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April 20, 2005
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New Notice Requirement for Many Employers Maintaining Health Plans
Excerpt: "By November 15, 2005, every employer who offers pres.cription drug coverage to active or retired employees (or their spouses/dependents) who are eligible for Medicare will be subject to new notice requirements under regulations (CMS-4068-F, 70 Fed. Reg. 4194 (1/28/05)) issued by the Centers for Medicare & Medicaid Services (CMS)." (BNA Tax Management)
Office of Personnel Management Says Dental and Vision Coverage Will Improve Next July
Excerpt: "Enhanced dental and vision benefits will be available to federal employees and retirees in July 2006, the Office of Personnel Management said yesterday in a letter to insurance companies. The letter, sent to companies that participate in the Federal Employees Health Benefits Program, said OPM plans to issue a request for proposals on how to design a new dental and vision package by year's end." (The Washington Post; one-time registration required)
Vermont House Health Care Plan Is Recipe for Disaster for the State
Excerpt: "Done right, Vermont's health care reform will be a landmark accomplishment. Under Gov. Jim Douglas' leadership, Vermont can lead the nation with a world-class medical system including systematic chronic disease management, exceptional primary care and disease prevention, effective cost control and universal access -- all founded on personal choice and personal responsibility. Done wrong, Vermont's health care reform could be a landmark catastrophe." (Rutland Herald)
Overview: Medicare Part D Actuarial Guidance
Excerpt: "The Centers for Medicare and Medicaid Services' (CMS) 'Medicare Part D Guidance on the Actuarial Equivalence Standard for the Retiree Drug Subsidy,' dated April 7, 2005, provides additional guidance on how to calculate the 'actuarial equivalence' of employer plans in comparison to the Medicare Part D drug benefit. This new guidance is intended to clarify and supplement guidance the CMS published in final regulations earlier this year." (Deloitte)
Brief Summaries of Legal Developments in the Health Law News, April 19, 2005, Edition (PDF)
3 pages. Excerpt: "On March 29th, the New York Court of Appeals ruled that an insurer did not have to pay health care claims to entities that were violating the corporate practice of medicine even when the services provided were medically necessary. ....... [T]he Minnesota Court of Appeals recently declared that an insurance company could not deny payments to their insureds on the grounds the health care providers were violating the corporate practice of medicine." (Jenkens & Gilchrist, PC)
Large Employer Health Plans Switching to National Plans from Regional Health Plans in Minnesota
Excerpt: "More and more of Minnesota's biggest employers are switching from regional health plans to national ones to cut administrative costs and offer uniform benefits to employees around the country. Nearly half of the 58 Minnesota companies responding to a survey by Watson Wyatt Worldwide said they are switching to a national plan in 2005, compared with one in three that said they switched from a regional plan in 2004. The numbers reflect those of employers nationally." (Star Tribune; one-time registration required)
Report: Excess Deaths Associated with Underweight, Overweight, and Obesity
Excerpt: "Conclusions Underweight and obesity, particularly higher levels of obesity, were associated with increased mortality relative to the normal weight category. The impact of obesity on mortality may have decreased over time, perhaps because of improvements in public health and medical care. These findings are consistent with the increases in life expectancy in the United States and the declining mortality rates from ischemic heart disease." (The Journal of the American Medical Association)
Blues Plans, Providers Face New Conflicts Over Reimbursement Rates
Excerpt: "Blue Cross and Blue Shield plans often have the largest provider networks of any insurer in their service area. In several markets, however, Blues plans are in the midst of contract disputes with health care providers over payment rates. These conflicts threaten to shrink some Blues' networks, while others already have seen providers leave the network." (The AIS Report on Blue Cross and Blue Shield Plans via AISHealth.com)
Health Care Crossroads Part III: Real Solutions
Excerpt: "The United States has a health care system that is notable for its world-class techniques, equipment, procedures, and overall ability to bring to bear the best quality health care in the world when needed. The U.S. health care system also is characterized by unnecessary costs, unnecessary medical care, and medical errors that kill hundreds daily." (Spencer Benefits Reports)
Are Rising Health-Care Costs Making Your Company Sick?
