| The BenefitsLink Newsletter - Welfare Plans Edition |  |
September 7, 2001 - 6,348 subscribers
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Experts Disagree on Genetic Info Law
Excerpt: "Existing law might keep Americans safe from genetic discrimination in health insurance, experts told a House committee Thursday, but it remains unclear whether more regulation is needed.... Scientists are uncovering more genetic markers related to specific medical conditions everyday, and some are worried insurers might refuse to cover otherwise healthy people who have those markers." (United Press International via IFEBP)
The Dawning of 21st Century Health Plan Administration: HIPAA's EDI Standards (PDF)
Excerpt: "This NewsLetter discusses what multi-employer health and welfare funds must do by October 16, 2002, to be able to handle health and insurance information in compliance with the HIPAA EDI standards.... In many cases, group health plan sponsors will be required to rethink how they have structured their health information systems and external vendor relationships." (The Segal Company)
When Employer Is Told of Need for Medical Leave, It Must Give Employee Written Notice of Policies
Excerpt: "The employer ... told the [W.D. Pa. federal district] court that it did not grant [the plaintiff] 12 weeks of statutory leave because she had neither specifically asked for FMLA leave, nor revealed her precise diagnosis when she said her doctor had prescribed a month off work. But the court found that once [she] had requested medical leave, the employer was obligated to respond to the request in writing, telling the employee what her rights and responsibilities under the act were." (Thompson Publishing Group)
Seventh Circuit Dismisses ERISA Claims of Benefit "Assignee," Warns Other Courts of Plaintiff
The Seventh Circuit U.S. Court of Appeals has dismissed a lawsuit filed by the 'assignee' of a benefits claim seeking to recover benefits under a health care plan. In addition, in Simon v. Allstate Employee Group Medical Plan, et al. (No. 00-3120), the Seventh Circuit issued a warning to other courts concerning the plaintiff's 'litigious ways." (Spencernet)
Benefit Plans Sponsored By City Water System and Sewer District Are Governmental Plans: PWBA
In Advisory Opinion 2001-08A, the Department of Labor's Pension and Welfare Benefits Administration (PWBA) concludes that three welfare benefit plans jointly sponsored by a city water system and city sewer district constitute 'governmental plans' within the meaning of Title I of ERISA. The advisory opinion was written by John J. Canary, chief of the division of coverage, reporting, and disclosure in the PWBA's Office of Regulations and Interpretations. (Spencernet)
Verizon Workers Pay More for Some Drugs
Excerpt: "Verizon's policy, thought to be the first of its kind in the country, comes down to this: If it's a matter of life or death, you pay $15 per month for the drug. But if your Zocor, Prozac or Claritin is to treat what one Verizon executive calls 'a lifestyle issue,' your copay is $35." (St. Petersburg Times)
How Employers Influence Health Plan Enrollment
Excerpt: "Today a lower percentage of workers receive coverage from their employer than was the case ten years ago, not because fewer employers offer coverage, but because fewer employees accept coverage that is offered.... This paper shows how eligibility and take-up rates vary by employer policies and characteristics, such as firm size, employee income, industry, and region." (Health Affairs via aHealthyMe.com)
Coalition Presses for Universal Health Coverage in Maryland
Excerpt: "Leaders of a statewide coalition of labor, religious and civic groups are proposing an ambitious health plan costing up to $1 billion that would provide coverage for the state's 650,000 uninsured residents. The strategy, already under attack by business interests, would require employers to provide insurance or pay a tax, expand a government health program for children and create a buying pool so the elderly could get their medicine cheaper." (The Baltimore Sun)
How Managed Care Can Be Ethical
Excerpt: "The 'managed care problem' is understood generally as the need to protect individuals against large companies that care more about their bottom line than about people. The premise of the BEST (Best Ethical Strategies for Managed Care) project is that the 'managed care problem' is best understood as an ethical problem-- a conflict of values that arises as the country changes from a patient-centered to a population-centered approach to health care." (Health Affairs via aHealthyMe.com)
NCQA Releases State of Managed Care Quality: 2001 Report
Press release. Excerpt: "The National Committee for Quality Assurance (NCQA) today released its fifth annual State of Managed Care Quality report and, for the second consecutive year, reporting health plans achieved significant gains in all key areas of care and service.... The 372 health plan products submitting data to the 2001 edition ... cover more than 63 million people." (PR Newswire via Excite News)
State of Managed Care Is Improving, Report Notes
Excerpt: "While Congress was bickering over a federal patient bill of rights, many managed care plans quietly made significant improvements in several key areas, according to an evaluation of 372 health plans released on Thursday. Prepared by the National Committee for Quality Assurance (NCQA), the report found that participating plans ... made across-the-board gains in delivering needed healthcare services." (Reuters Health via Yahoo! News)
HMOs Praised Over Treatments for Cholesterol, Blood Pressure
Excerpt: "More HMO patients are getting treatments, medicines and advice that help fight dangerous cholesterol levels, high blood pressure and other life-threatening ailments, according to an annual survey of health plans." (Associated Press via Washington Post)
Newly Posted or Renewed Job Openings (Post Yours!)
| Compliance Administrator | for Delaware Investments in PA |
| Testing Compliance Manager | for The 401(k) Company in TX |
Newly Posted Press Releases
| DailyAccess.Com compliance to be overseen by McKendry (DailyAccess.Com) |
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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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