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March 20, 2006
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Overview: HIPAA Privacy Notice Reminder Due April 14, 2006
Excerpt: "The HIPAA Privacy Rule requires a health plan to remind enrollees of the availability of its Notice of Privacy Practices, as well as how to obtain a copy, no less frequently than once every 3 years. (CFR 164.520(c)(1)(ii)). The reminder notice is one of four disclosure requirements for the Notice of Privacy Practices; the other three being at the time of enrollment for new enrollees, upon request and within 60 days of a material change to the Notice." (ERISAdiagnostics,Inc.)

Language Becoming an Issue for Health Insurers
Excerpt: "A Spanish-speaking couple is suing Blue Cross, saying it should not have [canceled] a policy that it wrote in English." (Los Angeles Times via BlueCross BlueShield Association)

Disability Insurance Policy with Employer-Paid Premiums Included in Employee's Income Not ERISA Plan
Excerpt: "Because the employer in this case apparently was not involved in the ongoing administration of the policy, the court distinguished it from precedent holding that, where there is ongoing administrative involvement by the employer, an individual policy can be part of an ERISA plan even if the employer initially pays the premiums but then adds the amount of the premiums to the employee's income." (Employee Benefits Institute of America Inc.)

Maine Eyes Self-Insurance for Dirigo Program
Excerpt: "Maine Gov. John Baldacci next week intends to ask state legislators to pass a measure to introduce a self-insurance system for a state program that subsidizes health insurance premiums of low-income individuals and employees who work for small employers." (Business Insurance)

COBRA Claims against Insurer May Continue Pending Discovery
Excerpt: "The plan administrator is responsible for providing the COBRA initial and election notices and is the person designated as such in the plan instrument. However, the court in this case concluded that the plan document was insufficient to establish that the insurer was not the plan administrator, perhaps wanting to be satisfied that there had been no other designation by the employer." (Employee Benefits Institute of America Inc.)

Seriously Ill Newborn Not Enrolled During HIPAA Special Enrollment Period Not Entitled to Coverage
Excerpt: "The HIPAA special enrollment regulations generally require most health plans to allow a period of at least 30 days to enroll a newly acquired dependent. Here, the plan met that requirement by allowing the longer period (31 days). In addition, the special enrollment regulations require that a notice of special enrollment rights be provided at or before the time the employee is initially offered the opportunity to enroll." (Employee Benefits Institute of America Inc.)

When a Health Plan Is Allowed to Disclose PHI to a Person Who Calls on Behalf of a Covered Person
Excerpt: "This FAQ is especially welcome because the example involving the HR representative clarifies that the covered person does not need to be in the physical presence of the health plan representative in order for the covered person to indicate that he or she agrees to the disclosure." (Employee Benefits Institute of America Inc.)

Testimony: Electronic Health Records and 'Smart' Health Information Systems (PDF)
15 pages. Excerpt: "Statement of Consumers Union William Vaughan Senior Policy Analyst before Subcommittee on Health The Committee on Energy and Commerce U. S. House of Representatives on Legislative Proposals to Promote Electronic Health Records and A Smarter Health Information System March 16, 2006" (Consumers Union)

Company Details True Cost of Health Care
Excerpt: "As the Bush administration presses for wider use of health savings accounts, experts acknowledge that a big piece of the puzzle is still missing: ready access to the true cost of a medical procedure." (AP via The New York Times; one-time registration required)

Examples of Health Care Costs
Excerpt: "Examples of insured patients' average out-of-pocket health care costs for two common procedures. The figures are an average based on region, according to Golden, Colo.-based HealthGrades Inc." (AP via The New York Times; one-time registration required)

Maryland Legislation Would Force Wal-Mart to Put More Money Toward Employees' Health Insurance
Excerpt: "Maryland's Fair Share Health Care Act mandates that companies with at least 10,000 employees put at least 8% of their payroll toward health care, or pay the difference into a state Medicaid fund. Among the state's largest employers, only Wal-Mart currently falls below the 8% payroll threshold, so, at least for now, it would be the only company affected. However, similar initiatives are reportedly under consideration in more than 30 states." ( one-time registration required)

Overview: Creditable Coverage Disclosure to CMS
Excerpt: "The Disclosure Notice is required to be provided to CMS by certain entities listed in the regulations and include employer sponsored group health plans that offer pres.cription drug coverage to Medicare eligible employees, retirees and their eligible dependents; as well as union/Taft-Hartley plans; church, Federal, State and local government, and other group-sponsored plans." (ERISAdiagnostics, Inc.)