Excerpt: "Even at companies where they're not a problem -- yet -- directors need to know the treatment options." (Corporate Board Member Magazine)
Summary: Congressional Budget Office Release of Cost Analyses of Health Care-Related Legislation
Excerpt: "Association health plans: Legislation (HR 525) to allow small businesses to form AHPs across state lines would decrease federal revenues by $3 million in 2006 and $71 million between 2006 and 2010, according to a CBO analysis, ...." (Kaiser Family Foundation)
Issue Brief: An Update on Americans' Access to Pres.cription Drugs
The Issue Brief presents sections titled: Pres.cription Drug Affordability Problems Grow; Insurance No Panacea; Income and Rx Access; Blacks at Higher Risk; Implications; Notes; and Data Source. (Center for Studying Health System Change)
A Variety of Factors May Contribute to Lower Drug Cost Trends in 2005
Excerpt: "Market withdrawals, safety issues, a smaller pipeline and larger copays could help drive down pharmacy costs in 2005, according to some recent forecasts. UnitedHealth Group last week said it lowered its projections for full-year 2005 pharmacy cost trends, citing a number of external market forces along with internal pharmacy strategies. The Segal Co. also said recent drug sales data indicate lower-than-expected drug costs." (MANAGED CARE WEEK via AISHealth.com)
How High Is Too High? Implications of High-Deductible Health Plans
Excerpt: "The major purported advantages of HDHPs are that they will a) lower health care costs by causing patients to be more cost-conscious, and b) make insurance premiums more affordable for the uninsured. This report, based on the Commonwealth Fund Biennial Survey of Health Insurance ..., finds that such plans are unlikely to have a substantial effect on either costs or coverage. The 42 page full report is at http://www.cmwf.org/usr_doc/816_Davis_how_high_is_too_high_implications_HDHPs.pdf." (The Commonwealth Fund)
HRAs vs. HSAs: Which Type of Plan Favors the Pharmacy Benefit?
Excerpt: "CDH plans typically combine a high-deductible health plan (HDHP) with an HRA or an HSA. The main difference between the two is that both employers and employees can make pre-tax contributions to an HSA and that account is portable, meaning a person can bring the money to his or her next employer. HRAs typically are unfunded, notional (virtual) accounts that are accessible only when claims are filed." (DRUG BENEFIT NEWS via AISHealth.com)
Owens Corning Tops 70% in Consumer-Directed Health Plan Enrollment
Excerpt: "A consumer-directed health (CDH) strategy that went live at Owens Corning in 2004 has ensured that employees there are no longer 'insulated' from health care costs. The ... manufacturer ... went live with two CDH options in 2004, and added a third CDH option for 2005. More than 70% of the company's 9,000 non-union salaried employees are now enrolled in one of the health reimbursement arrangement (HRA)-based CDH options -- unchanged from 2004's enrollment, ...." (INSIDE CONSUMER-DIRECTED CARE via AISHealth.com)
Summary of Results: The 2004 Segal Survey of Multiemployer Funds' Strategies (PDF)
2 pages. Late last year, at the International Foundation of Employee Benefits Plans' annual conference, Segal conducted an opinion survey on multiemployer funds' strategies for handling a range of current challenges with health care and retirement plans. This PDF presents a brief report of highlights from The 2004 Segal Survey of Multiemployer Funds' Strategies. (The Segal Company)
April Cover Story: The Top 4 Power Struggles in Healthcare
Excerpt: "In the pressure cooker known as our national healthcare system, all the major players seem ready for battle. On the right, advancing slowly ..., are the cost-cutting forces of managed care. On the left, hurling brickbats at almost everyone, are the physicians. In the rear, licking their wounds after their latest brawl with the physicians, and plotting their next ambush on the health plans, are the hospitals. Looking on from the sidelines are the healthcare policy-makers, employers...." (HealthLeaders Magazine)
CBO Testimony on April 19, 2005: The Cost and Financing of Long-Term Care Services (PDF)
18 pages. Excerpt: "Currently, elderly people finance LTC services from various sources, including both private resources and government programs. Incentives inherent in the current financing structure have led to increased reliance on and spending by government programs and may have discouraged people from relying on private resources (savings, private LTC insurance, and donated care) to prepare for potential future impairment." (Congressional Budget Office)
Links to Items on Executive Comp, Benefits in General
Submission to IRS/Treasury: Recommendations for Guidance Under 409A
Excerpt: "The ERISA Industry Committee (ERIC) and the HR Policy Association today filed a joint submission with the Treasury Department and the Internal Revenue Service recommending additional guidance under the recently-enacted legislation governing deferred compensation plans." (The ERISA Industry Committee)
Overview: EBSA Voluntary Fiduciary Correction Program Updated
Excerpt: "An expanded and simplified VFC Program was published in the April 6, 2005 Federal Register. In a move towards expediting the availability of these enhancements, the updated program is effective immediately and will be available during the comment period." (McKay Hochman Co., Inc.)
