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March 25, 2008

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

Today's sponsor is Employee Benefits Institute of America Inc. (EBIA)

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EBIA's InPerson Seminar Series

EBIA's InPerson seminars provide education on employee benefits topics to professionals, including TPAs, attorneys, benefits consultants, human resources managers, plan administrators, insurance professionals, and accountants. For information about CE credit, course materials, speakers, locations, and agenda details, and to register, please visit EBIA's InPerson Seminars.

[Guidance Overview] Does Your Wellness Program Comply with the HIPAA Nondiscrimination Regulations? (PDF)
3 pages. Excerpt: "On February 14, 2008, the Department of Labor . . . issued Field Assistance Bulletin No. 2008-02 covering: What types of health promotion or disease prevention programs . . . offered by a group health plan must comply with the HIPAA nondiscrimination regulations; and How to determine whether your company's wellness program complies. . . . The bulletin includes a checklist and related analysis, which are summarized [in the target document.]" (Holme Roberts & Owen LLP)

Supreme Court Allows Retiree Benefit Cuts
Excerpt: "The Supreme Court on Monday gave employers a green light to reduce health benefits for millions of retirees who turn 65 and become eligible for Medicare. The justices turned away a legal challenge from AARP, the nation's leading senior citizens lobby, which had contended these lower benefits for older retirees violated the federal law against age discrimination. The court's action upholds, in effect, a rule adopted last year by federal regulators that says the 'coordination of retiree health benefits with Medicare' is exempt from the anti-age-bias law." (Los Angeles Times)

Health Blog - Big Employers Cover Contraceptives But Not Weight-Loss Meds
Excerpt: "Some 77% of large employers provide drug coverage for contraceptives without limits on quantity or cost, but the number falls to 33% when it comes to coverage of emergency contraceptives, according to a survey out from Mercer, one of the big human-resource consulting shops." (The Wall Street Journal)

Health Blog - Wal-Mart Prevails in Case to Recover Health Costs
Excerpt: "More companies see such recoveries as a way to make a dent in soaring health care costs. Daphne Moore, a Wal-Mart spokeswoman, said, 'It's a very sad case, and we understand that people have a very emotional and sympathetic reaction.' But the plan, she said, is obligated to act in the interest of the health benefits of its employees as a whole. The benefits are designed so that when an employee does have an accident, 'the plan steps in and covers those medical expenses so our associates don't have to worry about them being covered,' and then later to reimburse the plan if and when they receive funds for the accident from a third party, she said." (The Wall Street Journal)

Controlling Health Insurance Premiums with FSA, HRA, HSA Plans
Excerpt: "Health insurance costs are rising much faster than inflation. But what can manufacturers do about it? One idea that seems to be working is giving employees 'ownership' in their health plans. A big problem is that employees are disconnected from the cost of healthcare. For instance, when asked in surveys, a surprising number of people think the doctor only receives their health plan's co-pay amount, $10 or $20!" (Penton Media, Inc.)

Transitioning to Medicare Before Age Sixty-Five
Excerpt: "Disabled workers who start receiving Social Security Disability Income (SSDI) must wait twenty-four months to qualify for Medicare. Legislation introduced in Congress would eliminate this waiting period, to guarantee that people with disabilities severe enough to qualify for SSDI will not be uninsured. We provide a longitudinal view of Medicare enrollment before age sixty-five by following a national sample of people ages 55-64. One person in six was covered by Medicare before turning sixty-five. A quarter of new enrollees were uninsured during the waiting period. There were great disparities in reliance on Medicare and coverage in the waiting period." (Health Affairs)

On-Site Care Motivated by Productivity and Cost Issues
Excerpt: "Among companies that have set up on-site health care clinics, the most common motivation was a desire to improve worker productivity, a survey shows. The survey, released March 19 by Watson Wyatt Worldwide, compared the use of such facilities by early and recent adopters, with early adopters defined as those companies that set up clinics before 2000." (Workforce Management; free registration required)

Medicare Out-of-Pocket Costs: Can Private Savings Incentives Solve the Problem?
Excerpt: "This report analyzes the extent to which incentives to save could offer significant relief of post-retirement healthcare costs. We analyze this with a particular focus on low-income participants as part of a broader analysis of families of varying income levels. We include projections of savings potential for individuals of varying income levels if they could save a modest percentage of their income tax free and receive a rate of return equivalent to that in a basket of U.S. Treasury bonds." (The Commonwealth Fund)

Hoping to Get Healthy, and Wealthy, Through HSAs
Excerpt: "For now, most people are still struggling to understand the basic concept of HSAs for medical spending. The idea of investing is still a ways off." (The Star Tribune via NewsEdge Corporation via Human Resource Executive Online)

Minnesota Lawsuit Addresses Retiree Health Insurance Guarantee
Excerpt: "A Duluth lawyer, who won a case in which the Minnesota Supreme Court ruled that his client's right to the payment of health insurance premiums vested at the time she retired could not be terminated by her former employer, has brought a similar lawsuit against the Chisholm school district." (Duluth News-Tribune via NewsEdge Corporation via Human Resource Executive Online)

National Federation of Independent Business Advances Role In Health Reform
Excerpt: "The National Federation of Independent Business (NFIB) has announced its new initiative, 'Solutions Start Here,' to urge policymakers at the state and federal level, as well as presidential candidates, to 'deliver real and meaningful health care reform for small business.' The NFIB asserts that small businesses are disproportionately burdened by health care costs. [C]urrent law does not provide small businesses the same tax breaks, coverage, or pooling options as large businesses and corporations and, on average, they pay 18% more for the same health care benefits." (Wolters Kluwer)

Physicians Group Calls for Protections Against Genetic Discrimination
Excerpt: "The American College of Physicians is urging federal lawmakers to approve legislation that would prohibit employers from using an individual's genetic information in employment decisions. The group released six policy positions, saying there is a need for federal protections against genetic discrimination in employment and insurance practices." (Business & Legal Reports, Inc.)

