| BenefitsLink Welfare Plans Newsletter |   |
November 15, 2004
Today's sponsor: BenefitsLink.com
(Click on company name or banner to learn more.)
Downloadable Software Available Now! Now you can buy employee benefits software on the Internet quickly and securely, through a web site you know and trust. Come back at any time and buy other software just by clicking a link and entering a password, without having to go through all the credit card info and other online forms all over again. The Downloadable Software page on BenefitsLink-- click above for details!
Two-Year Statute of Limitations Upheld for COBRA Claim in Lopez v. Premium Auto Acceptance Corp.
Excerpt: "The Fifth Circuit Court of Appeals has held that a lawsuit filed more than four years after an employer allegedly failed to notify a terminated employee of her right to elect COBRA coverage was time-barred ... COBRA does not contain an express time limit for filing a lawsuit ... so the trial court applied the statute of limitations for what it considered to be the most analogous state-law claim--a claim for unfair insurance practices under the Texas Insurance Code." (Employee Benefits Institute of America Inc.)
Spitzer Sues Broker Used for Workplace Insurance, Universal Life Resources, of Fraudulent Practices
Excerpt: "The New York attorney general's investigation into abuses in the insurance industry escalated [Nov. 12] with a lawsuit accusing a California broker of fraudulent practices that led to higher premiums for employees at some of the nation's leading companies. The attorney general ... sued Universal Life Resources, accusing the firm of steering business to insurers like MetLife, Prudential and Unum Provident ... for millions of dollars ... which, until 2003, were not properly disclosed." (The New York Times; one-time registration required)
Impact of Spitzer Complaint on Health Insurers Reviewed in Wall Street Transcript Managed Care Issue
Excerpt: "Wall Street Transcript has just published its Managed Care issue, a report offering a timely review of the sector to serious investors and industry executives. This 47-page feature contains a roundtable panel, commentary from industry analysts and interviews with seven top companies from the sector. The full issue is available by calling (212) 952-7433 or via The Wall Street Transcript Online." (The Wall Street Transcript via Yahoo! Finance)
MA State Attorney General Probes State Health Insurers -- Focus on Commissions Paid to Brokers
Excerpt: "The Massachusetts attorney general's office is investigating the state's health insurance industry over lucrative commissions offered brokers who are supposed to bring employers the best insurance deals. Insurance brokers, who can influence heavily which health plans employers buy, for years have received cash bonuses, sometimes valued in the hundreds of thousands of dollars for the largest brokerage firms, and recently even exotic vacations. But brokers generally don't disclose ..." (The Boston Globe)
Employee of Covered Entity Gets 16 Months in Prison for HIPAA Privacy Violation
Excerpt: "The case involved an employee of a covered entity who obtained a patient's name, birth date, and Social Security number and used the information to obtain credit cards. The plea agreement called for the employee to serve a prison term of 10 to 16 months and pay restitution to the credit card companies and the patient. The employee was sentenced last week, and the judge imposed the full 16-month sentence, even though the prosecutors recommended a 12-month sentence." (Employee Benefits Institute of America Inc.)
