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February 22, 2008

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


Today's sponsor is University Conference Services

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Are Your Health and Welfare Benefit Plans Headed Down the Right Road?

Dramatic cost increases have made the job managing your medical benefit plans a real challenge. Attend the Health & Welfare Plan Management for Mid-Sized Employers, March 2-5, in Orlando to find out how to map a long-term course for your plans.

[Guidance Overview] What Multiemployer Health Plan Trustees Need to Know About San Francisco's Employer Health Mandate
Excerpt: "The law's ESR requires immediate attention from employers with employees who work in San Francisco, and from multiemployer plan sponsors with contributing employers employing those employees. Those employers must file their first annual report with the San Francisco government, covering their health care expenditures for 2007, by April 30, 2008,3 and contributing employers may need the assistance of fund offices to do so. This Capital Checkup summarizes details of the ESR, its impact on employers, and what trustees of multiemployer health funds need to know about the mandate." (The Segal Group, Inc.)

[Guidance Overview] DOL Opines on ERISA Preemption After the Pension Protection Act (PDF)
2 pages. Excerpt: "In Advisory Opinion 2008-02A . . ., the Department of Labor issued its first advisory opinion addressing the scope of ERISA's preemption provisions since the enactment of the Pension Protection Act in 2006." (Sutherland Asbill & Brennan LLP)

[Guidance Overview] Department of Labor Proposes Overhaul of FMLA Rules
Excerpt: "It is important to keep in mind that the revisions proposed by the DOL are just that, mere proposals, and that the 1995 rules remain in effect for now. The final rules that will emerge at the end of the year may be significantly different from this proposal. However, employers may want to consider how these proposed rules, along with the new FMLA leaves created for employees with family members in the military, would impact their employee leave practices and begin planning for changes." (Perkins Coie LLP)

[Guidance Overview] New Law Creates Leave Rights Under FMLA for Military Families (PDF)
2 pages. (Milliman)

[Guidance Overview] Hewitt Federal Legislation Quick Guide Updated February 20, 2007, for Health and Welfare Plans (PDF)
11 pages. This Federal Legislation Quick Guide provides short updates on federal legislation that is currently under active consideration by Congress or has recently been enacted into law regarding health and welfare benefit plans. (Hewitt Associates)

[Guidance Overview] EEOC Issues Final Rule on Retiree Health Benefits Exemption - Regulation Reverses Decision in Erie County Case
Excerpt: "This final rule comes after years of debate on the issue of retiree health benefits sparked by the Third Circuit's 2000 decision in Erie County Retirees Association v. County of Erie ('Erie County'). The implementation of the final rule will have an impact on millions of retirees and employers." (Blank Rome LLP)

Court Says San Francisco Health Care Program Can Continue While Lawsuit Pending
Excerpt: "Without comment, Justice Anthony Kennedy refused a request by the Golden Gate Restaurant Association to halt the program while the 9th U.S. Circuit Court of Appeals considers its legality." (San Francisco Chronicle)

HHS Advisory Group To Recommend Patient Control of EHRs
Excerpt: "The National Committee on Vital and Health Statistics, a high-level HHS advisory group, approved a policy letter recommending that the Nationwide Health Information Network allow patients to withhold or limit certain parts of their electronic health records, Government Health IT reports." (California HealthCare Foundation; free registration may be required)

Group Touts New Health Care Model As Cure-All
Excerpt: "Some policy experts want a new health care model that combines elements of the employer-based system and the Medicare program, thus creating big savings and providing coverage for nearly every American. Health Care for America, developed for the Economic Policy Institute by Yale political scientist Jacob S. Hacker, would cover 99.6% of Americans and save more than $1 trillion in health care costs over the next 10 years, according to an analysis of the plan . . . ." (Employee Benefit News; free registration required)

A Company Named 'Fruit Guys' Delivers Healthier Workplace Snacks
Excerpt: "[Chris] Mittelstaedt was working as a temp in a San Francisco hotel when he and a friend hit upon the idea of delivering fresh fruit to local businesses. The two began making deliveries by hand in 1998. 'We believe that [when] people gather around [healthier] food, they will be more conscious about their health' . . . ." (Employee Benefit News; free registration required)

Health Care Reforms Should Include Evidence-Based Medicine
Excerpt: "Advisers and policy wonks were eager to offer suggestions for incorporating value-based care into the U.S. health care system last week at the conclusion of the World Congress Leadership Summit on Evidence-Based Medicine. A panel at the final session presented a variety of opinions and varying degrees of hopefulness on the health care system, predicating that it will change in the near future." (Employee Benefit Advisor; free registration required)

