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December 16, 2002 - 8,030 subscribers
Today's sponsor: EBIA's Group Health Plans: Federal Mandates Other Than COBRA & HIPAA

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   Group Health Plans: Federal Mandates Other Than COBRA & HIPAA,
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More Large Employers Expected To Adopt E-Health Plans In 2003
Excerpt: "Large employers are expected to offer e-health plans in greater numbers next year, with 16% of human resources and benefits managers reporting that they will begin offering Web-based health plans in 2003, according to a recent survey from Forrester Research." (iHealthBeat.org; free registration required)

Insurers Predict Drug Costs Will Rise 19% in 2003
Excerpt: "Prescription drug prices will rise 19% in 2003, a situation that could add fuel to the debate over a Medicare drug benefit, according to a survey of 60 major insurers, the Hartford Courant reports. The insurers were surveyed by the human resources consultant Segal Co." (KaiserNetwork.org)

Minneapolis Requires Contractors To Provide Domestic Partner Benefits
Excerpt: "With some exceptions, businesses with contracts of more than $100,000 with the city of Minneapolis will be required to provide domestic partner benefits to their employees within a year. After extensive debate, the City Council on Friday passed an ordinance 8 to 4 imposing the requirement." (The [Minneapolis] Star Tribune)

Insurance Regulators To Consider Reforming Association Health Plan Market
Excerpt: "A panel of the National Association of Insurance Commissioners this week considered creating stricter regulations to prevent abuses in health insurance sold through associations, the Wall Street Journal reports." (KaiserNetwork.org)

GOP Congressional Members Preparing 'Aggressive' Health Care Agenda
Excerpt: "Responding to the 'escalating crisis in health care,' Republicans, who will assume control of Congress next year, are drafting a health care agenda that would 'drastically reshape' how health care services are delivered, Gannett News/Detroit News reports ..." (KaiserNetwork.org)

10 FAQs about the Interplay of HIPAA Privacy Rules with Employment Policies and Practices
Excerpt: "An employer may offer an employee assistance program ('EAP') through a vendor (e.g., insurance contract) and/or through counselors who are employed directly by the employer. The vendor or counselor will gain access to medical information of a particularly sensitive nature, e.g., mental health, substance abuse, etc. How will HIPAA affect these EAPs?" (Ballard Spahr Andrews & Ingersoll LLP)

Bush Calls for Repeal of Paid Family Leave 'Experiment'
Excerpt: "Business groups are praising the Bush administration's plan to repeal a regulation that allows states to use unemployment insurance funds to compensate workers who take time off for the birth or adoption of a child.... Although some states considered the concept, no state dipped into its unemployment insurance trust fund to provide paid family leave." (Houston Business Journal via bizjournals.com; free registration required)

Overview: New California Employment Laws for 2003
Excerpt: "Legislation signed by Governor Davis this year will markedly expand the rights and benefits of California workers. The new laws make California the first state in the nation to provide paid leave to employees taking time off to care for a sick family member or bond with a new child. New legislation also makes certain absenteeism policies automatically illegal, and imposes additional obligations on California employers undergoing mass layoffs or terminations." (Davis Wright Tremaine LLP)

Childcare Tax Credits Available, Yet Unknown To Many Employers
Excerpt: "25 states offer employer childcare tax credits. State laws differ, but the credits generally permit the offset of some childcare expenses associated with constructing and operating a childcare facility, purchasing childcare services, childcare subsidies and resource and referral services." (BenefitNews.com)

Analysis: Supreme Court Holds ERISA Does Not Preempt State Independent Medical Review Statute (PDF)
At pp. 12 through 17. Excerpt: "In Rush Prudential HMO, Inc. v. Moran, 122 S.Ct. 2151 (June 20, 2002), the U.S. Supreme Court addressed whether ERISA preempts Illinois' independent medical review statute for HMOs, which requires an HMO to provide the requested benefit if the independent reviewer finds it is 'medically necessary.'" (Robert Rachal and Mary Ellen Signorille, published by the American Bar Association, Section of Labor and Employment Law, Employee Benefits Committee)

Can the HIPAA Privacy Notice Obligation be Met by Placing the Privacy Notice in the Plan's SPD?
Excerpt: "Yes, although as a practical matter including the privacy notice in the SPD may not be the best choice.... [I]f a plan wishes to deliver the combined SPD/privacy notice electronically, it will be faced with additional requirements under HIPAA that would not apply if the SPD were delivered separately.... [And including] the notice with the SPD will require the combined document to satisfy the distribution requirements of both ERISA and HIPAA." (EBIA Weekly (Question of the Week))

How Do the DOL Claims Regs Work for Extending the Time to Decide Incomplete Claims?
Excerpt: "There are several things that may not be obvious from the literal language [of the claims regulations]. First, the plan's decision period starts to run again when the claimant responds, regardless of whether the response provides all the additional information required to decide the claim.... Second ... the plan has only 15 days in which to decide the claim once the claimant responds in a timely manner." (EBIA Weekly (Question of the Week))

What's the Effect of HIPAA Rules on Employers?
Excerpt: "The rules require employers to examine how they use and protect what HIPAA calls workers' protected health information, or PHI, which is anything that could be linked to a particular person. Employers have more access to this kind of information than you might think." (The Denver Business Journal via bizjournals.com; free registration required)

U.S. Hospitals to Be Rated on Performance
Excerpt: "The U.S. hospital industry said [on Thursday, Dec. 12, 2002] it will establish a system that for the first time will let consumers judge an individual hospital's performance -- and compare it directly with others' -- based on nationally recognized indicators of quality." (Washington Post)