Deciphering Whether Employee "Has a Serious Health Condition:" Preventing Misuse of the FMLA (PDF)
FMLA Update presented by the Council on Education in Management, by Jacqueline Jackson-DeGarcia. November 4, 2004. 14 pages. Excerpt: "This presentation is designed to help human resources determine whether or not an employee's health condition is serious enough to merit leave." (Kirkpatrick & Lockhart LLP)
Father-Friendly Benefits Can Improve a Company, Aid Employee Retention
Excerpt: "While companies can realize results from father-friendly efforts in a number of areas, retention may be the most obvious. 'The way employees are treated is reflected in how they are as workers,' ... The Families and Work Institute's National Study of the Changing Workforce shows that employees who have more access to flexible work arrangements are significantly more satisfied with their jobs: 65%, as opposed to 30% satisfaction with low flexibility." (Employee Benefit News)
Rising Cost of Health Care Impacts Company Pay Raises
Excerpt: "Although health care costs are expected to dip slightly in 2005, companies throughout the country are still cautious about doling out pay hikes. The PNC Economic Outlook, which was commissioned by The PNC Financial Services Group Inc. and released in September, shows that concerns about health care premiums continue to weigh heavily on the minds of business owners. In fact, more than 40 percent of the surveyed business owners nationwide and 46 percent within PNC Bank's primary ..." (Pittsburgh Business Times via bizjournals.com; one-time registration required)
State of Kansas Offers Health Care Reform Plan with $50 Million HealthyKansas Reform Initiative
Excerpt: "Gov. Kathleen Sebelius and Insurance Commissioner Sandy Praeger want to make health care more affordable, more accessible and less bureaucratic. And they want to pay for the $50 million HealthyKansas reform initiative with an additional state tax on cigarettes and tobacco products. The two outlined their plans Tuesday in a series of talks around the state, including one in a high-tech procedure room at Wichita's Via Christi Regional Medical Center." (The Wichita Eagle)
Faith-Based Health Insurance Plan for Federal Workers Generates Controversy
Excerpt: "On Sept. 13, OPM officials announced the launch of a faith-based health insurance program for federal workers in Illinois. Operated by OSF Health, which is run by the Sisters of the Third Order of St. Francis, the plan specifically will prohibit payment for contraceptives, abortions, sterilization or artificial insemination. OPM officials have sought to portray the OSF Health plan as just one of many across the country." (GovExec.com)
Integrating Patient Data Reduces Drug Errors, Cuts Hospitalization Costs and Improves Patient Safety
Excerpt: "An old English proverb states, 'Prevention is better than cure.' For health plans seeking ways to cut unnecessary care costs, [that] might best be put to practice in the context of preventable hospitalizations caused by drug errors. Preventable hospitalizations represent a growing concern for many health plans from both a clinical and fiscal perspective. In 2000, preventable hospitalizations caused by problems with pres.cription medications cost health plans more than $121 billion." (Employee Benefit News)
Incentives? To Do What? Why Paying Incentives to Doctors or Employees to Alter Behavior Is Doomed
Excerpt: "Human beings are rather predictable creatures, a simple fact that we tend to forget with frightening frequency. Simply put, if you provide an incentive to do something, people will do it. A good example of that is the widely used practice of incentive compensation. The theory goes that base pay is insufficient to motivate people to achieve exceptional results or to have them focus on the primary objective of the moment. To achieve that, we need incentives that pay workers only ..." (Richard D. Quinn via Employee Benefit News)
Health Risk Appraisals Address Employees' Individual Problems -- Aim to Instill Healthy Habits
Excerpt: "More large employers are expected to ask employees to answer health-related questions as part of an appraisal process that can help gather useful baseline information as well as motivate employees to improve their health. .... Generally, the goal of such programs is to identify employees' individual health-care needs, such as smoking cessation or obesity treatment, and steer them into programs that are tailored to their needs, interests and their willingness to participate ..." (Business Insurance via Workforce Management)
Online Tools Promote Rx Comparison Shopping: Drug-Price Web Sites Could Bring Employer Savings
Excerpt: "Employers looking to reduce their pres.cription drug costs have a new tool available to them: independent pres.cription drug-price comparison Web sites. Many employers already encourage their employees to use the online price comparison tools their insurers or pres.cription benefit managers make available to them. These Web sites give employees information on generic drugs or the price benefits of ordering pres.cription drugs by mail rather than purchasing them at retail outlets." (Business Insurance via Workforce Management)
