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| September 6, 2007 |
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Official Guidance; News
Insurance Regulators in 36 States Investigating Limited-Benefit Plans Amid Allegations of Deceptive Sales TacticsExcerpt: "Insurance regulators in 36 states led by Alaska and Washington have launched an investigation into limited-benefit health plans offered by HealthMarkets, USA Today reports. HealthMarkets, which has 650,000 members in 44 states, has received fines from insurance regulators in seven states and has faced lawsuits from dozens of members since 2002." (Kaiser Family Foundation)
California Lawmakers Working on Compromise Health Reform Legislation
Excerpt: "California Gov. Arnold Schwarzenegger (R) and Assembly Speaker Fabian Nuñez (D) late last week discussed an agreement that aims to overhaul California's health care system through a simple majority vote in the Legislature this session followed by a ballot initiative next year on a funding mechanism, the Los Angeles Times reports." (Kaiser Family Foundation)
District Court Used Improper Standard for Dismissal of Accidental Death Suit
Excerpt: "The 8th U.S. Circuit Court of Appeals has reversed a district court's decision to dismiss a case in which an employee's children sought accidental death benefits, saying the district court should have instead considered the case for summary judgment." (PLANSPONSOR.com; free registration required)
Five-Year Maternity Leave Plan Proposed in Malaysia
Excerpt: "The five-year maternity leave scheme for women in the civil service is expected to have a minimal effect on government operations, although 65 per cent of the public sector workforce comprise women. Cuepacs president Omar Osman said the government's decision was a good opportunity for mothers to be with their families. He suggested that every government department have proper planning to fill the positions temporarily left vacant by women taking up the scheme." (The New Straits Times Press (Malaysia) via Human Resource Executive Online; free registration required)
Summary/Analysis of Official Guidance
Overview: Court Orders QMCSO Coverage, Even Though This Exceeded Coverage Ordinarily Provided by PlanExcerpt: "EBIA Comment: In general, this case illustrates what may come as a surprise to some -- how state laws enacted under Section 1908A can override plan provisions excluding certain children from eligibility. Indeed, we anticipate more litigation on the issue of what new types of benefits could be imposed under these circumstances." (Employee Benefit News; free registration required)
State PEO Law Does Not Determine Status as a MEWA; Stop-Loss Coverage Does Not Make a MEWA Fully Insured
Excerpt: "EBIA Comment: As these advisory opinions illustrate, both MEWAs and the state agencies that regulate them continue to be vexed by the complex interplay of state and federal law created by ERISA's special preemption rules for MEWAs." (Employee Benefit News; free registration required)
Trends; Surveys; Research
State Mandated Health Coverage of Non-Dependents Could Cost EmployeesExcerpt: "States that require continued health care coverage for adult children under their parents' insurance policies could be creating taxable income for the parents. Colorado, Maryland, Massachusetts, New Jersey, and Utah are among the states that recently have passed health insurance continuation laws." (Winston & Strawn LLP)
Financial Incentives in a Globally Budgeted Healthcare Payment System & Way Patients Are Categorized (PDF)
10 pages. Excerpt: "Objective [of the study]: To assess the responses to financial incentives after a change in the payment system in a capitation-style healthcare payment system over a 5-year period." (The American Journal of Managed Care)
Companies Working in a Variety of Ways to Improve Employees' Care
Excerpt: "Helen Darling calls it 'revolutionary,' this effort on the part of employers to more closely monitor and improve the health of their workers. Darling, the president of the National Business Group on Health, . . . says that corporate America began getting much more involved in trying to improve clinical outcomes for its workforce about three years ago." (Managed Care Magazine)
Six Steps for Cutting Spending for Multiemployer Self-Funded Health Plans (PDF)
8 pages. Excerpt: "Based on the analysis of multiemployer self-funded health plans across multiple markets, the author estimates that these plans spend approximately $50 per member per month more than is appropriate to provide high-quality medical services. . . . This $50 represents a 27% overpayment for health care services . . . . This article discusses this issue and provides six recommendations that directly address the overpayment problem." (International Foundation of Employee Benefit Plans)
Higher Costs for Health Coverage Seen in '08
Excerpt: "Health plan costs for 2008 may rise an average 6.7 percent - a slightly steeper increase than this year's - and many workers will foot a larger part of the premiums, medical bills, or both, a new survey says. The numbers in Mercer Health & Benefits' survey of 1,557 employers nationwide offer a preliminary peek into how employers and their employees will fare next year. Complete survey results, which will reflect about 3,000 employers, won't be released until later this year." (The Hartford Courant)
Health Plans See Generic Use Rates Rise by Offering Samples to Doctors' Offices
Excerpt: "Taking their cue from the brand drug industry, an increasing number of health plans are starting to offer generic drug samples in doctors' offices. The programs, which allow physicians to fill free prescriptions at the point of service, are boosting plans' generic utilization rates and providing a tidy return on investment (ROI), according to insurers contacted by DBN." (DRUG BENEFIT NEWS via AISHealth.com)
Unsnarling Medical Bills: Slew of Online Tools Let Consumers Create and Manage Their Digital Records
Excerpt: "In the past, services such as WebMD Inc. and others offered consumers similar online tools. But the services typically came through an employer or health plan. Unlike these older services, the new ones are available directly to consumers. Anyone can sign up, even the uninsured." (The Wall Street Journal Online)
