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| November 1, 2007 |
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(a) New Guidance Documents
(None today.)
(b) News
U.S. Health Insurers Suggest Swiss, Dutch as Prototypes
Excerpt: "America's health insurers put the spotlight on their counterparts in Europe Wednesday, part of an effort to demonstrate that not all countries with universal health systems have government-run programs like Can.ada or the United Kingdom." (USA TODAY)
Unlikely Alliance: Small Business Organization Agrees with Major Companies on Need for Health Reform
Excerpt: "The National Federation of Independent Business will join AARP, the Service Employees International Union and the Business Roundtable -- which represents chief executives of major companies -- in an umbrella group called Divided We Fail. The effort is aimed at ensuring that healthcare and retirement security are at the top of the presidential candidates' domestic agendas next year." (Los Angeles Times; free registration required)
(c) Summaries of Guidance; Filed Comments
Managed Care Contract Gives Rise to 'Independent Legal Duty' Which Survives ERISA Preemption
Excerpt: "[T]he United States District Court in Northeast Hosp. Authority v. Aetna Health Inc. ultimately added another decision to growing list of cases in which managed care contracts permit payment disputes between provider and health plan to survive ERISA preeemption. The contours of a successful argument for provider reimbursement are taken from the outline of critical factors set forth in AETNA Health, Inc. V. Davila 542 U.S. 200 (2004)." (Health Plan Law blog by Attorney Roy F. Harmon III)
Health Plan Coverage Exclusions - Observations
Excerpt: "In the area of cancer treatment, health plan payers have frequently been quixotic in their application of exclusions. The medical science is often at odds with these outcomes. To prevail, however, health care providers must present a solid case for the administrative record - something that providers often do not take the time to do." (Health Plan Law blog by Attorney Roy F. Harmon III)
Frequently Asked Questions on Health Savings Accounts (PDF)
12 pages. Excerpt: "There are many questions regarding who is signing up for HSAs and why they are choosing this type of plan, whether HSAs will have an effect on rising health care costs, and how the traditional health insurance market will be affected. While extensive data still does not exist, the most complete illustration of trends, with respect to HSAs, can be found in health insurance studies on HSAs and related products. This issue brief utilizes this available data to provide an actuarial perspective on a number of key questions related to HSAs." (American Academy of Actuaries)
(d) Trends, Surveys, Research
Employers Losing War on Stress: New Survey Says Most Do Not Adequately Address Workers' Mental Health Needs
Excerpt: "Employers are not doing enough to combat stress and other mental health issues in the workplace, according to a recent survey conducted by Meritain Health and the Partnership for Workplace Mental Health." (Inc.com)
DOD Pharmacy Benefits Program: Reduced Pharmacy Costs Resulting from the Uniform Formulary and Manufacturer Rebates (PDF)
6 pages. Correspondence sent to Congressional Committees. Excerpt: "This report responds to your request for information specifically on DOD's estimate of reduced pharmacy costs (1) resulting from drug costs avoided through its uniform formulary, and (2) from manufacturer rebates for drugs dispensed at retail network pharmacies. We plan to report more fully on DOD's pharmacy benefits program in a subsequent report." (U.S. Government Accountability Office)
Insurance Rates May Increase With Privacy Concerns About Genetic Information
Excerpt: "A new study published in The Journal of Risk & Insurance explores the financial implications of banning insurance companies from accessing genetic information. Drawing on data that includes economic, demographic, and relevant family background information, the study simulates the market for 10-year life insurance plans that include breast cancer testing for women 35-39 years of age, examining the potential impact of keeping genetic test results away from insurers." (Medical News Today)
Tackling the Obesity Epidemic: Scary Stats Employers Should Know
Excerpt: "More than two-thirds of Americans are overweight or obese, and childhood obesity has tripled in the past two decades, according to Dr. James Rippe, cardiologist and founder of the Rippe Lifestyle Institute. He shared insights about the economic and health consequences of obesity in the workplace during a standing-room only pre-conference session at last week's summit on health, productivity and absence management, sponsored by the National Business Group on Health and the Integrated Benefits Institute." (Employee Benefit News; free registration required)
