| BenefitsLink Welfare Plans Newsletter |   |
May 10, 2005
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Health and welfare issues * 401(k) plans Employee compensation * Actuarial pension issues Health Savings Accounts * Legal & fiduciary issues You don't want to miss this one! Register online today. Brought to you by WP&BC and ASPPA. |
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Disability Claim Remanded to Plan Administrator for Failure to Consult Independent Medical Expert
Excerpt: "This case is interesting because it discusses the requirement under the new ERISA claims procedure regulations to consult an 'independent medical expert' during the appeal of a disability or health claim. A participant's long-term disability benefits under an ERISA plan were discontinued after 24 months, based on the company physician's determination that the participant was not totally and permanently disabled from being gainfully employed." (Employee Benefits Institute of America Inc.)
Expecting Better: A State-by-State Analysis of Parental Leave Policies (PDF)
52 pages. Excerpt: "Expecting Better: A State-by-State Analysis of Parental Leave Policies provides a roadmap to solutions, describing programs in every corner of the country that expand on the federal Family & Medical Leave Act and provide support to new parents and their babies. It is the most comprehensive state-by-state analysis of laws, programs and policies regarding maternity and paternity leave produced to date." (National Partnership for Women & Families)
FMLA Suit Needs Clarification of Company Restructuring
Excerpt: "A US District Judge refused to dismiss a lawsuit brought by a man who claims that, upon his return from a three-month Family and Medical Leave Act (FMLA) outage, he was told that his position no longer existed - but that he could take a new position with a $20,000 decrease in pay. In the case Heron v. American Heritage Federal Credit Union, US District Judge Petrese B. Tucker rejected a summary judgment motion from the defense, ruling that the case should be heard by a jury." (PLANSPONSOR.com; one-time registration required)
U.S. Medical Group Coalition Launches Online Medical Record Program
Excerpt: "Patients will be able to see, change and share medical records on the Internet with a service launched [May 9, 2005] by a company set up by a coalition of professional medical groups. They say the service, called iHealthRecord, will let patients control their own records, while allowing doctors vital access when they need it, eventually reducing the risks of mistakes such as prescribing errors. And ... it could provide a way for doctors and patients to replace thick medical ...." (Reuters via Yahoo! News)
Opinion: The Next Insurance Scandal -- Health Insurance Kick-Backs
Excerpt: "In the health insurance arena, the commission paid to the broker is built into the premium the insurer quotes. Since premiums are based upon numerous factors considered by the underwriter related to the composition of the company's employee group, it's relatively easy to manipulate premiums quoted to conceal commissions. And since all the insurers pay these commissions, all quotes are inflated to some degree." (Benchmark Advisory Services, Inc., and Benchmark Financial Services, Inc.)
FDA Releases Guidelines for Drug Information Site and Proposed Oversight Board
Excerpt: "The FDA on Friday issued guidelines for its 'Drug Watch' Web site, which would provide consumers with drug safety information, the Wall Street Journal reports. The agency also issued more information on its proposed Drug Safety Oversight Board, which would discuss drug safety issues and would handle the information posted on the Drug Watch site." (California HealthCare Foundation)
Employer Health Insurance Plans Seek Ways to Control Use of Hard-to-Define `Lifestyle Drugs'
Excerpt: "While insurers are often reluctant to use the term 'lifestyle drugs' because it lumps together a number of therapies that many people rely on, employers and insurers are considering their options for controlling the use of medications like Via.gra (silde.nafil) that would fall into this category. 'More and more employers and plans are further dissecting the definition of 'lifestyle' drugs,' says consultant Tim Watson, Pharm.D., president of Pharmaceutical Strategies Group." (DRUG BENEFIT NEWS via AISHealth.com)
New Choices in Health Plans Reduce Costs; Raise Financial Risk for Employees
