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January 15, 2008

Here are the Web's best new links about compliance and cost aspects of plan operation, design and policy.

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Complete Benefits Law Guidance from Law Journal Press

The nation's workforce and health care system are constantly evolving and so are the legal issues. Law Journal Press helps you handle any benefits law question with up-to-date, authoritative books on all aspects of the field. Get legal and practical advice from leading experts on everything from COBRA to ERISA, "contingent" employees to family and medical leave, and more. Browse our product listings for detailed information and special offers.

(a) New Guidance Documents

(None today.)

(b) News

Reactions Vary on EEOC Changes to Retiree Health Benefits Rule
Excerpt: "Retiree advocates gave a mixed reaction . . . to a new regulation allowing employers to provide more limited health care benefits for retirees who are 65 and older, though some critics called the change tantamount to discrimination." (USA TODAY)

Most Back Mandatory Health Coverage, According to Study
Excerpt: "As health care generates debate in this year's presidential campaign, about 68 percent of Americans say individuals should be required to have medical insurance, with government help for those who cannot afford it, a survey released on Tuesday found." (Reuters via Yahoo! News)

Early Retirees Try to Fill Gap in Health Coverage
Excerpt: "Finding a way to bridge that gap -- eligible for Social Security but not for Medicare -- will be the hardest and costliest challenge for many of the boomers who want to retire early or are forced out of their jobs." (USA TODAY)

Nevada's Public Employees' Benefits Program Board OKs Domestic Partner Benefits
Excerpt: "A panel that oversees the state employee health insurance plan voted . . . to extend benefits to domestic partners, including those of the same sex, and their children." (Las Vegas Review-Journal)

As Public Agencies Seek to Cover Retiree Health Costs, Financial Firms May Cash In
Excerpt: "Unlike traditional pensions that government workers receive, public agencies have largely employed pay-as-they-go accounting for medical, dental, vision and other health benefits. However, revenue is not expected to allow this strategy in the future, amid surging health prices and the looming retirement of the massive baby boomer generation." (The Sacramento Bee)

(c) Summaries of Guidance; Filed Comments

Study of Retiree Health VEBAs (PDF)
4 pages. Excerpt: "All of the retiree health VEBAs in the study are related to the manufacturing, retail or transportation industries . . . . Among the key findings of the study are: Bankrup.tcy has historically been the most common reason for the formation of retiree health VEBAs; Some of the VEBAs studied have been in existence for decades; Funding is not limited to upfront company contributions; many of the VEBAs in the study have ongoing funding streams." (The Segal Group, Inc.)

Removal of State Law Claims to Federal Court -- An ERISA Removal Primer
Excerpt: "A spate of recent cases discussing the requirements for removal of a state action to federal court returns us to the practical world of ERISA litigation. Few contexts better combine the factual element necessary to successful litigation with legal theory and federal court motion practice than a notice of removal." (Health Plan Law blog by Attorney Roy F. Harmon III)

Deadline for Meeting Massachusetts Health Care Reform Act's Reporting Requirements Approaching Fast
Excerpt: "The Massachusetts Health Care Reform Act has two reporting requirements that plan sponsors must fulfill by January 31, 2008 if they provide health coverage to adult residents of Massachusetts. If the health plan is insured, the insurance carrier is generally responsible for these reports. If the health plan is self-funded, including multiemployer plans, plan sponsors should discuss with counsel whether these state reporting requirements are applicable to the plan, including whether the requirements are preempted by the Employee Retirement Income Security Act (ERISA)." (The Segal Group, Inc.)

