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November 4, 2004
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Californians Vote to Repeal Health Insurance Mandate Scheduled to Take Effect January 1, 2006
Excerpt: "California voters have narrowly voted down the state's controversial 'play or pay' health insurance mandate. Following a major advertising campaign by the ballot initiative's opponents, 50.9% of voters in California voted to defeat Proposition 72, repealing the Health Insurance Act of 2003. Proposition 72 would have allowed the act, signed by then-Gov. Gray Davis, to take effect." (Business Insurance)
California Embarks on Spitzer-Style Insurance Broker Probe
Excerpt: "Lockyer spokesman Tom Dresslar declined to give specific broker targets. The move comes after Garamendi recently released new proposed regulations (http://www.insurance.ca.gov/docs/FS-News.htm) requiring brokers to disclose all fees and other incentives they receive for selling certain products or steering business to certain companies. A Garamendi spokesperson told Advisor that his office planned to file lawsuits against 'several' brokers and insurance carriers ...." (The Adviser via BenefitNews.com)
Managed Care Organizations Downplay Insurance Broker Probe Risk
Excerpt: "Several health insurance executives last week sought to downplay the risk that the broadening investigation of insurer/broker relationships would turn up illegal activities in the health insurance market. These executives emphatically denied rigging bids or making large contingent payments designed to induce brokers to steer business to them -- the allegations involved in the Oct. 14 lawsuit filed by New York Attorney General Eliot Spitzer (D) ...." (MANAGED CARE WEEK via AISHealth.com)
Analysis: the Effect of Rush Prudential v. Moran: a Review of Three State External Review Laws (PDF)
Excerpt: "In June of [2002], the Supreme Court issued Rush Prudential HMO, Inc. v. Moran the latest in a recent string of ERISA [Employee Retirement Income Security Act] preemption decisions, this time addressing whether ERISA preempts state 'external review laws.' These laws, currently adopted in over 40 states, are state-imposed procedures for resolving disputes between health plans and their enrollees over adverse benefit determinations. Health" (BNA's Health Law Reporter via Miller & Chevalier Chartered)
New Employee Assistance Program Offerings Show Sustained Market Interest in Wellness Benefits
Excerpt: "Employer interest in lowering health costs through wellness programs is manifest through various new product offerings entering the market. The latest comes from work life program provider Workplace Options, which teamed up with weight management and fitness specia.lists SparkPeople to develop an online wellness program." (The Adviser via BenefitNews.com)
Retirement Plan Advisor Roundtable on Financial Education as an Employee Benefit (PDF)
4 pages. Excerpt: "Financial education is rapidly becoming an emerging employee benefit--one that is either in place or being considered by the nation's most prestigious and innovative companies. We've assembled a panel of experts to discuss how they are using financial education to help plan sponsors achieve strategic objectives with their retirement plans and to address the myriad of issues their employees face." (Employee Benefit Plan Review via Financial Finesse)
California Employers Now Have Right to Control Medical Treatment in Workers' Compensation Cases
Excerpt: "With the enactment of SB 899 on April 19, 2004, the California legislature implemented much needed reforms to the State's ailing workers' compensation system. Although there are many employer friendly provisions in this bill, one area of reform stands out. Effective January 1, 2005, employers will have the opportunity to regain full control over medical treatment by selecting the treating doctors who will provide treatment to their industrially injured workers." (Littler Mendelson, P.C.)
