief for reliance on an inadequate Plan Summary, we hold there is not a more general equitable estoppel claim based solely on an inadequate Plan Summary. We leave for an appropriate case whether there may exist an equitable estoppel claim in cases where misrepresentations exist apart from the Plan Summary." (Findlaw.com) New Claims Regulations Mean More Leeway for Workers, More Work for HR Excerpt: "Administering your benefit plans will become more burdensome and costly under new regulations issued last fall by the U.S. Department of Labor (DOL). The new regulations require employers to modify their claims procedures for all plans subject to the Employee Retirement Income Security Act (ERISA)." (HR magazine) IRS Information Letters Online for 2000 and Later Excerpt: "An information letter provides general statements of well-defined law without applying them to a specific set of facts. Information letters are furnished by the IRS National Office in response to requests by taxpayers, by congresspersons on behalf of constituents, or congresspersons on their own behalf for general information." (Internal Revenue Service) Tips That Could Save Your Lifestyle Excerpt: "Most Americans won't be laid off. Of the unlucky few, most will find a new job fast. Still, you never know when the moving finger might tap you on the shoulder. If not a layoff, some other emergency might turn up. An auto accident. A medical problem. Slow-paying clients, if you're self-employed." (Jane Bryant Quinn, in the Washington Post) Newly Posted or Renewed Job Openings (Post Yours!)
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