| BenefitsLink Welfare Plans Newsletter |   |
April 26, 2005
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Congress May Let Internet Help Solve the Health Care Crisis with Online Health Insurance Purchasing
Excerpt: "In the next couple of weeks a bill will be introduced into Congress that could easily revolutionize the way we purchase health insurance, making it much more affordable and suitable to our individual needs. The bill, from Rep. John Shadegg, R-Ariz., would allow us to purchase health insurance online. It's called the Health Care Choice Act." (San Francisco Examiner)
Insurer Properly Denied Claim For LTD Benefits Where The Beneficiary Was Not 'Disabled'
Excerpt: "An insurance company properly denied a beneficiary's claim for long term disability benefits because the beneficiary was not 'disabled' within the meaning of the LTD plan. This was the ruling of the First Circuit U.S. Court of Appeals in Orndorf v. Paul Revere Life Insurance Company (No. 04-1520)." (Spencer Benefits Reports)
U.S. House Bill Creates Employer Higher Education Tax Break
Excerpt: "Three US House Republicans have joined forces to introduce a new bill that provides tax incentives for employers who help pick up the tab for the higher education of their workers' children. The Family Friendly Employer Act (HR 1518), grants tax deductions of up to $2,500 for employers who pay for their employees' children's education, according to a statement by sponsor Representative Ric Keller (R-Florida)." (PLANSPONSOR.com; one-time registration required)
Lobbyists Play Tug of War Over Family and Medical Leave Act Changes
Excerpt: "Welcome to 'Family Feud,' Washington-style. The Labor Department has been mum about its plans to make changes to a Family and Medical Leave Act rule that allows workers unpaid time off to handle serious illnesses and health problems. The cone of silence has stoked a recent burst of lobbying from interest groups seeking to change the rules or preserve them." (The Washington Post; one-time registration required)
Value of Vision Plan Benefits to Employers Examined
Excerpt: "Eyes are said to be the window to a person's soul, but to doctors, they're also the window to a person's health. Routine eye exams provide an opportunity for spotting systemic health problems, especially in people who visit their optometrist more often than they visit their primary care provider. Eye exams can be used to spot symptoms of diseases like diabetes, hypertension, multiple sclerosis, brain tumors, lupus, AIDS, osteoporosis, rheumatoid arthritis and Grave's disease." (Employee Benefit News)
Legal Transformation: Group Legal Plan Offerings Are Adapting to Changing Demographics
Excerpt: "Group legal plans are undergoing an evolution regarding their usage - and, consequently, an evolution in their offerings. Participation in legal benefits plans is rising. Legal insurance provider ARAG, based in Des Moines, Iowa, has seen 'a significant amount of growth the past several years,' says James Kraynik, vice president of business and product development." (Employee Benefit News)
Overview: HIPAA Administrative Simplification; Enforcement Proposed Rules April 18, 2005 (PDF)
2 pages. Excerpt: "On April 18, 2005 the Secretary of Health and Human Services ('HHS') proposed rules imposing civil monetary penalties ('CMP') on entities that violate the Administrative Simplification Provisions('ASP') of HIPAA. In an effort to unify the investigation of potential HIPAA noncompliance, the proposed rules would amend the existing rules, making the CMPs applicable to all of the HIPAA ASPs (the current rules apply only to the privacy standards)." (Powell Goldstein LLP)
Privacy Rule Implications for Employers: A Neglected Side of HIPAA
Excerpt: "Most HIPAA-implementation attention has been focused on how hospitals and physicians interact with patients and handle their protected health information (PHI), or how traditional health insurers protect their enrollees. But many employers -- including hospitals, health plans and other health care entities -- have additional HIPAA privacy obligations as a result of the health benefit they offer to their work force." (REPORT ON PATIENT PRIVACY via AISHealth.com)
Technology Helps Employers Define Health-Cost Drivers
Excerpt: "It's often said you can't control what you can't measure. Taking that maxim to heart, more employers are using technology to analyze their health-cost data and make decisions on which benefit programs to implement." (Employee Benefit News)
Support as Important as Incentives for Physician E-Prescribing
Excerpt: "A small raft of health care payers and their partners have launched new campaigns to encourage physicians to write electronic pres.criptions. This time, they are offering support along with free equipment, software and other incentives. [A] collaborative of three automakers sent letters to over 6,000 physicians asking them to participate in a new program: SEMI (Southeast Michigan ePrescribing Initiative), ...." (CIO Insight)
DOL Advisory Opinion 2005-05A on Investigation of Pharmacy Benefit Manager for Potential Violations
Excerpt: "Regarding the provisions in ERISA § 514(b)(8) and ERISA § 609(b) on State causes of action to obtain reimbursement for their Medicaid programs from ERISA plans." (U.S. Department of Labor)
CMS's Final Rule on Medicare Drug Benefit Offers Uncertainties and Opportunities for PBMs
