| BenefitsLink Welfare Plans Newsletter |   |
November 22, 2005
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Court Rejects Employer's Reliance on Medical Necessity Definition Not Contained in SPD or Plan
Excerpt: "Courts pay particular attention to medical plan denials based on lack of medical necessity. Consequently, employers and their advisors should carefully review medical necessity provisions in their plans to be sure that they are drafted with as much specificity as possible and that they are carefully and consistently communicated in the plan's SPD and other plan-related documents." (Employee Benefits Institute of America Inc.)
Company Plans Able to Recoup Disability Overpayments
Excerpt: "[A] federal judge in Indiana has tossed aside arguments by two General Motors employees that the company was barred from recouping disability payments from Social Security-eligible members." (PLANSPONSOR.com; one-time registration required)
West Virginia City's Savings with Consumer-Directed Health Care Plan Could Result in State Pilot
Excerpt: "City officials in Hurricane -- a tiny municipality in West Virginia -- said last month that its consumer-driven health (CDH) plan has helped it trim health coverage costs by nearly $300,000 in less than three years." (INSIDE CONSUMER-DIRECTED CARE via AISHealth.com)
Transcript of the Release of the Results of National Consumer Survey on Health Privacy (PDF)
59 pages. Excerpt: "The California HealthCare Foundation [released November 9, 2005, the] results of a survey on health privacy in America. As efforts to build a nationwide electronic health information network proceed, the study has major implications for employers, policymakers, the health care industry and consumers." (California HealthCare Foundation via kaisernetwork.org)
Study Shows Paying Doctors More for Better Care Seems to Work
Excerpt: "Doctors will provide higher quality care when given financial incentives to do so, concludes a three-year study of seven so-called P4P (pay-for-performance) programs. However, it's still not clear 'whether the return on investment and the quality gains outweigh the financial and human effort,' according to the Robert Wood Johnson Foundation, which funded the study." (CIO Insight)
Links to Items on Executive Comp, Benefits in General
Overview: FASB Vote to Reconsider Accounting for Pensions and Other Retiree Benefits (PDF)
3 pages. Excerpt: "At its Board meeting on November 10, 2005, the Financial Accounting Standards Board (FASB) discussed whether to add a project to its agenda to reconsider the accounting for pensions and other postretirement benefits. The FASB unanimously agreed to pursue a two-phase project, as recommended by the FASB Staff." (Hewitt Associates)
Why Disparate Impact Claims for Age Discrimination Still Face an Uphill Battle
Excerpt: "In March, the U. S. Supreme Court held for the first time that the Age Discrimination in Employment Act (ADEA) allows current or former employees to sue for age discrimination even where there is no evidence of intentional discrimination, under what are known as 'disparate impact' claims. Such claims allege discrimination based on the impact of a policy on a group of employees, rather than deliberate discriminatory treatment." (Faegre & Benson LLP)
Utah State Faculty to Debate Domestic Partner Benefit Coverage
Excerpt: "A proposal to offer domestic partners the same benefits as married employees is back at the Utah State University campus after a nine-month hiatus. Barry Franklin, a professor at the College of Education and Human Services, circulated a petition and won the right to raise the issue Monday before the school's faculty. The Faculty Senate will decide Dec. 5 whether to keep the proposal alive." (AP via kutv.com)
Newly Posted Events
Four Important Sources of Benefit Plan Liability and How to Avoid Them Teleweb
Nationwide on December 8, 2005
presented by International Foundation of Employee Benefit Plans
Quarterly Meeting
in Montana on December 1, 2005
presented by Western Pension & Benefits Conference - Montana Chapter
Newly Posted Press Releases
PBGC Assumes Pension Plans Of Two Falcon Products Companies
(Pension Benefit Guaranty Corporation (PBGC))
Treasury and IRS Issue Guidance on FSA Grace Period and HSA Eligibility
(U.S. Treasury Department and Internal Revenue Service)
CRR Releases New Women's Game on Retirement Planning
(Center for Retirement Research at Boston College)
Newly Posted or Renewed Job Openings
Pension Consultants/Administrators
for Northern NJ Mid-Size Pension Consulting Firm
in NJ
Health and Welfare Implementation Manager
for Constantin Control Associates
in NJ
ERISA Fiduciary
for Sentinel Fiduciary Services
in FL
401(k)/ Retirement Plan Administrator
for Pension Consulting/Services Firm
in MI
Employee Benefits Administration Specialist
for Large, locally owned CPA firm
in LA
Manager Distribution Desk
for Associates in Excellence
in CA
Plan Administrator
for Continental Benefits Group, Inc.
in NJ
Retirement Plan Specialist
for Leggette Actuaries, Inc.
in TX
Handy Links:
- View Today's Active Message Threads
- Search BenefitsLink
- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
Copyright 2005 BenefitsLink.com, Inc.; except that you may reprint this newsletter in full (including this sentence) without obtaining our permission.
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