Rising Health Costs Cut Into Wages as Higher Fees Squeeze Employers and Workers
Excerpt: "Employees and employers are getting squeezed by the price of health care. The struggle to control health costs is viewed as crucial to improving wages and living standards for working Americans. Employers are paying more for health care and other benefits, leaving less money for pay increases. Benefits now devour 30.2 percent of employers' compensation costs, with the remaining money going to wages, the Labor Department reported this month. That is up from 27.4 percent in 2000." (The Washington Post; free registration required)

Generics Increasingly Used to Control Pharmacy Benefit Costs
Excerpt: "Employers have been using cost sharing and tiered copayment structures to decrease pharmacy benefit costs, but Mercer has found employers are looking to other cost-reduction strategies such as more actively encouraging members to use generic drugs and mail-order plans to further reduce costs." (; free registration required)

Massachusetts Health Care Board Pondering Employer Payment Hikes
Excerpt: "The board running Massachusetts' new state-subsidized health insurance program is considering raising contributions required from employers that fail to provide coverage to their workers. Currently employers must pay up to $295 per uninsured employee per year. This fee has raised only about $6 million this year, far less than had been expected, according to Business Insurance." (; free registration required)

High Court Decision Paves Way for Two-Tiered Retiree Medical Benefits
Excerpt: "As expected, the U.S. Supreme Court Monday declined to review a federal appeals court ruling that effectively upholds employers' ability to reduce health care benefits when retirees become eligible for Medicare, putting a final end to nearly eight years of litigation and uncertainty." (Financial Week; free registration required)

Links to Items on Executive Comp, Benefits in General

Annual Social Security and Medicare Reports to Be Released Today
Excerpt: "Treasury Secretary Henry Paulson will be joined by members of the Social Security and Medicare boards of trustees for a news conference to discuss the release of the annual Social Security and Medicare trustees' reports at 2 p.m. EDT Tuesday, March 25." (Modern Healthcare; free registration required)

Budy and Bales on Naming a Defendant in an ERISA Action
Excerpt: "This article argues that courts should permit suit against any entity that played a role in denying the claim. This approach (1) is consistent with the plain language of ERISA, (2) is consistent with the legislative intent behind ERISA which was to protect employees from underfunded plans and from erroneous benefit denials, (3) is consistent with Supreme Court precedent permitting fiduciaries to be sued under ERISA, and (4) creates an incentive for entities making benefits determinations to make those determinations correctly." (Workplace Prof Blog)

Findings of 14th Annual Deloitte/ISCEBS Top 5 Rewards Priorities Survey Findings (PDF)
9 pages. Excerpt: "More than two-thirds of survey respondents (68 percent) plan to undertake a redesign of other rewards programs within the next year. The most commonly identified programs slated for an overhaul were learning and development programs (51 percent), followed by paid time off (44 percent), flexible work arrangements (39 percent), and mentoring programs (28 percent)." (International Society of Certified Employee Benefit Specialists)

Help Increases for Partners of Relocated Workers
Excerpt: "Relocating for a job is always a challenge. But human-resource executives say that it has become increasingly difficult through the years, and that spouse issues are among the biggest hurdles, especially for dual-career couples." (The Wall Street Journal)

Social Security Trustees to Give Annual Update
Excerpt: "The trustees of Social Security and Medicare are certain to kick off a fierce round of debate when they release their annual assessment of the fiscal health of the government's two biggest benefit programs. . . . The new report is expected to make only small changes in the estimates made last year for when both trust funds will be depleted." (The Washington Post; free registration required)

Newly Posted Events
(Post Yours!)

Integrating Wellness Into Employee Benefit and HR Programs
in Virginia on April 16, 2008
presented by Capital Chapter ISCEBS

PenServ Annual Conference
in South Carolina on August 4, 2008
presented by PenServ, Inc.

Take the Mystery out of the RFP Process
in District of Columbia on March 27, 2008
presented by Capital Chapter ISCEBS

Newly Posted Press Releases
(Post Yours!)

Talent Shortage Emerges as No. 1 Employer Concern: Deloitte/ISCEBS

Council Applauds End of AARP v. EEOC Legal Battle
American Benefits Council

First Health Plans Receive Bridges to Excellence Endorsement and Certification
Bridges to Excellence (BTE)

Bridges to Excellence Launches Medical Home Program
Bridges to Excellence (BTE)

Blue Cross and Blue Shield of Texas Announces Wellness Tools and Resources
Blue Cross and Blue Shield of Texas

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