Employee Benefits Outside the Box Have Unexpected Benefits for Employers
Excerpt: "Like a lot of companies, Gen-Probe views employee benefits as a key to recruiting and keeping the best workers. But the Southern California biotech firm has found one unintended benefit from its 9/80 workweek program, which gives workers a day off every other Friday. 'We have a rule that we don't have meetings on Friday,' .... 'People look forward to working on Fridays now because they know they won't be interrupted by meetings and they'll be more productive.'" (California Job Journal)
Bush: Deregulating Health Insurance and Allowing Insurers to Make Health Insurance Less Protective
Excerpt: "Bush has proposed three main ideas: to extend refundable tax credits of up to $1,000 per individual and $3,000 per family for low-income purchasers of health insurance, to create association health plans to allow small businesses to pool together to buy health insurance at cheaper rates, and to promote use of health savings accounts (HSAs) that allow workers with high-deductible plans to set aside money tax-free to cover health expenses." (CBS MarketWatch)
Paying the Price: the High Cost of Pres.cription Drugs for Uninsured Americans
Excerpt: "Uninsured consumers carry the full cost of overpriced pres.cription drugs. The federal government uses its buying power to negotiate lower prices for the drugs it purchases for its beneficiaries – such as veterans, government employees and retirees. In addition, consumers with health insurance coverage pay only a portion of the discounted price negotiated by their insurance company.' Full text of the report is at http://uspirg.org/reports/payingtheprice.pdf. (U.S. Public Interest Research Group)
Voters in the Medical Liability Crisis States of Florida and Nevada Passed Reform Measures
Excerpt: "In Florida, voters passed Ballot Measure 3, limiting the contingency fees lawyers receive; and entitling patients in medical liability cases to no less than 70 percent of the first $250,000 awarded, and 90 percent of any damage award over $250,000. .... Nevada voters passed Ballot Question 3, placing a hard cap of $350,000 on noneconomic damages in medical liability cases, installing a periodic payment plan for damages totaling more than $50,000 and limiting attorney contingency fees." (American Medical Association)
Health Savings Accounts -- the Health Savings Plan You Can't Get -- Yet
Excerpt: "A major hiccup. There's one obvious reason that employers aren't scrambling to sign up employees for 2005. Most larger employers plan their insurance offerings for the following year by the middle of the previous year, but it took the Treasury department until this summer to sort through all of the questions that employers had about how to administer them. This particular delay is just a one-time hiccup." (Wall Street Journal via SFGate.com)
Health Care Delivery Via E-Visit with Reimbursement Grows Slowly, But Strong Potential Remains
Excerpt: "Online communications between doctors and their patients have not expanded markedly in the last two years, but research and pilot programs should pave the way to faster growth in the next several years, says a consultant in the field." (PHYSICIAN COMPENSATION REPORT via AISHealth.com)
Full-Replacement Consumer-Directed Health Plan Helps Company Control Rate Hikes
Excerpt: "As a result of a full-replacement consumer-directed health (CDH) strategy, Minneapolis-based Apogee Enterprises, Inc. says the cost of its employee health coverage will hold steady in 2005...just as it did in 2004. In 2003, prompted by several years of double-digit rate hikes as high as 18%, the company decided to drop its three existing PPOs in favor of a single CDH plan from Aetna Health, Inc." (INSIDE CONSUMER-DIRECTED CARE via AISHealth.com)
After the Voting: What May Lie Ahead for Business in America on the issues of Health Care and Taxes
The NYT provides an industry-by-industry look at some significant business implications of the election. Excerpt: "As in its first term, the administration will seek to restrain the growth in spending and improve health quality by providing tax breaks, free-market incentives and greater choice for individuals in shopping for their own care. At the same time, the administration says it will have only a limited role in regulating prices for drugs, medical devices and health services." (The New York Times; one-time registration required)
Analysis of ASCA Compliance Plans for Implementing HIPAA Transactions and Codes Standards (PDF)
Excerpt: "ASCA also directed the Secretary to furnish the National Committee on Vital and Health Statistics (NCVHS) with a sample of the plans submitted in response to ASCA, and NCVHS to undertake analysis of the sample. Specifically, Congress directed NCVHS to 'regularly publish, and widely disseminate to the public, reports containing effective solutions to compliance problems identified in the plans analyzed ....' This paper reports on the analysis of those plans." (National Committee on Vital and Health Statistics)
Medicare Announces New Payment System for Inpatient Psychiatric Facilities (PDF)
261 pages. Excerpt: "The new system replaces the current cost-based payment system for reporting periods beginning on or after January 1, 2005. It will affect about 1,800 inpatient psychiatric facilities, including freestanding psychiatric hospitals and certified psychiatric units in general acute care hospitals. The final rule will be published in the November 15 Federal Register, and will become effective for cost reporting periods beginning on or after January 1, 2005." (Centers for Medicare & Medicaid Services)
Changes to the Hospital Outpatient Prospective Payment System for Calendar Year 2005
Excerpt: "Starting January 1, Medicare beneficiaries will have greater access to preventive benefits, quicker access to new technologies and lower copayments for hospital outpatient services under a final rule announced today by the Centers for Medicare & Medicaid Services (CMS)." (Centers for Medicare & Medicaid Services)
Revisions to Medicare Payment Policies Under the Physician Fee Schedule for Calendar Year 2005
Excerpt: "This document went on display at the Office of the Federal Register on November 2, 2004, and will be published on November 15, 2004. The comment period will close on January 1, 2005. We are providing this information on this website as a service to the public. This allows the public to download tables and addendums. While we provide a document on this website, the document that we publish in the Federal Register is the official CMS ... publication." (Centers for Medicare & Medicaid Services)
Links to Items on Executive Comp, Benefits in General
11 States Back Bans on G.ay Unions; Georgia, Ohio Bar Partner Benefits
Excerpt: "Voters in 11 states on Tuesday gave resounding approval to constitutional amendments banning same-sex marriage -- and in some cases, barring all cohabitating couples from receiving domestic partnership benefits. The only state that registered significant opposition to the ban was Oregon. But even there, a constitutional amendment prevailed." (Los Angeles Times; one-time registration required)
ERIC's Comments to the Treasury Department on Amendments to Law Governing NQDC Plans (PDF)
Excerpt: ERIC's November 3, 2004, letter to Treasury's William Sweetnam attaches 'comments from The ERISA Industry Committee (ERIC) regarding certain questions related to the provisions of the American Jobs Creation Act (P.L. 108-357) that amend the law governing nonqualified deferred compensation plans." (ERISA Industry Committee)
Overview:Tax-Exempt Organizations Significantly Impacted by New NQDC Legislation
Excerpt: "The penalties on deferred compensation arrangements that fail to comply with the law include a 20% tax on the deferred compensation in addition to regular income tax. The Act affects deferred compensation at both taxable and tax-exempt organizations. Given the potentially severe tax consequences, organizations should consult with tax and benefits counsel now so that necessary changes can be made by year end." (Dorsey & Whitney LLP)
Recommended Action Steps for Employers with Nonqualified Deferred Compensation Plans
Excerpt: "Every participant in a NQDCP could suffer severe tax penalties if the new rules are not met. Therefore, employers must review NQDCPs quickly and make initial decisions in the next few months on how to deal with the new rules, communicate these decisions to employees, and put the new rules into effect." (Hanson, Bridgett, Marcus, Vlahos & Rudy, LLP)
Summary of New Rules for Nonqualified Deferred Compensation Plans
Excerpt: "[The newsletter provides] a summary of key portions of the nonqualified deferred compensation rules of the American Jobs Creation Act of 2004 (the 'Act'). Please note that the IRS is working on a fast track to give guidance regarding some of these rules but may not issue critical guidance until December or even next year." (Hanson, Bridgett, Marcus, Vlahos & Rudy, LLP)
Hewitt Federal Legislation Quick Guide Updated November 2, 2004
Excerpt: "Hewitt's Federal Legislation Quick Guide provides short updates on federal legislation that is currently under active consideration by Congress or has recently been enacted into law regarding health and welfare benefit plans, retirement plans, and human resources and employment law." (Hewitt Associates)
Bush Pledges a Broad Push Toward Market-Based Policies
Excerpt: "'For us, the challenge is pretty straightforward,' Mr. Gingrich said. 'Can we pile up enough practical, real solutions so that people think we're the natural governing party - they like our product line better.' He named three domestic priorities for Republicans: 'transforming health,' a new focus on improving high schools and the creation of personal accounts in Social Security. 'Those three would be adequately transformational,' Mr. Gingrich said with a smile." (The New York Times; one-time registration required)
Full Text of Monthly Benefit News and Developments, November 2004, Published by Milliman (PDF)
2 pages. Excerpt: "The November 2004 issue of Monthly Benefit News and Developments covers: the status of federal legislation affecting employer-provided health and retirement benefits; upcoming key dates; IRS, DOL, SSA, and EEOC regulatory guidance; the Congressional Research Service's study on automatic enrollment in 401(k) plans; the GAO's study of pres.cription drug price trends; and the Congressional Budget Office's report on disease management programs." (Milliman)
Full Text of the Accounting Roundup November 2004 Edition Published by Deloitte (PDF)
12 pages. Excerpt: "The purpose of this publication is to briefly describe key regulatory and professional developments that have recently occurred in the field of accounting and to provide links to locations where additional information can be found on each topic." (Deloitte Development LLC via Financial Executives International)
Newly Posted Events
Chicago Advanced Pension Conference
in Illinois on September 7, 2005
presented by SunGard Corbel
Third Annual Conference: Health Information Technology 2004: Improving Chronic Disease Care in California
in California on November 18, 2004
presented by California HealthCare Foundation and Center for Health Research at UC Berkeley
Newly Posted Press Releases
Introducing Online Immediate Annuity Quotes
(Dietrich & Associates, Inc.)
4myBenefits Unveils HR-Wizard
(4myBenefits, Inc.)
Individual(k) Plans Cited as One of The Most Powerful Retirement Savings Products for Growing Numbers of Owner-Only Businesses
(American Express Financial Advisors)
Newly Posted or Renewed Job Openings
Health & Welfare Consultant
for Towers Perrin
in CA, CT, NJ, NY
Health & Welfare Associate
for Towers Perrin
in CT, MA, NJ, NY
Sales Representative
for Great-West Healthcare
in ANY STATE, GA
Pension Administrator
for The Pension Alliance, Inc.
in PA
Retirement Plan Administrator
for Metavante Corporation
in WI
Programmer - Benefits Administration
for ProView
in CA
Junior Account Administrator
for Local Third Party Administration Firm
in TX
Benefits Coordinator
for The College Board
in NY
Client Relationship Manager
for Metavante Corporation
in WI
Senior Retirement Program Specialist
for Providence Health System
in WA
RFP Consultant
for Diversified Investment Advisors
in NY
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