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| September 7, 2007 |
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Official Guidance; News
UnitedHealthcare Will Pay to Settle Claims QuestionsExcerpt: "UnitedHealthcare has agreed to pay up to $12 million to 37 states to settle insurance commissioners' concerns over the company's claims payment services. Based on complaint data, some of the states in 2004 launched an analysis of UnitedHealthcare companies' compliance with insurance regulations, according to the settlement agreement. The analysis, aided by the National Association of Insurance Commissioners, identified 'areas of concern' involving claims handling and administrative practices." (Modern Healthcare; free registration required)
House, Senate SCHIP Bills Include Medicare and FMLA Provisions
Excerpt: "The House and Senate approved separate bills to reauthorize and expand the State Children's Health Insurance Program (SCHIP), setting the stage for conference negotiations in September. The bills also would make changes to Medicare and the Family and Medical Leave Act (FMLA) - with implications for employers." (Watson Wyatt Worldwide)
Auto Companies Eye Trusts for Retirees: Independent Funds Would Handle Health Care Funds
Excerpt: "As negotiations with General Motors Corp. and other domestic automakers near the Sept. 14 contract deadline, retiree health benefits are a top priority, and a trust called a VEBA might be retirees' best hope for maintaining coverage." (The Journal Gazette)
Trade-Off on Jobs, Benefits in Works: Historic Deal Aims to Shift Retiree Health Costs to UAW
Excerpt: "The union is willing to bargain toward a landmark deal to shift more than $100 billion in retiree health care costs from Detroit's auto companies to a union-run trust fund, but only if General Motors Corp., Ford Motor Co. and Chrysler LLC lay a lot of money on the table and make very specific promises about what products will be built by UAW workers in U.S. factories during the term of the next labor contract." (Detroit Free Press)
Third Circuit Holds that Exhaustion of Administrative Remedies Does Not Constitute a Jurisdictional Issue
Excerpt: "In the context of a dispute over life insurance benefits, the Third Circuit has rendered further guidance on the distinction between defenses that are (1) jurisdictional in nature, such that the federal court cannot hear the case, and (2) those that are procedural or judicial doctrines. If a defense simply involves an element of a claim or goes to the merits of the case, then federal courts may adjudicate the case before it." (Health Plan Law blog by Attorney Roy F. Harmon III)
Summary/Analysis of Official Guidance
Overview: IRS's New Proposed Cafeteria Plan Regulations (PDF)2 pages. (Milliman)
Report on Domestic Partner Benefits (PDF)
13 pages. Excerpt: "This chapter addresses the legal and administrative issues surrounding an employer's provision of benefits to the domestic partners of its employees, and the recognition of domestic partners . . . as spouses and beneficiaries for survivorship benefits purposes. It provides a general overview of the information HR needs to have in order to properly operate and administer employee benefit arrangements which offer domestic partner coverage." (Thompson Publishing Group, Inc.)
Trends; Surveys; Research
Abstract of the 2008 Segal Health Plan Cost Trend SurveyExcerpt: "The 2008 Segal Health Plan Cost Trend Survey - The Segal Company's eleventh annual survey of managed care organizations (MCOs), health insurers, pharmacy benefit managers (PBMs) and third party administrators (TPAs) - forecasts continued declines in trends for 2008." (The Segal Group, Inc.)
New Analysis Examines the Relative Burden of Out-of-Pocket Costs on Seniors and Younger Adults
Excerpt: "This analysis examines the relative burdens of out-of-pocket spending on seniors and younger adults. Using data from the Consumer Expenditures Survey from 1998 to 2003, it finds that seniors consistently spent a larger share of their income out of pocket on health care than younger people. Given the persistent differences between young and old, it suggests that even with Medicare's prescription drug benefit, significantly narrowing the wide gap between seniors and younger adults . . . is unlikely." (Kaiser Family Foundation)
Farmers Struggling with Health Insurance Costs, According to Report
Excerpt: "The cost of health care in the U.S. is putting a pinch on many family farmers and ranchers who struggle to pay high premiums and out-of-pocket expenses, a new report has found. About 90 percent of the more than 2,000 farmers and ranchers who were surveyed said they had some sort of health coverage, according to the 2007 Health Insurance Survey of Farm and Ranch Operators released [yesterday]." (AP via The New York Times; free registration required)
Workers to Bear Health Cost Rise
Excerpt: "Health plan costs are expected to increase by nearly 7 percent next year, with many workers bearing the brunt of the expense, a survey on employee benefits shows. Preliminary estimates in the Mercer Health and Benefits survey of more than 1,500 employers nationwide portend a gloomy scenario for how employers and their employees will make out next year." (The Washington Times)
Policy; Opinion; Advocacy
Opinion: The Free Market Health Care ProposalExcerpt: "The American people, through the mechanism of the free market, are best able to reform the health- care system. A consumer-oriented system, which is user-friendly for both the apprentice electrician and the aspiring entrepreneur, is the best way to control costs, maintain or improve quality and increase accessibility." (The Evening Bulletin)
Funding OPEB Liabilities: A Proposal for the Automotive Industry
Excerpt: "How can companies like GM and Ford advance-fund their OPEB liabilities and at the same time continue to invest additional resources into developing new energy-saving automobiles? The authors propose the use of government-guaranteed bonds as a means of stopping the financial hemorrhaging of American automakers that are burdened by OPEB liabilities." (New York State Society of CPAs)
Netherlands' Health Care System Could Provide Model for U.S.
