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August 27, 2003 - 8,445 subscribers
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IRS Official Comments on Several Key Cafeteria Plan Issues
Excerpt: "The IRS's top cafeteria plans expert, Harry Beker, commented on a variety of cafeteria plan issues during the ECFC's 16th Annual Cafeteria Plan Symposium, held in Chicago on August 13-15. Below, we highlight a few items that were addressed on an informal, non-binding basis by Mr. Beker." (EBIA Weekly)
Failure to Define 'Qualifying Event' Makes COBRA Election Notice Inadequate, 3rd Circuit Rules
Excerpt: "Because the term 'qualifying event' was not defined in a letter describing COBRA election rights, insufficient information was provided to a qualified beneficiary by the employer/plan administrator, which therefore was liable for the qualified beneficiary's medical expenses, the 3rd U.S. Circuit Court of Appeals ruled in an unpublished opinion. The case is Emilien v. Stull Technologies Corp., 2003 WL 21675343 (3rd Cir., July 18, 2003)." (Thompson Publishing Group)
Employer Has Fiduciary Duty When Explaining Enrollment Rules Under Insured ERISA Plan
Negley v. Breads of the World Medical Plan (D. Colo. 2003). Excerpt: "This case--with a set of facts to make a benefits manager's blood run cold--illustrates how HIPAA's portability rules may have increased the potential for ERISA fiduciary breach claims.... [F]or insured plans, the employer will be responsible ... for processing enrollments. Therefore, it is critical that benefits department personnel know the terms of their plans and the requirements of HIPAA and other applicable laws ..." (EBIA Weekly)
Health Claim Denial Was Arbitrary and Capricious for 'Utterly Failing to Consider Plan Language'
Wheeler v. Aetna Life Ins. Co. (N.D. Ill. 2003). Excerpt: "In this case, the failure of an ERISA health plan insurer to refer to specific plan provisions and to provide specific reasons for claims denials caused the court to find that those denials were arbitrary and capricious.... [T]he claims were denied without reference to specific plan provisions and without setting forth a clear rationale relating to the medical record or the plan." (EBIA Weekly)
IRS to Issue Guidance on HRA Distribution After Divorce
Excerpt: "Acknowledging that not all participants in health reimbursement arrangements (HRAs) live happily ever after, the IRS is due to issue guidance within the next year regarding how to handle HRA distributions when couples divorce, according to a top agency official." (BenefitNews.com)
23% of Michigan Manufacturers Have Downsized to Cope With Health Coverage Costs
Excerpt: "Twenty-three percent of the Michigan manufacturers that participated in an informal survey earlier this year said they had reduced their workforce to offset health coverage cost increases, according to the Michigan Manufacturers Association, Lansing, Mich." (National Underwriter via International Foundation of Employee Benefit Plans)
Overview: Enforcement of HIPAA Electronic Transaction Requirements (PDF)
Excerpt: "The Centers for Medicare & Medicaid Services (CMS) has issued its first piece of guidance on the agency's enforcement of the Health Insurance Portability and Accountability Act's (HIPAA) electronic transaction requirements. Under the requirements-- which are part of HIPAA's 'administrative simplification provisions'-- employer-sponsored health plans and other covered entities must comply with national standards for electronic health care transactions beginning October 16, 2003." (Milliman USA)
Adverse Selection and the Challenges to Stand-Alone Prescription Drug Insurance
Working paper. Excerpt: "This paper investigates a possible predictor of adverse selection problems in unsubsidized stand-alone' prescription drug insurance: the persistence of an individual's high spending over multiple years.... [We find it is] unlikely that unsubsidized drug insurance can be offered for sale, even with premiums partially risk adjusted, without a probable adverse selection death spiral." (Mark V. Pauly and Yuhui Zeng, published by the National Bureau of Economic Research)
GAO Suggests Tax on Employer-paid Health Insurance
Excerpt: "Congress should consider a tax on all employer-paid health insurance, the General Accounting Office (GAO) suggests in 'Opportunities for Oversight and Improved Use of Taxpayer Funds,' a report [www.gao.gov/new.items/d031006.pdf] it presented to the House and Senate Budget Committees this month." (Thompson Publishing Group)
Americans' Views of the Uninsured: An Era For Hybrid Proposals
Excerpt: "Most agree that something should be done to help the uninsured, but they don't want to pay higher taxes to do it." (Health Affairs)
Building On the Job-Based Health Care System: What Would It Take?
Excerpt: "A blueprint for preserving the U.S. system's strengths while addressing its weaknesses." (Health Affairs)
The Politics of Health Reform: Why Do Bad Things Happen To Good Plans?
