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January 8, 2007
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States to Expand Health Coverage As Legislatures Seek to Help Uninsured
Excerpt: "States are planning large expansions in health care coverage this year in an aggressive and potentially expensive attempt to reduce the ranks of the 42.4 million Americans who are uninsured. The states are acting at a time when Congress, now under Democratic control for the first time since 1994, has put health care lower on its agenda." (USA TODAY)
Accessing the Future of Retirees' Costs for State and Local Governments
Excerpt: "Figuring out how much cities and towns owe for medical benefits requires the services of an actuary. . . . [T]here is a common-sense science to the process by which actuaries develop the tables and charts that let people, or in this case, municipalities, know how much they owe." (Republican-American)
Employer Benefits for Elder Care Vary
Excerpt: "McGraw-Hill Cos. employees can add one adult family member to their health insurance plan in place of a spouse. The benefit works for single employees who purchase family coverage, as well as for married employees whose spouses can tap into a separate health insurance policy." (Los Angeles Times via Daily Press)
2006 Version of Publication 503, Child and Dependent Care Expenses, Issued with Few Changes
Excerpt: "EBIA Comment: Some DCAP administrators use Pub. 503 to help guide them as to what expenses are employment related. However, Pub. 503 is written primarily for the purpose of helping taxpayers determine whether their expenses qualify for the DCTC and should be used with caution when trying to determine what expenses are reimbursable under a DCAP." (Employee Benefits Institute of America Inc.)
Assignments and Contractual Agreements Form Basis for Differing Preemption Outcomes
Excerpt: "'[T]he critical question for courts is whether the provider's claim is based on a direct cause of action against the managed care company, in which situation it is not preempted, or whether it is derivative to the patient's cause of action, where ERISA applies.'" (Health Plan Law blog by Attorney Roy F. Harmon III)
A Florida Hospital System Plans to Offer Affordable Housing to Attract and Retain Employees
Excerpt: "Baptist Health South Florida, the region's largest private employer, has decided that it needs to start providing affordable housing to attract workers." (The Miami Herald; free registration required)
Employer that Failed to Notify Plan of Qualifying Event Must Pay Medical Bills
Excerpt: "EBIA Comment: Under most plans, the employer is the plan administrator so that the issue of whether the employer notified the plan of a qualifying event never arises. But for any plan, leaves of absence can raise many difficult COBRA issues." (Employee Benefits Institute of America Inc.)
Guidance on Protection of Electronic PHI When Accessed or Stored Offsite
Excerpt: "EBIA Comment: The HIPAA privacy and security rules apply to PHI and electronic PHI regardless of location. Anytime electronic PHI is carried offsite, accessed offsite, or downloaded offsite there is a risk of inappropriate access, loss, interception, or corruption. This guidance offers practical suggestions for reducing risk, and it is recommended reading for anyone involved with electronic PHI privacy and security measures." (Employee Benefits Institute of America Inc.)
Patients Caught in the Middle of Reimbursement Negotiations
Excerpt: "On Jan. 1, the pediatric physician group [Nemours] dropped out as a network provider for Blue Cross, raising the cost of medical care for thousands of parents . . . . Nemours and the state's largest health insurer failed to reach a new contract, unable to compromise on reimbursement rates. Blue Cross said Nemours wants higher rates than it is willing to pay, while Nemours claimed the insurer isn't paying enough to cover its cost of providing care." (The Florida Times-Union)
Health Plans Differ on Coverage for Breast Cancer Treatment
Excerpt: "Several Blues plans last month announced they would provide coverage for partial-breast radiation therapy used to treat early stage breast cancer patients. Although at least 50 health plans cover the treatment, known as MammoSite, many insurers do not provide coverage, citing an FDA finding that the therapy does not replace standard radiation therapy." (Managed Care Week via AISHealth.com)
Opinion: Prescription Drug Prices -- Should Government Negotiate?
