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November 7, 2006
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(Please visit our sponsors. We try to make sure their products and services will be of interest to you. Thanks! --Editor)

Health Plan Enrollees Baffled Over Why Health Insurance Claims Were Rejected May Get Some Relief
Excerpt: "Highmark, a Blue Cross Blue Shield affiliate and Pennsylvania's largest insurer, has settled a lawsuit filed by an elderly couple who say they went without benefits for months because of information the insurer failed to provide." (United Press International)

Employer's Failure to Inform Participant About Coverage Exception May Breach Fiduciary Duties
Excerpt: "EBIA Comment: As this court points out, its recognition of a limited fiduciary duty to inform a beneficiary of material facts without a specific request for information is not a groundbreaking proposition. In fact, this court is headed in the same direction as several other courts that have gone beyond the Supreme Court's ruling in Varity Corp. v. Howe . . . ." (Employee Benefits Institute of America Inc.)

Ruling Highlights Fiduciary Need for Hindsight
Excerpt: "A recent decision by a U.S Appeals Court serves as a sober reminder of ERISA plan fiduciaries' duties and liability concerning a plan's dealings with service providers. [Chao] v. Merino, 452 F.3d 174 (2d Cir. 2006) . . . is especially instructive to new plan fiduciaries." (Employee Benefit News)

Market Research Firm Rates Vision Plans
Excerpt: "Market research firm J.D. Power & Associates released its second ranking of national vision plans last week, which included the three companies offering new federal employee vision insurance. Of the eight vision plans studied, VSP -- the Vision Service Plan -- ranked first for customer satisfaction." (

How to Identify an Exempt Governmental Plan
Excerpt: "In providing a general approach to identifying a self-funded ERISA plan, a consideration of plans exempt from ERISA coverage is naturally required. As governmental plans constitute one of the important exemptions from ERISA coverage, this article will address in more detail the prerequisites for exempt governmental plans." (Health Plan Law blog by Attorney Roy F. Harmon III)

NHIN Architectures Hope to Balance Patient Privacy and Population Health Needs
Excerpt: "The architects of a prototype National Health Information Network (NHIN) are testing various approaches to balance the need to monitor population health and protect patient privacy." (REPORT ON PATIENT PRIVACY via

Mere Existence of Computerized Notice System Not Enough to Satisfy COBRA
Excerpt: "We just can't emphasize enough the importance of being able to prove that procedures were followed in individual cases, including producing evidence of what was sent, when it was sent, and to whom." (Employee Benefits Institute of America Inc.)

Rejected by Supreme Court, Medical Organizations May Refile Lawsuit on Patient Privacy Consent
Excerpt: "A group of medical professional organizations and individuals may file another lawsuit in an attempt to protect patients' rights to consent after the U.S. Supreme Court declined to hear the case on Oct. 2." (REPORT ON PATIENT PRIVACY via

A Way to Defray Health Care Costs in Retirement
Excerpt: "Will your employer pay for your health insurance in retirement? Most won't. . . . But some companies that don't or that stopped offering retiree health benefits use a voluntary employee beneficiary association (VEBA) to help workers defray health costs in retirement." (U.S. News & World Report)

With Health Costs Still Rising, Companies Testing New Ways to Save. The Trendiest: Workers Pay More
Excerpt: "For the average employee, premiums and out-of-pocket expenses will reach $2,904 a year for a family, up $300 from 2006. That's the pass-along pain of the costs that employers now endure, nearly $9,000 per employee, up an estimated $518 from this year." (TIME)

PBM Fee Transparency Affects Employers' Performance Perception
Excerpt: "The 2006 Pharmacy Benefit Manager Customer Satisfaction Report by the Pharmacy Benefit Management Institute (PBMI) found that employers who are 'extremely satisfied' with financial transparency of their PBM (26%) gave their PBMs an average overall service rating of 8.9 on a 10-point scale . . . ." (; one-time registration required)

A Brief Guide to the Latest Research Available on Consumer-Directed Health Plans and HSAs
The target page provides a listing of titles with links to the most recent research. (Galen Institute)