Excerpt: "In the United States, the more desirable health care reform is on substantive grounds, the less politically feasible it is." (Health Affairs)
Is There Hope for the Uninsured?
Excerpt: "Most probably not, this seasoned economist concludes, although it is not for lack of good ideas and sound policy reasoning." (Health Affairs)
IRS Official Outlines Agency Benefits Projects For Upcoming Year
Guidance on using debit cards for an IRC Sec. 132 transportation benefit are among the projects the Internal Revenue Service expects to complete in the upcoming year, according to Harry Beker, the branch chief of the health and welfare division of the IRS's Office of Chief Counsel. In outlining the specific benefits projects that the IRS will be working on, Mr. Beker noted that the IRS Guidance Priorities are a 'living plan that is reviewed quarterly." (Spencer Benefits Reports)
Links to Items on Executive Comp, Benefits in General
Overview: IRS Issues Long-Awaited ISO Guidance-- It's Tardy But Reliable
Excerpt: "On June 6, 2003, the IRS released a new set of proposed regulations intended to govern the treatment of incentive stock options (ISOs). The ISO provisions (which effectively permit compensation income to be taxed at capital gains rates) were added to the Internal Revenue Code over 20 years ago and have been amended several times." (Ballard Spahr Andrews & Ingersoll, LLP)
Another Question is Answered in the Stock Options, Restricted Stock and Other Long-Term Employment Incentives Q&A Column
I agreed to help a small start-up bank. I became chairman, invested in common stock, and have an agreement that I will receive stock once the bank becomes profitable. The agreement is somewhat vague, so now I'm interested in making sure we follow the best path with regards to this stock grant. Can you help? (BenefitsLink.com)
Newly Posted or Renewed Job Openings
Retirement Plan Administrator
for Benefit Consultants Group
in NJ
Retirement Plan Specialist
for Diversified Investment Advisors
in OH
Retirement Plan Administrator
for Turning Point Associates, Inc.
in NJ
Newly Posted Conferences
(Post Yours!)
401(k) Plans
in TX
November 18, 2003
Employee Benefits Institute of America LLC (EBIA)
401(k) Plans
in CA
December 9, 2003
Employee Benefits Institute of America LLC (EBIA)
Cafeteria Plans
in MD
November 5, 2003
Employee Benefits Institute of America LLC (EBIA)
Cafeteria Plans
in MN
November 12, 2003
Employee Benefits Institute of America LLC (EBIA)
Cafeteria Plans
in TX
November 19, 2003
Employee Benefits Institute of America LLC (EBIA)
Cafeteria Plans
in CA
December 10, 2003
Employee Benefits Institute of America LLC (EBIA)
ERISA Compliance for Health & Welfare Plans
in MD
November 6, 2003
Employee Benefits Institute of America LLC (EBIA)
ERISA Compliance for Health & Welfare Plans
in MN
November 13, 2003
Employee Benefits Institute of America LLC (EBIA)
ERISA Compliance for Health & Welfare Plans
in TX
November 20, 2003
Employee Benefits Institute of America LLC (EBIA)
ERISA Compliance for Health & Welfare Plans
in CA
December 11, 2003
Employee Benefits Institute of America LLC (EBIA)
HIPAA Portability & Privacy
in MD
November 7, 2003
Employee Benefits Institute of America LLC (EBIA)
HIPAA Portability & Privacy
in MN
November 14, 2003
Employee Benefits Institute of America LLC (EBIA)
HIPAA Portability & Privacy
in TX
November 21, 2003
Employee Benefits Institute of America LLC (EBIA)
HIPAA Portability & Privacy
in CA
December 12, 2003
Employee Benefits Institute of America LLC (EBIA)
COBRA Compliance for Group Health Plans
in MD
November 6, 2003
Employee Benefits Institute of America LLC (EBIA)
COBRA Compliance for Group Health Plans
in MN
November 13, 2003
Employee Benefits Institute of America LLC (EBIA)
COBRA Compliance for Group Health Plans
in TX
November 20, 2003
Employee Benefits Institute of America LLC (EBIA)
COBRA Compliance for Group Health Plans
in CA
December 11, 2003
Employee Benefits Institute of America LLC (EBIA)
Newly Posted Press Releases
(Post Yours!)
McCallen Named President and CEO of ICMA Retirement Corporation
(ICMA Retirement Corporation)
Pyramid Enables ReservePlus Loan Program Integration for BPA
(Pyramid Digital Solutions)
Handy Links:
- View Today's Active Message Threads
- Search BenefitsLink
- Using the Web for Employee Benefits Research
- Employee Benefits Library
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