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April 1, 2008

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

Today's sponsor is International Foundation of Employee Benefit Plans

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Celebrate National Employee Benefits Day on April 2, 2008!

The International Foundation of Employee Benefit Plans is once again leading the celebrations for National Employee Benefits Day. This year the day has a special focus on health care literacy. The Foundation is encouraging those who are involved in employee benefits to use the day to educate themselves and their plan participants. Visit for free informational resources to help you plan your celebration!

[Official Guidance] Proposed Dept. of Defense Regs on Relationship between TRICARE and Employer-Sponsored Group Health Plans (PDF)
3 pages. Excerpt: "This proposed rule implements Section 1097c of Title 10, United States Code. This law prohibits employers from offering incentives to TRICARE-eligible employees to not enroll, or to terminate enrollment, in an employer-offered Group Health Plan (GHP) that is or would be primary to TRICARE. Cafeteria plans that comport with section 125 of the Internal Revenue Code will be permissible so long as the plan treats all employees the same and does not illegally take TRICARE eligibility into account." (U.S. Department of Defense)

[Guidance Overview] DOL Clarifies Effect of Plan Pre-Authorization Requirements on Medicaid Recoupment Actions
Excerpt: "In ERISA Advisory Opinion 2008-03A, the DOL was asked to provide guidance on whether ERISA would preempt a State Medicaid Agencies action to recoup benefits on individuals having dual coverage under an ERISA plan. Specifically, the concern turned on the effect of plan pre-authorization requirements that might set up a defense to the recoupment action . . . ." (Health Plan Law blog by Attorney Roy F. Harmon III)

[Guidance Overview] Modification to Terms of Split-Dollar Life Insurance Arrangements Is Not a Material Change to Underlying Life Insurance Contract
Excerpt: "IRS guidance provides that a modification of a split-dollar life insurance arrangement that does not affect the life insurance contract underlying the arrangement is not a material change in the life insurance contract that would cause it to lose its 'grandfathered' status and become subject to recently enacted tax rules provided in Code Sec. 101(j) and Code Sec. 264(f)." (CCH Incorporated)

[Guidance Overview] IRS Clarifies Availability of Dependent Care Tax Credit and Other Family Tax Law Benefits Based on 'Qualifying Relatives'
Excerpt: "The IRS has issued Chief Counsel Advice (CCA) 200812024, which provides guidance on whether a taxpayer may claim the dependent care tax credit (DCTC) under Code Section 21 or certain other family tax law benefits, based on a member of the taxpayer's household who is a 'qualifying relative' under Code Section 152(d) and Notice 2008-5 . . . ." (Employee Benefits Institute of America)

[Guidance Overview] Plan Document Established Employer Endorsement and Defeated ERISA's Voluntary Plan Safe Harbor
Excerpt: "EBIA Comment: We think this employer and insurer intended for the plan to be subject to ERISA. As a result, the plan document clearly showed the employer's endorsement, thus making it easy for the court to reach its conclusion while examining solely the plan document. There can be advantages for an employer and insurer when a plan is subject to ERISA, such as insulation from contract and fraud claims and the larger damages often awarded under state law (including possible consequential and punitive damages)." (Employee Benefits Institute of America)

[Guidance Overview] Claim for Negligent Misrepresentation That Employee Had Health Coverage Was Not Preempted by ERISA
Excerpt: "EBIA Comment: As this court noted, generalizations as to the scope of ERISA preemption can be problematic. Some state laws affect employee benefit plans in 'too tenuous, remote or peripheral' of a manner to warrant preemption by ERISA." (Employee Benefits Institute of America)

NY Court Strikes Down Domestic Partner Benefits Ruling
Excerpt: " A New York appeals court has vacated the ruling of a lower court that a g.ay man was not entitled to spousal health insurance benefits even though he and his spouse were lawfully married in Can.ada." (

Colorado Lawmakers Unveil Legislation To Tighten Regulations on State Health Insurers
Excerpt: "Colorado House and Senate Democratic lawmakers on Sunday unveiled legislation that would impose stricter rules on how health insurance providers set premium rates and require them to pay claims in a timely manner, the Denver Post reports." (Kaiser Family Foundation)

New Long-Term Care Cost Bill Floated
Excerpt: "Introduced by Rep. Adam Putnam, R-Fla., and called the Long-Term Care Retirement and Security Act of 2008, HR 5559 would create tax deductions for eligible long-term-care insurance premiums for a taxpayer and that person's spouse and dependents . . . ." (Investment News; free registration required)

The Murky Politics of Mind-Body - Is an Ailment a Legitimate Disease If You Can't Test for It?
Excerpt: "How much of a difference should it make to health care -- and health insurance -- if a condition is physical or mental?" (The New York Times; free registration required)

Consumer-Driven Health Plans Impact Study (PDF)
22 pages. Excerpt: "Do consumer-driven health plans (CDHPs) help reduce healthcare costs? Many have opined on this issue but objective analysis has been lacking. So Milliman, in partnership with the National Business Group on Health (NBGH), undertook the industry's first independent, risk-adjusted study of six employers' CDHPs. The results show that CDHPs are creating modest (1.5%) savings for employers. These results reinforce the need for better consumer information. Actual savings are likely to increase when people have the patient education resources they need to truly compare and shop for healthcare based on quality and cost." (Milliman)

Employers Are Taking New Approaches to Reducing the Toll of Stress in the Workplace
Excerpt: "For many employers, efforts to reduce workplace stress have focused on educating workers about basic stress management. But some have found this approach inadequate, particularly when the nature of work itself is such that no amount of free massages, 'stress ball' giveaways and time-management seminars will be enough -- that it's the jobs and the workplace that may need 'massaging,' not the employees." (Human Resource Executive Online)

