| BenefitsLink Welfare Plans Newsletter |   |
May 6, 2005
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The 'Economist' Looks at Barriers to Health IT
Excerpt: "The Economist this week examines the 'woeful, even scandalous' failure of the worldwide health care industry to adopt health information technology. Creating interoperable databases remains 'a very distant goal,' with the health care industry spending roughly 2% of its revenues on IT, compared with 10% in other information-driven industries, the Economist reports." (California HealthCare Foundation)
Appellate Court Ruling May Have Implications for Health Plans' Coordination of Benefits Provisions
Excerpt: "The U.S. Court of Appeals in Chicago recently held that a health plan that provided secondary coverage for a participant's wife had to pay almost all of her approximately $160,000 in medical claims.* Although this decision will only directly affect plans covering people in the Seventh Circuit (Illinois, Indiana and Wisconsin) all sponsors of group health plans will want to be on the alert for cost-shifting devices such as the 'sub-plan/no loss' provisions used here." (The Segal Company)
Overview: DOL Advisory Opinion on ERISA Preemption of Medicaid Reimbursement Claims
Excerpt: "Medicaid is the payer of last resort. If a State Medicaid program pays a claim that should have been paid by another plan, including a group health plan, the Medicaid program can recover those payments from that plan. But special issues may arise if the State Medicaid program is seeking reimbursement from an ERISA plan, as illustrated by a recent Department of Labor (DOL) advisory opinion. Advisory Opinion 2005-05A (March 23, 2005)." (Deloitte)
Employee Benefits Developments, April 2005 Edition, Covers Three Court Cases
The newsletter summarizes three cases; see the following subtitles: Providing Inaccurate Benefit Information Can Be a Breach of Fiduciary Duty; Court Upholds 'Lifetime' Benefits Language in Health Plan; and, Elvis Checks Into Heartbreak Hotel After Disability Claim Is Denied. (Hodgson Russ LLP)
Opinion: Single-Payer Health Care Bill Passed by Vermont House Could Have National Reverberations
Excerpt: "A bill passed last month in the Vermont House that would establish a single-payer health care system in the state is 'the most radical health care proposal ever to gain majority support in a state legislative chamber,' John McClaughry, president of the Ethan Allen Institute and a former Republican Vermont senator, writes in a Wall Street Journal opinion piece." (Kaiser Family Foundation)
HIPAAdvisory.com reports that CMS Has Posted Five New HIPAA Frequently Asked Questions to Site
Excerpt: "CMS Posts FAQ on HIPAA Security Incidents & More Today, the Centers for Medicare and Medicaid Services (CMS), in charge of enforcing the HIPAA Security Rule, posted five new frequently asked questions (FAQ) to its web site concerning security incidents, risk analysis, and user IDs." (HIPAAdvisory.com)
Court OKs Health Plan's Suit Under ERISA 502(a)(3) for Equitable Restitution from Investment Account
Excerpt: "[T]he Eleventh Circuit held that the funds could be traced even though they had been placed in an account holding unrelated funds of the Sereboffs [the plan participants] and that the funds belonged in good conscience to the Plan. Sereboff is an important decision because it further affirms that equitable relief, as contemplated by the Supreme Court in Great-West v. Knudson ..." (Lawrence & Russell)
Opinion: Advancing Quality in a Consumer-Directed World: 'May You Live in Interesting Times'
Excerpt: "Five years into the new millennium, the role of health plans and insurers in advancing healthcare quality is changing. Three fundamentals are driving this change: the evolution of the health insurance marketplace, the affordability crisis faced by business and consumers, and plan and provider experience." (The American Journal of Managed Care)
Survey Shows Missouri Employers May Up Workers Health Cost Share
Excerpt: "Missouri workers could be hit with higher out-of-pocket costs for health care this year. And they already pay more than the national average for the employee portion of their family health insurance, according to a statewide poll released Thursday by the Missouri Foundation for Health (MFH)." (St. Louis Business Journal via bizjournals.com; one-time registration required)
Audio: Health Care and the Uninsured Middle Class -- A Discussion During 'Cover the Uninsured Week'
Excerpt: "In the United States, 45 million people have no health care insurance -- and more middle-class Americans are feeling the pinch. As 'Cover The Uninsured Week' launches, Ed Gordon discusses this aspect of the health care crisis with Dr. Gary Wiltz, chief executive officer of Teche Action Clinic in Franklin, La., and David Cutler, professor of economics at Harvard University and author of Your Money Or Your Life: Strong Medicine For America's Health Care System." (News & Notes with Ed Gordon via National Public Radio)
Employees Save with Drug Discount Card
Excerpt: "As spending on pres.cription drugs continues to soar, a discount drug card called ScriptSave has shown an increase in savings to individuals. The discounts range from 15% to 50%, depending on the pharmacy and type of medication. Cardholders saved an average of 21%, or $10.97 per pres.cription in 2004, with cardholder savings totaling $170 million last year, compared to $163 million in 2003." (BenefitNews Connect)
Los Angeles City Council Approves Creation of Pres.cription Discount Plan for Residents
Excerpt: "The Los Angeles City Council on Wednesday voted 14-0 to create a pres.cription drug discount program for residents, a move that could make Los Angeles the first city in the United States to offer such a plan, the Los Angeles Times reports. Council member and mayoral candidate Antonio Villaraigosa (D) sponsored the ordinance (Hymon, Los Angeles Times, 5/5)." (California HealthCare Foundation)