Audio: Massachusetts Law Uncovers More Uninsured Than Expected
Excerpt: "How to achieve universal health coverage is a major issue in this year's presidential campaign. Massachusetts has implemented a 2006 law requiring nearly every citizen to sign up for health insurance or pay a tax penalty." (Morning Edition via National Public Radio)

San Francisco 'Pay or Play' Law Allowed to Proceed
Excerpt: "The U.S. Supreme Court has denied a request by a California restaurant association seeking to prevent San Francisco from enforcing its new health care insurance spending measure." (Workforce Management; free registration required)

The Pros and Cons of an Individual Mandate for Health Insurance
Excerpt: "Since Massachusetts enacted the Health Care Reform Act in 2006, the debate surrounding health care reform has centered on the pros and cons of adding an individual mandate at the federal level. According to a recently-released paper from the Urban Institute entitled, Do Individual Mandates Matter?, an individual mandate is absolutely necessary to provide health care coverage for every American citizen." (Wolters Kluwer Financial Services)

Medicare Part D: Plan Sponsors' Processing and CMS Monitoring of Drug Coverage Requests Could Be Improved (PDF)
47 pages. Excerpt: "GAO recommends that CMS (1) reduce the need for an AOR form by requiring that sponsors and the IRE, upon receipt of standard appeal requests submitted by prescribing physicians without AOR forms, telephone beneficiaries to see if they wish to initiate the appeal, and (2) provide specific definitions for data that sponsors must report to CMS. The agency supports the intent of our first recommendation and is considering it in light of current legal requirements. CMS has taken steps to implement the second recommendation." (U.S. Government Accountability Office)

National Committee for Quality Assurance to Measure Effectiveness of Obesity Treatment
Excerpt: "The total annual cost of obesity in the United States is an estimated $117 billion, according to the NCQA, a nonprofit organization that focuses on improving health care quality. Further, studies have shown that overweight children and teenagers are more likely to become obese adults, which is why NCQA is adding assessments of body mass index -- the ratio between a person's weight and height -- and how consistently physicians perform BMI assessments to HEDIS." (Business Insurance)

Pharma.ceutical Companies Continue to Raise Prescription Drug Prices Despite Presidential Candidates' Criticism of Industry
Excerpt: "The prices of brand-name medications have continued to increase despite calls from all three major presidential candidates for pharma.ceutical companies to make their products more affordable, the Wall Street Journal reports." (Kaiser Family Foundation)

LA City Attorney Alleges Health Net Defrauded Policyholders by Dropping Patients Who Needed Costly Care
Excerpt: "One of the state's largest insurers, Health Net Inc. of Woodland Hills, sold individual policies with the promise of medical coverage while engaging in a secret and illegal scheme to drop patients if they needed expensive treatment, the Los Angeles city attorney contended in a lawsuit filed [this week]." (Los Angeles Times)

Chambers of Commerce Endorse New Health Insurance Plan to Help Small Businesses Cope with the High Cost of Health Care
Excerpt: "California chambers of commerce are increasingly taking a leadership role to help small businesses cope with rising healthcare costs and improve access to quality health insurance for their employees, according to BEN-E-LECT, a leading third party administrator (TPA) and innovator of Employer Driven Health Plans." (Business Wire)

High Costs Drive Online Prescribing Push
Excerpt: "Motivated by mounting medical costs, lawmakers and executives are urging doctors to embrace a seemingly simple way to save billions of dollars a year: prescribe medications online. Officials in the public and private sectors say electronic prescriptions will make transactions more efficient, reduce medication errors and entice doctors to prescribe less expensive drugs." (AP via Yahoo! News)

Medicare Drug Benefit Complicates Coverage for the Unwary
Excerpt: "[The] troubles were triggered by a controversial provision under a federal Medicare program that in 2006 gave seniors and others prescription-drug benefits for the first time. Among the new beneficiaries were more than 6 million Americans who . . . were covered by both Medicaid and Medicare. Such 'dual eligibles' already had good drug coverage through Medicaid. But the federal government required them to switch to one of the Part D plans sold by commercial insurers -- or to be assigned to one randomly." (The Seattle Times)

[Opinion] Criminalizing Health Insurance Disputes
Excerpt: "A small book could be compiled of cases in which the federal judiciary has construed ERISA as condoning 'wrongs without remedy'. Without taking a position on the proper allocation of duties and obligations, suffice it to say that society expects that wrongs will have remedies. Unfortunately, the politically inspired prosecutor may tap into that vein of public discontent to deliver a remedy that fails in proportionality. Perhaps it is too much to say the outcomes can be 'remedies without wrongs', but the danger lies in that direction." (Health Plan Law blog by Attorney Roy F. Harmon III)