Excerpt: "In the aftermath of CMS's Jan. 21 issuance of the final rule for the Medicare Part D pres.cription drug benefit, one analyst says the program will provide PBMs the potential for 14 million to 15 million new covered lives. Under the new drug benefit, PBMs have the option of applying as a Pres.cription Drug Plan (PDP) or a fallback plan -- the option that opens up if there is no PDP in a region ...." (DRUG BENEFIT NEWS via AISHealth.com)
Despite CMS Guidance on Medicare Rx, Erie County Problem May Impede Implementation by Employers
Excerpt: "[T]he 2000 Erie County ruling, in which the Third Circuit held that coordination of retiree health benefits with Medicare eligibility violates the Age Discrimination and Employment Act, may interfere with Congress' goal of designing the law to encourage employers and unions to continue drug coverage for their Medicare-eligible retirees." (HR Policy Association)
Sen. Clinton & Rep. Markey Introduce Bill to Protect Privacy of Patients' Personal Information
Excerpt: "The legislation, the Safeguarding Americans from Exporting Identification Data (SAFE ID) Act, would close gaps in the U.S. privacy laws that leave consumers vulnerable when American businesses and health care organizations send accounting and medical information overseas for processing, the legislators say." (REPORT ON MEDICARE COMPLIANCE via AISHealth.com)
Number of Health Care Uninsured May Be Overstated, Studies Suggest
Excerpt: "The number of Americans without health insurance -- one of the most watched and worrisome indicators of economic well-being -- may be overstated by as much as 20%, according to research conducted for the government. That could mean 9 million fewer uninsured, reducing the total to 36 million from the 45 million reported for 2003, the latest year for which data are available." (Los Angeles Times; one-time registration required)
HSAs Could Transform Health Insurance Into `Secondary Component,' Expert Warns
Excerpt: "The impact that health savings accounts (HSAs) will have on the health insurance industry -- and small niche companies -- could parallel the negative effect 401(k) retirement plans had on the traditional pension industry more than 20 years ago, some industry observers suggest." (INSIDE CONSUMER-DIRECTED CARE via AISHealth.com)
Pennsylvania Senate Passes Health Savings Account State Tax Exemption
Excerpt: "The Pennsylvania Senate has passed legislation that would exempt health savings accounts (HSAs) from that state's personal income tax. On April 20, the state Senate unanimously passed the legislation. Under it, any HSA that complies with the federal tax code is also eligible to be exempt from the state tax." (PLANSPONSOR.com; one-time registration required)
Eleven States Tax Health Savings Accounts
Excerpt: "Employers looking to add health savings accounts next year should check to see if their employees would be hit by state taxes. Eleven states, including California, New Jersey, Pennsylvania and Minnesota, levy taxes on HSAs." (Employee Benefit News)
Links to Items on Executive Comp, Benefits in General
Online Benefit Statements for Employees Help Uncover 'Hidden' Value of Total Job Compensation
Excerpt: "Do your employees know the true value of their total benefits package? Probably not. According to the U.S. Chamber of Commerce, nearly 80 percent of employees don't understand the worth of their compensation packages. Yet benefit costs continue to rise. The U.S. Chamber recently published a study indicating that employers spent an average of $18,358 per employee on benefits in 2003, up slightly from $18,000 the year before." (Nashville Business Journal via bizjournals.com; one-time registration required)
Larger Outsourcing Vendors Are Offering More Services to Employers for Less
Excerpt: "Stung by rising health care costs, some large companies are finding solace in bargains offered by a new breed of outsourcers that can handle everything from benefits to recruiting." (Employee Benefit News)
Former Employees' Claims of ERISA 510 Discrimination Fail; Employer Had Legitimate Reason
Excerpt: "The U.S. Court of Appeals for the Eighth Circuit held that a division of Honeywell International that acts as a government contractor for the U.S. Department of Energy (DOE) did not intentionally interfere with former employees' pension rights when it outsourced the division to a subcontractor in order to make a more competitive bid to the DOE to continue its government contract. Register v. Honeywell Fed. Mfg. & Techs. LLC, No. 04-1902, (8th Cir. 2/17/05)." (BNA Tax Management)
Newly Posted Events
The Future of Roth 401(k)
Nationwide on May 19, 2005
presented by ASPPA (American Society of Pension Professionals & Actuaries)
Ultimate Fixes — The New VFCP and Bankruptcy Rules
Nationwide on May 9, 2005
presented by SunGard Corbel
Newly Posted Press Releases
Workers' Comp Woes to be Addressed at GIANT SEMINAR
(ClearComp)
Rep. Ben Cardin, Architect Of Retirement Plan Reforms, To Speak At SPARK National Conference
(Society of Professional Administrators and Recordkeepers (SPARK))
Newly Posted or Renewed Job Openings
Member Retirement Services Specialist
for Orange County Teachers Federal Credit Union
in CA
Tax Manager
for Deloitte
in NC
Senior Compliance Analyst
for Leggette Actuaries, Inc.
in TX
Supervisor TPA Firm
for Chicago TPA Firm
in IL
Employee Benefits Specialist
for Principal Financial Group
in NC
Employee Benefits Specialist - Voluntary Benefits
for Principal Financial Group
in MA
Account Manager - AMT
for CitiStreet
in NJ
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