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| April 25, 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] Proposed Rule Clarifies Prohibition on Employer Incentives for TRICARE Beneficiaries
Excerpt: "As expected, the Department of Defense (DoD) has issued proposed regulations regarding the coordination of employer-provided group health care and TRICARE. . . . In general, the proposed rule seeks to clarify an earlier TRICARE amendment that prohibits an employer from offering financial or other benefits to TRICARE beneficiaries as incentives not to enroll or to terminate enrollment in a group health plan that would be primary to TRICARE." (Littler Mendelson P.C.)
[Guidance Overview] Hewitt Federal Legislation Quick Guide Updated April 23, 2008, for Health and Welfare Plans (PDF)
14 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] DOL's Proposed FMLA Regulations
Excerpt: "On February 12, the Department of Labor (DOL) proposed the first new regulations under the Family and Medical Leave Act of 1993 (FMLA) since 1995. In this article, we'll discuss many of the key FMLA issues, trying to focus somewhat equally on what the proposed regulations tell us, what's different in the proposed regulations, and what guidance is still needed." (JPMorgan Chase & Co.)
Ultimatum to City of Duluth Retirees: Sign up for Medicare or Lose Coverage
Excerpt: "Thirty-seven city of Duluth retirees are getting letters in the mail saying they need to sign up for Medicare or lose their retiree health-care benefits. All city retirees who are eligible must sign up for Medicare. Mayor Don Ness said the 37 who have not done so were discovered during a review of the retiree health-care program last year. Once the retirees sign up, he said, the city stands to save $400,000 to $600,000 a year." (Duluth News-Tribune via NewsEdge via Human Resource Executive Online)
Postscript to Metlife v. Glenn
Excerpt: "In my opinion, the notion of internal firewalls and protections hinted at by Justice Kennedy shows a failure to understand the practical realities of insurance company claims administration. Moreover, Justice Roberts conflates insurance company administration and employer self-funded claims administration in his comments. I doubt anything definitive will come of this case and that we will have at least one footnote (probably by Justice Roberts) that will spawn endless speculation." (Health Plan Law blog by Attorney Roy F. Harmon III)
Microsoft Explains HealthVault Strategy
Excerpt: "With comparisons to both Microsoft's Xbox platform and the PayPal online payment platform, Microsoft aims to correct common misperceptions about its HealthVault platform. . . . HealthVault . . . aggregates personal health information, but allows consumers to control access to the information along with the sharing of their own health information. HealthVault also enables consumers to collaborate with caregivers and connect to new sources of health information." (eWeek)
Senate Passes Genetic Discrimination Bill
Excerpt: "People learning through genetic testing that they might be susceptible to devastating diseases wouldn't also have to worry about losing their jobs or their health insurance under anti-discrimination legislation the Senate passed Thursday." (AP via The New York Times; free registration required)
Senate Passes Ban on Genetic Discrimination
Excerpt: "The bill prohibits employers from firing, refusing to hire or otherwise discriminating against workers with respect to compensation and other terms of employment based on genetic information. Employers are banned from requesting, requiring or buying genetic information." (Workforce Management; free registration required)
Text of Genetic Information Nondiscrimination Act (S. 358), as Reported by Senate HELP Committee (PDF)
Excerpt: "To prohibit discrimination on the basis of genetic information with respect to health insurance and employment." (U.S. Senate via American Benefits Council)
Descriptions of Health Care Systems: Denmark, France, Germany, The Netherlands, Sweden, and the United Kingdom (PDF)
18 pages. Excerpt: "The work of the Commonwealth Fund's international program highlights the valuable lessons the U.S. can learn from the health care systems in other industrialized countries. These country profiles provide overviews of the health care systems of several countries, including Denmark, France, Germany, the Netherlands, Sweden, and the U.K. Each profile includes descriptions of how each country organizes, finances, and delivers health services and highlights quality, efficiency, and cost-controlling policy initiatives and reforms" (The Commonwealth Fund)