Humana to Test Healthcare Evaluation System -- Software Developed by Rand Corporation
Excerpt: "Humana will be the first health benefits company to test software developed by Rand Corp. to determine whether consumers are getting appropriate health care. Rand's QA Tools software was developed after a Rand study last year found that adults get the care recommended by clinical guidelines about half the time. The study was based on medical records of thousands of patients." (The Courier-Journal)
Making CDH Work: Health Plans, Employers Need to Expand Consumer-Driven Health Plan Education
Excerpt: "For consumer-driven health care to work, employees have to begin making prudent decisions based on the quality and cost of that care. However, some experts believe there currently are not enough education and decision support tools in the consumer-driven box available to help people make those choices." (Employee Benefit News)
Health Plan Providers See Plans Going from Prix Fixes to a La Carte Design
Excerpt: "Health plan providers believe that health benefits will end up taking on almost a piecemeal approach as more employers and employees rely on voluntary supplemental medical benefits to keep costs down. While that day may not be here for a number of years, there already are some indications that we may be heading in that direction." (Employee Benefit News)
Going It Alone: More People Flock from Group Health Plans to Individual Coverage
Excerpt: "As company-paid health insurance loses some of its long-held luster, individual insurance plans are enjoying a certain shine.... Unlike group plans, where all employees can get coverage regardless of their health status, individual plans generally are offered only to people who are in relatively good health. That reduces the insurer's risk in comparison with a group plan." (The Kansas City Business Journal via bizjournals.com; one-time registration required)
Pres.cription Drug 'Follow-Ons' Increase Competition, Reduce Prices, Tufts University Report Finds
Excerpt: "Pres.cription drugs that are similar to medications currently on the market and treat the same conditions, or 'follow-ons,' lead to increased competition, reduced prices and provide improved treatment options for physicians and patients, according to a Tufts University report.... For the report, the Tufts Center for the Study of Drug Development ... studied 235 medications that have received FDA approval for sale in 72 markets since 1960." (Kaiser Family Foundation)
Revival of 'Pay-or-Play' Health Bill Expected in Massachusetts
Excerpt: "Legislative efforts to force most small companies to provide health insurance for their employees are set to make a comeback over the coming year. Recent bills to expand health care coverage in various ways have failed, even as health care costs escalated and more people lost coverage. But the new crop of bills represent a solid push to return to some form of the 'pay-or-play' law repealed in the mid 1990s." (Boston Business Journal via bizjournals.com; one-time registration required)
Pittsburgh Area Businesses Want Health Care Cost and Tax Relief According to Informal Survey
Excerpt: "In an informal online poll, the Pittsburgh Business Times recently asked readers, 'What is the most important issue that President George W. Bush could address in his next term to positively impact your business?' Health care costs topped the list, but tax reform and tax incentives are also major priorities, respondents said. 'President Bush could expand health care coverage for some of the people currently uninsured,' said Michael Baker, director of strategic planning ..." (Pittsburgh Business Times via bizjournals.com; one-time registration required)
American Health Line Highlights Medical Malpractice Developments in Eight States
Excerpt: "Florida: More than half of rural physicians over the past year have limited medical services, and most cited increasing medical malpractice premiums as a 'key reason' for limiting service, according to a 2003 study published ... in the Archives of Internal Medicine, the St. Petersburg Times reports. Researchers from the Florida State University College of Medicine surveyed 781 doctors in rural areas and found that 61% of physicians reduced the number of childbirth procedures ..." (The National Journal Group, Limited via BlueCross BlueShield Association)
Report: the Medicare Pres.cription Drug Benefit: Potential Impact on Beneficiaries
Excerpt: "In this AARP Public Policy Institute Issue Paper, the potential impact of this benefit overall - and with respect to specific categories of beneficiaries - is examined ... For the most part, the analyses are conducted so as to be consistent with assumptions of the Congressional Budget Office. The report finds that, overall, the MMA represents a $407 billion shift in resources to Medicare beneficiaries, health plans, employers, and states over the period 2006-2013, according to CBO." (AARP)
Opinion: Dispelling Malpractice Myths
