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August 15, 2001 - 6,189 subscribers
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Steep Increases Projected for HMO Premiums
Excerpt: "Managed care premiums across the U.S. are expected to rise by an average of 15% in 2002, marking another year of double-digit increases, according to the August 15 issue of the Managed Healthcare Market Report." (Medscape; free registration required)
North Carolina State Employees To Be Covered Under State Patients' Rights Bill
Excerpt: "The plan is designed to allow people to sue insurers and managed-care companies who have denied necessary medical coverage. It also would allow an independent review panel, whose decisions would be binding on insurers, to examine coverage decisions before lawsuits were filed. Appeals would have to be exhausted before a lawsuit is filed, but an expedited review would be allowed if a person's life or health were in jeopardy." (WNCN via MSNBC.com)
Retiree Health Benefits Likely to Keep Shrinking, New Report Finds
Press release. Excerpt: "Employment-based retiree health benefits, which have been getting trimmed back in recent years, are likely to continue shrinking because of recent business accounting changes, age discrimination rulings by federal courts, medical inflation, and potential federal legislation, according to a new report by the nonpartisan Employee Benefit Research Institute (EBRI)." (PR Newswire via Excite News)
Opinion of Plaintiff's Treating Physician Ruled No More Important Than Plan Physician's Opinion (PDF)
Delta Family-Care Disability & Survivorship Plan v. Marshall (8th Cir. July 31, 2001). Excerpt: "[A] treating physician's opinion does 'not automatically control, since the record must be evaluated as a whole' ... Here, the Plan did not base its decision to terminate benefits on the report of any physician who had merely reviewed [the plaintiff's] medical records. All of the doctors who conducted [his] IMEs and IPEs examined him ..." (U.S. Court of Appeal for the Eighth Circuit via Findlaw.com)
Opinion: the Fight Over the Patients' Bill of Rights: Why Hatred of Trial Lawyers Plays a Large Role
Excerpt: "It is easy to agree to grant patients the right to get something they already receive, and that is exactly what, for the most part, both versions of the bill have done. The real fight ... has to do with a very small but significant gap between the two versions. It has to do with how HMOs will be sued in America in tort ... the effect of ERISA has been to cut off the right of employees who receive health insurance through their employers to sue their HMOs in tort." (FindLaw.com)
Analysis: More Guidance on HIPAA Privacy Rules
Excerpt: In an attempt to lay to rest some of the more hoary myths about the federal health privacy rules scheduled to take effect in 2003, the Department of Health and Human Services (HHS) has issued more guidance on these standards ... The guidance offers a 'plain English,' if high level, summary of the privacy rule, along with additional examples of how the rule actually works." (Deloitte & Touche)
Analysis: ERISA Health Claims and Appeals Rules Delayed
Excerpt: "Rules that greatly speed up the processing of ERISA health benefits claims and appeals will be delayed for as much as a year, according to a Department of Labor (DOL) announcement in early July. These rules, originally scheduled to apply to claims filed on or after January 1, 2002, will now apply to plan years beginning on or after July 1, 2002, but not later than January 1, 2003." (Deloitte & Touche)
Opinion: Getting to the Bottom of CEO Compensation
Excerpt: "If it makes sense to dangle a pre-emptory share-price incentive in front of executives when times are good, it makes sense when times are bad. And managers aren't slaves. They'll just go work someplace else if their options are hopelessly out of the money." (CareerJournal.com)
20th Annual Small Business Survey Results Available from Dun & Bradstreet
Excerpt: "Only 17% of small businesses offer their employees retirement benefits. In this area, women-owned and home-based businesses continue to lag behind their counterparts. Among those companies providing retirement benefits, 401K and IRA/Keogh accounts are the most popular. As in past years, few companies provide childcare assistance." (Dun & Bradstreet)
Opinion: Option Gambles Are a Devil's Bargain
Excerpt: "Let's sympathize with folks in Silicon Valley who struck it rich and now find they owe more money in taxes than they actually ever pocketed. Aw gee, I'm tempted to say, maybe the New New Thing is that life is really tough ... Incentive stock options, unlike non-qualified options ... offer some tax advantages. There is no ordinary tax due on exercise of the option. Indeed, tax isn't levied until the option is sold. There is, however, the alternative minimum tax ..." (Graef Crystal, on Bloomberg.com)
Newly Posted or Renewed Job Openings (Post Yours!)
| Actuarial Analyst/DB Administrator | for Lorraine Dorsa & Associates in FL |
Newly Posted Conferences (Post Yours!)
| Introduction to ESOPs | in WA on October 24, 2001 presented by National Center for Employee Ownership |
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Copyright 2001 BenefitsLink.com, Inc., but you may freely distribute this email newsletter in whole. This newsletter is edited by David Rhett Baker, J.D.
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