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March 7, 2007


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Eleventh Circuit Rebuffs Aetna for Preferring Nurses' Opinions Over Treating Physician's Assessment
Excerpt: "In this unpublished opinion, the Eleventh Circuit Court of Appeals delivered a scathing rebuff to Aetna in its handling of a disability claim and the subsequent administrative review. The Court did not address the question of whether the disability policy required de novo review, holding that 'Aetna's decision to deny STD benefits does not survive even the more deferential arbitrary and capricious standard.'" (Health Plan Law blog by Attorney Roy F. Harmon III)

Financial and EAP Counseling Can Improve Fiscal and Physical Health
Excerpt: "'Most people don't realize how often their physical problems are caused by stressing over money problems,' says Mary Brown, senior vice president at BrownRichards & Associates, a company specializing in providing national and international work-life consulting and referral services." (Employee Benefit News)

Peer Assistance Program Supports EAP in Counseling Workers
Excerpt: "Nearly all of us at some point have taken a co-.worker into our confidence for help solving a personal problem. Several California transportation unions have built on this aspect of workplace relationships, creating a peer assistance program (PAP) in which specially trained employees lend support to colleagues in crisis." (Employee Benefit News)

Overview of San Francisco's New Paid Sick Leave Ordinance, Updated March 6, 2007 (PDF)
4 pages. Excerpt: "Due to complaints from employers that they were not given enough time to get ready for the San Francisco's New Paid Sick Leave Ordinance, the Ordinance was amended on February 27, 2007 to allow employers to delay paying for sick leave until June 6, 2007 and to waive any penalties for such delay in payment." (Groom Law Group)

HIPAA Privacy Rule Still Causing Confusion
Excerpt: "It's been more than 10 years since the Health Insurance Portability and Accountability Act became law, but many healthcare practitioners across the country are still unsure of what the law requires and how its provisions interact with other state and federal privacy laws, according to participants in a federally funded healthcare privacy research project who are meeting in Bethesda, Md., this week." (Modern Healthcare; one-time registration required)

The Data Tell a Different Story on Heart Patients
Excerpt: "In the current, long-overdue debate about health care, the focus is almost entirely on health insurance. And there is no question that the country would be better off if everyone were covered. But the gaps in insurance aren't the only problem with the medical system. They are not even the biggest problem." (The New York Times; free registration required)

How Will the Medical Tourism Industry in the United States Develop?
Excerpt: "The US medical tourism market is still a burgeoning industry. As such, its development will be dictated by a variety of market factors and the reactions of a variety of market sectors." (Consumer Health World)

Three Maine Provider Systems Announce Collaborative Effort To Reduce Costs
Excerpt: "Officials from Eastern Maine Healthcare Systems, MaineGeneral Health and MaineHealth have agreed to a 'memorandum of understanding' regarding the collaboration to prevent illegal practices, such as price fixing . . . ." (Kaiser Family Foundation)

What Everyone Should Know About Health Reinsurance (PDF)
2 pages. Excerpt: "Proponents claim that requiring the government to take up the reinsurance function would lower premiums because insurers and employers would cost-shift the most expensive patients to the government. But there is no free lunch. The money for the high-dollar claims would have to come from somewhere -- i.e., taxpayers." (The Council for Affordable Health Insurance)

Overview: Reinsurance and the Federal Government (PDF)
2 pages. Excerpt: "[Some suggest] that if the government were to pick up part or all of the costs of the small percentage of people responsible for much of the health care spending -- in essence, becoming the national reinsurer -- premiums would decline and health insurance coverage would increase." (Council for Affordable Health Insurance)

U.S. Doctors Warn on Costly 'Consumer' Insurance
Excerpt: "Pediatricians in the United States on Monday warned that new high-deductible health plans risk compromising patient care, especially among poorer children, with the unintended consequence of increasing medical costs. The new health plans are dubbed 'consumer-directed' plans by supporters, because patients are responsible for more of the costs, a feature they say should encourage people to take a more active role in their medical care." (Reuters Health via pharmasentry)

Baby Boomers Will Spur 18% Rise in Health Care Costs by 2050, Study Says
Excerpt: "Baby boomers will contribute to an 18% increase in health care costs by 2050, according to a study conducted by Minnesota-based insurer HealthPartners, the St. Paul Pioneer Press reports. The study, published in Health Services Research, found that costs are not projected to increase uniformly across major categories of medical practice." (Kaiser Family Foundation)

Trends in Manufacturer Prices of Prescription Drugs Used by Older Americans
The 17-page 2006 year-end update is at http://assets.aarp.org/rgcenter/health/dd154_drugprices.pdf. (AARP)

