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December 19, 2002 - 8,030 subscribers
Today's sponsor: World Research Group

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   Voluntary Benefits Management & Enhanced Benefit Communications Forum

   January 29th & 30th, 2003 - Orlando, FL

   This event will examine new trends in voluntary benefits, but it
   will also address how to solve employee communication needs.
   Attend this forum to receive an in-depth analysis on how to design
   an effective benefit communications strategy, choose which
   voluntary benefits to offer, select benefit providers, administer
   plans and educate employees about voluntary benefits. Earn up to
   14 CPE Credits!

(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)
Court of Appeals Ruling Assures More Texans the Right to Challenge HMO Claim Denials
Excerpt: "The 5th U.S. Circuit Court of Appeals reversed its earlier decision and ruled that federal law does not override a state law protecting ... the right to seek independent reviews for all Texans covered by licensed insurance companies and HMOs. No one disputed that the state regulation applied to roughly half of all insurance plans in Texas. The question in the lawsuit was whether it also extended to plans that fall under federal law. The court ruled it does." (The Houston Chronicle via the Society for Human Resource Management)

Full Text of 5th Circuit's Decision That ERISA Does Not Preempt Texas Claims Statute (PDF)
5 pages. Corporate Health Insurance, Inc. v. Texas Department of Insurance, No. 98-20940. Excerpt: "We hold that the [Independent Review Organization] provisions of the Texas statute are not preempted by ERISA because they are within the saving clause of ERISA and do not offer an additional remedy in conflict with ERISA's exclusive remedy. Because self-funded ERISA plans are not covered by ERISA's saving clause, ERISA preempts any application of the IRO provisions to self-funded plans." (U.S. Court of Appeals for the Fifth Circuit)

Report Examines Purchasing Health Insurance Online
Excerpt: "Purchasing Health Insurance Online, a report in CHCF's Trends and Analysis in Insurance Markets series, describes the strengths of broker sites, health plan sites, and small business purchasing alliance sites. It also offers recommendations for site improvements in the areas of quality, accuracy, convenience, privacy, and information requests." (California HealthCare Foundation)

Corporate Aircraft May Be Cost-Effective But Require Careful Analysis
Excerpt: "A corporation must determine which ownership or use option-- i.e., buy, lease or charter-- is right for its unique needs, and whether the corporation can take advantage of the tax benefits associated with corporate aircraft use." (Pillsbury Winthrop LLP)

Federal Employees Unlikely to Get Christmas Eve Off This Year
Excerpt: "An official decision on whether federal employees will have to work on Christmas Eve is still pending, according to the Office of Personnel Management." (GovExec.com)

Texas Officials Order Unauthorized Health Insurers to Stop Operations
Excerpt: "State insurance regulators have ordered several individuals and entities to stop operating unlicensed health plans that target small businesses and their workers. The emergency cease-and-desist order said the unauthorized plans are marketed under the names of Privilege Care, Professional Industrial and Trade Workers Union, Southern Plan Administrators and American Heartland Health Administrators." (The Houston Chronicle via the Society for Human Resource Management)

Drug Profit Debate Builds; Claritin's Over-the-Counter Cost Focuses Attention
Excerpt: "Claritin's move to an over-the-counter medication-- a 30-day supply of the drug now costs many consumers with prescription coverage more than the co-pay they previously paid-- has again put pharmaceutical company revenue in the spotlight. The specific breakdown of that revenue is part of the debate swirling over drug spending, among the hottest topics in health care." (Atlanta Journal-Constitution via International Foundation of Employee Benefit Plans)

Association Health Plans Could Help Workers, But Benefits to Brokers Unknown
Excerpt: "Hill watchers say that AHPs could make a comeback next year, particularly with avid support from both Labor Secretary Elaine Chao and President Bush himself.... What AHPs could mean for brokers who market group health plans is uncertain, at least until certain issues are clarified. There are those who say the plans could open new markets because they enable groups of small businesses to band together ..." (BenefitNews.com)

