| The BenefitsLink Newsletter - Welfare Plans Edition |  |
March 21, 2001
Today's sponsor: Employee Benefits Business for Sale (click)
View our online listing of Employee Benefits Businesses For Sale! No charge to access any of the information. For just $200, you can list your business and all the particulars, using our page to reach prospective buyers for your business nationwide. (Over 7,000 people use this site per day; over 71,000 different people per month!) And you know why they're here: for employee benefits compliance information and tools. There's no better place to advertise your Employee Benefits Business For Sale.
Democrats Urge HHS To Enforce Medical Privacy Rules
Excerpt: "'This is the first time I've seen a piano tuned with a sledgehammer. They want to kill it,' Senate Judiciary ranking member Patrick Leahy, D-Vt., said at a news conference. The regulation requires providers to better safeguard the privacy of patients' medical records and requires permission for them to be given to third parties in many cases." (GovExec.com)
Democrats Urge Thompson To Implement Privacy Rule
Excerpt: "A group of 46 Democratic senators and representatives have asked HHS Secretary Tommy Thompson to make new medical privacy standards effective as scheduled on April 14. In a letter to Thompson, the lawmakers pleaded with him 'not to give in to the data miners and business interests.'" (Modern Healthcare)
New York State: HMOs Can't Be Sued for Bad Faith Coverage in Denying Treatment
Excerpt: "Health insurers and health maintenance organizations can not be sued for bad faith denial of coverage in refusing to authorize treatment, the New York Appellate Division, 1st Department, ruled in a split decision. Five justices voted 3-2 against adopting a cause of action for a tortious breach of an implied covenant of good faith between the HMO and its subscribers." (Law.com)
New York Appeals Court Upholds Claims Against HMO in 5-0 Decision
Excerpt: "Yesterday, a New York Appeals Court issued a landmark decision upholding claims against the Prudential Insurance Company of America and its New York-based health management organization ('HMO') subsidiary ... for breach of contract, common law fraud and deceit and improper interference with existing contractual relations. In a unanimous vote of the five-judge panel, the Appellate Division affirmed the [lower court's] decision ... substantially upholding the class action complaint." (Pomerantz Law Firm press release)
Coordination of Benefits--What You Say is All You Get
Boston Mutual Insurance v. Murphree (9th Cir. 2001). Excerpt: "At issue in this case were the underinsured motorist ('UIM') benefits under the auto insurance policy. The insured claimed that she was entitled to the benefits, and the group medical plan claimed that it was entitled to the proceeds under the plan's coordination of benefits provision." (Employee Benefits Institute of America)
Plan May Require Subrogation Acknowledgement Form to be Signed Before Benefits are Paid
Alves v. Silverado Foods Inc. and Silverado Foods Welfare Benefit Plan (10th Cir. 2001). Excerpt: "The couple refused to sign the proffered reimbursement acknowledgement form, believing that it gave the plan additional legal rights. The plan then offered a second reimbursement form, which they also refused to sign. Because it did not have a signed form, the plan refused to pay any medical expenses." (Employee Benefits Institute of America)
AT&T Sued By Union, Employees Over Pregnancy Leave
Excerpt: "The Communications Workers of America union and several AT&T Corp. employees filed a lawsuit Tuesday alleging the No. 1 U.S. long-distance telephone and cable television company discriminated against female employees who took pregnancy leave before April 1979." (Reuters via Excite News)
Internet Layoffs May Test Federal Statutes
Excerpt: "The Internet's role in many of the layoffs that have roiled the economy this year may test the flexibility of a federal statute designed to warn workers who are about to lose their jobs. The Worker Adjustment and Retraining Notification Act requires companies to give employees and public officials a 60-day notice of plans for a 'mass layoff' or plant closure." (NewsFactor Network)
Bush Threatens Veto of Any Patients Bill That Includes Right to Sue
Excerpt: "President Bush turned thumbs-down Wednesday on legislation in Congress that would allow wronged patients to sue their HMOs for millions of dollars. 'I want to sign a patients' bill of rights this year, but I will not sign a bad one,' he said." (Associated Press)
Bush Pushes Patients Rights in Florida Speech to Physicians
Excerpt: "President Bush is promoting his vision for a patients bill of rights as negotiations continue on Capitol Hill on legislation laying out the details.... In the Capitol Hill discussions, the White House is insisting that whatever legislation is developed allow patient lawsuits only in federal courts, not in state courts, where damage awards typically are larger." (Associated Press)
Bush Touts Patients' Bill of Rights
Excerpt: "President Bush told a convention of cardiologists on Wednesday that he wants to sign patient protections into law by year's end, but will not accept any of the options currently before Congress." (Associated Press, via Excite News)
Consumer Advocate Testifies on Need for Strong Patients Bill of Rights