(e) Policy, Opinion, Advocacy
Reservists are Like Pregnant Women: A Fertile Battleground for a Reinterpretation of USERRA
Excerpt: "[The] article argues that when forced to find some group that is similarly situated to reservists on a comparable leave, pregnant women on leave are the most similarly situated, as a group, and their leave is most comparable. Therefore, reemployed reservists should receive all rights and benefits that an employer offers to pregnant women." (Social Science Research Network)
Chart: Immigration Not Driving the Erosion of Health Insurance
Excerpt: "Some analysts have argued that [the increase in the uninsured] is driven by the fact that there are more immigrants living in the United States, and that immigrants are less likely than native-born people to have health insurance. While both of these facts are true (the share of the foreign-born population increased 1.2 percentage points from 2000 to 2006, and the share of immigrants without health insurance was 20 percentage points higher over this period than that of native-born people), these facts are not driving the overall decline in coverage." (Economic Policy Institute)
Hearing on Health Insurer Consolidation: The Impact on Small Business
Links to testimony at hearing held October 25, 2007, are provided. (U.S. House Committee on Small Business)
CBO's Health Insurance Simulation Model: A Technical Description (PDF)
50 pages. Excerpt: "This background paper describes a model the Congressional Budget Office (CBO) developed to simulate and analyze an array of policy options involving health insurance coverage. It describes the model's design, basic methodology, and fundamental assumptions. To illustrate the model's use, the paper reports estimates for two scenarios in which policy regarding health insurance coverage would differ from current law." (U.S. Congressional Budget Office)
The Likely Efficacy of Mandates for Health Insurance
Excerpt: "Several health insurance reform plans, including the recently enacted Massachusetts plan, envision the use of individual or employer mandates to increase coverage rates. In this paper we summarize and analyze existing evidence on the effectiveness of mandates, drawing on evidence both from health insurance and from other arenas where mandates are often used. We find that mandates can, but do not always, increase participation in programs. The effectiveness of a mandate depends critically on the cost of compliance, the penalties for noncompliance, and the timely enforcement of compliance." (Health Affairs)
Toward Higher-Performance Health Systems: Adults' Health Care Experiences in Seven Countries, 2007
Excerpt: "This 2007 survey compares adults' health care experiences in Australia, Can.ada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. In all countries, the study finds that having a 'medical home' that is accessible and helps coordinate care is associated with significantly more positive experiences." (Health Affairs)
Editorial: America's Lagging Health Care System
Excerpt: "Americans are increasingly frustrated about the subpar performance of this country's fragmented health care system, and with good reason. A new survey of patients in seven industrialized nations underscores just how badly sick Americans fare compared with patients in other nations." (The New York Times; free registration required)
Patient-Centered Care: What Does It Take?
Excerpt: "The findings from this project indicate that, while there are many promising examples of organizations achieving excellence in patient-centered care, these innovators are not yet the norm. The challenge lies in elevating the norm through strategies at both the organization and system level that leverage the experience of these innovators to motivate large-scale implementation of patient-centered care." (The Commonwealth Fund)
Commentary: Zycher's Dishonest Report on Health Care/Insurance Administrative Costs
The target page includes excerpts from the Manhattan Institute for Policy Research publication of Benjamin Zycher's report, a Wall Street Journal editorial on the issue, and comments from Don McCanne, MD. (Physicians for a National Health Program)
Links to Items on Executive Comp, Benefits in General
Agencies Release 'Information Only' Copies of 2007 Form 5500 Series
Excerpt: "The Employee Benefits Security Administration (EBSA), IRS, and PBGC have released advance information copies of the 2007 Forms 5500, 5500-EZ, and instructions." (Wolters Kluwer Financial Services)
