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January 17, 2008

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

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[Opinion] How Ontario Law Outlawing Private Healthcare Insurance Hurt a Brain Tumor Patient
Entitled 'A Short Course in Brain Surgery,' the video lasts a little over 5 minutes. The individual was told he would not be able to have an MRI for 4 months when he was diagnosed with a possible brain tumor by a general practice physician; he went to Buffalo the next and paid for one, which found the brain tumor; he was told a 3-month delay would be required to see a neurosurgeon; he went to Buffalo again and had the surgery. A lawsuit seeking reimbursement from Ontario has been filed. (Filmmaker Stuart Browning)

Massachusetts Penalties to Rise for Rejecting Health Care Coverage
Excerpt: "Massachusetts residents who can afford to buy health insurance coverage but do not would pay penalties of as much as $900 in 2008, under proposed regulations." (Workforce Management; free registration required)

Increasing Numbers of Insured Workers Required to Meet a Deductible
Excerpt: "A growing number of US private sector workers are covered by health plans that require them to meet a deductible before any benefits are paid by their insurer, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. The amount of that deductible also is increasing sharply." (Medscape)

Petition for Certiorari Filed in Criticized Wal-Mart Health Plan Subrogation Case
Excerpt: "Note: The Eighth's Circuit distinction between the reasoning in Ahlborn, which presented a question of interpretation of the Medicaid statute, and that applicable in the context of interpretation of the ERISA statutory scheme, is a logical one. What the Supreme Court meant by the reservation of analysis of 'appropriate' equitable relief, however, remains ambiguous. Challenges to plan reimbursement claims will undoubtedly continue to emphasize that ambiguity so long as the Court leaves the matter open to interpretation." (Health Plan Law blog by Attorney Roy F. Harmon III)

Mercer Finds Lack of Consensus Among Employers About Health Care Reform
Excerpt: "From Spencer's Benefits Reports: Play-or-pay health care systems fail to get support nearly equally from small employers and from large employers (those with at least 500 employees), according to recently released data from a Mercer study conducted in the summer of 2007." (Wolters Kluwer Financial Services)

Report: Cost Efficiency at Hospital Facilities in California (PDF)
63 pages. Excerpt: "[Milliman understands] that PBGH will use this information to better understand the relative cost differences among hospitals in California and will make this report available to CalPERS, other PBGH members, and the public. We include in this report patient severity adjusted comparisons of commercial buyer costs (i.e., what commercial insurers pay for hospital services) and comparisons of hospital operating costs (i.e., what hospitals reported as their operating costs)." (Pacific Business Group on Health)

A Look at the State of Health Information Technology in California, 2008
Excerpt: "The State of Health Information Technology in California, the first comprehensive look at HIT adoption in the state, reveals that large majorities of physician practices, hospitals, clinics, and long term care facilities, as well as patients, are still far from realizing the benefits of HIT. Reasons for the slow pace of adoption range from implementation costs to concerns about security and confidentiality." (California HealthCare Foundation; free registration may be required)

New Economic Analysis of ABX1 1 Examines How Many People Would Be Covered and Type of Coverage (PDF)
9 pages. Excerpt: "This new analysis by MIT researcher Jonathan Gruber comes as the Senate Health Committee prepares to vote on the compromise coverage expansion proposal." (Jonathan Gruber, Ph.D. via California HealthCare Foundation; free registration may be required)

Hospital Costs for Insured Vary Widely Statewide, Study Finds
Excerpt: "Hospital charges vary widely across California, largely depending on the degree of competition from other facilities in the area, according to a study released Tuesday, the San Francisco Chronicle reports (Colliver, San Francisco Chronicle, 1/16). The variations remained even after adjusting for wage differences (Hogarth, East Bay Business Times, 1/15)." (California HealthCare Foundation; free registration may be required)

Universal Health Care Plans Up Against U.S. Law
Excerpt: "Several states and communities are moving to provide universal health coverage for their residents, but a federal law is blocking their efforts. Many of the proposals require employers either to offer health coverage themselves or pay into a public fund to help cover the uninsured. Some employers say that conflicts with a federal law that bars states from requiring or regulating employer-provided benefits such as health coverage. The law, which protects private-sector companies from having to meet a patchwork of state and local demands, is supported by businesses." (USA TODAY)

Individual Mandates to Increase Health Coverage May Top State Reform Strategies for 2008
Excerpt: "While the idea of individual mandates has received a lot of attention from state governments over the past two years, Massachusetts is the only state that has actually put such a strategy into place, says Melissa Hansen, a health policy analyst with the National Conference of State Legislatures (NCSL). Key components of that law, enacted in April 2006, include a mandate for individuals to purchase health coverage and an assessment on employers that don't offer coverage to workers. It also created subsidies to help low-income residents purchase coverage." (Health Plan Week via

North Carolina Blues Continues Trend Toward 'Value-Based' Drug Formularies
Excerpt: "In the latest move toward 'value-based' drug formularies, Blue Cross and Blue Shield of North Carolina (BCBSNC) said Dec. 27 that it will waive copayments on all generic drugs that treat congestive heart failure, high blood pressure, high cholesterol and diabetes." (Drug Benefit News via

Health IT Spending Expected To Jump in Next Five Years
Excerpt: "Annual health IT spending is expected to increase from $6.9 billion in 2007 to $10.8 billion in 2012, according to a study released Monday by market research firm Input, Government Health IT reports. Overall, the health IT market will expand at a rate of 8.6% annually, according to Input." (California HealthCare Foundation; free registration may be required)

