BenefitsLink |   |
| September 18, 2007 |
| Here are the Web's best new links about compliance and cost aspects of plan operation, design and policy. |
Today's sponsor is Employee Benefits Institute of America Inc. (EBIA)
(Click on company name or banner to learn more.)
| Record Retention Requirements for Health & Welfare Plans |
| In Record Retention Requirements for Health & Welfare Plans, EBIA's experts analyze record retention requirements for ERISA health and welfare plans as well as other employer-provided health and welfare benefits not subject to ERISA. You'll find answers to your record retention questions for many benefits including cafeteria plans, DCAPs, qualified transportation plans, HSAs, group health plans (like major medical, dental, health FSAs, and HRAs), and other ERISA benefits.
Available now at the introductory price of $195. Please enter priority code BL195. For more information and to order, visit http://www.ebia.com/OtherOfferings/Books/RecordRetention. |
New Compliance Rules; News
Court Affirms Blue Cross Denial of Benefits for Gastric Bypass SurgeryExcerpt: "The U.S. District Court for the Southern District of Mississippi recently affirmed a denial of benefits by Blue Cross and Blue Shield of Mississippi for a doctor's corrective surgery following complications from a gastric bypass procedure." (PLANSPONSOR.com; free registration required)
Appellate Judges Set Out New Benefits Review Standard
Excerpt: "In a sweeping ruling that sets out a new framework for how judges should decide such cases, a federal appellate court has thrown out a lower court decision dismissing a disabled New Jersey dentist's lawsuit over the cutoff of her benefits." (PLANSPONSOR.com; free registration required)
First Circuit Holds State Law Claims Preempted Under ERISA
Excerpt: "The Court also recognized that state laws that conflict with ERISA's objectives cannot survive preemption." (Seyfarth Shaw LLP)
Resolving Competing Claims to Settlement Funds - Subrogation Controversy Involves Insurers in ERISA Litigation
Excerpt: "This district court opinion addresses a common concern in the area of group health plan subrogation. What is the liability of a third party insurance carrier to a group health plan when placed upon notice of the plan's subrogation rights?" (Health Plan Law blog by Attorney Roy F. Harmon III)
CMS Informally Answers Questions About Medicare Part D Disclosure Notices
Excerpt: "[T]here is no specific statutory or regulatory obligation under ERISA to provide Part D disclosure notices (or even SPDs or SMMs) in non-English languages. However, ERISA does require plans covering certain minimum numbers of participants who are literate only in the same non-English language to provide minimal assistance in that non-English language." (Employee Benefits Institute of America)
Compliance Rule Summaries/Analysis/Filed Comments
Overview of Recent Court Decision Paving Way for Coordination of Retiree Health Benefits with Medicare Benefits (PDF)Pages 3-5 of 7 pages. Excerpt: "If the EEOC's proposed regulation is finalized, plan sponsors will have the ability to design their plans to coordinate retiree health benefits with Medicare or comparable state-sponsored health benefits without having to meet the 'equal cost/equal benefit' rule under the ADEA. (Note that the EEOC's exemption only applies to health benefits. The equal benefit or equal cost rule is still applicable to other benefits such as retiree life insurance.)" (Trucker Huss)
Third Circuit Expands Scope of ERISA Structural Conflict of Interest Analysis
Excerpt: "The Third Circuit has weighed in again on the proper scope of review in a denial of benefits case under ERISA when there is a structural conflict of interest for the plan . . . ." (Workplace Prof Blog)
Overview: Massachusetts Provides Additional Guidance on Section 125 Requirement; HIRD Deadline Approaches (PDF)
2 pages. Excerpt: "The Massachusetts Commonwealth Health Insurance Connector (Connector) recently issued an administrative bulletin that effectively eliminates the filing requirement for Section 125 plans and makes some additional changes to the Section 125 provisions of the Massachusetts health law. In addition, employers are reminded that they must collect the employee HIRD form by September 30th for all employees who decline coverage." (Buck Consultants)
Use of CMS Model Prescription Drug Notice Requires Caution (PDF)