Temporary North Carolina State Workers Sue for Benefits
Excerpt: "Two former temporary state employees who argue they deserved the benefits of permanent workers after being on the job for 12 months have sued the state of North Carolina. The lawsuit asks a judge to grant it class-action status, demanding that all such employees be given credit for pensions and vacation, and health insurance reimbursements." (NBC17.com)
The Effect of Health Savings Accounts on Health Insurance Coverage
Excerpt: "The authors investigate the potential of Health Savings Accounts (HSAs) to expand health insurance coverage. They examine how many currently uninsured people might be encouraged to buy coverage through HSAs, and what the impacts of such actions might be on the group and nongroup health insurance markets. [The 8 page full report is at http://www.cmwf.org/usr_doc/811_Glied_effect_hlt_savings_accounts_coverage.pdf.]" (The Commonwealth Fund)
No Application for Benefits, No Exhaustion of Administrative Remedies -- Court Rules for Employer
Excerpt: "A participant in a severance plan who only learned about his ineligibility for benefits through an informal conversation with a human resources executive but did not apply for those benefits failed to exhaust his administrative remedies, according to a federal court." (PLANSPONSOR.com; one-time registration required)
Newly Posted Events
ABA Retirement Services Conference
in District of Columbia on June 26, 2005
presented by ABA
Newly Posted Press Releases
ERIC Recommends Additional Guidance For Employers Under American Jobs Creation Act
(ERIC (ERISA Industry Committee))
Before House Financial Services Panel: Social Security Debate Shows Growing Need for Financial Literacy, EBRI’s Salisbury Testifies
(ERIC (ERISA Industry Committee))
Organizations Endorse Simple Cafeteria Plan Legislation
(Small Business Council of America (SBCA))
MCOL Honors 10th Anniversary As Premiere Managed Care Web Destination With Launch Of The Managed Care Museum
(MCOL)
MVP Plan Administrators, Inc. selects ICC Plan Solutions as enrollment kit provider.
(Metrics Partners)
Ottawa Legislative Update
(International Foundation of Employee Benefit Plans)
Washington Legislative Update
(International Foundation of Employee Benefit Plans)
ERISA Advisory Council to Hold First Meeting of 2005
(U.S. Department of Labor, Office of Public Affairs, Washington, D.C.)
Newly Posted or Renewed Job Openings
Trusco Marketing Specialist I
for SunTrust Bank
in FL
Internal Sales Specialist
for Principal Financial Group
in CA
Installation Administrator
for Transamerica
in CA
ERISA Technical Consultant
for SunTrust Bank
in GA
Paralegal
for NRECA
in VA
Benefits Analyst, Sr.
for Sun Chemical Corporation
in NJ
Pension Actuary
for Nyhart
in IN
Pension Analyst
for Benetrends, Inc.
in CA
Implementation Consultant
for Administaff
in TX
Conversion Team Leader
for Administaff
in TX
Associate Manager: Regulatory Policy and Contracts
for Great-West Financial Services
in CO
Pension Paralegal/Administrator
for Actuarial Consulting and Administration Firm
in NY
Pension Administrator
for Jackson Kelly PLLC
in WV
Retirement Plan Administrator
for Retirement Plan Services, Inc.
in NC
Health and Welfare
for Recruiting firm
in MA
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