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November 13, 2002 - 7,973 subscribers
Today's sponsor: Alexander Hamilton Institute Audio Conferences

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

   HIPAA Privacy Rules: Impact On Employers-Live Audio Conference 

   As you know, rules issued under the Health Insurance Portability &
   Accountability Act (HIPAA) greatly restrict the use and disclosure
   of individuals' health information. They apply to most group health
   plans, all health plan service providers, and any other "business
   associates" related to the plan. These rules take effect April 14, 2003.
   AHI has teamed up with an expert on HIPAA issues, attorney John L. Barlament,
   to present a 90-minute audio conference on November 20, 2002, to help clear
   up the confusion surrounding the rules and to help you avoid penalties.
   Click to learn more: http://www.ahipubs.com/redir/bl111302.cgi

(Help BenefitsLink to provide this newsletter at no charge to you -- our sponsors pay your way. Remember to visit them periodically; we try to make sure their products and services will be of interest to you. Thanks! --Editor)
Rx: Cost Containment
Excerpt: "Health-care inflation is back, and prescription drug costs are rising at a double-digit rate. Here are some ways to get in front of the problem." (Business Finance magazine)

RAND: Cost Sharing Cuts Employers' Drug Spending-- But Employees Don't Get the Savings
Do increased patient cost sharing and formulary restrictions reduce pharmaceutical use and costs? To answer this question, a RAND team ... examined more than 700,000 person-years of data on beneficiaries enrolled in health plans from 25 private employers.... The study's key findings: Increasing co-payments causes consumers to use less medication and less-expensive drugs. Higher co-payments do cut costs, but [m]ost of the savings go to health insurance plans, not to consumers." (The Rand Corporation)

Health Insurers' Group to Teach Real Cost of Healthcare
Excerpt: "The Minnesota Council of Health Plans (MCHP) has a new tool kit to help employers explain rising premiums to employees: It provides the true cost of a visit for an ear ache, a tonsillectomy and many other procedures.... Businesses can use the materials to educate employees about how rising health-care costs lead to premium increases, said Kirby Erickson, interim executive director of MCHP, a state association of health insurers." (The Business Journal (Minneapolis/St. Paul) via bizjournals.com; free registration required)

Consumer-Focused Health Information Web Sites Launched with Backing from Commonwealth Fund
Excerpt: "The Commonwealth Fund recently helped launch three Web sites that provide information to consumers about health care access and insurance." (KaiserNetwork.org)

IRS Discusses Deductibility of Nursing Home Care Under Code Section 213
IRS Information Letter 2002-0169 (Aug. 7, 2002). Excerpt: "In this Information Letter, the IRS responds to an inquiry about the extent to which expenses for nursing home care are deductible on an individual's federal income tax return.... Code Section 106(c) specifically provides that expenses for qualified long-term care services cannot be reimbursed on a tax-free basis through a health FSA." (EBIA Weekly)

What Changes Are Needed To Our COBRA Administration Procedures Under the Trade Act of 2002?
Excerpt: "Question: We know that the Trade Act of 2002 amended COBRA to provide for a special second COBRA election period for certain displaced workers and that the amendments become effective in November of 2002. Should any changes be made in our COBRA procedures or notice forms (or in our plan's SPD) as a result of the Trade Act of 2002?" (EBIA Weekly (Question of the Week))

COBRA Election Notice to Former Employee Was Adequate for Dependent Children Living at Home
McDermott v. Case Windham Pub. Schs., 2002 U.S. Dist. LEXIS 20949 (D. Conn. 2002). Excerpt: "This case briefly addresses a rarely contested issue: the adequacy of a COBRA election notice to qualified beneficiaries who are dependent children. The case was brought against a school district by a teacher whose employment was terminated. Included among the teacher's claims was a COBRA claim on behalf of her children." (EBIA Weekly)

Maryland's Highest Court Finds State's External Review Law Not Preempted by ERISA
Connecticut General Life Ins. Co. v. Ins. Comm'r for Maryland (Md. Ct. App. 2002). Excerpt: "In this opinion, the highest court in the state of Maryland followed the U.S. Supreme Court's recent decision in Rush Prudential HMO v. Moran to uphold Maryland's external review law against the preemption challenge of an insurer targeted by the state insurance commissioner for enforcement under the law.... Over 40 states have enacted external review laws ..." (EBIA Weekly)

Ten Questions to Ask About Your Disability Plan (PDF)
Pages 1 through 4 of a 12-page document. Excerpt: "The subjective nature of determining the risk and the long-term nature of the liability mean that disability costs can be extremely volatile. A moment's inattention can result in a significant cost increase for both employers and employees. To keep disability costs under control, employers should periodically review their disability plans, paying particular attention to the following 10 questions." (Milliman USA)

IRS Information Letters Address Issues Relating to Qualified Transportation Fringe Benefits
Excerpt: "Is car pooling a qualified transportation fringe benefit? What about parking for motorcycles and other single-occupancy vehicles? The IRS analyzes these questions in two information letters that have recently been made public." (Deloitte & Touche Human Capital Advisory Services)

COLI Controversy Builds As IRS, Federal Courts Intervene
Excerpt: "A complaint against the underwriters, marketers and designers of aggressive COLI filed Sept. 3 by Wal-Mart in a Delaware state court provides a revealing look at how the many companies that bought the product are likely to come back on the underwriters and marketers of the product." (BenefitNews.com)