More Kansas Insurers Offering Limited-Benefit Plans for Employer-Sponsored Health Care
Excerpt: "Employer health insurance plans with limited or capped benefits and high deductibles -- sometimes called 'mini-medical' plans -- are increasingly available to Kansas workers, the Wichita Eagle reports. Three of the largest health insurance companies in the Wichita area -- Preferred Health Systems, Blue Cross and Blue Shield of Kansas and CIGNA -- have either begun offering such plans this year or plan to offer them in 2007." (Kaiser Family Foundation)

Overview: In FAB 2006-02, DOL Provides Important Follow-Up Guidance on HSAs and ERISA Issues (PDF)
4 pages. Excerpt: "Reading this guidance, FAB 2004-1 and the applicable IRS guidance together, it would appear that ERISA would not apply solely because an employer establishes an arrangement under which accounts are established and pre-tax salary reduction contributions are made by default. Also, it is important to ensure that state and federal banking requirements applicable to account establishment are satisfied." (Alston & Bird, LLP)

Links to Items on Executive Comp, Benefits in General

457(f) & 409A Update (PDF)
Excerpt: "457(f) standards remain somewhat in flux, which could also argue in favor of taking at least partial advantage of the December 31, 2007 amendment extension for 409A." (Gardner Carton & Douglas LLP)

Overview: Executive Compensation Disclosure -- Changes to Form 8-K (PDF)
3 pages. Excerpt: "Public companies will now need to disclose compensation changes on Form 8-K only if they are truly 'material' to investors. The SEC has revised Form 8-K disclosures of compensation changes and has moved them from Item 1.01 to Item 5.02 in order to separate them from 'material agreement' disclosure." (Powell Goldstein LLP)

An Analysis of the Bush Tax Advisory Panel's Proposals
Excerpt: "Summary of the Tax Panel's Proposals for Individual Taxpayers . . . . Combine 15 different tax provisions for at-work saving, health saving, education saving, and retirement saving into three simple savings plans . . . ." (NYSSCPA's Tax Policy Subcommittee via The CPA Journal)

2006 Election Night Guide and Analysis (PDF)
17 pages. (Pillsbury Winthrop Shaw Pittman LLP)

Retire Well for Less Than You Think
Excerpt: "Once you qualify for post-retirement benefits like Social Security or Medicare, you get to start getting paid by the services you have been paying for throughout your entire career." (The Motley Fool)

Newly Posted Events
(Post Yours!)

401(k) Educational Seminar With Speaker Robert Kaplan From McKay Hochman
in Connecticut on December 6, 2006
presented by National Institute of Pension Administrators-CT Chapter

401(k) Plans: Beyond the Basics
in Georgia on December 6, 2006
presented by SunGard Corbel

HIPAA and Health Laws Compliance Assistance Seminar
in Nevada on November 28, 2006
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Legislative Update: Pension Protection Act of 2006.....and a little more
in Pennsylvania on November 16, 2006
presented by Central Pennsylvania Chapter - ISCEBS

Newly Posted Press Releases
(Post Yours!)

Funding Status of U.S. Pension Plans Improved in October
(Mellon Financial Corporation)

Newly Posted or Renewed Job Openings
Post a Help Wanted Ad

Pension Administrator
for Snyder Cohn
in MD

Retirement Plan Consultant
for the MandMarblestone Group, LLC
in PA

Pension Manager
for Philadelphia Area TPA (Montgomery County)
in PA

Director of Client Services
for BISYS Retirement Services
in PA

Retirement Plan Coordinator
for American Funds, a part of The Capital Group Companies, Inc
in TX

401(k) Administrator - Analyst
for The Pension Group, Inc.
in CA

Client Relationship Manager
for Freedom One Financial Group
in MI

Pension Administrator
for Staffordshire Benefits, LLC
in NJ, PA

Retirement Services Provider Consultant
for Deloitte Consulting LLP
in MA, MN, NY

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