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The BenefitsLink Newsletter -
Welfare Plans Edition
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January 7, 2002 - 6,356 subscribers
Today's sponsor: The ERISA Health and Welfare Handbook: Questions and Answers on ERISA Compliance

(Click on company name or banner to learn more.)

   This important book offers guidance on more than 30 key issues
   involving ERISA and employee welfare plans, including benefits
   entitlement, HIPAA, plan document language, discrimination issues
   and employer obligations under managed care plans.

   Written by veteran benefits consultant Terry Humo, Esq. of
   Intermountain Administrators.

(Help BenefitsLink to provide this newsletter at no charge to you -- our sponsors pay our way. Remember to visit them periodically; we try to make sure their products and services will be of interest to you. Thanks! --Editor)

HMO Review: Supreme Court Will Decide Who Gets Final Say
Excerpt: "One of the U.S. Supreme Court's first acts of 2002 will be to take up the matter of Rush Prudential HMO Inc. v. Debra C. Moran and the State of Illinois. The case is expected to determine the future of state laws requiring independent review of health maintenance organization decisions to deny coverage for patient care." (American Medical News)

Voluntary Benefits a Bright Spot in 2002
Excerpt: "During days of relentlessly rising health costs and all-around corporate belt-tightening, voluntary benefits are helping employers take a 'bad news, good news' approach to benefit planning. Health plan co-payments may double, but employees might be able to recoup the difference with 25% discounts on car insurance and competitive rates for home refinance loans." (BenefitNews.com)

Alaska Enacts Strict Prompt-Pay Law for Health Claims
Excerpt: "Alaska's new prompt-pay law requires group health insurers to pay health insurance claims within 20 working days. Formerly, insurers had 30 days to pay after receiving a 'clean claim,' or a claim submitted to them without any defects." (insure.com)

Paying Someone Else to Talk Back to Your Doctor or HMO
Excerpt: "Dr. Riccardi, who started the nonprofit advocacy company, American Medical Consumers, in 1992, is one of a small group of independent personal advocates who help patients around the country resolve disputes with insurance companies and doctors over what treatments are medically necessary and who should pay for them." (New York Times; free registration required)

California Governor Proposes Regulation Requiring HMOs To Cover Specialized Care for AIDS
Excerpt: "The [1999 California law creating external reviews] required managed care companies to provide HIV patients with access to specialists, but it did not provide criteria to define an HIV specialist. 'We found that some of the HMOs were using the lack of a clear definition of an HIV/AIDS specialist to send those patients to people who are not qualified,' said Daniel Zingale, director of the managed health care department." (Fresno Bee)

U.S. Health Care System Headed Toward 'Danger Zone," Opinion Pieces Warn
Excerpt: "The U.S. health care system has moved 'toward the danger zone' in the past year, and the 'conditions are coalescing for a surge in the ranks of the uninsured, similar to the crisis of the early 1990s,' Los Angeles Times reporter Ronald Brownstein writes in a column." (KaiserNetwork.org)

Opinion: Fix Health Care Now
Excerpt: "At the start of the new year, an old problem is forcing its way back onto the national agenda: health care. The American system of medicine is threatened with meltdown from a combination of rising costs, declining access and incredible inefficiencies." (Washington Post)

Drug Middlemen Are Facing Pressure Over Rising Prices
Excerpt: "The companies, called pharmacy benefit managers, administer drug plans for some 200 million Americans and play a critical role in determining which drugs people take for different ailments." (New York Times via Yahoo!)

Employer Premium Subsidies Provides Modest Increase In Health Insurance Coverage, HSC Study Reveals
A study released by the Center for Studying Health System Change (HSC) reveals that a 30% premium subsidy targeted at small employers would provide coverage for only about 500,000, or 3%, of the 16 million people working in small firms currently not offering health insurance. (Spencernet)

URAC Announces Health Web Site Accreditation
Thirteen Web sites have been accredited by URAC, under a program which measured them against rigorous standards for quality and accountability. The newly-accredited sites are some of the nation's largest and busiest health Web sites, including WebMD, InteliHealth, the Heath Insurance Association of America (HIAA), and Healthyroads. URAC is the Washington, D.C. health accreditation organization. (Spencernet)

OPM Proposes Rules On Sanctions of Health Care Providers That Participate In the FEHBP
The Office of Personnel Management (OPM) has issued proposed regulations concerning administrative sanctions of health care providers that participate in the Federal Employees Health Benefits Program (FEHBP). The proposed regulations appeared in the December 12 Federal Register. (Spencernet)

(Following items are in both editions of the BenefitsLink Newsletter)


Final Regs on Document Requests by DOL; Civil Penalty Provisions
Excerpt: "This document contains a final rulemaking under [ERISA] that implements certain amendments to ERISA added as part of the Taxpayer Relief Act of 1997 (TRA '97). The final rule implements section 104(a)(6) of ERISA by requiring the administrator of an employee benefit plan subject to Part 1 of Title I of ERISA to furnish to the Department, upon request, certain documents relating to the employee benefit plan." (U.S. Department of Labor)

Benefits Manager Pay Nears $80,000, Three Studies Show
Excerpt: "Here are highlights from Watson Wyatt's ECS 2001-2002 Geographic Report on Middle Management Compensation, the PricewaterhouseCoopers' Middle Management Compensation Survey: 2001, and the William M. Mercer/ Society of Human Resource Management (SHRM) 2001 Human Resource Management Compensation Survey." (IOMA's Report on Managing Benefits Plans, via International Foundation of Employee Benefit Plans)




Newly Posted or Renewed Job Openings - Post a Help Wanted Ad
Employee Benefits Attorneys Needed for Warner Norcross & Judd LLP
in
MI
Account Executive for DailyAccess.Com
in
AL
Senior Pension Administrator for Snyder Cohn Collyer Hamilton & Associates
in
MD
Rollover Specialist for New York Life Investment Management LLC
in
NJ
401(k)/DC Retirement Plan Administrator for Bellevue, WA Third Party Administration Firm
in
WA



Newly Posted Conferences (Post Yours!)
2002 Enrolled Actuaries Meetingin DC on March 10, 2002
presented by Conference of Consulting Actuaries and American Academy of Actuaries



Newly Posted Press Releases (Post Yours!)
Companies Get Creative In Accounting For Postretirement Benefits, Spencer Survey Reports (Spencernet)

Subscribe to the Retirement Plans Edition, too (click)


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.