If this message looks garbled to you or if the headlines in this message don't connect you to Web pages when you click on them, please request the "plain text" version of this newsletter ("Welfare Plans Edition") by emailing your request to publisher Dave Baker

The BenefitsLink Newsletter -
Welfare Plans Edition
BenefitsLink logo

July 4 - 5, 2001
Today's sponsor: Guide to the Form 5500 Series: 2001 Edition for 2000 Plan Years (click)


   The Guide to the Form 5500 Series: 2001 Edition for 2000
   Plan Years provides plan administrators concise,
   complete explanations of the forms, schedules, and
   instructions in the Form 5500 Series, which was revamped
   last year.   Written by respected author and lecturer
   Valeri L. Stevens. Just $134, but what a time-saver!
   Click for more details or to order online now.


Borrowing from Upcoming HIPAA Regs, Court Requires Notice to Patients Prior to Disclosure of Records
Excerpt: "In this criminal case involving a doctor accused of unlawful distribution and dispensing of controlled substances, the court considered a government subpoena of the medical records of the doctor's patients. The hospital that maintained the records resisted disclosure, arguing that compliance with the subpoena would subject it to civil liability for disclosure of privileged information." (EBIA Weekly)

Providing Smaller Stipend for Health Coverage to Medicare-Eligible Retirees Does Not Violate ADEA
Gutchen v. Board of Governors of the University of Rhode Island (D.R.I. 2001). Excerpt: "The question before the court was whether the retirement plan violated the ADEA because it decreased the health benefit stipend as a result of Medicare eligibility. The court found that although the health benefits stipend depended on Medicare eligibility, which is inextricably tied to the retiree's age, the retirement plan did not violate the ADEA." (EBIA Weekly)

Plan's Interpretation of "Reasonable and Customary" Clause Found to Be Reasonable
Barden v. Sheet Metal Workers Local No. 20 Welfare and Benefit Fund (7th Cir. 2001). Excerpt: "The plan administrator ... denied a portion of the requested benefits because they exceeded the applicable 'reasonable and customary charges,' based on the TPA's routine use of 'CPT' codes (numeric codes used by medical providers to identify each type of medical service and procedure for which they are seeking payment) and data supplied to it by an outside company." (EBIA Weekly)

Supreme Court Will Consider Medical Leave Case
Excerpt: "The U.S. Supreme Court agreed [on June 25] to clarify how maternity or other medical leave offered by employers counts against the 12-week leave guaranteed by the federal government." (Law.com)

Opinion: House Should Qualify Senate Patients' Rights Bill
Excerpt: "The Senate bill gives patients a fairly broad opening to take their health plan to court and win very high punitive damages. The House bill would appropriately qualify that right by limiting the type of malpractice suits that can go into state courts where liability suits judgments are often the most unrestrained." (The Dallas Morning News)

Opinion: Bush In Corner on Patients' Rights
Excerpt: "In a few short weeks, he has gone from dictating the agenda - pushing his tax-cut plan through Congress with remarkable speed and authority - to a more defensive posture. As he tries to counter coming Democratic measures, he may rely more and more on Republicans in the House, as well as his own veto power." (Christian Science Monitor)

Whether VEBA's Health Coverage to Domestic Partners Violates ERISA Fiduciary Duties
Excerpt: "[T]he excess of the fair market value of the coverage to a nondependent, nonspousal domestic partner over the amount paid by the participant for such coverage, is includible in the participant's income and is wages for FICA, FUTA and income tax withholding purposes. Also, the amount of participant FICA attributable to the coverage paid by the Fund on his or her behalf is includible in income and is wages for employment tax purposes." (EBIA Weekly)

Testimony: Consultants' Billing Advice May Lead to Improperly Paid Insurance Claims
Testimony to U.S. Senate Finance Committee June 27, 2001, by Robert H. Hast of the U.S. General Accounting Office. Excerpt: "I am pleased to be here today to discuss the results of our investigation concerning health care billing consultants who conduct seminars or workshops that offer advice to health care providers on how to enhance revenue and avoid audits or investigations." (U.S. General Accounting Office)

Senate Hearing Findings on Billing Consultant's Seminars 'Misleading,' Consultant Says
Excerpt: "In a USA Today letter to the editor, George Conomikes responds to allegations made at a Senate Finance Committee hearing last week that his consulting firm, Conomikes Associates Inc., sponsored seminars that encouraged physicians to increase income by overcharging government and private insurers for services." (KaiserNetwork.org)

Transcript of Online Newshour Presentation: Patients' Rights
July 2, 2001 program. Available in Real Audio format as well. Excerpt: "The Senate adopted new patients' rights legislation late Friday night. Four policy experts assess whether the proposal will improve health care in America." (Online Newshour, PBS)

