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The BenefitsLink Newsletter -
Welfare Plans Edition
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February 4, 2002 - 6,451 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)

HIPAA Electronic Transaction Standards Regulation
Excerpt: "In August of 2000, the Department of Health and Human Services (HHS) published final regulations under the administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) setting forth uniform standards for the electronic exchange of administrative and financial health care transactions.... The following is a summary of the final electronic transaction and uniform code set requirements." (Ballard Spahr Andrews & Ingersoll LLP)

Feds Say Health Plan's Officers Paid Themselves $6 Million While Claims Went Unpaid
Excerpt: "While their 22,000 customers nationwide racked up an estimated $4.5 million in unpaid health insurance claims, the principals of Employers Mutual LLC and its affiliated associations diverted more than $6 million of the health plan's assets into their own personal bank accounts, according to the United States Department of Labor (DOL)." (insure.com)

Denial of Benefits Improper Due to Lack of "Concrete Evidence" Supporting Denial
Excerpt: "The record contains an overwhelming amount of medical evidence supporting Lain's claim of disability. Further, there is no evidence in the administrative record and UNUM has not presented any evidence to this Court which establishes that Lain was capable of working ... Thus, because there is a complete absence in the record of any 'concrete evidence' supporting UNUM's determination that Lain is not disabled, the district court properly held that UNUM abused its discretion." (U.S. Court of Appeals for the Fifth Circuit, via FindLaw.com)

Most Workers Looking for Flexible Schedules Do Not Request Them From Current Employer
Excerpt: "Fifty-nine percent of respondents expressed reluctance to inquire about a flexible work arrangement. Respondents most often cited company policy and a perception that they would be seen as less than serious about their careers as the reasons for not asking about new work arrangements." (Society for Human Resource Management)

HIPAA Privacy Standards and Employer-Sponsored Health Plans
Excerpt: "[V]iew a summary intended to help employers who sponsor health benefit plans understand and comply with the HIPAA privacy regulations." (Ballard Spahr Andrews & Ingersoll LLP)

Commissioner Kreidler Revives Universal Coverage Plan in Washington State
Excerpt: "State Insurance Commissioner Mike Kreidler was a member of the Washington commission that 10 years ago drafted a blueprint for radical health-care reform in Washington. Now, a decade later, Kreidler seeks to rekindle reform efforts with the aid of another commission of sorts assembled by the Legislature." (Puget Sound Business Journal)

New York Senate Republicans Offer Compromise Bill, Would Mandate Contraceptive Coverage
Excerpt: "Republican lawmakers have offered a compromise bill requiring health insurers to cover contraceptives, winning the support of birth control advocates and closing much of the gap between their position and the Democrats'." (New York Times; free registration required)

State of the States: Health Insurance Coverage Challenges, Insurance Market Reforms in 2001 (PDF)
35 pages. Excerpt: "[T]he states remained committed to understanding and addressing their uninsured throughout the course of the year. In 2001, more than half the states participated in public or private grant programs aimed at planning or implementing new coverage models, the majority of which are still under way. It may be tempting to lose faith in the value of planning to expand coverage at a time when finances are so strained, but we must not do so." (The Robert Wood Johnson Foundation)

Income, Poverty, and Health Insurance In the United States In 2000
Excerpt: "Based on the U.S. Census Bureau's March 2001 Current Population Survey, this AARP Public Policy Institute Fact Sheet by Ke Bin Wu reports that median household income declined 0.1%, poverty declined by 0.5 percentage points, and an estimated 38.7 million persons were without health insurance coverage. (2 pages)" (AARP Research Center)

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

Agencies Release Year 2001 Version of 5500 Forms
The Department of Labor's Pension and Welfare Benefits Administration (PWBA), the Internal Revenue Service, and the Pension Benefit Guaranty Corporation have released information copies of the Form 5500 annual return/reports, schedules, and instructions to be used by employee benefit plans for plan year 2001 filings. Certain changes were made to the forms to reflect changes in the law or regulations, to improve forms processing, and to clarify the instructions. (Spencernet)

Even Last Year, Option Spigot Was Wide Open
Excerpt: "As corporate earnings and cash flow have ebbed and stock prices have fallen, boards have been doling out options as a cheap, balance-sheet-friendly way of compensating managers.... According to a survey done in the third quarter of last year ... the number of options granted by 50 major companies that will report their 2001 compensation this spring was up an average of 12 percent from 2000." (New York Times via Yahoo!)

Newly Posted or Renewed Job Openings - Post a Help Wanted Ad
Benefits Administrator for Philips PACE - A Division of Philips Electronics North America
Defined Contribution Administrator for Thomas, Beck, Zurcher & White, P.A.
Manager, Benefits/Employee Programs for Fast Growing Energy Company
401(k) ERISA Compliance Consultant for Pinnacle Financial Services, Inc.
President for Rockford Pensions, LLC

Newly Posted Conferences (Post Yours!)
Test Your SPD Compliance IQin NY on February 27, 2002
presented by New York Metropolitan Area Chapter - ISCEBS
Defined Contribution Health Plans: Can This Approach Work for You? - Teleweb Seminarin ALL STATES on February 14, 2002
presented by International Foundation of Employee Benefit Plans

Newly Posted Announcements of Promotions and New Personnel (Post Yours!)
Patrick J. Farzaroli (BenefitStreet, Inc.)

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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.