2 pages. Excerpt: "Sponsors of plans that provide noncreditable prescription drug coverage need to be aware of an error in the model notice posted on the Centers for Medicare & Medicaid Services (CMS) website." (Buck Consultants)
Trends; Surveys; Research
Moms Eye Part-Time Jobs to Achieve Work-Life BalanceExcerpt: "A recent Pew Research Center survey found that when working mothers were asked about their 'ideal' situation, only 21 percent cited full-time work, down from 32 percent in 1997. Instead, 60 percent of this year's respondents cited part-time work as 'ideal,' up sharply from 48 percent a decade earlier, while 19 percent of employed moms this year said they'd prefer not to work outside the home at all." (The Christian Science Monitor)
New Program Could Give Boost to Employer Health Plans
Excerpt: "[C]ompanies want to know how far they can go to encourage workers to [stop smoking]. They're even getting some help from the federal government--Sen. Tom Harkin, D-IA, recently proposed tax credits for businesses that employees eat better, exercise, manage stress, and quit smoking. Introduced in July, the bill would give companies a tax credit of $200 each for the first 200 employees participating in the company wellness programs, and as much as $100 for each additional participant." (Warner Norcross & Judd LLP)
The Current and Future Role of U.S. Companies in the Provision and Financing of Health Insurance
Excerpt: "This issue brief examines the central importance of employer coverage in our health system, and why it is imperative that employers join individuals, government, and other stakeholders in designing and contributing to a more equitable, rational, and high performing health care system." (The Commonwealth Fund)
Employers Anticipate Slightly Higher Health Care Cost Growth in 2008
Excerpt: "From Spencer's Benefits Reports: Health benefit costs are expected to rise only slightly in 2008, to 6.7%, after three years of flat annual growth of approximately 6%, according to preliminary results of Mercer Health & Benefits' annual health care cost survey." (Wolters Kluwer Law & Business)
Medicare Prescription Drug Plan Guide: How to Choose Your 2008 Plan
Excerpt: "AHIP recently published a new guide/workbook for helping Medicare beneficiaries make informed decisions about their prescription drug plan options for 2008. This resource is an updated version of a guide, released last year by AHIP, that received positive feedback from beneficiaries, advocates and other partners." (America's Health Insurance Plans)
U.S. Companies Receiving Higher Ratings from Human Rights Campaign Foundation on on G.ay, Les.bian, Transgender Policies
Excerpt: "The number of U.S. companies whose employment policies received the top rating from a civil rights organization for g.ay, les.bian, bise.xual and transgender people has risen 41 percent since the group's last survey in 2006 . . . . The Human Rights Campaign Foundation said 195 companies scored a full 100 points on its most recent annual evaluation, called the Corporate Equality Index, which recognizes employers for offering health insurance to domestic partners, forbidding job discrimination . . . ." (San Francisco Chronicle)
Health Spending by State of Residence, 1991-2004
Excerpt: "Differing trends in health spending by state underlie national spending trends. To shed light on the complexities of health spending patterns among state residents, we present updated per capita health spending estimates by state of residence for 1991-1998 and new estimates for 1999-2004, and we offer summaries of trends exhibited during these time periods." (Health Affairs)
PBM Prime Therapeutics Cites Specialty Management as Key to Controlling the Costs of Specialty Drugs
Excerpt: "While specialty drug costs continue to climb, one pharmacy benefit manager (PBM) is demonstrating that tightening its management of these drugs through various tactics can help mitigate the growth of this spend." (SPECIALTY PHARMACY NEWS via AISHealth.com)
Working Paper: Prescription Drug Coverage and Elderly Medicare Spending
Excerpt: "The introduction of Medicare Part D has generated interest in the cost of providing drug coverage to the elderly. Of paramount importance -- often unaccounted for in budget estimates -- are the salutary effects that increased prescription drug use might have on other Medicare spending." (National Bureau of Economic Research; paid subscription or individual purchase required to retrieve fulltext)
