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February 10, 2004 - 8,783 subscribers
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Relying on New Claims Regs, Court Orders Plan Insurer to Produce Additional Information to Claimant
Excerpt: "[T]his recent case relied on the new DOL claims procedure regulations ... [and hence] provides insight into how future decisions may interpret the new rules. The disability plan claimant in the case sought information from the plan's insurance company regarding a determination that his dementia was a mental illness subject to the plan's 12-month payment limit." (Employee Benefits Institute of America (EBIA))
Insurer Not Liable for Failure to Provide Plan Documents
Excerpt: "EBIA Comment: ... [T]his case allows us to emphasize that in most single-employer benefit plans, the employer/plan sponsor is the plan administrator. As a result, ERISA imposes many obligations (and liabilities) directly on the employer ... Other persons and entities associated with an ERISA plan--such as insurers, TPAs and other service providers--do not become plan administrators unless they agree to be designated as such in governing plan documents." (Employee Benefits Institute of America (EBIA))
HSAs Will Spur New Type of Health Debate Among Employers
Employers may begin to debate how to provide health insurance to their employees in an entirely new way because of health savings accounts (HSAs), according to some benefits experts. Rather than looking at health care options such as HMOs, PPOs, and other managed care designs, employers now will consider combinations of high-deductible health plans with HSAs, flexible spending accounts under IRC Sec. 125, or health reimbursement arrangements (HRAs). (Spencer Benefits Reports)
Agencies' Regulatory Agendas Include Guidance on HIPAA
Excerpt: "[F]ederal government agencies have published their semiannual regulatory agendas. These agendas are each agency's 'to do' list of regulations that the agency expects to review or develop. Here's a list of the regulations that HHS, DOL, and the Treasury Department (which includes the IRS) are working on that fall within the scope of our HIPAA Portability & Privacy manual." (Employee Benefits Institute of America (EBIA))
Newspapers Examine Rep. Tauzin's Potential Move To Head PhRMA
Excerpt: "Two newspapers recently published articles that examined Rep. Billy Tauzin (R-La.), who last week announced that he will resign as chair of the House Energy and Commerce Committee effective Feb. 16 and will not seek re-election in November. Tauzin last week recused himself from committee issues related to the Pharmaceutical Research and Manufacturers of America, which in January offered Tauzin a position as president." (KaiserNetwork.org)
Links to Items on Executive Comp, Benefits in General
5th Circuit Case: SPD Controlled Over Conflicting Language in Plan Enrollment Guide
Excerpt: "This case involved a beneficiary who received physical therapy covered under an employer-sponsored group health plan. After about three months of therapy, the beneficiary was informed that no additional sessions would be covered because the plan limited physical therapy coverage to 60 visits per year. The plan's summary plan description (SPD) described the 60-visit-per-year limit, but an Enrollment Guide also provided by the plan did not specify any limit." (Employee Benefits Institute of America (EBIA))
Newly Posted Press Releases
Optimistic Alliance Benefit Group Enters 2004 Rolling
(Alliance Benefit Group)
Former Owner of Mississippi Home Health Care Agency Sentenced for Embezzling Pension Assets
(U.S. Department of Labor, Office of Public Affairs, Atlanta)
ICC Plan Solutions Continues Rapid Expansion With 2 New Client Wins
(Metrics Partners)
Movers and Shakers: Newly Posted Announcements of Promotions and New Personnel
(Post Yours!)
Dean Rodewald (DATAlynx)
Newly Posted or Renewed Job Openings
Retirement Plan Administrator
for Benefit Consultants Group
in NJ
Financial Control/401 (k) Specialists
for Constantin Control Associates
in
Conversion Team Administrator
for Administaff
in TX
iFlex New Plans Specialist
for First Trust
in CO
Internal Wholesalers
for Minnesota Life
in MN
Pension Actuary Consultant/Expert
for Philadelphia-based law firm
in ALL STATES
Disability Claims Practices Professionals
for Law firm
in ALL STATES
Pension Administrator/Compliance Analyst
for CNA Trust
in IL
Sr. Technical Analyst - Consulting, Planning and Compliance
for Black Mountain Management, Inc.
in NY
Retirement Benefits Specialist
for Excellent opportunity with a leading global manufacturing organization!
in IN
Processing and Quality Assurance Specialist
for GoldK, Inc.
in MA
Trust Reconciliation Analyst
for GoldK, Inc.
in MA
Sales Consultant - Retirement Benefits
for Diversified Investment Advisors
in NY
Director, Communications and Product Development
for BISYS Retirement Services
in PA
Defined Benefit Actuarial Specialist
for Standard Insurance Company
in OR
Dir-Compensation
for American Express
in MN
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