Links to Items on Executive Comp, Benefits in General

[Official Guidance] Text of IRS Rev. Rul. 2008-13: Identifying Performance-Based Compensation for Purposes of Sec. 162(m) (PDF)
5 pages. Excerpt: "The ruling holds that compensation paid to an executive is not qualified performance-based compensation for purposes of § 162(m), even if the compensation is paid upon the attainment of the performance goal, if the plan agreement or contract provides for payment of compensation to an executive upon the attainment of a performance goal or for (1) termination without 'cause' or for 'good reason' or (2) voluntary retirement." (Internal Revenue Service)

[Guidance Overview] Hewitt Federal Legislation Quick Guide Updated February 20, 2008, on Human Resources & Employment Law (PDF)
15 pages. This Federal Legislation Quick Guide provides short updates on federal legislation that is currently under active consideration by Congress or has recently been enacted into law regarding human resources and employment law. (Hewitt Associates)

Disclosure of Incentive Pay Targets Improved in 2007
Excerpt: "Corporations are making progress in disclosing more details about how executives' bonuses are determined -- but many are still far from giving regulators and shareholders the full monty." (Workforce Management; free registration required)

[Guidance Overview] IRS Adopts Controversial Letter Ruling Position on Deductibility of Certain Executive Bonuses
Excerpt: "The revenue ruling formally adopts a controversial position taken in a recent private letter ruling (IRS Letter Ruling 200804004, TAXDAY, 2008/01/28, L. 1). The ruling apparently responds to a letter signed by 90 of the country's largest law firms, which requested clarification of the letter ruling . . . ." (CCH Incorporated)

[Guidance Overview] Law Firms Urge IRS to Clarify Controversial Private Letter Ruling on Executive Compensation
Excerpt: "The IRS must clarify its position in IRS Letter Ruling 200804004 (TAXDAY, 2008/01/28, L.1), according to 90 of the country's largest law firms. The 90 law firms wrote to the IRS on February 19 requesting that the Service immediately review IRS Letter Ruling 200804004 and explain how it intends to treat incentive awards in executive compensation arrangements. Since publication of the letter ruling in late January, benefits practitioners and their clients have been struggling to understand if the ruling signals a departure from the IRS' traditional treatment of incentive awards or not." (CCH Incorporated)

Supreme Court ERISA Docket Watch
Excerpt: "In addition to Wal Mart v. Shank, there are two other ERISA cases in which a Petition for Writ of Cert. is currently pending. Both of these other cases are scheduled for conference on Friday, 2/29." (Health Plan Law blog by Attorney Roy F. Harmon III)

U.S. Department of Labor's Office of Labor-Management Standards Announces '5,000th Indictment'
Excerpt: "In January 2008, the U.S. Department of Labor's Office of Labor-Management Standards (OLMS) marked its 5,000th indictment since recordkeeping began in 1964. During January, OLMS obtained eight convictions, nine indictments and court orders of restitution totaling $121,867." (Health Plan Law blog by Attorney Roy F. Harmon III)

Yahoo Inc. Implements Generous Severance Pay Benefits to Discourage Microsoft Takeover Attempt
Excerpt: "Yahoo Inc., owner of the most-visited U.S. website, adopted severance plans for employees that would pay as much as two years of salary to fend off a $44.6-billion bid from Microsoft Corp. . . . Yahoo's plans also entitle departing employees to health insurance, accelerated vesting of options and job-search assistance." (Bloomberg via Los Angeles Times)

[Opinion] IRS Affirms New 162(m) Position, But with Some Relief
Excerpt: "Yesterday the IRS released Revenue Ruling 2008-13, clarifying its new position under Section 162(m) for provisions that accelerate performance-based compensation upon an employee's termination for Cause, Good Reason or Retirement. This was not worth the wait." (Michael S. Melbinger via Winston & Strawn LLP)

[Opinion] How Baby Boomers Are Changing Work and Retirement
Excerpt: "The media report that you, the first wave of the giant cohort eligible for Social Security's early retirement benefits, may also be the first wave of economic fatalities as the Social Security and Medicare cupboards start getting bare. But there is cause for celebration and optimism. Baby boomers have changed the nature of work, why not the nature of retirement?" (The San Diego Union-Tribune)

[Opinion] Go on a Savings Spree
Excerpt: "For some reason, legislation to create universal investment accounts -- proposed by senators and representatives from both parties over the past decade -- has repeatedly stalled in Congress. But now the economy is in trouble, and there is general agreement that this is a time for action. President Bush has already authorized the plan to stimulate more of the spending that got us into this trouble. But it's still not too late to make the effort to create a true investor society." (The New York Times; free registration required)


Newly Posted Press Releases

U.S. Court Approves AK Steel's VEBA Health Care Settlement With Middletown Works Retirees
AK Steel

Managing Eldercare and the Workplace
VNA Private Care

National Organizations Join to Launch America Saves Week to Promote Effective Saving Strategies
Consumer Federation of America


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