Summary of the Colorado Managed Care Review 2007
Excerpt: "This is the 14th edition of Allan Baumgarten's annual analysis of trends and issues in the Colorado health care market. Baumgarten, an independent analyst and researcher on health finance in local markets has published his Colorado market study since 1994 He also publishes annual market reports in California, Florida, Illinois, Kentucky, Michigan, Minnesota, Ohio, Texas and Wisconsin. A new Arizona study will be published in 2008." (Allan Baumgarten)
Gift Card Allows Consumers to Give Health Care Dollars to Loved Ones
Excerpt: "what if that something people had their eye on wasn't a new pair of shoes or a copy of 'Guitar Hero,' but rather a colonoscopy or a refill of their cholesterol medication? That's exactly what Highmark, a Blue Cross Blue Shield subsidiary, thought of when they launched their new health care gift card program last year." (Employee Benefit News; free registration required)
Evidence-Based Dentistry Hopes to Redefine Dental Benefits
Excerpt: "Other dental benefit analysts said the use of evidence-based practices in dentistry will enhance benefit coverage. They cited research linking periodontal diseases to other health conditions, such as heart diseases, diabetes and low birth weight." (Employee Benefit News; free registration required)
Who Pays for Medical Errors? An Analysis of Adverse Event Costs, the Medical Liability System, and Incentives for Patient Safety Improvement
Excerpt: "Patient safety advocates have long sought to make a 'business case' to demonstrate that if health care organizations invest in safer practices and systems, they will reap financial returns in the form of reduced malpractice costs and other expenses. In [this study first published in the Journal of Empirical Legal Studies, Dec. 2007, the authors] tested this case by gauging the extent to which hospitals actually absorb the costs of medical errors." (The Commonwealth Fund)
New Thinking In Employee Health Care
Excerpt: "Corporate America's long effort to shift more of the cost of employee health care onto employees themselves may be reaching its useful limits. Most employers have already boosted the percentage of health insurance premiums paid by their employees, and have adopted health plans that feature bigger deductibles and larger co-pays for plan participants. Now, . . . 'The very largest employers recognize that cost-shifting has run its course." (The Wall Street Journal)
Taking Stock of Wellness Programs (PDF)
7 pages. Excerpt: "Wellness programs offer potential for improved outcomes and reduced costs. But do these programs actually work? Questions remain: What role does evidence have in a wellness program? How should employers target wellness candidates in their organization? And how do those investing in wellness measure success and failure?" (Benefits Quarterly via Milliman)
Newark Star-Ledger Examines Effect of Wal-Mart Generic Drug Discount Program on Pharma.ceutical Industry
Excerpt: "The Newark Star-Ledger on Tuesday examined how analysts say the 'overall impact' of Wal-Mart Stores' generic prescription drug program on the pharma.ceutical industry 'has been relatively small' . . . ." (Kaiser Family Foundation)
'The American Prospect' Special Report Focuses on U.S. Health Care System
Excerpt: "The May 2008 issue of The American Prospect features a special report on health care issues in the U.S. [Issues covered include state reform efforts; medical debt; and Medicare.]" (Kaiser Family Foundation)
[Opinion] What the Massachusetts Experiment Teaches Us About Incremental Efforts to Increase Coverage by Expanding Private Insurance
Excerpt: "[T]he proposals for reform taken most seriously by Democrats -- including Barack Obama and Hillary Clinton -- would retain the central role of the investor-owned private insurance industry as well as the thousands of for-profit businesses it pays to deliver medical services. This is the industry, mind you, that has brought us to the predicament we're in now, so let's take a quick look at it." (The American Prospect)
[Opinion] New Labor Dep't Proposed Rules for FMLA