Excerpt: "It sounds so simple. Our liberal friends say that since we are in favor of competition and price negotiation, what could possibly be wrong with government negotiating prices? Plenty." (Galen Institute)
Trends in Manufacturer Prices of Prescription Drugs Used by Older Americans
Excerpt: "These AARP Public Policy Institute reports present the results of studies of changes in manufacturers' prescription drug list prices . . . for roughly 200 brand name and 75 generic prescription drugs most widely used by Americans age 50+. [A 14 page update report on the third quarter of 2006 is at http://assets.aarp.org/rgcenter/health/dd151_drugprices.pdf.]" (AARP)
Democrats' Drug Plan Has Pitfalls, Critics Say
Excerpt: "Democrats want the government to negotiate lower drug prices for Medicare beneficiaries, but insist that the government should not decide which drugs are covered." (The New York Times; free registration required)
Corrected Link to Opinion Piece: The Facts-- Medicare Part D and Prescription Drug Prices
Excerpt: "Competitive markets always do a better job of finding the price that works best for both buyers and sellers than government experts. This fact sheet was jointly prepared by health policy experts from the American Enterprise Institute, the Galen Institute, The Heritage Foundation, and the Institute for Research on the Economics of Taxation." (Galen Institute)
Wal-Mart Public Advertising Campaign Will Highlight Employee Health Care
Excerpt: "Wal-Mart [today] will launch a television public advertising campaign to highlight its employee health insurance plan and 'its record as an employer and corporate citizen,' the AP/New York Times reports." (Kaiser Family Foundation)
Cognitive Rehabilitation Not Covered by Many Health Insurers
Excerpt: "The Wall Street Journal [today] examined how many brain injury patients who experience subsequent problems with memory, mental processing or behavior often do not receive cognitive rehabilitation because their health insurers do not cover the treatment." (Kaiser Family Foundation)
House Minority Members Try Again on AHPs
Excerpt: "The AHP bill would give small employers the same ability that large, self-insured employers now have to avoid state benefits mandates, by buying health coverage through multistate associations." (National Underwriter Life & Health; free registration required)
Some Health Insurers Deny Policies Based on Occupation and Prescription Drug Use
Excerpt: "Health insurers in California refuse to sell individual coverage to people simply because of their occupations or use of certain medicines, according to documents obtained by The Times. Entire categories of workers -- including roofers, pro athletes, dockworkers, migrant workers and firefighters -- are turned down for insurance even if they are in good health and can afford coverage, according to the confidential underwriting guidelines of four health plans." (Los Angeles Times; free registration required)
Connecticut Health Plan Draws Interest from Managed Care Companies and Hospital Administrators
Excerpt: "Managed care companies and hospital administrators have expressed early support for Connecticut Gov. Jodi Rell's (R) plan to offer health insurance with monthly premiums of $250 or less to uninsured state residents ages 19 to 64, the Connecticut Post reports." (Kaiser Family Foundation)
How to Design Consumer-Directed Plans for High-Cost Members
Excerpt: "If CDH plans are going to attract people who have a high utilization of health care and those with chronic diseases, they need to do four things, says Michael Parkinson, M.D., chief health and medical officer of CDH firm Lumenos, Inc., a subsidiary of WellPoint, Inc." (Managed Care Week via AISHealth.com)
Overview: Sen. Wyden's Universal Health Coverage Proposal: 'The Healthy Americans Act'
Excerpt: "The proposal would create a centrally financed health care system with universal health care coverage delivered through private health plans." (Hewitt Associates)
Unusual Perks at the Fortune 100 Best Companies to Work For
Excerpt: "[At Goldman Sachs, e]mployees who get married or register a domestic partnership are given an extra week of vacation." (CNNMoney.com)
Newly Posted Press Releases
PBGC Becomes Trustee Of Delta Pilots Pension Plan
Pension Benefit Guaranty Corporation (PBGC)
Electronic Filing of PBGC Premiums Mandatory For All
Pension Benefit Guaranty Corporation (PBGC)
Funding Status of U.S. Pension Plans Improved in December and for All of 2006, According to Mellon Financial
Mellon Financial Corporation
CIGNA HealthCare Expands Health Savings Accounts to Small Group Employers
CIGNA HealthCare
White Horse Advisors, LLC Named in Atlanta Business Chronicle's Book of Lists
White Horse Advisors, LLC
Newly Posted or Renewed Job Openings
Retirement Plan Administrator
for PlanTech, LLP
in AL
Pension/ERISA Attorney
for Major Lindsey & Africa
in MA
Retirement Consultant
for Automobile Club of Southern California
in CA
Senior Education Specialist
for Regions Bank
in TN
ESOP Administrator
for American Qualified Plans, Inc.
in CA, MT
Regional Sales Consultant
for Gallagher Retirement Services
in CO, WA
Director of Plan Administration
for Los Angeles Based Executive Benefits Consulting Firm
in CA
Benefits Administrator
for Phillips-Van Heusen Corp.
in NJ
New Business Analyst
for Securian Financial Group
in MN
Retirement Plan Communication Assistant, #0603816
for John Hancock
in CA
Retirement Plan Communication Associate, #0605146 (Bi-Lingual in Spanish or Vietanamese or Chinese)
for John Hancock
in CA
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- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
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