Employers with Retiree Drug Benefits Charting Different Courses for 2007, According to Study (PDF)
5 pages. Excerpt: "There's increasing evidence that employers are rethinking their pres.cription drug strategies for both Medicare-eligible and non-Medicare-eligible retirees. Fewer appear committed to taking the federal subsidy again in 2007, and more seem interested in alternative approaches. At the same time, most organizations aren't sure yet what they'll do next year." (International Society of Certified Employee Benefit Specia.lists and Towers Perrin)

The Case against Health Savings Accounts
Excerpt: "With health-care costs perched high on their list of worries, many CFOs see health savings accounts as a way to stanch the bleeding. But growing corporate interest in HSAs has been met by a growing backlash by critics and researchers." (

Budget Bill Allows for Health Reform Funding
Excerpt: "The original text of the bill includes a section that would permit either the Senate Finance Committee or the Senate Health, Education, Labor and Pensions Committee to use its budget allocation to set up a program to address health care costs, coverage or care for the uninsured." (National Underwriter Life & Health; free one-time registration or paid subscription required)

Fact Sheet: Income, Poverty, and Health Insurance in the United States in 2004, January 2006 (PDF)
2 pages. Excerpt: "An estimated 45.8 million persons were without health insurance coverage during the entire 2004 calendar year (15.7 percent of the total population). This number was about 0.8 million persons higher than in 2003 (0.1 percentage points higher), a statistically significant increase." (AARP)

Links to Items on Executive Comp, Benefits in General

Corporate Governance Forum Discusses SEC's Proposed Executive Compensation Disclosure Rules (PDF)
6 pages. Excerpt: "[A] PANEL OF CORPORATE, EXECUTIVE-COMPENSATION, AND SECURITIES EXPERTS DISCUSS some of the more pressing corporate governance issues facing public companies today: executive compensation, corporate penalties, and internal investigations." (8-K magazine, Daily Journal Corp. via Orrick, Herrington & Sutcliffe LLP)

Overview: Code Section 409A Proposed Regulations (PDF)
13 pages. Excerpt: "On September 29, 2005, the Treasury and IRS issued proposed regulations under Section 409A of the Internal Revenue Code (the 'Code'). Code Section 409A was enacted as part of the American Jobs Creation Act of 2004 and contains extensive restrictions on nonqualified deferred compensation plans and arrangements. [Originally published October 2005]" (Epstein Becker & Green, P.C.)

Overview: Filing Deadline for Initial LM-10 Reports and Additional Compliance Information (PDF)
4 pages. Excerpt: "[T]he Department of Labor (DOL) announced an extension of the filing deadline for initial LM10 reports and issued additional guidance concerning employer LM10 reporting obligations under the Labor Management Reporting and Disclosure Act (LMRDA or Act), 29 U.S.C. §§ 401 et seq. Employers with fiscal years ending December 31 now have until May 15, 2006 to submit their initial LM10 reports to the DOL." (Morgan, Lewis & Bockius LLP)

Newly Posted Events
(Post Yours!)

Administering Plans Under the Final 401(k) Regulations
in Kentucky on March 28, 2006
presented by ASPPA Benefits Council of Greater Cincinnati

Newly Posted Press Releases
(Post Yours!)

Survey Shows Employers Are Rethinking Their Prescription Drug Strategies for 2007
(International Society of Certified Employee Benefit Specialists (ISCEBS))

Newly Posted or Renewed Job Openings
Post a Help Wanted Ad

Pension Consultants/Administrators
for Northern NJ Mid-Size Pension Consulting Firm
in NJ

Senior Plan Administrator
in CA

Senior Plan Administrator
for American National Insurance Company
in TX

Client Integration Transition Manager
for Diversified Investment Advisors
in NY

Defined Benefit and Defined Contribution Administrator
for Pension Strategies
in AZ

Enrolled Actuary
for Nicholas And Hicks, Inc
in AK, AZ, CA, CO, ID, NV, OR, TX, UT, WA

Account Manager
for LaRhette Manin Benefits Service Group (LMBSG)
in MA

Enterprise Operations Specialist
for Wachovia Corporation
in NC

Annual Plan Reporting Services Manager - PA
for Vanguard
in PA

Handy Links:

Copyright 2006, Inc.; except that you may reprint this newsletter in full (including this sentence) without obtaining our permission.

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Editor and Publisher: David Rhett Baker, J.D.