Working paper: Dynamic Inefficiencies in Employment-Based Health Insurance System Theory and Evidence
Excerpt: "We investigate how the employment-based health insurance system in the U.S. affects individuals' life-cycle health-care decisions. We take the viewpoint that health is a form of human capital that affects workers' productivities on the job, and derive implications of employees' turnover on the incentives to undertake health investment." (National Bureau of Economic Research; paid subscription or individual purchase required to retrieve fulltext)
Total Number of Retail Prescription Drugs Filled at Pharmacies, 2006
Excerpt: "Data shown . . . are for calendar year 2006 and include the total number of prescription drugs filled at retail pharmacies only. Data are based on Vector One(TM):National by Verispan, L.L.C., which collects data from a panel of retail pharmacies, third party payers, and data providers." (Kaiser Family Foundation)
Policy; Opinion; Advocacy
The Senate and House Mental Health Parity Bills: Key Differences, Updated Sept. 14, 2007 (PDF)3 pages. Excerpt: "House bill inappropriately requires that all employer-sponsored health plans (except for those with 50 or fewer workers) cover all the same conditions as the federal government covers for its employees." (American Benefits Council)
Side-by-Side Comparison of the Senate and House Mental Health Parity Bills, Updated Sept. 14, 2007 (PDF)
5 pages. Excerpt: "House bill exceeds the stated objective of achieving 'parity' by requiring coverage of all conditions in the diagnostic manual for mental health and substance abuse disorders if a plan decides to cover 'any' mental health or substance abuse conditions at all. No similar federal requirement applies to any other category of benefits." (American Benefits Council)
Clinton Unveils Details of Her Health Care Plan
Excerpt: "Determined to avoid the fatal flaws of her 1993 plan, Hillary Rodham Clinton proposed an overhaul of the nation's health care system Monday that would require Americans to buy insurance but allow them to keep what they have." (USA TODAY)
Opinion: State Health Care Reform: Critical Laboratories for Quality and Innovation
Excerpt: "[I]t is not surprising that some states and local communities are leading the way to health care reform through innovation in coverage expansion and by enabling and promoting greater quality and cost savings in health care. California, Connecticut, Maine, Indiana, New Hampshire, New York, Vermont, Wisconsin and Massachusetts, are notable examples of states that are already exercising leadership in this area." (Senator Richard T. Moore via CommonHealth)
Links to Items on Executive Comp, Benefits in General
Hearing About Retired NFL Players Will Produce Bluster Aplenty
Excerpt: "[P]oliticians on the Senate Committee on Commerce, Science and Transportation will spend a couple of hours on Tuesday posturing and declaiming on the plight of retired NFL players, and what the league and the players union are doing for them." (ESPN.com)
Overview: IRS Provides One-Year Extension of Deadline for 409A Document Compliance
Excerpt: "Following the expression of concern by practitioners that compliance with the original deadline of December 31, 2007 would be problematic, the IRS has announced a one-year extension of the deadline for documentation compliance under Code Sec. 409A." (Wolters Kluwer Law & Business)
The Principal 10 Best Companies for Employee Financial Security -- 2007 Winners
Excerpt: "On September 17, 2007, The Principal Financial Group® announced the 2007 winners of The Principal® 10 Best Companies for Employee Financial Security. The independent panel of judges -- all experts in employee benefits -- praised the winners for their consistent, holistic approach to providing a broad range of benefits. Judges also noted increased trends toward wellness initiatives, face-to-face benefits and financial guidance at the worksite and continued commitment to auto savings tools." (Prudential Financial)
Retirement Benefits 'Pay' for Some Top CFOs
Excerpt: "It pays to stick around. At least that's what new Securities and Exchange Commission-mandated information about pension and deferred-compensation plans would suggest." (Financial Week; free registration required)
Overview: Limited Relief and Additional Guidance Under Code Section 409A (PDF)