New Tools for Reducing Medication Errors
Excerpt: "Pathways for Medication Safety, a comprehensive set of tools designed to reduce medication errors, was released this week ... The tools, which were developed by the American Hospital Association, the Health Research and Educational Trust (HRET) and the Institute for Safe Medication Practices (ISMP) with the support of The Commonwealth Fund, are designed to help hospitals take a process-driven, system-based approach ..." (Pathways for Medication Safety)

Commentary: Major California HMOs Fatten As Insurance Costs Rise
Excerpt: "The state's five largest health maintenance organizations had stockpiled reserves totaling $3.15 billion as of Sept. 30. That was $2.2 billion more than they needed to meet the minimum standards of financial health mandated by the California Department of Managed Health Care." (AP via Foundation for Taxpayer and Consumer Rights)

Opinion: Universal Healthcare Coverage Will Take Universal Sacrifice
Excerpt: "Universal health-care reform is back in vogue, but it will take sacrifice by every stakeholder in health care to achieve it.... The problem with getting universal coverage in the U.S. has always been the politics, not the policy. Insuring everyone is indisputably the most cost-effective system, because everyone pays less when all are insured; also, sickness is dealt with when it is cheapest to treat." (Jamie Court, Executive Director of the Foundation for Taxpayer and Consumer Rights)

Sources of Health Insurance and Characteristics of the Uninsured
Executive summary of new Issue Brief. Full text available from EBRI for a fee at http://www.ebri.org/store/ebriib.htm - Excerpt: "This Issue Brief provides summary data on the insured and uninsured populations in the nation and in each state. It discusses the characteristics most closely related to an individual's health insurance status." (Employee Benefit Research Institute)

California HMO Watchdog Gets New Clout, Challenges
December 9, 2002 article. Excerpt: "Two new state laws that go into effect in January will give the state Department of Managed Health Care (DMHC) authority to regulate the quality of care that health maintenance organizations (HMOs) provide to the roughly 21.4 million Californians enrolled in such health plans, and to ensure that HMO enrollees who are seriously ill get the prescription drugs they need." (California HealthCare Foundation)

Sharing Long-Term-Care Insurance
Excerpt: "More Americans are buying coverage that lets them transfer benefits to spouses or other family members, such as elderly parents.... [Benefit-sharing policies are] being offered by more carriers as they gain popularity among both employers and employees ..." (Ellen Hoffman on Business Week Online)

Links to Items on Executive Comp, Benefits in General

Report: Is Working Longer the Answer for an Aging Workforce?
Link to 12 page article. Excerpt: "In recent years, many public policies and private institutions that encourage early retirement have been modified. Mandatory retirement was outlawed in most jobs. Social Security is no longer growing more generous, and coverage under company pension plans is no longer rising.... An open question is whether further changes are needed." (Gary Burtless and Joseph F. Quinn, published by the Boston College Center for Retirement Research)

Should Older Workers Be Encouraged to Delay Retirement?
Press release. Excerpt: "With the first members of the baby boom generation nearing age 60, policymakers may want to consider ways to encourage older workers to delay retirement ... The brief-- co-authored by Gary Burtless of The Brookings Institution and Joseph Quinn of Boston College-- discusses the potential social and economic benefits of extending worklives and assesses how policy changes affect workers' decisions." (Boston College Center for Retirement Research)

Analysis: Bright Line Drawn for the Attorney-Client Privilege and Work Product Doctrine (PDF)
At pp. 17 through 19. Excerpt: "The District Court for the Southern District of West Virginia has delineated a bright line test for the application of the attorney-client privilege and work product doctrine in employee benefits matters. Additionally, this case serves as a reminder of the importance of carefully monitoring all written materials relating to matters involving persons acting in a fiduciary capacity to a plan." (Debra Davis, published by the American Bar Association, Section of Labor and Employment Law, Employee Benefits Committee)

Appropriate Equitable Relief After Great-West v. Knudson (PDF)
At pp. 2 through 6. Excerpt: "After the Supreme Court's recent decision in Great-West Life & Annuity Insurance Company v. Knudson, 122 S. Ct. 708 (2002), ERISA lawyers need to add to their arsenal an understanding of the historic distinction between law and equity. Fortunately, or not, there are approximately 600 years of doctrine available to those who are looking for guidance on that distinction." (Prof. Dana M. Muir, published by the American Bar Association, Section of Labor and Employment Law, Employee Benefits Committee)

Great-West v. Knudson: the Death Knell of Fiduciary Liability Claims? (PDF)
At pp. 6 through 12. Excerpt: "[At one time] it appeared the Court was opening the door to damage claims against ERISA fiduciaries for misrepresentations and other negligent conduct in administering plan benefits. That door has arguably swung the other way with the Knudson ruling." (Mark D. DeBofsky, published by the American Bar Association, Section of Labor and Employment Law, Employee Benefits Committee)

Survey Results: Employer Costs for Employee Compensation
Excerpt: "In September 2002, employer costs for employee compensation for civilian workers in private industry and State and local government in the United States averaged $23.44 per hour worked, the U.S. Department of Labor's Bureau of Labor Statistics reported [on Dec. 11, 2002]. Wages and salaries, which averaged $16.93, accounted for 72.2 percent of these costs, while benefits, which averaged $6.51, accounted for the remaining 27.8 percent." (U.S. Department of Labor, Bureau of Labor Statistics)

Overview: Changes in NYSE and Nasdaq Requirements Affecting Equity Plans and Executive Comp
Excerpt: "In October 2002, the Securities and Exchange Commission ('SEC') published for comment proposed rule changes by the New York Stock Exchange ('NYSE') and The Nasdaq Stock Market ('Nasdaq') that, upon approval by the SEC, will require shareholder approval of most equity compensation plans and material revisions to such plans. The rule changes also affect other aspects of executive and director compensation." (Cooley Godward LLP)

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