Opinion: Drugstore Lobby Attacks Proven Cost Savings of Mail-Service Pharmacies. Again
Excerpt: "A study funded by the drugstore lobby flies in the face of numerous government and independent research that documents the increased savings of the mail-service pharmacy option, the Pharma.ceutical Care Management Association (PCMA) said today." (PR Newswire Association via pharmasentry)

AARP Says Drug Prices Zoom, But Numbers Disputed
Excerpt: "For the sixth year in a row, manufacturers' prices of brand-name prescription drugs rose last year at roughly twice the rate of inflation, according to a report released [yesterday]. The annual report by AARP . . . found that prices for the 193 drugs most commonly used by that age group increased an average of 6.2 percent in 2006, while the Consumer Price Index rose 3.2 percent. The pharma.ceutical industry called the study 'inaccurate and misleading.'" (The Atlanta Journal-Constitution; free registration required)

Audio: Miracle-Gro Faces Lawsuit over No-Smoking Policy
Excerpt: "an effort to cut the costs of providing health insurance to its employees, Scotts Miracle-Gro in Ohio has invested heavily in a million-dollar general wellness program. It encourages employees to exercise, eat well and be healthy. They've also implemented an anti-smoking policy, which has resulted in a lawsuit." (Weekend Edition via National)

Author Discusses Strategies for Inducing Employee Behavior Change
Excerpt: "[I]nfluencing behavior change is easier said than done. Managing Editor Leah Carlson Shepherd recently interviewed Raymond Miltenberger, director of the master's program in applied behavior analysis at the University of South Florida, about best practices in behavior change." (Employee Benefit News)

Md. Experts Find Circuit Court's Decision Appealing
Excerpt: "Health care experts in Maryland heaved a sigh of relief on January 17 when the U.S. Court of Appeals for the Fourth Circuit upheld a decision by a federal district court saying Maryland's Fair Share Health Care Fund Act, popularly known as the 'Wal-Mart law,' violated the Employee Retirement Income Security Act (ERISA) of 1974.' (Health Care News via The Heartland Institute)

Short-Term Medical Provides Alternative Solution to Eligibility Gaps
Excerpt: "Budget time always brings stress to HR/benefits professionals, particularly when dealing with employee health benefits. However, creative solutions are out there; among them is expanding waiting periods and recommending short-term health coverage to new employees to ease the burden of the health benefits budget crisis." (Employee Benefit News)

Mandated Benefits Definition Memo, Updated February 2007 (PDF)
15 pages. Excerpt: "A health insurance 'mandate' is a requirement that an insurance company or health plan cover (or offer coverage for) health care providers, benefits and patient populations. Sometimes states require the mandate be covered; sometimes they only require that it be offered to employers and/or individuals, who can then choose whether to include it in their policy. Insurers must adjust their premiums accordingly." (Council for Affordable Health Insurance)

Summary of Notice 2007-22 Regarding New HSA Provisions in Tax Relief & Health Care Act of 2006 (PDF)
3 pages. (Financial Executives International)

Chart: Summary of Health Savings Account Changes in the Tax Relief and Health Care Act of 2006 (PDF)
6 pages. (Financial Executives International)


Links to Items on Executive Comp, Benefits in General

FASB Is Kicking Off Phase Two in Its Work on FAS 158
Excerpt: "In late March or early April, the Financial Accounting Standards Board (FASB) is set to take up the thorny issue of measurement when it comes to including liabilities and assets from defined benefit (DB) plans and other post-employment benefits (OPEB) on corporate income statements as prescribed in FAS 158." (Treasury & Risk)

Making Benefit Change Work - A Towers Perrin Survey Report (PDF)
24 pages. Excerpt: "Are employees capable of managing the new roles and risks inherent in today's health care and retirement plan designs? Are they even willing to try? And how are benefit changes affecting U.S. businesses and their ability to engage their people?" (Towers Perrin)


Newly Posted Events

2007 Fall Forum
in Minnesota on September 10, 2007
presented by BISYS Retirement Services

2007 Fall Forum
in Massachusetts on October 15, 2007
presented by BISYS Retirement Services

2007 Fall Forum
in Nevada on October 29, 2007
presented by BISYS Retirement Services

2007 Fall Forum
in Texas on November 12, 2007
presented by BISYS Retirement Services

2007 IRA Institute
in Illinois on June 25, 2007
presented by BISYS Retirement Services

2007 IRA Online Institute
Nationwide on May 7, 2007
presented by BISYS Retirement Services

2007 IRA Online Institute
Nationwide on September 10, 2007
presented by BISYS Retirement Services

2007 Web/Telephone Seminar: Advanced Health Savings Accounts
Nationwide on April 19, 2007
presented by BISYS Retirement Services

2007 Web/Telephone Seminar: Basic IRAs
Nationwide on April 5, 2007
presented by BISYS Retirement Services

2007 Web/Telephone Seminar: Coverdell Education Savings Accounts
Nationwide on April 3, 2007
presented by BISYS Retirement Services

2007 Web/Telephone Seminar: Introduction to Health Savings Accounts
Nationwide on April 10, 2007
presented by BISYS Retirement Services

2007 Web/Telephone Seminar: IRA Excess Contributions
Nationwide on April 12, 2007
presented by BISYS Retirement Services

401(k) Plans
in California on June 5, 2007
presented by Employee Benefits Institute of America Inc. (EBIA)

Cafeteria Plans
in California on June 6, 2007
presented by Employee Benefits Institute of America Inc. (EBIA)

COBRA Compliance for Group Health Plans
in California on June 8, 2007
presented by Employee Benefits Institute of America Inc. (EBIA)

Consumer-Driven Healthcare
in Arizona on March 22, 2007
presented by International Society of Certified Employee Benefit Specialists--Phoenix Chapter

Current IRS and Treasury Guidance and Issues; Planning and Implementing Provisions - Webcast
Nationwide on March 29, 2007
presented by West LegalEdcenter

Developing Key Performance Indicators for Consumer-Directed Health Care and Pay-For-Performance
in California on March 20, 2007
presented by Healthcare Web Summit

Domestic Partners and Employee Benefits -- Practical Advice for Cafeteria Plans and Health Plans (Including Health FSAs and HRAs)
Nationwide on April 5, 2007
presented by Employee Benefits Institute of America Inc. (EBIA)

ERISA Compliance for Health & Welfare Plans
in California on June 7, 2007
presented by Employee Benefits Institute of America Inc. (EBIA)

Fundamentals of Employee Benefits Law (Part 1) - Webcast
Nationwide on March 7, 2007
presented by West LegalEdcenter

HIPAA Portability, Privacy & Security
in California on June 8, 2007
presented by Employee Benefits Institute of America Inc. (EBIA)

HSAs, HRAs, and Consumer-Driven Health Care
in California on June 7, 2007
presented by Employee Benefits Institute of America Inc. (EBIA)

Keeping Your ESOP Culture Strong
Nationwide on May 23, 2007
presented by National Center for Employee Ownership

New Developments in Benefits Litigation; ERISA Remedies; and Department of Labor Litigation Update - Webcast
Nationwide on March 28, 2007
presented by West LegalEdcenter

Planning and Implementing Provisions Affecting 401(k) Plans; Miscellaneous Issues; Code §409A and the New Rules for Deferred Compensation - Webcast
Nationwide on March 29, 2007
presented by West LegalEdcenter

Planning Considerations for Small Business and Professional Plans; Roth 401(k) Plans; Department of Labor Regulatory Update; Spousal Rights Alternatives - Webcast
Nationwide on March 30, 2007
presented by West LegalEdcenter

Qualified Plan Problems and Employee Welfare Benefit Issues; Contributory and Salary Reduction Retirement Plans; Supplemental Retirement Plans for Professional Groups - Webcast
Nationwide on March 30, 2007
presented by West LegalEdcenter

Terminating Plans under the DOL Automatic Rollover Safe Harbor; Handling Orphan Plans; What Financial Institutions Will and Will Not Do; 5500s; Determination Letters - Webcast
Nationwide on March 7, 2007
presented by West LegalEdcenter


Newly Posted Press Releases

Statement of Acting Assistant Secretary of Labor Bradford P. Campbell On 401(k) Fee Disclosure Initiatives
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Calendar and ToDo List Features Highlight March 2007 Upgrade of WebCOBRA.com from Travis Software
Travis Software Corp.

Most Workers Underestimate Chances, Impact of Disability, Survey Shows
Council for Disability Awareness (CDA)


Newly Posted or Renewed Job Openings
Post a Help Wanted Ad

Compliance Manager
for REPTECH
in CO

Pension Administrator
for Matthews, Gold, Kennedy & Snow, Inc.
in AZ

Enrolled Actuary
for Midtown Manhattan Consulting Firm
in NY

Compliance Specialist
for Lincoln Financial Group
in IL

Pension Manager - Retirement Consulting Group
for Fidelity Investments
in MA

Internal Marketing Associate - Retirement Plan Services
for Simpkins & Associates Dallas Office
in TX

Pension Analyst - Retirement Consulting Group
for Fidelity Investments
in MA

Branch Manager for Retirement Plan Services Office
for BenefitStreet, Inc.
in CA

Director of Employee Benefits and Payroll
for Blue Heron Executive Search & Consulting
in VA

Benefit Outsourcing Administrator
for USI Insurance Services
in NY




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