Opinion: A Serious Drug Problem in the U.S. Congress
Excerpt: "The new Medicare law subsidizes private health plans, which have repeatedly failed to deliver promised cost savings. It creates an unnecessary layer of middlemen by requiring that the drug benefit be administered by private insurers. The biggest giveaway is to Big Pharma: the law specifically prohibits Medicare from using its purchasing power to negotiate lower drug prices." (The New York Times; one-time registration required)
Counties Try Cutting Health Costs by Nudging Workers to the Gym and Other Healthy Practices
Excerpt: "The private sector across the country has already been experimenting with healthy incentives for employees with anything from rebates for gym memberships to insurance deductibles for nonsmokers. Lately, the wellness trend has been expanding to state and county governments as mounting healthcare costs drain budgets.' (The Christian Science Monitor via USA TODAY)
One House Bill Would Provide Tax Incentives for Using HSAs; Another Provides Uninsured a Tax Credit
Excerpt: "Reps. Sam Johnson (R-Texas) and Eric Cantor (R-Va.) are cosponsoring legislation (HR 1872) designed to position health savings accounts as 'an even more attractive health care option' by making premium payments tax deductible, providing tax credits to small businesses that offer HSAs and giving low-income U.S. residents tax credits for purchasing health care, ...." (Kaiser Family Foundation)
States and Employers Duel Over Health Care Provision Responsibility
Excerpt: "The relentless rise in health care costs is causing states and businesses to fight over whose job it is to insure workers. And nearly two dozen states, struggling with the growing burden of providing public assistance to people with jobs but no insurance, are looking to shift more of the financial burden onto the workers' employers." (The New York Times; one-time registration required)
Links to Items on Executive Comp, Benefits in General
The State of 50+ America – 2005 Edition (PDF)
60 pages. Excerpt: "The State of 50+ America 2005, AARP's second annual 'report card' on the quality of life of Americans age 50 and older, continues [an] examination of the many changes in the well-being of the 50+ population." (AARP)
Employee Benefits Developments March 2005 Summarizes Five ERISA Cases
The newsletter contains summaries of five ERISA cases subtitled as: Directed Trustee Granted Summary Judgment in WorldCom ERISA Action; Severance Benefits Described in E-mail Are Not Covered Under ERISA; Outsourcing Did Not Violate ERISA; Related Claims Not Subject to Plan's Arbitration Clause; and Denial Based on Lack of Objective Test for Pain Held to Be Arbitrary." (Hodgson Russ LLP)
NCR Corp. Shareholders Vote to Keep Domestic Partner Benefits
Excerpt: "A recent shareholder bid to end benefits for domestic partners at technology firm NCR Corp. is just the second such proposal nationwide to make it to a vote in five years, according to a g.ay-rights activist. NCR Corp. shareholders overwhelmingly voted down a proposal late last month to drop benefits for domestic partners of executives earning more than $500,000." (BenefitNews Connect)
Overview: IRS Issues Executive Compensation Audit Guidelines: What Employers Need to Do Now (PDF)
3 pages. Excerpt: "The IRS ... posted on its website new 'Audit Technique Guidelines' ('ATGs') which provide IRS agents auditing corporate tax returns (Form 1120) a road map for reviewing a company's executive compensation practices. Specifically they assist the agent in determining whether various common items of compensation are being properly reported to the company's executives as taxable income, and .... [Originally published March 7, 2005]" (Haynes and Boone, LLP)
U.S. Multinationals Revising Long-Term Incentive Programs for Executives Outside the U.S. (PDF)
8 pages. Excerpt: "U.S. multinationals are overhauling their long-term incentive (LTI) programs for non-U.S. executives. This is a departure from the recent practice of relying on LTI plan features that were uniform worldwide, with the same vehicle -- stock options -- and the same plan terms and award sizes. Now a growing number of companies are shifting to customized approaches." (Towers Perrin)
A Guide to Shareholders' Questions at Public Companies' 2005 Annual Meetings (PDF)
61 pages. Excerpt: "The purpose of this document is to assist management of public companies in preparing for the annual meeting and to be able to provide informed responses to shareholder questions. The document contains examples of questions that might be asked, based on those asked at annual meetings in recent years, and considering current events, including Section 404 compliance in this first year of reporting on internal control over financial reporting." (PricewaterhouseCoopers LLP)
Newly Posted Press Releases
Study Shows How Policy Options, Other Variables Could Affect Benefit Levels in Social Security
(Employee Benefit Research Institute (EBRI))
Long-Term Care Insurance: The Essentials
(MetLife)
HR Technology Professionals Discover COBRApoint at the HRMStrategies
(COBRApoint)
Newly Posted or Renewed Job Openings
Retirement Plan Sales Director
for First Mercantile Trust Company
in CT, MA, ME, NH, NJ, NY, RI, VT
Defined Contribution Administrator
for FACTS, inc.
in IN
Retirement Plans Manager
for TheBANK of Edwardsville
in IL
Client Service Officer
for AmSouth Bank
in FL
Pension Administration Specialist
for Miami Valley Pension, a Brady Ware Company
in OH
Defined Benefit Plan Administrator
for Ingham Group
in FL
Daily Retirement Plan Consultant
for Long Island, NY Employee Benefits Consulting Firm
in NY
Sales & Marketing Consultant
for Retirement Planning Center
in IL
Handy Links:
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- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
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