Tips Offered for HIPAA Compliance in the Home Stretch
Excerpt: "Many employers want to know what's the minimum that they have to do by April 14, 2003. Here's a guide to quick HIPAA compliance in the pinch of the last four months. First, build HIPAA compliance backward from April 14, 2003. Plan to schedule training time. Build in adequate time to amend plan documents and business associate contracts. Make sure you've considered the impact of HIPAA on your employees and their rights to health benefits." (Thompson Publishing Group)

Viag_ra and Medical Necessity: One Psychiatrist's View
Excerpt: "Increasingly, physicians and other prescribers are being forced to call central phone numbers, get placed on hold, and answer to clerks. No answer is immediately provided. Days later, the decision is handed down, as in the letter to me. Are certain managed care companies crossing the line? Are they practicing medicine, not just attempting to adjudicate benefits?" (Drug Benefit Trends, published by Medscape; free registration required)

Physicians Might Be Roadblock To Implementing Medical Error Reforms, Editorial Says
Excerpt: "Physicians 'may be the biggest obstacle' to reforms proposed to reduce medical errors, which kill 'tens of thousands' of patients each year and injure 'countless more,' a New York Times editorial states." (KaiserNetwork.org)

Audio Excerpt: Doctors, Lawyers Tussle over Texas Malpractice Caps
Excerpt: "Trial lawyers in Texas are fighting a different kind of legal battle, opposing legislative efforts to cap awards in medical malpractice cases. Though some research indicates otherwise, doctors insists limits on awards keep health insurance rates down. NPR's Wade Goodwyn reports.' (Dec. 18, 2002) (National Public Radio)

Senators Seek Public Input on Plan for Uninsured
Excerpt: "Seeking to break a 57-year cycle of failed efforts to reshape the nation's healthcare system, two U.S. Senators, one Democratic and one Republican, are launching an effort to use public participation in a planning process to force votes in Congress on ways to ensure health insurance coverage for all." (Reuters Health via Medscape; free registration required)

HMO Profits Surge in Early 2002
Excerpt: " The nation's HMOs demonstrated remarkable gains in financial strength in the first quarter of 2002, with profits spiking 162% for the three-month period, according to data released on Tuesday." (Medscape; free registration required)


Links to Items on Executive Comp, Benefits in General

Demographic Trends in the 20th Century (PDF)
222 pages (!) Fun facts about your country's development over the past 100 years, summarized and charted under these categories: Population Size and Geographic Distribution; Age and Sex Composition; Race and Hispanic Origin; Housing; Households. (U.S. Census Bureau)

Overview: PWBA Releases Semiannual Regulatory Agenda
Excerpt: "Items in the final rule stage are ... definition of 'collective bargaining agreement' ... regulations implementing the Health Care Access, Portability and Renewability Provisions of [HIPAA] ... reporting requirements for multiemployer welfare arrangements (MEWAs) providing medical care benefits ... prohibiting discrimination against participants and beneficiaries based on health status ... blackout notice regulations and civil penalty ..." (CCH News & Information Library (Pension/Benefits))


Newly Posted or Renewed Job Openings
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in AL

Sr. Benefits Compliance Specialist
for NRECA
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Pension Administrator
for Actuaries Unlimited, Inc.
in CA

New Business Associate
for RSM McGladrey, Inc.
in MN

Enrolled Consulting Actuary-LLY
for Los Angeles-area Employer
in CA
Newly Posted Webcasts
(Post Yours!)

Employer Coverage: Mounting Challenges, New Approaches
on December 16, 2002
presented by KaiserNetwork.org
Newly Posted Conferences
(Post Yours!)

NCEO/Beyster Institute Joint Annual Conference 2003
in CA
March 26, 2002
National Center for Employee Ownership (NCEO) and the Beyster Institute for Entrepreneurial Employee Ownership
Newly Posted Press Releases
(Post Yours!)

Can Quality Health Care Contain Health Costs? New Book Investigates the Possibilities of Value-Based Purchasing
(International Foundation of Employee Benefit Plans)

SunGard Corbel's 5500 Software is First for EFAST
(SunGard Corbel)

Komornicka to Serve as President of the International Society of Certified Employee Benefit Specialists Governing Council
(International Society of Certified Employee Benefit Specialists (ISCEBS))


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