| The BenefitsLink Newsletter - Welfare Plans Edition |   |
January 11, 2002 - 6,356 subscribers
Today's sponsor: EBIA's ERISA Compliance for Health & Welfare Plans
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ERISA Compliance for Health & Welfare Plans is an authoritative resource for employers, administrators and advisors. Written by leading employee benefits attorneys, this manual has all the information you need to bring your welfare benefit plans into compliance with ERISA. Click on the link to learn more about this valuable treatise, which is always kept current through periodic updates.
(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)
Analysis: Supreme Court Rules Plan Cannot Sue for $400,000 as Reimbursement Despite Plan Language
Excerpt: "Now what's a plan to do? This decision was supposed to clear up the muddle created by the federal circuits on enforcing reimbursement rights. Instead, it seems guaranteed to create even more confusion--at least in the short run, until lawyers for both sides figure out what direction things will go.... The ... perhaps more profitable direction for plans is to sue for imposition of a constructive trust on amounts recovered ..." (EBIA Weekly)
Supreme Court to Hear Arguments Jan. 16 in Challenge to Illinois External Review HMO Law
Excerpt: "The Supreme Court will hear a case on Jan. 16 that could either 'upset statutes enacted in many states' to reform managed care practices or 'undercut' the 1974 Employee Retirement Income Security Act, which has 'shielded' many health plans from state regulations, the Hartford Courant reports." (KaiserNetwork.org)
Supreme Court Will Decide ERISA Preemption Case on External Review of HMO Claim Denials
Excerpt: "Debra Moran's hunt for effective treatment of her rare condition became a seven-year saga marked by unnecessary surgery, conflicting medical advice and legal battles with her insurer. Next week, it winds up in the U.S. Supreme Court." (Associated Press via Yahoo! News)
Independent Review: An Opportunity to Improve the Medical Care System
Excerpt: "Americans are generally unaware that health plans' internal appeals and external review processes are effectively responding to patients who believe they are being denied needed treatment, speeding their access to appropriate care." (Medscape; free registration required)
Insurer With "Administrative Services Only" Contract Ruled to Be Fiduciary
Excerpt: "An employer's breach of fiduciary duty claims against an insurer under an administrative services only (ASO) contract were not dismissed -- even though the insurer was not named as a fiduciary in the plan documents -- because the insurer exercised discretion in managing plan assets and maintaining plan records, a federal district court ruled on a summary judgment motion." (Thompson Publishing Group)
Opinion: 13 Things Your Health Insurer Doesn't Want You to Know
Excerpt: "Do you ever feel that when it comes to your health plan the deck is stacked against you? That's because there are plenty of things your health insurer doesn't want you to know. Here are just 13 of them." (insure.com)
Party Battles Looming Over Costly Old Issue: Health Care Coverage
Excerpt: "As Congress and the Bush administration return to the domestic agenda, almost no issue will be harder, more expensive or more divisive to deal with than health care. But in an election year marked by a recession and rising health care costs, the issue will be very hard to ignore, political strategists and policy analysts say." (New York Times; free registration required)
Employers Drop Coverage As State Programs Expand
Excerpt: "State programs for low-income, uninsured residents have supplanted employer-provided coverage in many cases, according to a study of public health insurance programs in Minnesota, Oregon, Tennessee and Washington state." (Modern Healthcare)
Analysis: HIPAA EDI Compliance Extended (PDF)
Excerpt: "The Administrative Simplification Compliance Act extends the deadline for complying with the electronic data interchange (EDI) and medical data code set requirements of the Health Care Portability and Accountability Act (HIPAA) for one year, to October 16, 2003, for all plans if certain conditions are met. The Act also contains additional requirements, which are summarized in this Bulletin." (The Segal Company)
Analysis: IRS Issues Notice Concerning Split-Dollar Life Insurance Arrangements
Excerpt: "The Notice included several 'grandfathering' dates, the earliest and most important of which is January 28, 2002. Therefore, if you presently participate in a split-dollar arrangement, are considering entering into such an arrangement, or have been involved in structuring any such arrangement, it is important that you are aware of the following changes made by the Notice." (Duane Morris LLP)
Newly Posted or Renewed Job Openings -
| Plan Document Specialist | for Midwest Pension & Profit Sharing Services in MN |
| Senior Benefits Analyst | for TriNet - Total HR Solutions in CA |
| Document and Compliance Specialist | for Louis Kravitz & Associates, Inc. in CA |
| Manager - Reporting & Disclosure | for AEGON Insurance Group in IA |
| Retirement Plan Specialist | for Dorsey & Whitney, LLP in MN |
| Pharmacy Benefits Analyst | for The Segal Company in NY |
Newly Posted Conferences (Post Yours!)
| 401(k) Fiduciary Issues | in TX on February 5, 2002 presented by ASPA Benefits Council of the Texas Gulf Coast |
| 401(k) Plans | in OR on March 26, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| 401(k) Plans | in TX on April 2, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| Benefits Management Forum & Expo | in TX on September 29, 2002 presented by Employee Benefit News Magazine |
| Cafeteria Plans | in TX on April 3, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| Cafeteria Plans | in WA on March 20, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| COBRA Compliance for Group Health Plans | in OR on March 29, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| COBRA Compliance for Group Health Plans | in TX on April 5, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| ERISA Compliance for Health & Welfare Plans | in OR on March 28, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| ERISA Compliance for Health & Welfare Plans | in TX on April 4, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| HIPAA & Other Federal Mandates for Group Health Plans | in TX on April 4, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| HIPAA & Other Federal Mandates for Group Health Plans | in OR on March 28, 2002 presented by Employee Benefits Institute of America LLC (EBIA) |
| Implementing Pension and Welfare Benefit Changes in 2002 | in MA on January 23, 2002 presented by Massachusetts Metrowest WEB |
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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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