Excerpt: "Notice 2007-78 states that taxpayers can continue to rely on a reasonable, good faith interpretation pending further guidance. The Notice also provides that as to 'grace period assets' (i.e., certain assets set aside for nonqualified deferred compensation before March 21, 2006), taxpayers still have until December 31, 2007 to bring deferred compensation plans into compliance with the rules noted above, but no additional extension of time is being granted." (Sutherland Asbill & Brennan LLP)
Overview: Limited Deferred Comp Relief - but Employers Must Still Take Some Actions by December 31, 2007
Excerpt: "Employers and other service recipients should finalize action items and timing for meeting the deadline to adopt documents that comply with Section 409A, including: identifying all plans and agreements covered by Section 409A as soon as possible; properly designating compliant payment timing and form provisions before the January 1, 2008 deadline; adopting all necessary amendments to comply with the requirements of Section 409A, the final regulations, the notice and other guidance no later than the December 31, 2008 deadline . . . ." (Perkins Coie LLP)
Overview: Extension of Section 409A Document Compliance Due Date; Action Required by December 31, 2007 (PDF)
6 pages. Excerpt: "Notice 2007-78 extends the reasonable, good-faith standard in this area until the IRS issues further guidance. However, as to grace period assets, income inclusion under section 409A will be required as of January 1, 2008 if the plan is not in conformity with a reasonable, good-faith interpretation of section 409A(b) on December 31, 2007." (Morgan, Lewis & Bockius LLP)
Overview: Limited Extension of Section 409A Compliance Deadline (PDF)
2 pages. Excerpt: "The Notice does not extend beyond December 31, 2007 the deadline for documenting or amending a Plan to specify the time and form of payments. As of December 31, 2007, all Plans must meet the written document requirements regarding times and forms of payment in accordance with the requirements of the Notice." (Haynes and Boone, LLP)
Newly Posted Events
Business and National Health Care Reform - Webcast
Nationwide on September 19, 2007
presented by KaiserNetwork.org
Nonqualified Deferred Compensation Plans After The §409A Final Regs -- Seminar
in Virginia on September 26, 2007
presented by WEB (Worldwide Employee Benefits Network) Washington Chapter
Newly Posted Press Releases
McClanahan & Clearman Announces $9.975 Million Settlement in ERISA Litigation
McClanahan & Clearman, L.L.P.
As Obesity Rates Continue to Rise, Is the Workplace a Source of or Solution to Unhealthy Lifestyle Habits?; A Survey Released Today Found That 72 Percent of American Workers Eat an Unhealthy Snack at Least Once a Week While at Work
Nationwide Better Health
Merrill Lynch Develops New U.S. Pension Indices
Merrill Lynch
Newly Posted or Renewed Job Openings
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Consultant
for Kravitz - Louis Kravitz & Associates
in CA
Sales & Marketing - Vice President (VP)
for Raymond James Financial, Inc.
in FL
New Business Account Manager
for Standard Insurance Company
in PA
Senior ERISA Consultant
for Tofias PC
in MA
401(k) Plan Administrator
for Tofias PC
in MA
Benefit Analyst
for Kibble & Prentice
in WA
Retirement Plan Administrator
for Tegra Financial Partners
in GA
Defined Benefit Plan Senior Administrator/Consultant
for Tegra Financial Partners
in GA
Retirement Plan Specialist
for Diversified Investment Advisors
in VA
Administrator/Recordkeeper
for Scottsdale Pension Systems, Inc.
in AZ
Employee Benefits / ERISA Associate
for Cincinnati Law Firm
in OH
Client Service Consultant - Regional
for Standard Insurance Company
in CA
Client Service Consultant - Regional
for Standard Insurance Company
in MI
Communications Consultant
for T Rowe Price
in MD
Compliance Analyst
for T Rowe Price
in MD
Pension Analyst
for T Rowe Price
in MD
OmniPlus Users
for Casco Bay Benefits Group
in ANY STATE
Paralegal - Employee Benefits Practice
for Menke & Associates, Inc.
in CA
Client Services - Account Manager
for ExpertPlan, Inc.
in NJ
Implementation Specialist
for ExpertPlan, Inc.
in NJ
Client Relationship Manager
for PensionTrend
in MI
Handy Links:
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- Using the Web for Employee Benefits Research (hypertext article)
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