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The BenefitsLink Newsletter -
Welfare Plans Edition
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February 27, 2002 - 6,505 subscribers
Today's sponsor: Benelogic, LLC

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

   Benelogic, LLC develops intuitive software applications designed
   to simplify employee benefits administration.  By enabling the
   logical use of data to streamline and enhance the benefits
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   including: Employee Self-Enrollment, Employee Communications,
   Carrier Data Exchange, Voluntary Benefits Administration, COBRA
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(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)

CMS Issues Frequently Asked Questions on One-Year Extension for Electronic Transaction Requirements
Excerpt: "The Center for Medicare and Medicaid Services (CMS), formerly HCFA, has issued 24 frequently-asked questions about the delayed effective date for HIPAA's electronic transactions and code set requirements for covered entities that meet certain conditions." (EBIA Weekly)

Voluntary Employee-Pay-All AD&D Policy Is ERISA Plan Because of Employer's "Endorsement"
Cronin v. Zurich American Ins. Co. (S.D.N.Y. 2002). Excerpt: "The court found that the employer's administration of the voluntary policy was substantial: it was the policyholder, distributed SPDs and SARs, filed Form 5500s with the IRS, had the insurer modify the policy's provisions, processed the initial stages of claims, and 'perhaps most importantly, offered the [voluntary policy] along with the other various plans in their overall 'cafeteria plan' of employee benefits.'" (EBIA Weekly)

IRS Releases Q&As on Reimbursement of Health Insurance Premiums, Medicare Part B Premiums and More
Excerpt: "The IRS's Chief Counsel's Office for Tax-Exempt Government Entities (TEGE) has released Questions and Answers on employment tax issues of public employers. The guidance in many of the Q&As is also instructive for private-sector employers. Here are some highlights, along with abbreviated versions of the IRS's responses." (EBIA Weekly)

Employee's Lawyer Assessed Employer's Legal Fees for Pursuing Claims After Benefits Were Paid
Moreno v. St. Francis Hospital & Health Center (N.D. Ill. 2002). Excerpt: "After the suit was filed, the plan paid the [employee's COBRA] dental claims. Because the employee continued to seek ERISA penalties even though he had received his benefits, the court ruled in favor of the employer and the administrators.... It's rare for a plaintiff's lawyer to get stuck with paying the defendants' attorneys' fees." (EBIA Weekly)

Another Trial Court Rejects ERISA Reimbursement Claim
Hotel & Rest. & Bar Emples. Fringe Benefit Funds v. Trong (D. Minn. 2002). Excerpt: "Here is another reported case on ERISA subrogation and reimbursement that has been decided since the U.S. Supreme Court's decision last month in the Great-West case ... the court found that the plan had not alleged any claim for equitable relief of the kind required to support a lawsuit under ERISA." (EBIA Weekly)

Court Upholds Benefit Denial Where Employee Failed to Meet Deadline for Providing Proof of Loss
Peterson v. CIGNA Group Ins. (E.D. La. 2002). Excerpt: "An employee filed suit after she was denied disability benefits for failure to provide written proof of loss within the time required under her employer's long-term disability (LTD) insurance policy.... The court found no abuse of discretion in the claims administrator's decision. It noted that the plan's proof of loss provision was clear and there was no written proof that the employee had submitted her claim on time." (EBIA Weekly)

Opinion: the Latest Mammogram Report
Excerpt: "Both groups must make it very clear how they reached their conflicting judgments so the public can get a better sense of which side is right." (New York Times; free registration required)

Retiree Group Targets Healthcare Gaps
Excerpt: "Those retirees lucky enough to have employer-sponsored health coverage have, in a growing number of cases, seen that benefit come under attack by both tough economic times and rising healthcare costs. However, the National Retiree Legislative Network (NRLN), a Washington-based coalition of nearly a dozen retiree organizations dedicated to protecting the pension plans and retirement benefits of their members, has outlined an aggressive legislative agenda for 2002 ..." (PLANSPONSOR.com; free registration required)

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

Most Benefits Managers View Employee Self-Service as Essential
Excerpt: "Near-religious experiences with employee self-service is perpetuating belief in a technology some analysts say is still quite far from delivering on its divine potential." (BenefitNews.com)

Overview: New Regs on Furnishing Plan Descriptions and Information to the DOL (PDF)
Excerpt: "The new disclosure requirements, which are effective March 8, 2002, impose personal penalties of up to $1,000 for each failure to furnish requested information. These new regulations, when combined with modifications to the rules governing SPDs (especially for health plans), require plan administrators to ensure that they maintain up-to-date SPDs and summaries of material modifications (SMMs)." (Milliman USA)

Do Executives Have Too Much Privilege?
Excerpt: "Top executives have earned such gigantic sums in recent years that they're far more able to weather tough times than their underlings. Yet they keep demanding more -- at the expense of those they should be leading.... The special-deals mentality in some executive suites marks the culmination of a decade of runaway executive pay." (CareerJournal.com)

PWBA Activates New Toll-Free Telephone Number For Answers To Retirement, Health Inquiries
Secretary of Labor Elaine L. Chao has announced that the Department of Labor's Pension and Welfare Benefits Administration (PWBA) has activated a new toll-free 'participant and compliance assistance number' to make it easier for workers and employers to get help with questions regarding their retirement and health care benefit plans. The new number is (866) 275-7922. (Spencernet)

Newly Posted or Renewed Job Openings - Post a Help Wanted Ad
401(k) Administrator/Account Manager for Pension Specialists, Inc.
Documentation Compliance Specialist-LLY for Management Recruiters of Portland
Reporting Compliance Specialist for U.S. Department of Labor, Pension & Welfare Benefits Administration
Client Service Manager - Health and Welfare Plans for Mktg/Sales Company Offering Medical, Life, and Other Ancillary Benefits
Senior Benefit Consultant for Buck Consultants, Baltimore Office
Principal Health & Welfare Consultant for Buck Consultants, Secaucus Office
Compliance Specialist for The Segal Company
Owner-Partner-Employee Benefits Consultant for The Cherokee Benefits Group, Inc.
Institutional Consultant for TIAA-CREF

Newly Posted Webcasts (Post Yours!)
State Versus Federal Regulation: Which Way Is the Pendulum Swinging? on February 26, 2002
presented by KaiserNetwork.org
In the Midst of War and Recession: Health Care Issues in 2002 on February 26, 2002
presented by KaiserNetwork.org

Newly Posted Press Releases
SunGard Corbel Exceeds Test Specifications for GoldK (SunGard Corbel)
deciphr Partners with Empliant (Empliant, Inc.)
26 "real world" compensation handbooks in new book (Watson Wyatt Data Services)

Subscribe to the Retirement Plans Edition, too (click)

Copyright 2002 BenefitsLink.com, Inc., but you may freely distribute this email newsletter in whole. This newsletter is edited by David Rhett Baker, J.D.