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April 14, 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] Abstract: How Key Changes to the Federal Family & Medical Leave Act Affect Multiemployer Plans
Excerpt: "Multiemployer plans could be required to maintain health benefits for up to 26 weeks in some circumstances. The Act does not contain any new provisions relating to how multiemployer plans provide health benefits during FMLA leave. The FMLA regulations allow multi-employer plan sponsors to decide how to pay for FMLA health benefits - through either contributions for the individual employee or pooled contributions." (The Segal Group, Inc.)


[Guidance Overview] New Jersey Senate Approves Paid Family Leave; Governor Expected to Sign (PDF)
2 pages. Excerpt: "Nothing in the amended law increases, reduces, or otherwise modifies any entitlement of an employee to return to employment or rights of the employee to take action under the provisions of the New Jersey Family Leave Act. However, the law provides that if an employee receives family leave benefits from an employer who is not covered by the New Jersey Family Leave Act, the employer is not required to restore the employee to employment after the period of family leave." (Winston & Strawn LLP)


[Guidance Overview] New Jersey's Paid Family Leave Law: the Hidden Costs to Employers Doing Business in the Garden State
Excerpt: "On April 7, 2008, the New Jersey Senate approved the Paid Family Leave Law, which Governor Corzine has stated he will sign into law shortly. This new law will make New Jersey the third state to provide employees paid family leave benefits." (Littler Mendelson P.C.)


[Guidance Overview] The Myth of the 'Partially Self-Insured' Group Health Plan
Excerpt: "Group health plans are self-funded or they are insured. That employers or plans purchase stop loss insurance makes no difference to the self-funded status of these plans under ERISA. So why do so many commentators, and even the venerable 7th Circuit Court of Appeals (in an opinion concurred in by Judge Posner no less) used the confused phrase, 'partially self-insured'? It is a troublesome phrase that adds nothing to analysis. ERISA knows nothing of 'partially' insured or self-funded plans." (Health Plan Law blog by Attorney Roy F. Harmon III)


[Guidance Overview] Plans Required to Reimburse Medicaid Even if Participant Failed to Obtain Required Preauthorization for Services
Excerpt: "EBIA Comment: This opinion builds on Advisory Opinion 2005-05A, in which the DOL concluded that ERISA does not preempt state laws that authorize states to recoup Medicaid payments from a plan if the plan would have been liable to any third party before the Medicaid payment was made . . . . According to that advisory opinion, such state laws may be enforced 'notwithstanding the plan's procedural requirements governing participant benefit claims' (for instance, Medicaid does not have to comply with the plan's filing time limits)." (Employee Benefits Institute of America)


[Guidance Overview] Eligibility Requirement of More Than Twenty Hours of Active Employment Was Not Discriminatory Under HIPAA
Excerpt: "EBIA Comment: Typical pre-HIPAA actively-at-work clauses provided that an employee who was absent on the day that coverage would otherwise begin would not be covered until he or she was back at work. These actively-at-work provisions violate HIPAA's nondiscrimination rules unless employees who are absent due to a health condition are treated as if they were actively at work. On the other hand, as this case illustrates, plans are permitted to enforce nondiscriminatory eligibility conditions, even if they operate to exclude participants who fail to satisfy those conditions because of a health factor." (Employee Benefits Institute of America)


[Guidance Overview] Employer Breached ERISA Fiduciary Duties by Providing Misleading Health FSA Documents
Excerpt: "EBIA Comment: IRS regulations prohibit health FSAs from reimbursing medical expenses before they are 'incurred,' and provide that medical expenses generally are 'incurred' when medical care is provided, not when the employee is formally billed, charged for, or pays for the medical care. This is not the first time that an employer has run into problems by providing health FSA disclosure documents that refer to IRS Publication 502, which is used to help taxpayers determine what medical expenses they can deduct on their tax returns but is not intended to help someone decide what expenses are reimbursable under a health FSA . . . ." (Employee Benefits Institute of America)


Congress May Be Ready to Give Small-Business Health Pools Another Shot
Excerpt: "A bipartisan group of senators think they've found a way to overcome objections that have derailed past efforts to reduce health insurance costs for small businesses. New legislation introduced by Sen. Dick Durbin, D-Ill., and Sen. Olympia Snowe, R-Maine, would encourage states to set up health care purchasing pools for small businesses and the self-employed. The Small Business Health Options Program also calls for establishing of a nationwide purchasing pool in 2011." (Columbus Business First via bizjournals.com; free registration required)


Costs Soar for Massachusetts Health Care Law
Excerpt: "Two years after the state's landmark health law was signed, the cracks are starting to show. Costs are soaring and Massachusetts lawmakers are weighing a dollar-a-pack hike in the state's cigarette tax to help pay for a larger-than-expected enrollment in the law's subsidized insurance plans." (AP via Yahoo! News)