Excerpt: "News reports of recent efforts to reduce malpractice insurance costs have missed what is needed: genuine reform of the medical justice system. A good way to start is by jettisoning some commonly held misperceptions about the current malpractice system. Call them the 'Myths of Malpractice.' Here's what is really going on ..." (The Washington Post; one-time registration required)
Links to Items on Executive Comp, Benefits in General
SEC to Ramp Up Enforcement of Executive Compensation Disclosure Rules
Excerpt: "Based on a recent speech by a top SEC official, the agency appears ready to step up enforcement against companies for failure to adequately disclose executive compensation on corporate proxy statements. Alan Beller, the Director of the SEC's Division of Corporation Finance, stated: 'Unless a company has disclosed all plan and non-plan compensation for all services rendered that is awarded to, earned by, or paid to the executive officers and directors covered in the proxy ...'" (HR Policy Association)
Complying with the Sarbanes-Oxley Act Audit Compliance Deadline Proving Costly to Companies
Excerpt: "Some of the nation's biggest companies face a deadline today for completing reviews of their internal financial controls, a labor-intensive, costly effort that has created intense friction between corporate managers and auditors. Top regulatory officials repeatedly have warned that a significant minority of companies, from a few hundred to a thousand, may report serious weaknesses in their fiscal checks and balances, which could have repercussions in the price of stock shares." (The Washington Post; one-time registration required)
US Airways Seeks Benefit Cuts and Contract Repeals
Excerpt: "US Airways ... asked a bankrup.tcy court judge to terminate the long-term contracts of its flight attendants, mechanics, and customer service and ticket agents if the workers fail to agree on millions of dollars in pay and benefit cuts. The ... airline also asked the judge for permission to reduce or eliminate company-paid health benefits for retirees and replace the remaining defined-benefit retirement plans of its flight attendants and mechanics with a defined-contribution plan ..." (The Washington Post; one-time registration required)
Opinion: a New Twist to Your Tax Bill? Pay Only Sales Taxes -- No Payroll or Income Taxes
Excerpt: "The House Republican leadership supports substituting a sales tax for the federal tax system. The switch would essentially make interest, dividends, profits, and capital gains tax-free.... [At Americans for Fair Taxation], Mr. Wright has spent 14 years ... urging that the sales tax replace all current federal taxes - payroll taxes as well as income taxes. Collection would be done by the states ... The Internal Revenue Service would become redundant." (The Christian Science Monitor)
Oversight Hearing on Insurance Broker Practices, Conflicts of Interest, Current Regulatory Framework
Excerpt: "This oversight hearing will focus on insurance brokerage practices, such as contingent commissions, that raise conflict of interest questions, and whether these practices harm consumers or suggest changes to the existing regulatory framework." (U.S. Senate Committee on Governmental Affairs, Subcommittee on Financial Management, the Budget, and International Security)
Opinion: Bond Market Should Fear $43 Trillion Retirement Tab for Social Security and Medicare
Excerpt: "As ... George W. Bush prepares to 'spend political capital' to reform the retirement system, the best way of telling if his emerging plan is sound is to watch from the summit of the bond market. If Bush and Congress fail to prudently fund Social Security and Medicare, it may mean paring benefits or selling mountains of government debt to pay for the increasing costs of retiring baby boomers. That may increase interest rates and hurt everyone, from homebuyers to corporate ..." (Bloomberg.com)
Newly Posted Events
Dependent Definition Changes Impacting Benefit Plans as of January 1, 2005
Nationwide on December 2, 2004
presented by International Foundation of Employee Benefit Plans
Newly Posted Press Releases
Treasury and IRS Propose Retirement Annuity Regulations
(U.S. Department of Treasury)
Newly Posted or Renewed Job Openings
Investment Advisory/Retirement Sales Consultant – St. Louis
for Invesmart, Inc.
in MO
Head of Worksite ALM & Valuation
for ING US Financial Services
in CT
Benefit Analyst/Recordkeeper
for Leggette Actuaries, Inc.
in NC
Retirement Plan Consultant - Harrisburg, PA
for Invesmart, Inc.
in PA
Pension Administrator - DB Plan Experience / Actuarial Training
for Retirement System Group Inc. (www.rsgroup.com)
in NY
Sr. Benefit Analyst
for OfficeMax
in IL
Handy Links:
- View Today's Active Message Threads
- Search BenefitsLink
- Using the Web for Employee Benefits Research
- Employee Benefits Library
Copyright 2004 BenefitsLink.com, Inc.; except that you can reprint this newsletter in full (if you also include this boilerplate part) without obtaining our permission.
Published by:
BenefitsLink.com, Inc.
https://benefitslink.com/about.html
1298 Minnesota Avenue, Suite H
Winter Park FL 32789
(407) 644-4146
Fax: (407) 644-2151
Editor and Publisher: David Rhett Baker, J.D.
Housekeeping: