| The BenefitsLink Newsletter - Welfare Plans Edition |   |
May 7, 2002 - 6,424 subscribers
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Wall Street Journal Examines Short-Term Health Insurance Policies
Excerpt: "COBRA can be 'expensive and impractical for healthy workers' who do not have many medical claims, the Journal reports, pointing out that while COBRA premiums averaged about $400 a month in 2000, a 27-year-old woman living in California could get a short-term insurance policy with a $500 deductible for about $103 a month." (KaiserNetwork.org)
Owners and Their Relatives in a Family Business Are Counted as Employees for COBRA Purposes
Jimenez v. Mueblerias Delgado, Inc. (D.P.R. 2002). Excerpt: "With respect to the employer's argument that family members working in the business should not be counted as employees, the court held that state-law definitions did not apply. Instead, the court applied ERISA's definition of employee: 'any individual employed by an employer.'" (EBIA Weekly)
Employee's Discrimination Claims Based on Plan's Exclusions for Infertility Treatment Dismissed
Alexander v. American Airlines, Inc. (N.D. Tex. 2002). Excerpt: "The employee ... sought coverage for infertility treatment under her employer's heath plan. [In a lawsuit, she alleged] that her employer ... violated the Pregnancy Nondiscrimination Act (PDA) and Americans with Disabilities Act (ADA) by failing to cover infertility treatment ... Other courts have used similar 'equal access' reasoning to conclude that exclusions or limitations in health plans are not prohibited by the ADA." (EBIA Weekly)
Court Refuses to Dismiss Claim of Fiduciary Breach for Violation of HIPAA Nondiscrimination Rules
Mohr v. Benicorp Ins. Co. (D. Neb. 2002). Excerpt: "This case ... involves a benefit dispute in which the insurer of an employer-provided group health plan refused to pay claims submitted by a covered spouse and then terminated coverage for both the participant and spouse.... [T]hey also claimed that they should be reinstated in the plan because the insurance company had breached its ERISA fiduciary duties by canceling their insurance coverage in violation HIPAA's nondiscrimination rules." (EBIA Weekly)
Participant's Mental Incapacity May Suspend Deadline for Filing Appeal
Chapman v. Choicecare Long Island Long Term Disability Plan (2d Cir. 2002). Excerpt: "On this appeal to the Second Circuit ... the participant argued that her mental incapacity had interfered with her ability to communicate effectively with her attorneys, which in turn prevented them from acting on time.... The ... Second Circuit [has] never squarely addressed the threshold issue of whether, in appropriate circumstances, diminished capacity should toll time limits imposed by an ERISA plan." (EBIA Weekly)
Some Employers Taking Steps to Help Victims of Domestic Abuse
Excerpt: "Employers are starting to figure out just how to help their employees in such paralyzing and life-threatening situations, [and] why that assistance can help the organization.... Nationwide, about 5 percent of companies have some sort of domestic-violence policy." (Washington Post)
Some Companies Work to Level Field for Adoptive Parents
Excerpt: "In 2001, only 16 percent of U.S. companies provided adoption assistance, according to the Society for Human Resource Management based in Alexandria, Va. AstraZeneca's cutting-edge adoption policy, which includes resources and referrals, also offers up to 26 weeks of leave and a guaranteed job on return." (Chicago Tribune; free registration required)
Medical Cost Savings for Prescription Drugs Remains Elusive
Excerpt: "Academicians attempting to prove that money spent on prescription drugs does indeed lower other medical costs claim progress in mounting their evidence, though their methodology and findings still vary." (BenefitNews.com)
Bush Administration's Changes To Medical Privacy Rules Would Threaten Patients, Senator Boxer Writes
Excerpt: "By requiring that patients be told only that 'their information can and will be shared,' the Bush administration 'asserts that informing patients of the privacy regulations is an acceptable substitute for an individual's informed, written consent,' Boxer states, adding, 'Quite simply, it is not.'" (KaiserNetwork.org)
Hospital Industry Considers Whether Regulation or Competition Best Way To Improve Quality