Retooling for an Aging America: Building the Health Care Workforce (PDF)
Excerpt: "In 2007, the Institute of Medicine (IOM) charged the ad hoc Committee on the Future Health Care Workforce for Older Americans to determine the health care needs of Americans over 65 years of age and to assess those needs through an analysis of the forces that shape the health care workforce, including education and training, models of care, and public and private programs." (Institute of Medicine)


Boomers to Flood Medical System, According to Study
Excerpt: "The report from the [Institute of Medicine], an arm of the National Academy of Sciences, said: --There aren't enough specialists in geriatric medicine. --Insufficient training is available. --The specialists that do exist are underpaid. --Medicare fails to provide for team care that many elderly patients need." (AP via The New York Times; free registration required)


High Court Prepares To Hear ERISA Discretion Arguments
Excerpt: "The U.S. Supreme Court could hear oral arguments concerning a group benefits administration case April 23. The court has scheduled arguments on the case, Metropolitan Life Insurance Company et al. petitioners vs. Wanda Glenn, for that date." (The National Underwriter Company; free registration or paid subscription required)


Ford, UAW Settle Lawsuit Over Retiree Health Care Trust
Excerpt: "Ford Motor Co., the United Auto Workers union and lawyers representing retired workers have reached a legal agreement to shift retiree health care costs from the company to a union-administered trust fund. The company revealed the agreement Friday in a filing with the U.S. Securities and Exchange Commission." (Associated Press WorldStream via NewsEdge Corporation via Human Resource Executive Online)


Co-Payments for Expensive Drugs Soar
Excerpt: "Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases." (The New York Times; free registration required)


Ohio Paid Sick-Leave Law Supporters Want Legislators to Act
Excerpt: "Calling it 'hypocrisy with a capital H,' backers of legislation requiring employers to provide workers with paid sick leave accused lawmakers yesterday of ignoring the bill while taking their own sick leave at taxpayer expense." (The Toledo Blade Company)


Massachusetts Health Insurance Connector Approves 10% Increase in Affordability Standards
Excerpt: "The Commonwealth Health Insurance Connector on Thursday approved new rules that increase the monthly premium considered affordable by about 10% from 2007 levels, the Boston Globe reports. Under the state's health insurance law, residents who do not obtain coverage face a penalty of up to $912 if they are uninsured for the whole year unless the state determines that they are unable to afford coverage." (Kaiser Family Foundation)


Ex-Blues Boss to Oversee VEBA
Excerpt: "A former top Blue Cross executive will head up the board that will soon manage billions of dollars in health benefits for retirees from Ford, GM and Chrysler, according to new court filings. . . . According to court files, Robert Naftaly will be the independent trust's chairman; his term is set to expire Jan. 1, 2012." (Detroit Free Press)


California Assembly Bill Would Mandate Paid Sick Days
Excerpt: "State lawmakers on Wednesday took the first step toward making California the only state in the nation to require employers to provide paid sick days to workers. Although paid sick days have long been a benefit enjoyed by higher-income workers, sponsors of the bill say 6 million California workers, or about 42 percent of the work force, must choose between going to work sick or missing a day's pay." (Ventura County Star)


FMLA Cheats a Big Concern, Employers Say
Excerpt: "Suspected employee abuse of leave taken under the Family and Medical Leave Act is the No. 1 FMLA-related concern for employers, according to a survey. Forty-two percent of the human resource professionals surveyed said the potential for or suspicion of abuse by employees causes 'extreme difficulty' in administering intermittent FMLA leave. Among other top concerns cited, 38% reported inadequate notification prior to an absence and 28% reported difficulties tracking intermittent leave." (Financial Week; free registration required)


[Opinion] HR Policy Association Backs Proposed FMLA Regulations Despite Limitations
Excerpt: "In comments prepared by our Employment Rights Committee chaired by Northwestern Mutual's Sue Lueger, we noted our support for: allowing FMLA leave to be factored into attendance bonus programs; allowing direct contact between the employer and the employee's health care provider in certain circumstances, where the employee has signed a HIPAA release; permitting employers to require employees to follow reasonable notice procedures before taking leave; clarifying the ability of employers and employees to settle claims without DOL or court approval; and allowing employers to require adherence to notice requirements when employees substitute paid leave." (HR Policy Association)


[Opinion] Consumer-Driven Health Care - If You Fix It, They Will Come
Excerpt: "Consumer-driven health plans have stalled out. Adoption has slowed, enrollment rates are low and flat, and the tools needed to drive behaviors have never materialized, most recent studies of the plans have found. The most common plan designs are a setup for failure. For example, when Towers Perrin wanted to quantify potential cost savings from consumer-driven plans in a recent study, it found that the universe of well-designed plans was too small to do a credible survey." (Workforce Management; free registration required)


[Opinion] Kaiser Public Opinion Spotlight: Health Care and Elections
Excerpt: "With the presidential election coming up in November 2008, an examination of recent public opinion data as well as historical trends can give some insight into the potential role health care might play as an election issue. When it comes to the relative importance of different issues in deciding their vote, health care was one of the top five issues chosen by voters in three out of four presidential elections since 1992, while its ranking varied in congressional elections from 1994 through 2006." (Kaiser Family Foundation)