California's Data Breach Notification Law Now Covers Medical and Health Insurance Information
Excerpt: "Going well beyond the requirements of HIPAA and most state health privacy laws, California has amended its existing Database Security Breach Notification Act to require any organization that reasonably believes a breach of a California resident's medical or health insurance information has occurred, to notify that resident." (Pillsbury Winthrop Shaw Pittman LLP)

(d) Trends, Surveys, Research

Employment Cases Rule Supreme Court's World These Days
Excerpt: "Among Monday's orders, the Court asked the U.S. Solicitor General for the government's view on whether workers may settle with their employers their claims under the Family and Medical Leave Act. The issue arises in Progress Energy v. Taylor (07-539). The Fourth Circuit Court, ruling in conflict with the Fifth Circuit Court, decided that a Labor Department regulation barred both past and future waiver of all FMLA rights. The Labor Department has taken the position that its regulation permits backward-looking release of claims under that law." (Workplace Prof Blog)

Question: Guaranteed Issue Can Lead to Adverse Selection. Why Is This?
Excerpt: "This unintended consequence is important to note, because availability of coverage is generally not a problem. Affordability is the greater concern. Simply requiring a guaranteed issuance of coverage will not improve the affordability of coverage and, depending on the other requirements in place, may very likely make coverage even less affordable for most people because of the adverse selection it invites. So guaranteed issue can have the opposite effect of that intended as health coverage becomes less affordable." (Milliman)

Big Public Employee Health Care Tab Has California Considering Pre-Funding
Excerpt: "The report, commissioned by Gov. Arnold Schwarzenegger last year and released Jan. 7, suggests the state pre-fund its health-care liabilities in a manner similar to funding pension liabilities. The commission laid out a 34-point plan to address funding issues. If state and local systems follow the recommendation, it could be a boon to money managers." (Pensions & Investments)

Listening to Consumers: Values-Focused Health Benefits and Education (PDF)
24 pages. Excerpt: "How can employers educate their workers about health coverage? Is there a payback? Since the vast majority of Americans who have health coverage obtain it through their (or a family member's) employer, and with health benefits on track to become the single-largest expense of any employee benefit, the issue of education is important both to the sponsors and the beneficiaries of health insurance coverage. Among the key questions facing employers: What kind of education will work? And is there a payback for trying to educate workers about health coverage and care?" (Employee Benefit Research Institute)

Insurers Stop Paying for Care Linked to Errors
Excerpt: "Health insurers are taking a new tack in a bid to improve patient safety and reduce health-care costs: refusing to pay -- or let their patients be billed -- for hospital errors. Aetna Inc., WellPoint Inc. and other big insurers are moving to ban payments for care resulting from serious errors, including operating on the wrong limb or giving a patient incompatible blood." (The Wall Street Journal)

When a Health Insurer Says It Won't Pay
Excerpt: "Evidence or not, ethicists said patients would not trust insurers unless they were up-front about how they made decisions, because everyone knows they save money when they say no. And the amount of money some of them save works against them in the quest for public sympathy. Cigna expects to make $1.2 billion this year. Its CEO's total compensation in 2006 was $21 million." (

Total Health Management Strategies and Success Factors (PDF)
4 pages. Excerpt: "This issue focuses on THM success factors for sponsors of multiemployer health plans and includes a case study. The value of THM is not merely theoretical. Plan sponsors that have implemented a THM strategy have already seen savings." (The Segal Group, Inc.)

(e) Policy, Opinion, Advocacy

Overview: Employer-Sponsored Retiree Health Care Coverage Can Again Be Coordinated with Medicare
Excerpt: "In sum, after the resolution of various court challenges and appeals -- and notwithstanding that the AARP still has an outstanding writ of certiorari before the U.S. Supreme Court -- the EEOC, on December 26, 2007, finalized and made immediately effective a narrow exemption to the Age Discrimination Employment Act of 1967 (ADEA) that permits employer-sponsored health plans to alter, reduce, or eliminate a retiree's benefits when that individual becomes eligible for Medicare or a comparable state health benefit plan (regardless of whether the individual actually enrolls in Medicare or the comparable state plan)." (Morgan, Lewis & Bockius LLP)

The Public's Views on Health Care Reform in the 2008 Presidential Election
Excerpt: "There is overwhelming agreement that financing for health insurance coverage for all Americans should be a responsibility shared by employers, government, and individuals." (The Commonwealth Fund)

2008 State Legislators' Guide to Health Insurance Solutions and Glossary (PDF)
64 pages. Excerpt: "What can states do to keep health insurance accessible and affordable? Are there ways to expand choice and availability of insurance plans? Our annual guide to health insurance solutions has some answers." (Council for Affordable Health Insurance)

An Overview of Employer Organizations Speaking Up on Health Care Reform
Excerpt: "Almost all employer-based organizations now agree that the status quo no longer is workable." (Wolters Kluwer Financial Services)

Waits to See an Emergency Department Physician: U.S. Trends and Predictors, 1997-2004
Excerpt: "We evaluated the change in wait time to see an ED physician from 1997 to 2004 for all adult ED patients, patients diagnosed with acute myocardial infarction (AMI), and patients whom triage personnel designated as needing 'emergent' attention. Increases in wait times of 4.1 percent per year occurred for all patients but were especially pronounced for patients with AMI, for whom waits increased 11.2 percent per year." (Health Affairs)

Opinion: San Francisco Health Care: Risk and ERISA
Excerpt: "At a time when we're concerned with the growing number of uninsured in this country and access to quality health care, do we want to jeopardize a successful program that covers more than 100 million health care consumers? From an employer's perspective, ERISA is the very foundation from which health care was built and while reform is necessary, maybe we should maintain the parts of care proven to work." (National Association of Manufacturers) -- Election News, Analysis and Events
Excerpt: "Throughout this election season, the Kaiser Family Foundation will provide analysis of health care issues addressed by the presidential candidates." (

Links to Items on Executive Comp, Benefits in General

Changing Trends in the Labor Force: A Survey (PDF)
16 pages. Excerpt: "In this paper, the authors review the evidence of changing labor force participation rates, estimate the trends in labor force participation over the past 50 years, and find that aggregate participation has stabilized after a period of persistent increases. Moreover, they examine the disparate labor force participation experiences of different demographic groups. Finally, they survey some of the studies that have provided explanations for these differences." (Federal Reserve Bank of St. Louis)

Benefit Program Claim Audits Can Help Employers Save Money and Enhance Performance (PDF)
3 pages. Excerpt: "For starters, an audit can fulfill your plan sponsor fiduciary responsibilities -- by evaluating whether your benefit programs are administered accurately and according to contractual agreements. Of course, the best audit outcome confirms that vendor performance levels are at or above industry standards. But this level of quality continues to be the exception rather than the rule. More often than not, our audits reveal costly errors and a host of other performance issues. The good news? By uncovering these issues and identifying how to resolve them, an audit can help you save money, enhance performance and even deliver a better employee experience." (Towers Perrin)

Newly Posted Events
(Post Yours!)

403(b) Regulations - Webcast
Nationwide on January 22, 2008
presented by InterCall

EGTRRA Pre-approved Plan Workshops
Nationwide on March 18, 2008
presented by SunGard Relius

ERISA Fee Transparency: New DOL Rules for Service Provider Disclosures
Nationwide on February 6, 2008
presented by Thompson Interactive, A Division of Thompson Publishing Group

Free Benefits Webinar
Nationwide on January 24, 2008
presented by Ogletree Deakins

HIPAA Security Audits: Are You Prepared?
Nationwide on February 7, 2008
presented by Thompson Interactive, A Division of Thompson Publishing Group

Managing Long-Term Leaves of Absence
in Massachusetts on February 13, 2008
presented by WEB Worldwide Employee Benefits Network MA Chapter

Plan Design Workshop
Nationwide on March 18, 2008
presented by SunGard Relius

Newly Posted Press Releases
(Post Yours!)

Watson Wyatt Data Services' Newest Report Covers Latest Trends in Compensation Policies & Practices for the Insurance Industry
Watson Wyatt

CFDD Launches New Website For Retirement Advisors
Center for Due Diligence

Pension Governance, LLC and The Michel-Shaked Group Launch Pension Litigation Database as Lawsuits Surge
Pension Governance, LLC

Enwisen Continues Momentum -- Finishes Record Year with 80 New Customers

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