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The BenefitsLink Newsletter -
Welfare Plans Edition
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June 13, 2002 - 6,459 subscribers
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Deal in Albany on Mandated Health Insurance Coverage for Women
Excerpt: "After two years of grueling, often emotional talks, the Senate and Assembly have come to terms on a bill that would require insurers to cover a range of women's health services, like birth control and mammograms, officials said [June 12, 2002].... The bill would require job-based insurance plans to cover contraceptives, with a limited 'conscience clause' exemption for religious employers ..." (New York Times; free registration required)

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To Reduce Errors, Medical Education Accreditation Group To Restrict Residents' Hours To 80 Per Week
Excerpt: "The Accreditation Council for Graduate Medical Education, which accredits the nation's teaching hospitals, on June 12 announced the first national limits on the number of hours that medical residents may work in an effort to reduce the risk of 'dangerous errors by sleep-deprived young doctors,' the New York Times reports." (KaiserNetwork.org)

Humana Launches Individual Health Insurance Policies
Excerpt: "The Louisville managed-care company traditionally has focused on group coverage, selling to employers and contracting with governments. But Humana saw a growing opportunity to sell health coverage to individuals, because 'more and more employers are either offering limited or no health insurance for their employees,' said Dick Brown, director of media relations for Humana." (The [Louisville] Courier-Journal)

Vermont to Require Drug Makers to Disclose Payments to Doctors
Excerpt: "Amid rising concern about the cost of prescription drugs, Vermont is expected today to become the first state in the nation to require pharmaceutical companies to disclose their gifts and cash payments to doctors, hospitals and other health care providers." (New York Times; free registration required)

Health Advocacy Groups Launch Web Site for Consumers to Voice Concerns About Increasing Drug Costs
Excerpt: "A coalition of senior and health care advocacy groups on June 12 launched an online 'action center' that will allow consumers to have 'their voices ... heard' about increased pharmaceutical costs and prescription drug benefit for Medicare beneficiaries. The Web site, www.fairdrugprices.org, will allow consumers to send letters to members of Congress ..." (KaiserNetwork.org)

Senate Democrats Unveil Medicare Prescription Drug Benefit; House Democrats To Propose Own Version
Excerpt: "As expected, Senate Democrats on June 12 unveiled a Medicare prescription drug benefit plan, as their House counterparts prepared to release their own proposal on June 13, CongressDaily/AM reports." (KaiserNetwork.org)

Overview: Transferred Employees In Asset Sale May Continue FSA Without Interruption
6/13/2002 item. Excerpt: "Employees transferred pursuant to an asset sale may continue to exclude from their gross income amounts deducted from their paychecks for purposes of a health flexible spending arrangement (FSA) if they elected to participate in a health FSA under the seller employer's cafeteria plan." (CCH News & Information Library)

Court Appoints Independent Fiduciary To Operate New York Health and Welfare Plan
The Department of Labor has obtained a partial consent order that appoints an independent fiduciary to oversee the Huntington, N.Y.-based health and welfare plan of the Mutual Employees Benefit Trust (MEBT) and that requires all four plan trustees to resign their positions with the plan. The partial consent order was entered by the U.S. District Court for the Southern District of New York, in Chao v. Slutsky (Civil Action No. 01-7593(ADS)(TB)). (Spencernet)

Provisions of SPD Prescribing Statute of Limitations Were Ambiguous: Tenth Circuit
The provisions of a summary plan description (SPD) prescribing the statute of limitations for bringing an action to recover benefits were ambiguous and, as a result, a beneficiary could pursue his lawsuit seeking to recover health care benefits. This was the ruling of the Tenth Circuit U.S. Court of Appeals in Haymond, et al. v. Eighth District Electrical Benefit Fund (No. 01-4119). (Spencernet)

Analysis: New SPD Disclosure Rules for Health & Welfare Plans
Excerpt: "Prior to the first day of the second plan year beginning after January 20, 2001 (i.e., for calendar year plans, January 1, 2003) all summary plan descriptions for all group health and welfare plans will need updating in order to comply with the new DOL rules for SPD disclosure. In addition, the HMO exception ... has been removed ... All sponsors that provide health coverage through HMOs must now comply with the SPD disclosure rules." (Kilpatrick Stockton LLP)

Analysis: New Rules for Health & Welfare Plan Claims Procedures
Excerpt: "We are aware of certain national health insurers/TPAs who are advising their clients that they will switch to the new claims rules effective July 1, 2002 (even though those clients with calendar year plans are not subject to the new rules until 2003).... This does present a fiduciary challenge to employers since SPD disclosures will, until modified, continue to state the old rules while actual administration will be operating under the new rules." (Kilpatrick Stockton LLP)

CMS To Broadcast Video On Implementing HIPAA Transaction Standards
The Centers for Medicare and Medicaid Services (CMS) will air a video, 'Implementing HIPAA standards and the Administrative Simplification Act,' on June 18, 2002, from 2:00 p.m. to 3:30 p.m. The broadcast will cover only the HIPAA electronic transaction and transmission rules. The Administrative Simplification Compliance Act (P.L. 107-105) delayed for up to one full year, until Oct. 16, 2003, the implementation of standards for electronic transmission of health care information under HIPAA. (Spencernet)

How To Get Your Health Insurer To Pay For Your Weight-Loss Surgery
Excerpt: "If you're morbidly obese-- roughly meaning more than 100 pounds overweight-- a lot of things seem unfair, including your aching joints, shortness of breath, and your last several weight-loss attempts that went nowhere. As an added insult, your health insurer may have just denied you surgery to treat your obesity even though your doctor says the operation is medically necessary." (insure.com)




Newly Posted or Renewed Job Openings - Post a Help Wanted Ad
Director Compensation & Benefits for Leading Construction and Building Materials Company
in FL
Account Manager, Benefits Administration Outsourcing for Aliquant Corporation
in CT, PA
Retirement Plan Administrator for Jones & Roth PC and Jones & Roth Wealth Management LLC
in OR
Pension Administrator for EBC, Inc.
in CA
Record Keeping Manager for INVESCO Retirement, Inc.
in RI
Account Executive for CitiStreet
in FL
Senior Level Project Manager for The Paragon Consulting Group, Inc.
in FL
Retirement Plan Services Manager for Ceridian
in FL



Newly Posted Conferences (Post Yours!)
Western Pension & Benefits Conference Annual Meetingin UT on August 18, 2002
presented by Western Pension & Benefits Conference



Newly Posted Press Releases (Post Yours!)
SunGard Corbel's Hoffman to Become Fellow of the American College of Employee Benefits Counsel (SunGard Corbel)

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