Policy; Opinion; Advocacy
U.S. Residents Often Ignore Problems with Government-Run Health Care SystemsExcerpt: "The 'biggest of the big lies in the health care hype is that a lack of insurance means a lack of medical care,' and the 'second-biggest lie is that health care and medical care are the same thing,' Thomas Sowell, a senior fellow at the Hoover Institution at Stanford University, writes in a Baltimore Sun opinion piece." (Kaiser Family Foundation)
Opinion: No Reform Better than Giving Schwarzenegger Political Victory, Leaving Insurance Companies in Charge
Excerpt: "[M]ost critically, the plan reinforces and expands an insurance-based system -- the source of much of the present crisis -- thereby subverting real reform for years to come. At the center of the plan is a mandate on businesses to either provide health coverage or pay taxes into a fund to buy it for their employees. The new tax would fall between the 7.5% of payroll costs favored by Nuñez and the 4% Schwarzenegger proposes." (Los Angeles Times via California Nurses Association / National Nurses Organizing Committee)
Opinion: Fix Health Care by Making Americans Care About Costs
Excerpt: "If we want to increase access to health care, our first priority must be to contain costs. Nothing would help more than 200 million cost-conscious consumers. Letting Americans own their health care dollars is the right thing to do. And as it happens, it would also cover a lot of the uninsured." (USA TODAY via Cato Institute)
The Massachusetts Health Care Reform Plan: Could It Work in Texas? (PDF)
31 pages. Excerpt: "Whether or not the Massachusetts Plan is a good fit for Texas, understanding the underlying structure of the program, the factors that contributed to its passage, and the challenges Massachusetts faces in implementation can inform the design of strategies for reducing the number of Texas' uninsured." (Health Management Associates)
Links to Items on Executive Comp, Benefits in General
Opinion: State of Washington Not Owning Up to Future Retiree Benefit Costs
Excerpt: "The old rules made it very easy for governments to promise employees benefits during retirement, since doing so had no effect on their balance sheets. Costs were not reflected in the budget until benefits were paid to retirees years later, long after the politicians who made the promises left office. Currently, Washington is setting aside only about 20 percent of the $600 million needed annually to eliminate the unfunded liability in 25 years." (The Seattle Times)
Understanding and Communicating Employee Benefits to Workers
Excerpt: "Despite [the] numbers, neither executives nor their employees are happy with the current state of company benefits programs. A study by Towers Perrin found that both sides of the equation are displeased with the system." (Thomas Publishing Company)
IRS Updates List of Time Sensitive Acts
Excerpt: "The IRS has issued a Revenue Procedure updating its list of time-sensitive acts that may be automatically postponed under Code Sec. 7508(a)(1) for individual taxpayers serving in a combat zone or contingency operation." (Wolters Kluwer Law & Business)
Newly Posted Events
Code Section 409A Workshop
in Washington on September 25, 2007
presented by SunGard Relius
Code Section 409A Workshop
in New York on September 26, 2007
presented by SunGard Relius
Compensation Administration: The Fair Labor Standards Act with Craig J. Davidson, CEBS
Nationwide on September 18, 2007
presented by FutureOffice Network
ERISA Workshop
in Pennsylvania on October 2, 2007
presented by SunGard Relius
ERISA Workshop
in New York on October 3, 2007
presented by SunGard Relius
ERISA Workshop
in Georgia on October 3, 2007
presented by SunGard Relius
ERISA Workshop
in Ohio on October 3, 2007
presented by SunGard Relius
ERISA Workshop
in Massachusetts on October 4, 2007
presented by SunGard Relius
ERISA Workshop
in North Carolina on October 4, 2007
presented by SunGard Relius
ERISA Workshop
in Michigan on October 4, 2007
presented by SunGard Relius
Free Webinar Compensation: The Fair Labor Standards Act
Nationwide on August 18, 2007
presented by FutureOffice Network
Free Webinar Compensation: The Fair Labor Standards Act
Nationwide on August 18, 2007
presented by FutureOffice Network
IRS Issues Comprehensive Guidance for Cafeteria Plans Teleweb
Nationwide on September 13, 2007
presented by International Foundation of Employee Benefit Plans
Non-Qualified Deferred Compensation Plans: It's Time to Comply with Section 409A
in Ohio on September 20, 2007
presented by WEB (Worldwide Employee Benefits Network) Cleveland Chapter
Newly Posted Press Releases
Executive Of Tennessee Company Sentenced After Pleading Guilty To Theft Of 401(k) Assets In Case Investigated By U.S. Labor Department
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)
Guardian Offers Discounts on Tooth-Decay Fighting Sweetener
Guardian
National Retirement Partners Expands With 16 New Members
National Retirement Partners, Inc.
68 Percent of Americans Believe Prevention is the Solution to America's Healthcare Challenges
U.S. Preventive Medicine
Newly Posted or Renewed Job Openings
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Investment Consultant
for The Newport Group
in FL
Attorney
for Ogletree Deakins
in GA, IL, SC
Retirement Services Provider Consultant
for Deloitte Consulting LLP
in MA, MN, NY
Sr. Employee Benefit Specialist-Retire Secure
for The Principal Financial Group
in OH
Benefit and Planning Counselor
for The Principal Financial Group
in NY
Pension Plan Administrator
for Nationwide Insurance
in OH
Associate
for Epstein Becker & Green, P.C.
in NJ
Manager, New Business - Retirement Plans Administration
for Standard Insurance Company
in OR
Tax Manager - Employee Benefits, Global Employment Services
for Deloitte & Touche, LLP
in FL, GA
Pension Administrator
for Pension Investors Corp. of Orlando
in FL
Retirement Compliance Testing Manager
for Vanguard
in PA
ERISA Consultant
for Vanguard
in AZ
Relationship Manager - Defined Contribution Plans
for Vanguard
in AZ
Senior Compliance Testing Consultant
for Vanguard
in PA
Handy Links:
- View Today's Active Message Threads
- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
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