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May 6, 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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Smart is not a permanent state of being. What's your maintenance plan? Take advantage of the education and information available through the International Foundation of Employee Benefit Plans, a nonprofit educational association, and find out why over 35,000 industry professionals like Cindy Conway rely on the Foundation to stay informed and educated. Make sure you have the most comprehensive information on health, pension and compensation issues. Be smart by association.

[Guidance Overview] Municipal Regulation of Group Health Plans now Reality for Employers with 20 or More Employees in San Francisco (PDF)
8 pages. Excerpt: "This overview of the ERISA preemption controversy concerning the ['San Francisco Health Care Security Ordinance'], as well as the compliance guide, is intended for the use of employers that have covered employees in San Francisco. Until a federal court rules otherwise, San Francisco 'covered employers' must take steps to comply with the Healthy San Francisco Ordinance." (Jones Day)

[Guidance Overview] Insurer Operating Under an ASO Agreement May Sue Employer for Reimbursement of Fronted Health Plan Benefits
Excerpt: "EBIA Comment: Although the insurer ultimately won the day, it did so only after spending time and money pressing its case against the employer in court. This case illustrates, among other things, the perils that can be encountered by ERISA plan service providers that pay plan benefits from their own accounts. Such arrangements are not uncommon, but they can raise prohibited transaction, plan asset, exclusive benefit, and other issues under ERISA." (Employee Benefits Institute of America)

[Guidance Overview] New Jersey's New Paid Family Leave Law (PDF)
3 pages. Excerpt: "New Jersey Governor Jon Corzine has just signed a new law that provides New Jersey employees with up to six weeks of paid leave to care for seriously ill family members, newborns or newly adopted children. The new family leave benefits will be funded through an increase in employee payroll taxes." (Buck Consultants)

E.R.'s Are Busy, but Fewer Patients Are Uninsured
Excerpt: "The 26 percent increase in the number of visits in the period was largely caused by an increase in the number of people with private doctors who sought emergency room care. The authors suggest several reasons, among them an aging population, a growing number of time-sensitive medical treatments that can be performed only in an E.R., complications from medical and surgical treatments and the difficulty of obtaining a timely appointment with a private physician." (The New York Times; free registration required)

Trends in State Mandated Benefits, 2008 (PDF)
2 pages. Excerpt: "Since CAHI closely monitors mandate legislation, we see mandate 'trends' developing long before many others. The purpose of this short report is to periodically identify some of those trends: which state mandates are growing in popularity among state legislators and in which states." (The Council for Affordable Health Insurance)

Health Insurance Mandates in the States 2008 (PDF)
8 pages. The report provides a state-by-state breakdown of health insurance mandates and their costs. (The Council for Affordable Health Insurance)

Kaiser Completes National Installation of Outpatient Electronic Health Record System
Excerpt: "Kaiser Permanente said Monday that all of its 8.7 million enrollees in nine states and the District of Columbia have access to HealthConnect, an outpatient electronic health record Kaiser says is the world's largest privately funded EHR." (San Francisco Business Times via; free registration required)

Benefit Broker Compensation and Questions of Objectivity
Excerpt: "The attorney and president of Morristown, N.J.-based Pharmacy Benefit Consultants made it her mission to clarify the complicated fee and service structure of PBMs and pharmacy benefit brokers. She has done this through litigation and by example with her consulting firm, where her clients - employers - pay her directly." (Employee Benefit Adviser; free registration required)

Consumer-Driven Health Portal Provides Employees Entry Point Into Individual Market
Excerpt: ", launched in December by Canopy Financial, aims to fulfill many employers' wildest dreams: Getting out of the health insurance business. Goodbye, benefits brokers. Adios, open enrollment. So long, rising premiums. Under the program, employers pay a fixed monthly amount, usually $50 to $500, to each employee, who use the money to buy an individual high-deductible health plan with a health savings account." (Employee Benefit Adviser; free registration required)

Medical Tourism Numbers Are Still Low
Excerpt: "The number of people traveling the globe for medical treatment likely is far lower than commonly assumed, but there remains potential for huge growth in the industry, according to a study by consulting firm McKinsey & Co." (The Wall Street Journal)