The California Patient's Guide: Your Health Care Rights and Remedies
Excerpt: "This guide is intended to inform you of your rights to receive quality health care and what steps you can take if you encounter problems. It has been assembled by medical, legal and consumer experts under the supervision of a non-profit organization, The Foundation for Taxpayer and Consumer Rights, through a grant from the California Wellness Foundation." (The Foundation for Taxpayer & Consumer Rights)

NCQA Publishes Case Studies of Quality Improvements to Managed Care Plans
Excerpt: "We believe that the Quality Profiles website will be a useful resource for examples of quality initiatives that serve as models for organizations facing similar challenges. These case studies (profiles) illustrate the principles of quality improvement and reflect the standards each plan applied at the time of their initiative." (National Committee for Quality Assurance)

Analysis Predicts Multimillion-Dollar Litigation Costs in Screening Mammography
Excerpt: "In just 10 years, the cost of screening mammography litigation in the United States could top $250 million a year, a new analysis has found.... Malpractice insurance companies would likely increase their premiums as litigation costs go up, making it less attractive for radiologists to do screening mammography ... A solution ... could be a federally sponsored litigation pool similar to the one that currently exists for vaccine lawsuits ..." (Medscape; free registration required)

Employer Efforts to Slow Health-Care Inflation Raise Worker Privacy Concerns
Excerpt: "The goal is to stop what have become uncontrollable health care costs by identifying consumers who may be at risk for developing expensive, chronic medical conditions and pairing them with nurse managers who, armed with every detail of a patient's history, make phone calls, suggest prescriptions, recommend doctors and even offer recipes. The concept, known as outcomes management -- not to be confused with disease management ... is saving millions of dollars ... proponents say.'" (The Denver Post via International Foundation of Employee Benefit Plans)

Prospects Not Good for Federal Generic Drugs Bill
Excerpt: "[I]t's a good bet that the Republican victory will blunt the momentum that propelled a generic-drug bill through the Democrat- controlled Senate, only to stall in the Republican-led House of Representatives." (San Francisco Chronicle)

Healthcare Pollster Says Consumer Choice Threatens U.S. Health Insurance System
Excerpt: "[V]eteran healthcare pollster Humphrey Taylor ... says the trend toward more 'consumer-driven' healthcare will lead to the collapse of the employer-sponsored health insurance system, unless government intervenes." (Medscape; free registration required)

Health Insurance System Hangs On Despite Oregon Attempt at End Run
Excerpt: "The proponents [of Oregon's Measure 23 on universal health insurance coverage] may be kidding themselves about the 'success' of their ballot measure. But if the opponents think the issue can be swept under the legislative carpet, they, too, may be delusional." (Seattle Post-Intelligencer)

Employer Attitudes Toward Health Benefits Reveal Several Challenges, According To EBRI
According to research conducted by the Employee Benefit Research Institute, public and private sector employers provide health care coverage to 63% of the total U.S. population, or more than 165 million Americans younger than age 65, through voluntary employment-based programs. Despite private sector efforts, 14% of the total U.S. population and about 16% of the population younger than age 65 were without any health insurance coverage in 2000, accounting for 39 million people. (SpencerNet)




Links to Items on Executive Comp, Benefits in General

Period for Responding to Document Request Does Not Start Until Administrator Receives Request
Romero v. SmithKline Beecham, 2002 U.S. App. LEXIS 22576 (3d Cir. 2002). Excerpt: "Recall that the plan SPD must identify the plan administrator, and therefore the procedure for responding to requests for documents should be consistent with the SPD language.... Plans may wish to include a more specific procedure for making requests (e.g., require that requests be made to an identified person acting for the plan administrator)." (EBIA Weekly)

Double Benefits For Veterans Deal Reached
Excerpt: "Veterans who hoped to receive both pensions and disability benefits were disappointed when the House adopted a scaled-down version of the defense authorization bill in a voice vote Tuesday. Congressional negotiators who have tried to iron out the details of the bill since September finally agreed to allow veterans who have served at least 20 years to receive both benefits without the current dollar-for-dollar offset." (The [Biloxi, Miss.] Sun Herald)

Pressure to Expense Options Mounts, Even in Silicon Valley
Editorial. Excerpt: "The tech industry should give up the fight on expensing. It could make better use of its clout by working with the international and American accounting panels on the rules for expensing options. In the process, it would restore credibility with investors ..." (San Jose Mercury News)

Welcome to new BenefitsLink advertiser Corporate Benefit Services of America, Inc.
Excerpt: "CBSA is a national Benefits Administration and Medical Care Manager of employee benefits, providing an extensive array of services to both self-funded and fully insured companies. Competitive programs backed by superior service and enhanced by technological advancements that allow immediate access to data that is important to clients and their employees. CBSA has over 25 years of benefits administration experience and is committed to client service and satisfaction."




Newly Posted or Renewed Job Openings
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for Mullin Consulting, Inc.
in CA, IL

Qualified Retirement Plan Administration Specialist
for RSM McGladrey, Inc.
in MN

Retirement Plan Business Development Sales Professional
for RSM McGladrey, Inc.
in IL

Benefits Administrator/Admin Assistant
for Sound Benefit Solutions
in CA

Administrative Assistant-CCI
for Transamerica
in CA




Newly Posted Webcasts
(Post Yours!)

BENEFIT CLAIMS PROCEDURES FOR GROUP HEALTH PLANS
on October 29, 2002
presented by EBIA




Newly Posted Conferences
(Post Yours!)

An Afternoon with Brian Graff
in PA
December 12, 2002
ASPA Benefits Council of Western PA

HIPAA and Other Health Laws: Compliance Assistance Seminar
in NE
November 21, 2002
U.S. Department of Labor, Pension and Welfare Benefits Administration




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