[Opinion] John McCain on Health Reform
Excerpt: "Many of Sen. McCain's proposals coincide with the interests of business groups -- although not all, particularly his proposal to remove self-insured plans from ERISA exemption. His proposals offer a clear contrast with his Democratic opponents." (Dallas Salisbury via Human Resource Executive Online)


[Opinion] Current Trends in Employee Health Management
Excerpt: "The biggest trend relates to the scope of 'employee health', including the number of employees, types of health challenges, and measures of impact that are being addressed. From original modest 'worksite wellness' efforts by employers, and disease management efforts by insurers, the scope is moving to 'total population health management', with virtually all employees targeted for some kind of health maintenance, risk condition or behavior correction, or disease management, together with productivity and performance impairment factor reduction." (World Health Care Blog)



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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

Obama Wants Shareholders to Have Say in Executive Pay
Excerpt: "Democratic presidential candidate Barack Obama is prodding his populist economic message Friday by demanding that company shareholders have a say in how much executives get paid. Obama, in prepared remarks he planned to make to reporters Friday, says he wants Congress to pass legislation he has sponsored that would require corporations to have a nonbinding vote by shareholders on the compensation packages. Under Obama's legislation, shareholders could not veto a compensation package . . . ." (Associated Press WorldStream via NewsEdge Corporation via Human Resource Executive Online)


[Guidance Overview] The AMT and Stock Options: Taxpayers Continue to Lose in the Appellate Courts
Excerpt: "This 'substantially nonvested' exception to current taxation has been the subject of a substantial amount of litigation fueled by taxpayers' attempts to postpone the date of taxation so that subsequent stock losses can be recognized. One of the arguments posited by taxpayers in recent cases is that stock acquired through the exercise of stock options is 'substantially nonvested' if the company's insider trading policy prevents employees from trading the company's stock during certain blackout periods." (BNA Tax Management Inc.)


We've Had ERISA for Nearly 34 Years and DOL Has Had Mort Klevan; Interpreter of ERISA's Sometimes Ambiguous Provisions
Excerpt: "In October 1974, a month after ERISA was signed into law, he joined the DOL's Office of the Solicitor, charged with enforcing the law's fiduciary provisions. In the law's first five years, he and a handful of others wrote key regulations implementing the fledgling law. He also created the country's first course on ERISA's fiduciary rules at Georgetown University's law school, and helped educate generations of pension attorneys." (Workforce Management; free registration required)




Newly Posted Events
(Post Yours!)

"Social Security: How it Works and How to Fix it"
in Illinois on April 24, 2008
presented by The Center for Tax Law and Employee Benefits at The John Marshall Law School in Chicago

6th Annual Employee Benefits Symposium
in Illinois on April 25, 2008
presented by The Center for Tax Law and Employee Benefits at The John Marshall Law School in Chicago

Are You Ready For EGTRRA Restatements?
Nationwide on April 23, 2008
presented by ftwilliam.com

Cafeteria Plans for Rookies: Understanding the Rules and Learning to Play the Game Right
Nationwide on April 3, 2008
presented by Employee Benefits Institute of America (EBIA)/Thomson Tax & Accounting

Integrated Benefits Institute and National Business Coalition on Health's 2009 Health & Productivity Forum
in California on February 9, 2009
presented by National Business Coalition on Health

Integrated Benefits Institute and National Business Coalition on Health's 2009 Health & Productivity Forum
in California on February 9, 2009
presented by Integrated Benefits Institute

Providing Legal and Other Advice to Compensation Committees of Public Companies: Ethical and Professionalism Issues
in Illinois on April 22, 2008
presented by The Center for Tax Law and Employee Benefits at The John Marshall Law School in Chicago

The John Marshall Law School Inaugural Institute on the Ethics of Tax Law Practice
in Illinois on April 29, 2008
presented by The Center for Tax Law and Employee Benefits at The John Marshall Law School in Chicago



Newly Posted Press Releases
(Post Yours!)

RetirementWORKS,Inc. Announces New Website Offering Financial Planning for Retirees
Still River Retirement Planning Software, Inc.

The Wall Street Journal / Hay Group CEO Compensation Study Reveals New Patterns in CEO Pay
Hay Group

EBA&M Selects Benefit Informatics for Strategic Data Analysis and Reporting
Benefit Informatics



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401(k) Senior Plan Administrator
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Vice President, Retirement Plan Services Sales, Emerging Markets
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Retirement Plan Compliance Analyst
for Paychex, Inc.
in NY

Pension Compliance Specialist
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in WI

Benefits Project Specialist
for Prudential Financial
in NJ

Conversion/Installation Specialist
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in PA

Senior Consultant / Client Services Manager
for Boyce & Associates, Inc.
in AZ

Transition Manager - Retirement Services
for MassMutual Financial Group
in MA




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