BenefitsLink Health & Welfare Plans Newsletter for May 29, 2002

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May 29, 2002 - 6,419 subscribers

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Some Hospitals Balking at Large Employers' Push for Publicly Available Quality Criteria
Excerpt: "A coalition of employers, including Verizon Communications, General Electric, Fidelity Investments, and the state, will mail questionnaires to hospitals this week. The companies, disturbed by a rash of medical errors they say is harming patients and driving up costs, aim to encourage patients to migrate to hospitals that meet certain quality standards.... [C]ommunity hospital executives are worried that the standards will have unintended consequences ..." (Boston Globe)

Physicians Feel Pressured to Lie For Patients When Insurers Complicate Appeal Process
Excerpt: "Physicians become more willing to misrepresent clinical information to insurance companies as the process of appealing a denial of coverage becomes more difficult to navigate, according to a report ... Physicians' perception of the severity of the patient's medical condition will also affect their willingness to appeal an insurer's decision, versus simply lying about the situation to ensure coverage of what they consider to be necessary treatment." (Medscape; free registration required)

Health Insurance Reforms Not Expected To Help Colorado's Small-Group Market
Excerpt: "Insurers and regulators say health insurance reforms passed by lawmakers this session will not stem double-digit premium increases and an exodus of insurers from Colorado's small-group market. With membership dropping, and premiums increasing up to 60 percent a year, the small-group market, which includes groups of 50 and fewer, is considered by many to be in crisis." (The Denver Business Journal via bizjournals.com)

FDA's Regulation of Direct-To-Consumer Drug Ads 'Necessary,' Opinion Piece Maintains
Excerpt: "FDA regulation of direct-to-consumer advertisements is 'necessary' and should not be compromised by concerns over infringing upon the First Amendment rights of commercial speech, William Schultz and Michael Taylor, former deputy commissioners for policy at the FDA, write in a Washington Post opinion piece." (KaiserNetwork.org)

State Insurance Regulators Issue Position Statement on Association Health Plans
Excerpt: "NCOIL believes that the proposed exemption [for association health plans, or AHPs] in the House-passed legislation, H.R. 2563, would undermine state health reforms by allowing the federal government to regulate AHPs under what NCOIL believes are inadequate federal standards.... [E]xemption of AHPs 'would have dire consequences-- undermining state health reforms, eliminating consumer protections, and threatening access for small employers and consumers-- and should not be enacted.'" (National Conference of Insurance Legislators via BCBSHealthIssues.com)

Analysis: IRS Endorses Automatic Enrollment Cafeteria Plans
Excerpt: "Because IRS is taking the position that the employees who have to accept employee-only coverage because they don't have other health coverage are not eligible for the section 125 exception, the logical conclusion is that the cost of coverage is not part of their compensation for purposes of section 415(c). However, Rev. Rul. 2002-27 holds defined contribution plans [under certain conditions] may treat these amounts as 'deemed section 125 compensation' ..." (Deloitte & Touche)

Welcome to new BenefitsLink advertiser Evolution Benefits
Excerpt: "Using new stored-value-card technology, the Benny(tm) Card was created using a MasterCard(R) logo and has been applied first to flexible spending accounts (FSAs), making it easier for employees to access the pre-tax dollars they've set aside. The Benny(tm) Card offers enhanced convenience and savings (in time, money and paperwork), while paving the way toward new levels of individual responsibility as defined contribution plans become more and more popular in the workplace."

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

DOL Provides Additional Q&As on Benefit Claims Procedure Regulations
Excerpt: "The Questions and Answers included in this publication supplement the December 15, 2001 guidance. The views expressed in this publication represent the views of the Department of Labor.' The new guidance addresses prescription drug programs, arbitration of non-benefits claims, 'top hat' plans, and the application of the 'exhaustion of administrative remedies' doctrine when a plan fails to establish or follow a claims procedure consistent with the regulation. (U.S. Department of Labor, Pension and Welfare Benefits Administration)

Retirees Lobby Qwest Shareholders on Compensation Issues
Excerpt: "One proposal would require shareholder approval of severance packages for top executives. The second proposes that the growth in value of the company's pension fund not be a factor in determining executive bonuses. Both proposals were defeated last year. The pension proposal drew 17 percent approval, the severance proposal 27 percent." (AP via Lycos)

Use of PEOs On the Rise
Excerpt: "In general, PEOs ink one-year renewable contracts to perform triple duty: issuing paychecks and paying payroll taxes, managing employee benefits and making sure companies toe the line on workplace laws and regulations. Through the contract, PEOs become co-employers and share responsibility for hiring and firing and resolving employee disputes." (Kiplinger via International Foundation of Employee Benefit Plans)

Newly Posted or Renewed Job Openings -

Compliance Associate

for Marshfield Clinic - Security Health Plan
in WI

Technician

for Transamerica
in CA

ERISA/Employee Benefits Attorney

for Davis, Cowell & Bowe, LLP
in CA

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