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February 19, 2008

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

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[Guidance Overview] DOL Proposes Revisions to Current FMLA Implementation Rules - 2/19/08
Excerpt: "Among the proposed changes are restructured and reorganized sections, including consolidating into one section all guidance on pregnancy and childbirth leave and the guidance on employers' notice obligations. Other major revisions that the DOL proposes would do the following: . . . ." (CCH Benefits)

[Guidance Overview] DOL Updates FMLA Regulations -- A Benefits Perspective
Excerpt: "This Legal Alert summarizes the rules and any changes or clarifications contained in the Proposed Regulations relating to employee benefits." (Kilpatrick Stockton LLP)

[Guidance Overview] Restaurant Association Asks Supreme Court to Block San Francisco Health Care Ordinance
Excerpt: "Under the ordinance, employers with 100 employees must pay $1.73 per hour (or about $300 a month) in health care spending for full-time employees. Those with 20 to 99 workers must start at $1.17 per hour (or about $203 a month). These amounts are to increase by 5 % each year." (Hewitt Associates)

[Guidance Overview] FASB Proposes Greater Disclosure of Plan Asset Risk
Excerpt: "FASB explains that Statement 132 requires disclosure of the percentage of fair value of total plan assets 'for each major category of plan assets, which shall include, but is not limited to, equity securities, debt securities, real estate, and all other assets for each major category of plan assets.' FASB said users have expressed concerns that these asset categories are not specific enough to determine the risks associated with the types of assets held in a plan." (PLANSPONSOR)

[Guidance Overview] DOL Proposes Revisions to Current FMLA Implementation Rules
Excerpt: "Among the proposed changes are restructured and reorganized sections, including consolidating into one section all guidance on pregnancy and childbirth leave and the guidance on employers' notice obligations. Other major revisions that the DOL proposes would do the following:" (CCH Benefits)

[Guidance Overview] Letter Stating That Participant Wished to Appeal Benefit Denial Should Have Been Treated as an Appeal
Excerpt: "Three weeks before the deadline, the participant's attorney sent the insurer a letter stating, among other things, that the participant 'wishes to appeal' the decision and requesting certain documents and information. The insurer replied with a letter that gave the participant an additional 40 days to submit a 'complete appeal.'" (Employee Benefits Institute of America)

[Opinion] A Rip-Off By Health Insurers?
Excerpt: "Have health insurers been systematically cheating patients and doctors of fair reimbursement for medical services? That is the disturbing possibility raised by an investigation of the industry's arcane procedures for calculating "reasonable and customary" rates." (New York Times (free registration required))

[Opinion] Very Strange Bedfellows in Health Reform: National Federation of Independent Business, AARP and Service Employees International Union
Excerpt: "The National Federation of Independent Business has been one of the stalwart defenders of health freedom. But its recent association with two activist liberal groups is raising eyebrows around town. The NFIB was a leader in the 1990s in explaining to the American people the restrictions and complexities of the Clinton health reform initiative and the loss of freedom to Americans and especially small businesses. But something has changed 15 years later. The NFIB now has joined with the AARP and the Service Employees International Union (SEIU), as well as the Business Roundtable, in a campaign called 'Divided We Fail.'" (Galen Institute)

Health Plans Put Onus on Insured
Excerpt: "Of the estimated 54 million Americans who are covered by their employers' health plans, about three of four are in plans that give them the option of going out of network. And while most people covered under such plans probably understand that out-of-network services will cost them more, they may be startled to find out just how much more they may end up spending." (New York Times (free registration required))

Adviser Sheds Light on PBM Conflicts of Interest
Excerpt: "Fiduciaries could be breaching their responsibilities under ERISA if the revenue streams going to PBMs are not fully understood by the sponsor. Which begs the question: do your clients know about all the money you're making from their PBM relationship?" (Employee Benefit Adviser)

