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The BenefitsLink Newsletter -
Welfare Plans Edition
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June 21, 2002 - 6,490 subscribers
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UPI Coverage: States Can Regulate HMOs
Excerpt: "The Supreme Court struck a blow for HMO accountability Thursday, ruling in effect that states can regulate health maintenance organizations. Specifically, a narrow court majority said Illinois insurance law is not pre-empted by federal law governing health plans. The court split along ideological lines, with moderate Justice Sandra Day O'Connor joining the liberals to cast the deciding vote." (Washington Times)

Washington Post Coverage: Right of Second Opinion for HMO Patients Upheld
Excerpt: "Supporters of limiting managed-care companies' latitude to decide issues of medical necessity hailed the court's ruling as a vindication of the states' approach." (Washington Post)

Dow Jones Coverage: Supreme Court Backs Independent Review of HMO Decisions
Excerpt: "'Allowing disparate state laws that provide inconsistent external review requirements to govern a participant's or beneficiary's claim to benefits under an employee benefit plan is wholly destructive of Congress' expressly stated goal of uniformity in this area,' Justice Thomas said. Both the House and Senate have passed versions of a patients' bill of rights that call for a nationwide system of independent review." (Dow Jones via Yahoo! News)

Reuters Coverage: Supreme Court Rules Patient Has Right to Challenge HMO Under Illinois Law
Excerpt: "Had the decision gone the other way, it could have effectively invalidated not just the 'external appeals' law in Illinois, but those in more than 40 other states." (Reuters via Yahoo! News)

Corporate America Fears High Court Ruling Will Hike HMO Premiums Even More
Excerpt: "Already faced with soaring medical bills, corporate America fears that Thursday's U.S. Supreme Court ruling against an Illinois HMO will only drive up the cost of workers health insurance premiums even more. The nation's high court said state laws can require managed-care plans to pay for medical procedures that an outside independent panel determines are medically necessary." (Chicago Tribune via Hoover's Online)

Opinion: Supreme Court decision in Moran case no reason to enact Patients' Bill of Rights
Excerpt: "It makes no sense that employees living in different states but all covered by one health plan could have greater rights than others simply based on where they happen to live. But the proponents of PBOR have never been interested in a rational, uniform external review process to resolve benefit claims disputes." (American Benefits Council)

Minnesota Attorney General Sues Drugmaker Over Prices
Excerpt: "The suit against Pharmacia Corp. places Minnesota among the first five states to sue drug manufacturers in what is shaping up as the next coordinated legal assault by attorneys general on a major industry.... The nation's drug companies provide several national listing companies with an 'average wholesale price,' or AWP, for each of their drugs.... [T]he common joke about AWP within the industry is that it stands for 'Ain't What's Paid.'" (StarTribune.com)

Pre-Paid Legal Services Company Grows Customer Base But Faces Lawsuits
Excerpt: "This is a curious business, selling legal insurance-- it is more selling than insurance. The customer forks over on average $251 a year for the coverage. Only $83 goes to pay for supplying lawyers to customers. The rest goes to overhead and profits.... [A] company filing shows only 29% of the customers keep their policies going for three years or more. But a suit alleges Pre-Paid told agents the three-year retention rate was more than 70%." (Forbes.com; free registration required)

Pet Sitters Expects 5,000 Firms to Participate in 'Take Dog to Work Day'
Excerpt: "A study ... suggests that pets serve as 'social lubricants to facilitate social interaction.' Companies usually require owners to keep their pets current on their vaccinations, on a leash and flea-free, and to clean up after them." (The Seattle Times via International Foundation of Employee Benefit Plans)

Small Rewards Can Push Productivity
Excerpt: "Small gifts that symbolize your appreciation can have a surprising impact on employee satisfaction and performance, carrying more weight even than cold cash." (Workforce.com)

New York State Fines Two Health Insurers $2.5 Million
Excerpt: "Citing a litany of bungled claims, improper treatment denials, unlicensed health insurance agents, and poorly performing claims processors using out-of-date software, the New York Department of Insurance (DOI) has fined Aetna US Healthcare and UnitedHealthcare a total of $2.5 million." (insure.com)

Kennedy's Proposed Health Care Reforms Unnecessary, Investors Business Daily Editorial Says
Excerpt: "A plan to enter a 'new era of health reform' announced June 18 by Sen. Edward Kennedy (D-Mass.) could be 'another attempt to socialize health care' and 'should frighten sensible Americans,' an Investors Business Daily editorial states. Kennedy said he intends to propose several bills in an effort to reduce the number of uninsured, lower health care costs and provide a Medicare prescription drug benefit ..." (KaiserNetwork.org)

House May Include Health Insurance Tax Credit in Trade Bill
Excerpt: "A health insurance tax credit is among the provisions that the House may consider when it negotiates an omnibus trade bill with the Senate. The House Rules Committee late on June 19 approved a rule for the Trade Bill of 2002 (HRes 450), which sets the bargaining positions that it will take for a conference committee with the Senate on the trade bill." (Tax.CCHGROUP.com)

Newly Posted or Renewed Job Openings - Post a Help Wanted Ad
Account Manager for Benefitstreet Inc.
in CA
Client Advisors for CIGNA Retirement and Investment Services
in IA

Newly Posted Conferences (Post Yours!)
Fundamentals of Qualified Plans (3-day program) 5 Locations; June - Julyin CO, MI, MN, OH, TX on June 26, 2002
presented by SunGard Corbel

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