Insurers Faulted for Overloading Social Security with Disability Claims
Excerpt: "The Social Security system is choking on paperwork and spending millions of dollars a year screening dubious applications for disability benefits, according to lawsuits filed by whistle-blowers. Insurance companies are the source of the problem, the lawsuits say. The insurers are forcing many people who file disability claims with them to also apply to Social Security -- even people who clearly do not qualify for the government program." (The New York Times; free registration required)

Medical Tourism Soars As Americans Seek Major Savings on Health Care in Hospitals Abroad
Excerpt: "The number of Americans heading abroad for medical procedures is surging as the country's 46 million people without health insurance look for treatment they can afford and cash-strapped U.S. companies struggle to find cheaper ways to provide high-quality medical care to their employees, according to the American Medical Association." (Chicago Tribune)

Insurers Pay for Web-Based Physician Visits
Excerpt: "Health insurers Aetna and Cigna have announced that they will pay for online physician visits, and patients will be required to contribute a copayment for the visits, the Philadelphia Inquirer reports." (Kaiser Family Foundation)

McCain Health Care Proposal Would Exclude U.S. Residents With Pre-Existing Medical Conditions, Elizabeth Edwards Says
Excerpt: "Elizabeth Edwards, the wife of former Democratic presidential candidate and former Sen. John Edwards (N.C.), on Saturday said that the health care proposal announced by presumptive Republican presidential nominee Sen. John McCain (Ariz.) would not provide health insurance for U.S. residents with pre-existing medical conditions, the Los Angeles Times reports." (Kaiser Family Foundation)

Congress Looks at Hiking Health Care Premiums for Veterans
Excerpt: "Military retiree advocates are open to increasing health care fees for retirees for the sake of the armed services at war or on base, a Pentagon health official said. Under fire in a congressional hearing, Assistant Defense Secretary Ward Casscells added that advocates 'I've spoken with' would accept gradual out-of-pocket increases to help the military keep costs down." (San Angelo Standard-Times)

[Opinion] Support for National Health Insurance Among U.S. Physicians: 5 Years Later (PDF)
2 pages. Excerpt: "Reflecting a shift in thinking over the past five years among U.S. physicians, a new study shows a solid majority of doctors -- 59 percent -- now supports national health insurance." (Annals of Internal Medicine via Physicians for a National Health Program)

[Opinion] Not So Fast on the Health Insurance Mandates
Excerpt: "Are health insurance mandates constitutional? They are certainly unprecedented. The federal government does not ordinarily require Americans to purchase particular goods or services from private parties." (Los Angeles Times)

Drug Pricing Pressure Grows As Benefits Managers Gain Influence
Excerpt: "[Pharmacy benefits managers, the large insurers that provide prescription drug coverage for millions of Americans,] are playing as big a role in deciding who takes what medicine as physicians." (The Star-Ledger)

Sponsored by: ALM

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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.

(Please visit our sponsors. We try to make sure their products and services will be of interest to you. Thanks! --Editor)

Links to Items on Executive Comp, Benefits in General

Executive Compensation at Largest U.S. Companies
Excerpt: "The Wall Street Journal has partnered with Hay Group for an ongoing look at annual executive compensation at the largest public U.S. companies. Use this sortable chart to see which CEOs earn what." (The Wall Street Journal)

Tuition-Reimbursement Programs - A Case Study of a Company That Does It Right
Excerpt: "Tuition-reimbursement plans are often justified by their value in enhancing employee retention and recruitment, but few companies have put that hypothesis to the test. A recent survey of 180 companies conducted by the Corporate University Xchange (CUX) found that nearly half neither measure the impact of such programs on retention and recruitment nor follow up with employees and managers to learn how the programs affect job performance." (

Day Care's New Frontier: Your Baby at Your Desk
Excerpt: "More than 80 companies across the nation allow babies in the workplace, according to Parenting in the Workplace Institute in Framingham, Mass., which says that number is likely to be low. It's an extreme -- and controversial -- example of how employers are seeking more ways to help workers strike a balance between work and the rest of their lives. The number of companies allowing children at work on an occasional basis climbed to 29% last year, up from 22% in 2006, according to the Society for Human Resource Management." (USA TODAY)

Newly Posted Events
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Retiree Medical Benefits After Erie County: HIPAA, ADEA, Medicare Coordination and ERISA Compliance Issues
Nationwide on April 24, 2008
presented by ABA Joint Committee on Employee Benefits

Newly Posted Press Releases
(Post Yours!)

PBGC Protects Aladdin Industries LLC Pension Plan
Pension Benefit Guaranty Corporation (PBGC)

PBGC-Negotiated Agreement Secures Pension Funding As Ampex Corp. Enters Chapter 11
Pension Benefit Guaranty Corporation (PBGC)

Council Emphasizes Importance of ERISA, Urges Court to Strike Down San Francisco Law
American Benefits Council

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DB Implementation Specialist
for Milliman
in TX

Defined Contribution Consultant
for Callan Associates
in CA, IL

Daily Valuation Recordkeeper
for PensionTrend, Inc
in MI

Small Plan Actuarial Consultant
for Pension Planning Consultants, Inc.
in NM

Defined Contribution Plan Administrator
for Pension Planning Consultants, Inc.
in NM

Retirement Plan Administrator
for LarsonAllen
in MN

Pension Administrator
for Envoy Financial
in CO

ERISA Consultant
for Ascensus
in MN

Employee Benefits Service Coordinator
for Growing Financial Services Firm
in TX

Client Relationship Manager
for Great-West Financial Services
in OR

Defined Contribution Administrator
for Pension Funds of Arizona
in AZ

Sr Compliance Analyst - ERISA
for T Rowe Price
in MD

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