| The BenefitsLink Newsletter - Welfare Plans Edition |   |
December 4, 2001 - 6,718 subscribers
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Summary of Key Pending Health Legislation (PDF)
Useful 7-page chart includes description of bills on mental health parity, health care assistance for displaced workers, delay of HIPAA administrative simplification regulations, patients' bill of rights, retiree health, genetic discrimination, medicare reform. (American Benefits Council)
GAO Report: Small Employers Continue to Face Challenges in Providing Coverage
Excerpt: "Nearly all states have enacted laws that limit the extent to which insurers can vary premiums charged to small employers on the basis of the health and other risk factors of the group. State laws that more tightly restrict variation in premiums can make coverage more affordable for small employers with high-risk employees but may also increase the cost of insurance for healthier groups." (U.S. General Accounting Office)
Opinion: Congressional Expansion of Mental Health Parity Would Come at a Cost
Excerpt: "The benefit is unassailable. The problem is Congress's failure to face in a serious way the question of cost.... If Congress gets into the giddy business of conferring additional benefits without having to pay, or pay much attention to, the cumulative cost, the danger is that even more people will end up with no insurance at all." (Washington Post)
Lower Mental Health Benefits in Long-Term Disability Plan May Violate ADA
Johnson v. K Mart Corp. (11th Cir. 2001). Excerpt: "Long-term disability plans by definition cover individuals who are disabled--which makes them protected individuals under the ADA. The EEOC's position (and this court's) is that it is a violation of the ADA to discriminate among these groups of protected individuals." (EBIA Weekly)
Beneficiary of Individual Health Insurance Policy May Not Sue for Violation of HIPAA
O'Donnell v. Blue Cross Shield of Wyoming (D. Wy. 2001). Excerpt: "[The court said] HIPAA individual market provisions do not expressly provide for individual lawsuits but only for enforcement actions by the Department of Health and Human Services. The court joined with other district courts in holding that HIPAA does not give individuals an implied right to sue insurers for violations. However, it held that HIPAA did not preempt Ms. O'Donnell's state-law claims." (EBIA Weekly)
Pre-Ex Clause Does Not Apply When Treatment During Exclusionary Period Not Linked to Later Diagnosis
Cecchanecchio v. Continental Casualty Co. (E.D. Pa. 2001). Excerpt: "EBIA Comment: Although this case is not decided under HIPAA (because it involves a long-term disability policy and it predates HIPAA), it caught our eye because the exclusionary language that the court addresses is quite similar to HIPAA's required definition of a preexisting condition." (EBIA Weekly)
Utilization Review Company Not Subject to ERISA Penalties for Failure to Disclose Review Criteria
Rubin-Schneiderman v. Merit Behavioral Care Corp. (S.D.N.Y. 2001). Excerpt: "EBIA Comment: In reaching its conclusion ... the court cited a Second Circuit decision but made no mention of DOL Advisory Opinion 96-14A (July 31, 1996). This DOL opinion required disclosure of a group health plan's usual and customary fee schedule, which indicates that the DOL does not construe ERISA's document delivery requirements as narrowly as the courts have." (EBIA Weekly)
"Gross-Up" In Salary To Cover Health Insurance Premiums For Dependents Not An ERISA "Plan"
A 'gross-up' in salary that a law firm had provided to partners to make up for the deduction of health insurance premiums for dependents was not a 'plan' under ERISA and, hence, an attorney could not pursue an ERISA claim that she was terminated for complaining about the elimination of the gross-up. This was the decision of the Seventh Circuit U.S. Court of Appeals in Bilow v. Much Shelist Freed Denenberg Ament & Rubenstein, P.C. (Nos. 00-2467, 00-2587, and 00-3098). (Spencernet)
How Flexibility Can Help Employers Avoid Legal Hassles
Excerpt: "Employees suffering from Post Traumatic Stress Disorder, or PTSD, under certain conditions may qualify for FMLA protection because the act covers those with a 'serious health condition that makes the employee unable to perform the employee's job.'" (CareerJournal.com)
Opinion: U.S. Health-Care CEO Pay Is a Study in Extremes
Excerpt: "The U.S. health-care industry has exceedingly wide variations in chief executive officers' pay and performance. Unfortunately, these variations don't coincide with each other. That is a key finding from a study I conducted of last year's pay for 28 CEOs running companies that had revenue of $100 million or more." (Graef Crystal, on Bloomberg.com)
What Employers Must Do When Duty Calls
Excerpt: "As the war in Afghanistan escalates, many employers are taking another look at the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA). A Miami attorney discusses the law." (Workforce.com)
HMOs Flee Medicare Despite Rise in Payments
Excerpt: "The federal policy of increasing payments to health maintenance organizations in the hope of persuading them to stay in the Medicare program has largely been a failure, federal investigators said [on Monday, December 3.]" (New York Times; free registration required)
Evolution Is Certifiable In Work/Life Field
Excerpt: "[T]he work/life profession is gaining in stature: The Alliance of Work/Life Professionals, based in Alexandria, Va., was founded in 1996 with 250 members. Today it has 1,000 nationwide." (Chicago Tribune)
IRS Proposes Employment Tax Rules Detrimental to Incentive Stock Option Programs
Excerpt: "Shortly before the Thanksgiving holiday, the Internal Revenue Service published proposed rules that many sponsors of employee stock purchase plans (ESPPs) and granters of incentive stock options (ISOs) may view as unappetizing. Under these rules, which are proposed to be effective beginning in 2003, employers and participants may find ISOs and ESPPs to be less attractive and more expensive through the imposition of employment taxes ..." (Scott Kilgore & Barclay Collins, published by Foundation for Enterprise Development)
IASB Debates Income Statement Recording of Equity Compensation
Excerpt: "The International Accounting Standards Board (IASB) is facing a tough fight over its plans to adopt new accounting rules that would require companies to record the cost of equity-based compensation paid employees, and outside contractors and consultants in their income statements." (KPMG LLP’s Washington National Tax practice, published by Foundation for Enterprise Development)
Newly Posted or Renewed Job Openings (Post Yours!)
| Analyst 401(k) Plan Administrator | for J. D. Benefits, Inc. -- Chapel Hill, North Carolina in NC |
| Actuary - Senior Consultant | for Global HR Consulting Firm in DC |
| Client Relationship Consultant | for Ceridian in VA |
| Senior Plan Administrator | for Ceridian in VA |
| 401(k) Sales | for Alliance Benefit Group Of New England in MA, NH |
| Employee Benefits Attorney | for Thompson Hine LLP in DC |
| CONVERSIONS, TEAM LEADER | for Charles Schwab & Co., Inc. in OH |
| Retirement Plan Services Administrator | for Wayne County National Bank in OH |
Newly Posted Press Releases
| Powerful New Employer Plan Sponsor Database Introduced! (401kExchange) |
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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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