McDonald's UK CEO: Kids Are Fat Because of Video Games
Excerpt: "Steve Easterbrook, the CEO of McDonald's UK, says that video games cause obesity -- not his nutritionally void, heavily sweetened, processed junk that's voraciously marketed to kids . . . ." (boingboing)

Study is Unclear Whether Hospital Data Influence Patients' Decisions
Excerpt: "The study, titled 'Systematic Review: The Evidence That Publishing Patient Care Performance Data Improves Quality of Care,' found that there is scant evidence to determine if public reporting of hospital data impacts patients' decisions." (California HealthCare Foundation; free registration may be required)

Links to Items on Executive Comp, Benefits in General

The Compensation of Senior Executives at Listed Companies: A Manual for Investors
Excerpt: "As a supplement to The Corporate Governance of Listed Companies: A Manual for Investors, this manual builds awareness of how executives are paid and describes the governance structures that help set compensation plans within companies." (CFA Institute)

[Guidance Overview] Overview: Treasury/IRS Provide Limited Relief for Operational Failures Under Code Section 409A
Excerpt: "This article examines Notice 2007-100 which the Department of Treasury and the IRS published on December 24. Notice 2007-100 provides relief under particular circumstances for certain failures to comply with Internal Revenue Code Section 409A." (JPMorgan)

Older Workers Turning to Government for Second Careers
Excerpt: "Older workers are also looking beyond federal departments and agencies to state and local governments, where retirements will create many vacancies in social services and health care." (The Dallas Morning News; free registration required)

Finances of Employee Benefits, 1950−2006 (PDF)
Pages 7- of 12 pages. Excerpt: "Financing of the U.S. employee benefit system is a joint effort by employers and employees. Both employers and employees make payments to voluntary employee benefit programs that provide health insurance coverage, retirement benefits, and other benefits. In addition, employers and employees make payments to mandatory government social insurance programs--most notably Social Security and Medicare--which provide retirement income and health care coverage, respectively, for elderly and disabled workers and their dependents." (Employee Benefit Research Institute)

Newly Posted Events
(Post Yours!)

Background Checks: Getting The Facts On Job Candidates - Legally
Nationwide on January 22, 2008
presented by

Cafeteria Plan Compliance: Handling Status Change Rules - Including HSA Considerations
Nationwide on January 31, 2008
presented by

Newly Posted Press Releases
(Post Yours!)

House Committee on Small Business to Explore Factors Behind the Limited Health Care Options Available to Entrepreneurs
U.S. House Small Business Committee

Prudential Can Help Americans Create a Retirement Income Program and Guarantee It for Life
Prudential Financial, Inc.

CPI Qualified Plan Consultants, Inc. Announces Creation of CPI Common Remitter Services Division
CPI Qualified Plan Consultants, Inc.

AXA Launches Corporate Retirement Distribution Channel
AXA Financial, Inc

Wolters Kluwer Financial Services Launches Online HSA Enrollment and Management Solution
Wolters Kluwer Financial Services

GM Settles Class Action 401(k) Suit
Business Insurance Magazine

Social(k) 401k Platform Sees 186% Growth

The Online 401k Offers an Automatic Enrollment Feature to Small Businesses
The Online 401(k)

Ibbotson Study Finds Living Benefits Can Help Increase Retirement Income While Reducing Income Risk
Ibbotson Associates

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Retirement Compliance Testing Administrator
for Vanguard
in PA

Implementation Project Lead
for Vanguard
in PA

Assistant General Counsel
for Administaff
in TX

401(k)/Defined Contribution Valuation Processor
for National Retirement Services, Inc.
in CA, NC

Pension Administrator
for Jordan & Andrews
in CA

Documents Supervisor
for Associated Pension Consultants
in CA

Employee Benefits Administrator
for The Coffee Bean & Tea Leaf
in CA

Associate Account Manager, Retirement
for Cammack LaRhette Consulting
in MA

401(k) Plan Administrator
for Qualified Plans, LLC
in GA

401(k) Plan Administrator
for Southern Pension Services
in FL

Retirement Plan Administrator
for Envoy Financial
in CO

Sr. Implementation Consultant - Institutional Services Group
for AIG Retirement (Formerly AIG VALIC)
in TX

Sr. Implementation Analyst - Contracts & Agreements Specialist
for AIG Retirement (Formerly AIG VALIC)
in TX

In House ERISA/Employee Benefits Counsel
for National Financial Partners
in NY

Relationship Manager
for Swerdlin and Company
in GA

Cafeteria Plan Specialist
for Swerdlin and Company
in GA

Senior Retirement Plan Consultant
for Employee Benefit Resources, LLP
in MT

Assistant Account Administrator
for McCready and Keene, Inc.
in IN

Participant Services Representative I
for Standard Insurance Company
in TX

Retirement Services District Manager
for ADP
in CA, CO, CT, DC, FL, NY, WA

Account Manager II - Standard Retirement Services
for Standard Retirement Services
in OR

Account Manager II - Standard Retirement Svcs.
for Standard Retirement Services
in PA

Defined Contribution Analyst I
for Standard Retirement Services
in OH

Defined Contribution Analyst I
for Standard Retirement Services
in PA

New Business Account Manager - Standard Retirement Svcs.
for Standard Retirement Services
in PA

Team leader I -Standard Retirement Services
for Standard Retirement Services
in OR

Retirement Plan Administrator
for North Central Trust Company
in MN, WI

Product Manager
for Administaff
in TX

Group Benefits Senior Account Manager
for Wachovia
in FL

Qualified Plan Administrator
for Bentley Employee Benefits Group, LLC
in RI

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