Analysis: Critics of Health Industry Shaped Debate on Patients' Rights
Excerpt: "Public opinion polls have, for several years, shown that consumers resent the restrictions of managed care. The political dynamic on Capitol Hill was changing even before Democrats took control of the Senate in early June. Critics of the industry now have a well-honed response to every argument made by health maintenance organizations trying to fend off federal regulation." (New York Times; free registration required)

A Second Opinion on Patients' Rights
Excerpt: "Although it remains unclear what shape the employer-liability provision will take in the final law, health-policy analysts believe few small companies will be affected. So why the outcry from small-business groups? Paul Fronstin, economist and senior research associate at the non-profit Employee Benefits Research Institute, discusses the issue in this edited interview with BusinessWeek Online's Theresa Forsman." (BusinessWeek Online via Yahoo! Finance)

Opinion: Business' Lobbying Against Patients' Rights Bill Falls Short
Excerpt: "When the insurance industry closes ranks with the national business lobby to try to head off an unwelcome piece of legislation, it is accustomed to getting its way. But the leaders of business' campaign against the patients' bill of rights felt anything but triumphant last week as the legislation neared a climactic Senate vote." (Los Angeles Times)

Opinion: Small Victory in Washington Contraceptive Case Casts Light on a Much Bigger Problem
Excerpt: "Common sense says that health plans should cover contraceptives. They are prescription drugs and devices that help women manage their reproductive health the way hypertension medicines help people manage their heart health." (Abigail Trafford in the Washington Post)

GOP Leader Hasters Is 'Sure' Bush Will Sign Compromise Health Bill
Excerpt: "House Speaker J. Dennis Hastert says he's been assured President Bush will sign a new compromise patients' bill of rights crafted by House Republicans as an alternative to the Democratic version the Senate passed Friday night that the administration opposes." (Washington Times)

Opinion: the Cost of Health Care
Excerpt: "Most of us get our health-care coverage through our employers ... The effect is to lull people into believing that the benefit is free. Nothing could be further from the truth. Employers don't really 'pay' for health insurance ... Money that goes to pay for insurance comes out of whatever the employer would otherwise provide in salary or other benefits. The only difference is, employees often have little say ..." (Linda Chavez on Yahoo! News)

Catholics Lose Court Appeal on California State Law Contraceptive Coverage Requirement
Excerpt: "In a closely watched case, an appellate court Monday upheld the constitutionality of a California law requiring employers to offer contraceptives in their prescription drug plans, saying it does not infringe on religious freedom." (Los Angeles Times)

(Following items also appear in Retirement Plans Edition)


Prudential Publishes Online Guide to Demutualization for Group Contract Holders
Excerpt: "Your most important decision is deciding who owns the compensation that will be paid by Prudential under its Plan of Reorganization --the group policyholder (e.g., employer), an employee benefit plan or both. Amounts received in connection with a pension or profit sharing plan will be deemed an asset of the plan and, as a result, must be used to pay plan benefits or expenses. You may, however, have more flexibility in using compensation paid in connection with a welfare plan." (Prudential)

A Goodbye Kiss: Stock Options and Severance
Excerpt: "The whole topic of negotiating changes in a stock-option agreement as part of a severance package is one that only an accountant could love, but I'd be remiss not to say a little more about it...." (Fortune.com)




Newly Posted or Renewed Job Openings (Post Yours!)
Pension Consultant for Dreyfus
in NY
Regional Benefits Manager for St. Joseph Health System
in CA
Account Manager for U.S. Bank
in NE



Newly Posted Conferences (Post Yours!)
COBRA Compliance for Group Health Plans in WA on September 28, 2001
presented by Employee Benefits Institute of America LLC (EBIA)
HIPAA & Other Federal Mandates for Group Health Plans in WA on September 27, 2001
presented by Employee Benefits Institute of America LLC (EBIA)
ERISA Compliance for Health & Welfare Plans in WA on September 27, 2001
presented by Employee Benefits Institute of America LLC (EBIA)
Cafeteria Plans in WA on September 26, 2001
presented by Employee Benefits Institute of America LLC (EBIA)
401(k) Plans in WA on September 25, 2001
presented by Employee Benefits Institute of America LLC (EBIA)
The Ninth Annual Workers Compensation and Disability Management Conference in CA on October 22, 2001
presented by International Business Forum in conjunction with the leading publication, Business Insurance



Newly Posted Press Releases
Capital Analysts Joins with 401kExchange! (401kExchange.com)

Subscribe to the Retirement Plans Edition, too (click)
Copyright 2001 BenefitsLink.com, Inc.

You may freely distribute this email newsletter in whole.

Click here to learn how your company can sponsor a future issue!

BenefitsLink is a registered trademark of BenefitsLink.com, Inc., published by Dave Baker with much help from Mary Hall and lots of friends.

We're proud of our privacy policy.

To subscribe (free): visit https://benefitslink.com/newsletter - or the person desiring to subscribe can send an email to BLwelfare@add.mb00.net

We have an online archive of prior issues at
https://benefitslink.com/newsletters/