Brief Analysis: The Coming Tax Tsunami
Excerpt: "Over the next 25 years American taxpayers will face a fiscal tsunami. The first of the baby boomers will be eligible for early retirement beginning next year, and will be eligible for Medicare in 2011. The last of the Baby Boom generation, born in 1964, will reach normal retirement age (67 years) in 2031. Most baby boomers are approaching their peak earning years when they have the greatest capacity to save for retirement. Many failed to save when they were younger and need to catch up. Unfortunately, expected tax increases will make it increasingly difficult for each succeeding age cohort to save for retirement. Following are some of the tax hikes coming down the pike." (National Center for Policy Analysis)
Executive Remuneration Library: Coverage of Performance, Measurement, and Reward Issues
Excerpt: "[The] Executive Remuneration Perspective is Mercer's regular publication offering in-depth coverage of performance, measurement and reward topics. [Their] library allows you to browse through the list of recent issues and link directly to those that interest you." (Mercer LLC; free registration required)
Newly Posted Events
Autoenrollment and Default Investments: the New 401(k)Safe Harbors
Nationwide on November 29, 2007
presented by ABA Joint Committee on Employee Benefits
Employee Record Retention - What to Keep to Avoid Employment Litigation
Nationwide on November 27, 2007
presented by Thompson Interactive, A Division of Thompson Publishing Group
FMLA and Medical Certification - How To Deal With Complex Situations
Nationwide on November 15, 2007
presented by Thompson Interactive, A Division of Thompson Publishing Group
Getting to Universal Health Insurance Coverage: 20th Annual Conference
in District of Columbia on January 31, 2008
presented by National Academy of Social Insurance
How to Turn Your Problem Employees Into Assets
Nationwide on November 14, 2007
presented by Thompson Interactive, A Division of Thompson Publishing Group
Non-Compete Agreements-Are They Legally Enforceable
Nationwide on November 20, 2007
presented by Thompson Interactive, A Division of Thompson Publishing Group
Should Your Corporation Be Crisis Certified? How the New Law Will Affect You
Nationwide on November 7, 2007
presented by Thompson Interactive, A Division of Thompson Publishing Group
Using Captives in Employee Benefits Teleweb
Nationwide on November 15, 2007
presented by International Foundation of Employee Benefit Plans
Newly Posted Press Releases
IRS Seeks Applications for TE/GE Advisory Committee
Internal Revenue Service (IRS)
American Voters Worry Their Retirement Plans Are Inadequate
Americans for Secure Retirement (ASR)
Andrews Federal Credit Union (AFCU) Offers Retirement Gap Analysis for Employees through Flexible Synapses Technology
Synapses Inc.
Highmark Blue Cross Blue Shield Program Rewards Members for Enhancing Their 'Healthstyle'
Highmark Blue Cross Blue Shield
Newly Posted or Renewed Job Openings
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Plan Administrator
for Beneco, Inc.
in AZ
Defined Contribution Retirement Plan Administrator
for Loren D. Stark Company, Inc.
in TX
Wanted: Somebody with the right kind of limited DB/DC experience
for Hunter Benefits Consulting Group, Inc.
in CO, IL
Pension Administrator
for Snyder Cohn
in MD
Plan Administrator
for Clifton Capital Partners, Inc.
in TX
Senior Account Executive - Group Employee Benefits
for BWD Group LLC
in NY
Senior Account Executive - Group Employee Benefits
for BWD Group LLC
in PA
Pension Analyst
for Affiliated Computer Services
in NJ
Pension Administrator
for Valley Forge Consulting Corporation
in PA
Defined Benefits Sr Analyst
for Affiliated Computer Services
in NJ
Pension Administrator
for California Retirement Plans, Inc.
in CA
Compliance Specialist
for Benetech, Inc.
in GA
Team Leader - New Business - Retirement Plans
for Standard Retirement Services
in OR
Defined Contribution Account Manager II - Retirement Plans
for Standard Retirement Services
in WA
Pension Consultant
for Spectra Associates, Inc.
in PA
Plan Specialist - Plan Sponsor Desk (Los Angeles)
for Transamerica Retirement Services
in CA
Retirement Plan Services Senior Associate
for Goodman & Company
in VA
Retirement Plan Services Supervisor - Senior Manager
for Goodman & Company
in VA
Pension Plan Administrator/Pension Plan Actuary
for The Waage Law Firm
in CA
Handy Links:
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- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
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