Excerpt: "The public needs federal legislation because the protections that do exist today constitute a veritable patchwork quilt that is indecipherable and has many holes. Enormous differences exist today in the protections that are afforded to people based on the accidental happenstance of a consumer's state of residence and the payer and form of that consumer's health plan." (FamiliesUSA)
Full Text: EBRI Issue Brief on Defined Contribution Health Benefits (PDF)
32 pages. Excerpt: "[First, employers] are once again looking for ways to keep their health care cost increases in line with overall inflation. Second, some employers are concerned that the public 'backlash' against managed care will result in new legislation, regulations, and litigation ... Third, employers have modified not only most employee benefit plans, but labor market practices in general, by giving workers more choice, control, and flexibility." (Employee Benefit Research Institute)
Executive Summary: Defined Contribution Health Benefits
Excerpt: "The term 'defined contribution' is used to describe a wide variety of approaches to the provision of health benefits, all of which have in common a shift in the responsibility for payment and selection of health care services from employers to employees. DC health benefits often are mentioned in the context of enabling employers to control their outlay for health benefits by avoiding increases in health care costs." (Employee Benefit Research Institute)
Effective Date for Final Nondiscrimination Regulations Delayed for 60 Days
Excerpt: "Interim final and temporary HIPAA nondiscrimination regulations were jointly issued by the IRS, DOL, and DHHS on January 8, 2001.... The regulations were to become effective on March 9, 2001. Instead, on that same day, the agencies jointly announced a delay of the effective date to May 8, 2001 and made conforming amendments to the regulations." (Employee Benefits Institute of America)
Making Federal and State Roles in Managed Care Regulation and Liability Work for Health Coverage
Page contains links to prepared transcripts and to the audio testimony provided at the March 15, 2001 hearing. (House Committee on Energy and Commerce, Subcommittee on Health)
Insurance Group to Launch Ads Against Right to Sue
Excerpt: "The American Association of Health Plans (AAHP), the largest organization representing health insurance companies, is gearing up for a major television campaign aimed at convincing key lawmakers that suing health plans is not the way to resolve the nation's healthcare disputes." (Reuters via Yahoo! News)
Bush Takes First Crack at Health Care
Excerpt: "President Bush is set to deliver what aides are calling a significant speech to outline his positions on plans to expand health care access and improve the nation's medical systems. Speaking to a group of cardiologists today, Bush will 'lay down the parameters' of the health care reforms he would support, aides said." (ABCNews.com)
S. Ct.: ERISA Trumps State Law Attempting to Void at Divorce a Spouse's Designation as Beneficiary
Excerpt: "The justices ruled 7-2 in the Washington state case of a man who died without removing his ex-wife as the beneficiary of his employer-provided insurance and pension. His children from a previous marriage sued, saying they were entitled to the benefits, but the justices decided for the ex-wife. A Washington state law says getting a divorce automatically revokes a spouse's designation as beneficiary." (Associated Press, via Yahoo! News)
Full Text of Egelhoff v. Egelhoff Opinion from U.S. Supreme Court, re ERISA Preemption of State Laws
Excerpt: "... the statute at issue here directly conflicts with ERISA's requirements that plans be administered, and benefits be paid, in accordance with plan documents. We conclude that the Washington statute has a 'connection with' ERISA plans and is therefore pre-empted." (Legal Information Institute, Cornell Law School)
New Correction Program for Prohibited Transactions Expected
Excerpt: "The excise taxes and civil penalties imposed on correcting prohibited transactions have become a disincentive to employer correction, according to Internal Revenue Service (IRS) and Department of Labor (DOL) officials speaking at a recent American Bar Association (ABA) conference. Now both agencies are working together to create a new system to encourage early detection and correction of prohibited transactions by employers, with little or no penalties involved." (Thompson Publishing Group)
Forget Brass Rings -- Execs Grab for Gold
Excerpt: "There's gold in them thar employment contracts. Gold. As in golden handcuffs, the ample retention packages designed to keep executives from job hopping. Gold. As in golden parachutes, the payouts to CEOs whose companies are bought out. Gold. As in golden worlds, the incentive-laden pay packages that attract executives." (USA Today)
Newly Posted or Renewed Job Openings (Post Yours!)
| Asset Unitization Manager | for Reliance Trust Company in GA |
| Manager, Benefits, Payroll & HRIS | for St. Jude Medical, World Leader In Cardiac Medical Devices in CA |
| Business Analyst | for The 401(k) Company in TX |
| ERISA Attorney | for Kalish & Ward in FL |
| 401(k) Conversion Specialist | for Louis Kravitz & Associates, Inc. in CA |
| 401(k) Plan Analyst | for Stephen H. Rosen & Associates, Inc. in NJ |
| Tax Manager - Benefits/Compensation | for PricewaterhouseCoopers in CA, CO, DC, NY, PA |
| Implementation Project Manager | for Fidelity Investments in UT |
Newly Posted Conferences (Post Yours!)
| Retirement Technology Conference | in CA on May 31, 2001 presented by Profit Sharing/401(k) Council of America |
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