Excerpt: "The Netherlands last year enacted a health care system that uses 'competition and a small dose of regulation to pursue what many in the U.S. hunger to achieve: health insurance for everyone, coupled with a tighter lid on costs,' the Wall Street Journal reports." (Kaiser Family Foundation)
A Prescription for Healthier Medical Care Decisions: Begin by Defining 'Risk'
Excerpt: "While flawed thinking about risk can cause consumers to make decisions they like at the time, they may end up with poorer health prospects and more financial risk than if they had followed a model known as 'expected utility maximization,' . . . . Used primarily by economists and decision theorists, the expected utility (EU) model 'values risky prospects as a weighted average of the possible outcomes, with the weights being the probabilities and the values being the utility . . . .'" (Wharton School of the University of Pennsylvania)
Links to Items on Executive Comp, Benefits in General
Understanding the Employer's New USERRA Obligations (PDF)
13 pages. Excerpt: "DOL's regulations implementing USERRA are effective Jan. 18, 2006. While the regulations do not impose any new obligations on employers, they do provide important clarifications and examples of what is expected of employers. The new regulations are different in a number of respects from the proposed regulations that DOL issued in September 2004." (Thompson Publishing Group, Inc.)
Employer-Sponsored Benefits: Many Factors Affect Treatment of Pension & Health Benefits in Chapter 11 Bankrup.tcy
48 pages. Excerpt: "This report addresses (1) how, if at all, recent legislative changes affected the treatment of pension and health benefits during chapter 11 bankruptcies, and (2) what is known about the extent to which businesses have modified employee or retiree pension and health benefits. [Highlights are at http://www.gao.gov/highlights/d071101high.pdf.]" (U.S. Government Accountability Office)
Overview: Form 990 Executive Compensation Reporting
Excerpt: "Attached to this Alert is a chart comparing the executive compensation reporting requirements for the current Form 990 and the redesigned Form 990. Although the IRS may make further changes to the Form 990 during the process of finalizing the redesigned form, tax-exempt organizations can expect expanded reporting of executive compensation, along with the additional recordkeeping required to comply with the enhanced reporting obligations." (Venable LLP)
Newly Posted Events
Breakfast with Cornerstone Research: 401(k) Excessive Fee Cases: Do They Have Economic Merits?
in District of Columbia on October 17, 2007
presented by Cornerstone Research
FMLA and Medical Certification -- How to Deal With Complex Situations
Nationwide on September 25, 2007
presented by Thompson Interactive, A Division of Thompson Publishing Group
How to Determine Who is a Dependent
Nationwide on September 19, 2007
presented by Thompson Interactive, A Division of Thompson Publishing Group
Work and Retirement Roundtable: How Can Workers and Employers Navigate the Changing Landscape?
in Massachusetts on October 17, 2007
presented by Center for Retirement Research at Boston College
Newly Posted Press Releases
Microsoft Issues Case Study on InvestLink's New. NET Platform
InvestLink
Why Limit Your IRA to the Stock Market? PENSCO Trust Explains Self-directed IRA Rules and Reveals Opportunities for Professionals
PENSCO Trust Company
John Hancock Introduces New Program and Tools to Help 401(K) Participants on the Road to Retirement
John Hancock Retirement Plan Services
Humana Partners with Assist America for Global Emergency Services
Humana
Even the Best U.S. Corporations Fail to Provide Maternity and Paternity Leave; New Institute for Women's Policy Research Analysis Reveals Minimal Coverage for Working Parents
Institute for Women's Policy Research (IWPR)
401(k) Excessive Fee Cases: Do They Have Economic Merits?
Cornerstone Research
Newly Posted or Renewed Job Openings
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Pension Administrator
for AKT Retirement Plan Services
in CA
Defined Benefit Administration Software IT Consultant
for Winklevoss Technologies
in CT
Pension Administrator
for Preferred Pension Planning Corporation
in NJ
Senior Managers
for Deloitte Consulting LLP
in IL, NY
Pension Administrator
for Actuaries Unlimited, Inc.
in CA
Regional Sales Director
for RolloverSystems, Inc.
in NC
Plan Administrator
for The Newport Group
in FL
ERISA Attorney
for Pacific Northwest ERISA boutique firm
in WA
HR Generalist (part time)
for Goodrich
in NY
Legal & Document Specialist
for Standard Insurance Company
in OR
Retirement Plans Administrator
for Memorial Sloan-Kettering Cancer Center
in NY
Pension Administration Firm Office Manager
for Western New York TPA Firm
in NY
Handy Links:
- View Today's Active Message Threads
- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
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