Excerpt: "As double-digit increases in health care insurance plague business owners, health-plan providers are pushing new choices with the promise of lowering costs for employers and their workers. But along with cutting costs comes financial risk for employees and a new way of choosing a health plan." (The Fresno Bee via The Patriot-News)
Growth of HSAs, HDHPs Could Translate into Shrinking Health Plan Revenues, Report Says
Excerpt: "By 2012, fees related to health savings accounts (HSAs) could top $1 billion, according to a ... report from Cambridge, Mass.-based Forrester Research, Inc. While that's great news for the financial firms that have jumped into the HSA market as account administrators, it means many health plans will watch their slice of the health care payment pie shrink steadily during the next several years." (AISHealth.com via INSIDE CONSUMER-DIRECTED CARE)
EBRI Notes Article: The Relationship of Union Status and Employment-Based Health Benefits (PDF)
Pages 2-6 of 12 pages. Excerpt: "This article examines the relationship between health benefits and union status. Union workers are much more likely to have employment-based health benefits than nonunion workers. In September 2003, 86 percent of union workers were covered by health benefits through their own job, compared with 59.5 percent of nonunion workers (Figure 1). Overall, 95.4 percent of union workers had employment-based health benefits, compared with 77.8 percent of nonunion workers." (Employee Benefit Research Institute)
Links to Items on Executive Comp, Benefits in General
Milliman's Monthly Benefit News and Developments, May 2005 Edition (PDF)
5 pages. The newsletter provides a summary of the previous month's legislative, regulatory, and judicial information on employee benefits. (Milliman)
Insurer's Letter Promising a Decision in 30 Days Did Not Shorten Decision Period Set by Regulations
Excerpt: "A disability plan participant filed a claim that the insurer denied after almost six months and 17 requests for additional information. The participant appealed the denial as required by the plan and received a letter acknowledging the appeal and stating that 'under normal circumstances' the plan would decide her appeal within 30 days. The disability plan terms provided for a decision on the appeal within 60 days (or, if an extension applied, 120 days)." (Employee Benefits Institute of America Inc.)
Montana University System Excludes Many Same-Sex Couples from Obtaining Benefits
Excerpt: "Despite a court ruling that the Montana University System must provide benefits to the partners of g.ay and les.bian workers many same-sex couples remain without the insurance plans because of restrictions set in place by the plan. Last December the Montana Supreme Court ruled that the state must provide les.bian and g.ay employees of the University System with the option of purchasing health insurance and other employee benefits for their domestic partners." (365G.ay.com Newscenter)
Newly Posted Events
ASPPA Benefits Council of Greater Cincinnati: Washington Update with Brian H. Graff, Esq., APM, ASPPA Executive Director/CEO
in Kentucky on June 16, 2005
presented by ASPPA Benefits Council of Greater Cincinnati
Using Care Management Strategies to Reduce Benefit Costs and Improve Employee Health
in California on June 15, 2005
presented by Precept Human Capital Management
Newly Posted Press Releases
U. S. Labor Department Extends Annual Reports Deadline After Severe Storms Hit New York
(U.S. Department of Labor, Employee Benefits Security Administration (EBSA))
U. S. Labor Department Extends Annual Reports Deadline After Severe Storms Hit New Jersey
(U.S. Department of Labor, Employee Benefits Security Administration (EBSA))
Silver Slipper Casino Venture dba President Casino Partners with Gilsbar, Inc. to Provide Suite of Employee Benefits
(Gilsbar, Inc.)
ICC Plan Solutions Charges Into the Health Savings Account Market
(Metrics Partners)
Pension Plan Rates - Commuted Value Interest Assumptions for June 2005
(Hart Actuarial Consulting)
Newly Posted or Renewed Job Openings
Health Benefits Analyst
for The Segal Company
in AZ
Communications Consultant
for Diversified Investment Advisors
in NY
Key Account Consultant
for ING U.S. Financial Services
in IL
Relationship Manager
for Fidelity Investments
in KY
HR Strategic Research Consultant
for The Corporate Executive Board
in DC
Principal Administrative Analyst
for University of California, Office of the President
in CA
Retirement Plan Specialist
for Diversified Investment Advisors
in MD
Handy Links:
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- Search BenefitsLink
- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
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