The Workplace As Clubhouse
Excerpt: "Companies are again finding that adding a bit of social context to work is crucial to keeping employees happy and productive. That is where employee clubs come in. Workplace specialists say clubs are a way to build camaraderie and help people get to know fellow employees away from work." (New York Times (free registration required))

IRS Provides Safe Harbor for Supplemental Group Health Insurance
Excerpt: "[In Notice 2008-23, the] IRS has provided a safe harbor for supplemental group health insurance to be considered excepted from the general group health plan requirements found in Chapter 100 of the Internal Revenue Code. The IRS expects to incorporate the standards of this safe harbor as requirements in future proposed regulations." (CCH Tax News Headlines)

State E-Health Activities in 2007: Findings from a State Survey
Excerpt: "States see e-health initiatives as high-priority; however, they and their private sector partners face significant challenges that accompany such initiatives, including the issues of cost and time required for implementation and for realizing a return on investment. Nevertheless, as reflected in the wide range of e-health activities across the states, a consensus has emerged that these policies and initiatives are significant and well worth the effort." (The Commonwealth Fund)

San Francisco Businesses Preparing for Health Care Law
Excerpt: "The law requires employers to contribute a minimum dollar amount per worker that can be used to pay for health expenses or paid to the city for coverage under its new program. While the money doesn't actually have to be paid until April 30, it must be provided in full by that time dating back to Jan. 9. Companies that already provide health insurance to their employees are not off the hook. " (San Francisco Chronicle)

Insurers Say They Won't Pay for Preventable Medical Errors
Excerpt: "Employers could begin to see cost savings and improvements in the quality of health care in the next year as more private insurers plan to follow the federal government's lead in refusing to pay hospitals for medical errors. In recent months, Blue Cross and Blue Shield, Aetna and WellPoint have said they will look for ways to stop paying for certain preventable errors called 'never events' or 'serious reportable events' " (

Debating Healthcare Reform: Some Observations
Excerpt: "The political debate will continue to be conducted at the level of sound bites and big concepts, not the level of 'details' or 'weeds' that would actually allow an employer or an individual to know how the reform would likely affect them. My next five columns will explore the 'weeds' of what is being proposed." (Dallas Salisbury published by Human Resource Executive Online)

Report on Health Savings Accounts and the States, 2007
(National Conference of State Legislatures)

Health Care Reform Must Include Information Technology Support, Group Says
Excerpt: "The U.S. Congress needs to pass health-care IT legislation before private companies develop multiple systems that don't talk to each other, two advocacy groups say." (Washington Post; free registration required)

Gaps in Data Slow Retiree Prescription Subsidies
Excerpt: "Because of administrative snafus, some employers that have applied for the Medicare Retiree Drug Subsidy are now scrambling to meet a March 31 deadline for final reconciliation. If they are unable to confirm eligibility of all of their plan members, they will not be paid for them . . . ." (

PHCS Provider Reimbursement Controversy Affects ERISA Self-Funded Health Plans
Excerpt: "The investigation by New York Attorney General Andrew Cuomo into the protocols used by managed care companies to calculate reasonable and customary charges will likely have an effect on self-funded health plans and benefit administrators as well. The controversy promises to be technical, political and litigious." (Health Plan Law blog by Attorney Roy F. Harmon III)

Bush Family Leave Plan Has Workers Feeling Ill
Excerpt: "Employer groups didn't get everything they lobbied for. The rule doesn't redefine 'serious health condition,' which is now interpreted liberally. Lipnic said she believes Congress would have to make that change. Worker rights groups view most of the changes as rollbacks." (Bloomberg)

First Interim Report of the New Jersey Civil Union Review Commission (PDF)
21 pages; February 19, 2008. Excerpt: "For the overwhelming majority of civil union couples who testified, [ERISA] is the reason employers have given for not recognizing their civil unions. . . . In Massachusetts, a marriage equality law has prompted many employers to provide equal benefits to same-sex wives or husbands. . . . The testimony presented by many civil union couples indicated that their employers continue to discriminate against them, despite their familiarity with the law. . . . Civil union status is not clear to the general public, which creates a second-class status." (New Jersey Civil Union Review Commission)