Excerpt: "Daimler Chrysler officials testified in March that the company's annual health care spending totaled $3,519 per employee or family member in Wisconsin and $2,741 in Indiana -- two states without certificate of need ['CON'] laws. In contrast, the company said it spends $1,839 per person in Michigan and $1,331 in New York state, both of which have CON laws." (KaiserNetwork.org)
Texas Slaps HMOs With $1.7 Million In Fines
Excerpt: "Texas law requires HMOs and health insurance companies with preferred provider plans to pay properly documented and properly filed claims from their network physicians and providers no later than 45 days after receipt." (insure.com)
Generic Drugs May Lower Health Care Cost; Business Coalition Making Noise
Excerpt: "A coalition called Business for Affordable Medicine, which also has support from several state governors and labor unions, is loudly criticizing legal loopholes that help pharmaceutical companies keep generic drugs off the market. The lack of access to generics is costing hundreds of millions of dollars, the coalition contends." (Washington Post)
New York Shares Long Term Care Information Online
Excerpt: "The New York Department of Insurance (DOI) has created a 'Long Term Care Resource Center' on its Web site to provide consumers with information on long term care insurance. The site also lists insurance policies available in New York." (insure.com)
BLS Data Confirms Private Estimates of Double-Digit Cost Increases In 2001
Employers' health care benefits costs grew more than 10% in 2001, according to an Employment Policy Foundation (EPF) analysis of National Compensation Survey data. Released April 25 by the Bureau of Labor Statistics, the survey is a statistically representative sample of 7,300 establishments. (Spencernet)
First Circuit Takes Narrow View of ERISA Fiduciary Duty to Provide Individualized Information
Barrs v. Lockheed Martin Corp. (1st Cir. 2002). Excerpt: "The plaintiff ... was the ex-wife of an employee who was covered by two employer-sponsored life insurance policies ... The court drew a distinction between general fiduciary duties, owed to all participants, and individualized duties, which are usually created only by a special agreement. The distinction may be helpful to plan administrators who are accused of fiduciary breach based on a failure to provide individualized information." (EBIA Weekly)
Newly Posted or Renewed Job Openings -
| Extraordinary & Fun Defined Benefit Consulting Opportunities in So. Calif. | for Louis Kravitz & Associates, Inc. in CA |
| Assistant General Counsel | for Fortune 500 Firm in TX |
| Senior Pension Administrator/Consultant | for Pension Performance, Inc. in IL |
| Transfer Education Specialists | for ICMA Retirement Corporation in DC |
| ERISA Paralegal | for Prestigious National Law Firm In Atlanta Area in GA |
| Director of Compensation & Benefits | for Spencer Stuart Executive Search in ALL STATES |
| Daily Valuations/Relius/Network Administrator | for Freedom Capital, Inc. in FL |
Newly Posted Webcasts (Post Yours!)
| EGTRRA: Implementing & Interpreting the Law Part 2 | on May 8, 2002 presented by National Association of Government Defined Contribution Plan Administrators, Inc. |
Newly Posted Conferences (Post Yours!)
| Changes to HIPAA Privacy Requirements: Impact on Compliance Planning | in ALL STATES on May 7, 2002 presented by Thompson Publishing Group |
| Recent Developments in Health Claims Subrogation and Reimbursement: The Impact of Great-West Life Ins. Co. v. Knudson. | in ALL STATES on May 21, 2002 presented by Thompson Publishing Group |
| What Every Business Needs to Know About the Current Health Care Crisis | in CA on June 17, 2002 presented by The UCLA Anderson Forecast Center |
| Health & Welfare Plan Fundamentals: A One-Day Seminar | in NY on May 22, 2002 presented by New York Metropolitan Area Chapter - ISCEBS |
| After Enron: Employer Securities in Qualified Plans | in on May 10, 2002 presented by ABA Center for Continuing Legal Education, ABA Tax Section |
| Retiree Health Care-- Trends and Alternatives Teleweb | in ALL STATES on May 16, 2002 presented by International Foundation of Employee Benefit Plans |
Newly Posted Press Releases
| TALX Corporation Forms Alliance With Bryan, Pendleton, Swats & McAllister (BPS&M) (BPS&M, A Wells Fargo Company) |
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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.
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