Excerpt: "The comment period ended on Friday, April 11, 2008, and over 4000 comments had been filed. Debate on the changes is very hot at the moment. Workers worried about the economy and their job security do not want to see these changes implemented and are pushing Congress for some sort of paid leave." (Workplace Prof Blog)
[Opinion] State Health Reform: Six Key Tests
Excerpt: "Every state regulates its own insurance industry and thus has its own unique health care infrastructure. Although one 'standard' health reform proposal cannot meet every state's needs, state-based reform proposals can and should be evaluated on the basis of whether they would move a state's health care system toward patient-centered health care, which would maximize value to the patient." (The Heritage Foundation)
[Opinion] Federal Gov't Should 'Pay Its Bills' Instead of Shifting Health Care, Other Costs to States, Arizona Gov. Writes
Excerpt: "States are 'in a precarious position' this year because the 'economy is slowing down,' revenues from taxes are declining and 'demand for expensive services -- health care, food assistance and the like -- is growing,' Arizona Gov. Janet Napolitano (D) writes in a Wall Street Journal opinion piece. Napolitano adds that states' 'fiscal crunch is being made worse' by 'misguided policies put in place by Congress and the Bush administration.'" (Kaiser Family Foundation)
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Links to Items on Executive Comp, Benefits in General
[Guidance Overview] Hewitt Federal Legislation Quick Guide Updated April 23, 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)
Text of Corporate Executive Compensation Accountability and Transparency Act, S. 2866 (PDF)
24 pages. Excerpt: "To require greater disclosure of senior corporate officer compensation, to empower shareholders and investors to protect themselves from fraud, to limit conflicts of interest in determining senior corporate officer compensation, to ensure integrity in Federal contracting, to close corporate tax loopholes utilized to subsidize senior corporate officer compensation, and for other purposes." (American Benefits Council)
SSA's Annual Statistical Supplement, 2007
Printed copies of this document are scheduled for release in mid-May 2008. (U.S. Social Security Administration)
When Does an Employer Have an ERISA Plan?
Excerpt: "Many employers might assume that an ERISA plan is not created until they actually set up a plan, write a plan document and take formalized steps to create a plan. However, this is not necessarily the case. Employers need to be cautious when establishing an employee benefits program as they can inadvertently create an ERISA plan or find themselves in a situation where a common 'ongoing administrative scheme' can be construed to be an ERISA-governed benefits plan." (Aiken & Aiken)
Newly Posted Events
Ask the Experts: A Public Plan Option Under Health Reform - Webcast
Nationwide on May 1, 2008
presented by Kaiser Family Foundation
Fixing the Most Common 401(k) Blunders: The Dirty Dozen
Nationwide on May 15, 2008
presented by SunGard Relius
Newly Posted Press Releases
American Academy of Actuaries Appoints Grace Hinchman as New Executive Director
American Academy of Actuaries
A New WSJ.com/Harris Interactive Study Finds One Quarter of U.S. Adults Prematurely Withdraws Funds from Retirement Investment
Harris Interactive for the Wall Street Journal
Newly Posted or Renewed Job Openings
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Flexible Benefits (Cafeteria) Plan Administrator
for Pension Planning Consultants, Inc.
in NM
Pension Plans Analyst
for Illinois Tool Works Inc. (ITW)
in IL
Pension Consultant/Administrator
for Third Party Administrators, Inc.
in NH
Institutional Services Employee Benefit Operations Administration Analyst II
for BB&T
in NC
Actuary - ASA
for MassMutual Financial Group
in CT
Enrolled Actuary
for Laiken Associates, Inc.
in NY
Retirement Plan Senior Relationship Representative
for Nollenberger Capital Partners
in CA
Senior Retirement Plan Administrator
for First Midwest Financial Services
in IL
Retirement Services Education & Enrollment Specialist
for Prudential Financial
in CT
Manager, Health and Welfare Operations
for Kindred Healthcare
in KY
Benefits Specialist
for St. Joseph's Healthcare System
in NJ
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