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| April 21, 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] HMO Loses Third Party Beneficiary Contract Dispute With Health Care Providers
Excerpt: "In this health care provider versus HMO dispute, the providers chalked up a win. Having successfully moved for remand following the HMO's attempt to convert the payment controversy into an ERISA action, the HMO asserted ERISA preemption as an affirmative defense. The trial court, and subsequently, the appellate court, found this defense unavailing." (Health Plan Law blog by Attorney Roy F. Harmon III)
Bank of America Consolidates a Dozen Bennies Vendors, Hoping to Stabilize Costs
Excerpt: "Bank of America's overhaul of its employee benefits program may in many ways be the first of its kind among corporations with jumbo-sized work forces. But benefits experts say the banking behemoth is unlikely to be the last large employer to consolidate almost all of its health-care and related vendors onto a single platform, because scores of companies are battling to stabilize -- and streamline -- their health-care operations and expenses." (Financial Week; free registration required)
Physician Organization in Relation to Quality and Efficiency of Care: A Synthesis of Recent Literature
Excerpt: "This report summarizes and presents a framework for understanding recent research literature linking delivery system organizational attributes with health care efficiency and quality. The focus is on physician groups, as physicians represent the core of any organized delivery system. The report also highlights areas for further research and refinement of the framework and discusses whether and how policymakers can promote specific physician group attributes as a means of improving value." (The Commonwealth Fund)
Work-Site Support Groups for Health Conditions
Excerpt: "Some employers have formed work-site support groups for employees struggling with certain health conditions and lifestyle issues as a way to bolster their wellness programs and their bottom lines. While support groups have yet to become widely accepted by employers, experts say such support systems have the potential to be the next big thing in wellness and disease management initiatives." (Workforce Management; free registration required)
Corporate Wellness Initiatives May Run Afoul of the Law and Offer More Potential Liability Than Benefits, Experts Warn
Excerpt: "In an April 2 article in the Philadelphia-based Legal Intelligencer, Todd Alan Ewan and Carolyn M. Plump, both partners in the labor and employment law practice group of the Philadelphia-based law firm Mitts Milavec, argue that wellness programs could violate the Health Insurance Portability and Accountability Act, the Employee Retirement Income Security Act, the Americans with Disabilities Act, Title VII of the Civil Rights Act of 1964 and even a few others." (Human Resource Executive Online)
CBO Chief Is Health Care Referee
Excerpt: "The CBO director, who started his four-year term in January 2007, is going beyond the traditional budget-Cassandra role, and analyzing causes and solutions. He has emphasized that the biggest driver of rising medical costs is the increasing use of new technology, not simply an aging population." (The Wall Street Journal)
How Private Health Coverage Works: A Primer -- 2008 Update
Excerpt: "This primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee organizations that operate under the federal Employee Retirement Income Security Act (ERISA). The primer discusses the fundamental aims of private health coverage and sorts out the complicated web of state and federal regulations that govern it." (Kaiser Family Foundation)
Before Medicare - Health Insurance Sticker Shock and Rejection
Excerpt: "IF you want to retire before you are 65 and eligible for Medicare, health insurance is vital to your plans. Without it, you risk losing everything. . . . Those without [company-provided] retiree health benefits who are eligible can use a patchwork of federal and state laws to build an insurance bridge -- although an expensive one -- to Medicare." (The New York Times; free registration required)
Tiered Health Care Catches On
Excerpt: "Health insurance companies are shifting the cost of expensive prescription drugs on to patients, part of a larger trend toward 'tiered' private health insurance coverage. Although employers support these measures, vulnerable patients are being exposed to great financial risks." (Oxford Analytica via Forbes.com)
A Closer Look at Candidates' Health Plans
Excerpt: "[Sens. Hillary Rodham Clinton and Barack Obama] would make more affordable health insurance available to the uninsured, require many businesses to offer coverage or contribute to its cost, and ensure that people could obtain coverage even if they have pre-existing health problems -- all significant changes to the current system. The key distinction between the two is that the Clinton plan would mandate coverage for all Americans. Mr. Obama would require coverage only for children, though he might consider a mandate for adults." (Pittsburgh Post-Gazette)
New Democrat Coalition, New York City Officials Announce Proposal for Federal Health Care IT Program
Excerpt: "Members of the New Democrat Coalition on Tuesday announced a proposal that would use a New York City health care information technology program as a legislative template for a federal program, CQ HealthBeat reports." (Kaiser Family Foundation)
Benefit Managers Profit by Specialty Drug Rights
Excerpt: "[Express Scripts is] a company whose core business is supposed to be helping employers manage their drug insurance programs and get medicines at the best available prices. But in recent years, drug benefit managers like Express Scripts have built lucrative side businesses seemingly at odds with that best-price mission. A growing portion of their revenue comes from acting as exclusive or semi-exclusive distributors of expensive specialty drugs that can cost thousands of dollars. And the prices of such medicines are rising much faster than for the mainstream prescription drugs available through a wide variety of distributors." (The New York Times; free registration required)
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Links to Items on Executive Comp, Benefits in General
[Guidance Overview] The Final Deadline for 409A Compliance Is December 31, 2008
Excerpt: "The good news is that we now know a lot more about the details of 409A. Therefore, final compliance will be a bit easier as we are able to follow an established pattern and start from model language we have developed. And we have added one new step to the checklist, thanks to the IRS' creation of a self-correction program for 409A errors." (Winston & Strawn LLP)
[Guidance Overview] Flurry of Cases Could Make Employers Decide to Select 'Top Hat' Plans for Further Review (PDF)
Pages 1-4 of 8 pages. Excerpt: "In light of the fact that employers may be required to establish affirmatively that their unfunded deferred compensation arrangements satisfy ERISA's requirements for the top hat exemption, employers may wish to review this recent spate of cases to determine if they continue to have adequate comfort that their plans intended to be limited to a 'select group of management or highly compensated employees' are in fact so limited." (White & Case LLP)
Excerpt from 'The Big Squeeze: Tough Times for the American Worker'
Excerpt: "One of the least examined but most important trends taking place in the United States today is the broad decline in the status and treatment of American workers -- white-collar and blue-collar workers, middle-class and low-end workers -- that began nearly three decades ago, gradually gathered momentum, and hit with full force soon after the turn of this century. A profound shift has left a broad swath of the American workforce on a lower plane than in decades past, with health coverage, pension benefits, job security, workloads, stress levels, and often wages growing worse for millions of workers." (The New York Times; free registration required)
Newly Posted Press Releases
Updated Primer on How Private Health Coverage Works
Kaiser Family Foundation
Principal Updates Fiduciary Plan Sponsor Fiduciary Handbook
Principal Financial Group
Mercer Launches a New Online Retirement Savings Educational Program -- "Count on Your Retirement"
Mercer
Callan Associates and Natixis Global Associates Create UMA Program
Callan Associates and Natixis Global Associates
Newly Posted or Renewed Job Openings
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Pension Administrator
for The Nolan Company
in KS
TPA Sales Channel Manager - Retirement Services
for MassMutual Financial Group
in CA
Relationship Manager II
for AST Capital Trust Company
in AZ
Retirement Plan Specialist (Plan Administrator)
for First National Bank of Omaha
in NE
Trust Administrator II or III
for Associated Pension Consultants
in CA
CRTFL - Senior Operations Manager
for Citi
in FL
Handy Links:
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- Using the Web for Employee Benefits Research (hypertext article)
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