Sponsored by: CDHC Solutions

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Links to Items on Executive Comp, Benefits in General

[Official Guidance] Text of 'Monthly Benefits News & Developments' by Milliman for February 2008 (PDF)
Only 2 pages, but 'what's there is cherce,' as Spencer Tracy might say. (Milliman)

[Guidance Overview] IRS Takes Adverse Position in Ruling on Code Section 162(m) (PDF)
2 pages. Excerpt: "[An IRS agent told us that the IRS] hopes to publish guidance by the end of February [and that] companies [should not] engage in drastic measures at this time simply because of the ruling, but instead, to wait until the guidance is issued." (DrinkerBiddle)

Health Costs Loom Large for Retirees
Excerpt: "Many baby boomers are not going to be able to maintain their standard of living in retirement, not only because they're not saving enough but also because they face skyrocketing health care costs. A study being released Tuesday by the Center for Retirement Research at Boston College found that health care expenses could take a big bite out of retirees' budgets." (Washington Post; free registration required)

Health Care Costs, Lack of Savings Might Contribute to Lower Standard of Living for Future Retirees, Study Finds
Excerpt: "Alicia Munnell, director of the center, called the estimates 'shockingly large,' adding, 'The most effective step is to plan on working a few years longer' because that 'cuts the percent at risk by about 10 percentage points.'" (

Health Care Costs Drive Up The National Retirement Risk Index
Excerpt: "The results show that once health care is considered explicitly, the percentage of households that will be 'at risk' rises from 44 percent to 61 percent." (Center for Retirement Research at Boston College)

[Opinion] Benefits in 2020: Big Challenges Ahead
Excerpt: "Dallas Salisbury. The CEO of the Employee Benefit Research Institute, a well-regarded, nonpartisan think tank in Washington, D.C., paints a bleak picture of the future of employee benefits over the next 15 years." (

Newly Posted Events
(Post Yours!)

401(k)Plan Workshop
Nationwide on April 18, 2008
presented by SunGard Relius

EGTRRA Pre-approved Plan Workshop
in California on March 26, 2008
presented by SunGard Relius

EGTRRA Pre-approved Plan Workshop
in Pennsylvania on March 26, 2008
presented by SunGard Relius

EGTRRA Pre-approved Plan Workshop
in North Carolina on March 27, 2008
presented by SunGard Relius

EGTRRA Pre-approved Plan Workshop
in Washington on March 27, 2008
presented by SunGard Relius

Form 5500 Workshop
Nationwide on April 17, 2008
presented by SunGard Relius

Health Care Costs: A Growing Issue For Private Enterprises - Webcast
Nationwide on March 6, 2008
presented by Deloitte

Plan Design Workshop
in Pennsylvania on March 27, 2008
presented by SunGard Relius

Plan Design Workshop
in California on March 27, 2008
presented by SunGard Relius

Plan Design Workshop
in Washington on March 28, 2008
presented by SunGard Relius

Plan Design Workshop
in North Carolina on March 28, 2008
presented by SunGard Relius

Newly Posted Press Releases
(Post Yours!)

PBGC Announces New Investment Policy
Pension Benefit Guaranty Corporation (PBGC)

Proposed Rule on Financial and Actuarial Reporting
Pension Benefit Guaranty Corporation (PBGC)

URAC Launches On-Line Consumer Decision Support Tool for Consumers, Employers, Policymakers, Health Plans

ACS | Mellon HSA Solution Manages More Than 450,000 Health Savings Accounts

401kEmail™ Landing Pages Announced by Venture (k) Corp.
Venture (k) Corp.

Chrysler Goes Holistic to Revolutionize Back Pain Care in the Workplace
Henry Ford Medical Group

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