Health Insurance Benefits Offer Rates for Smaller Establishments by Business Age
Excerpt: "Researchers looking at the reasons why employers offer coverage have identified a variety of factors. These include both employee characteristics, such as earnings, occupation, part-time versus full-time status, union status, gender, and age, and employer characteristics, such as geographic region, industry, and firm and establishment size. This issue brief looks at a less well-understood factor that may also affect an employer's decision to offer health benefits: how long a business has been operating. We show that, among smaller and mid-sized establishments, the likelihood of offering coverage is associated with the age of the business." (Kaiser Family Foundation)

Extended Health Coverage Laws Can Burden Employers
Excerpt: "Measures that have been passed in recent years extend insurance coverage in many cases to age 25 or 26. In New Jersey, coverage must be offered up to age 30, the oldest cutoff among states." (Workforce Management; free registration required)

House Bill Would Permit FMLA Leave for Victims of Violent Crimes
Excerpt: "Rep. Rahm Emanuel (Ill.), along with seven cosponsors, has introduced the Crime Victims Employment Leave Act (H.R. 5845), which would amend the Family and Medical Leave Act (FMLA) to permit FMLA leave for victims of violent crime and domestic violence and immediate family members of such victims to attend court proceedings relating to the crimes." (Wolters Kluwer)

How Risky Is Individual Health Insurance? (PDF)
Excerpt: "This paper describes the relationship between type of insurance coverage in one period and the likelihood of becoming uninsured in the next. We find that for people at the median health status, becoming uninsured is most likely for those with individual insurance, less likely for those with small-group insurance, and least likely for those with large-group insurance. However, for people in poor or fair health, the chances of losing coverage are much greater for people who had small-group insurance than for those who had individual insurance. We attribute these results to the offsetting effects of high loadings and guaranteed renewability in the individual market." (Health Affairs)

Congress Inadvertently Legalizes Sharing of Genetic Information Without Patient Consent
Excerpt: "'While authors of the recently passed Genetic Information Nondiscrimination Act of 2008 (H.R. 493) had good intentions, the bill inadvertently legalizes the sharing of genetic information without patient consent,' says Sue Blevins, president of the Institute for Health Freedom (IHF). 'It does so by applying HIPAA regulations to genetic data.'" (PRNewswire-USNewswire via NewsBlaze)

Health Plans, PBMs Consider New Ways to Boost the Health Literacy of Their Members
Excerpt: "[S]ome health plans and pharmacy benefit managers (PBMs) contacted by AIS are taking steps to address the health literacy issues of their members in an attempt to improve therapeutic outcomes and the bottom line." (

Wal-Mart Expands Discount Drug Plan
Excerpt: "Wal-Mart . . . said that it would expand the program under which it charges $4 for a month's supply of more than 350 generic prescription drugs by offering a 90-day supply for $10. The company also added several women's medications to its list of prescriptions available for $9, including drugs to treat breast cancer and hormone deficiency. And it said it would lower the price of more than 1,000 over-the-counter drugs." (The Tennessean)

Supreme Court Considers Conflict for Plan Administrators That are Also Payers
Excerpt: "The U.S. Supreme Court heard oral arguments on a case to determine how much the conflict of a dual role of a plan administrator that is also a payer of benefits should be considered when reviewing the administrator's denial of benefits." (; free registration required)

Survey Finds Many Women Underinsured for Income Protection
Excerpt: "A survey sponsored by The Hartford Group, an insurance provider, found that two-thirds of moms say it is 'extremely' or 'very important' for their spouse or partner to have disability insurance, compared with only half who say it is 'extremely' or 'very important' to have coverage themselves. A news release said the poll found less than half of mothers (47%) who work outside the home have short-term disability insurance and even fewer (37%) have long-term disability coverage." (; free registration required)

Newly Posted Events
(Post Yours!)

Default Investments in 401(k) Plans: Lessons Learned
Nationwide on June 2, 2008
presented by ABA Joint Committee on Employee Benefits

Getting It Right: Know Your Fiduciary Responsibilities -- Free Compliance Assistance Seminar
in Colorado on June 10, 2008
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Newly Posted Press Releases
(Post Yours!)

U.S. Labor Department Team Receives First Annual Citizen Service Award
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Secretary Paulson Names Leadership for President’s Advisory Council on Financial Literacy
U.S. Department of Treasury

NBCH’s Community Coalitions Health Institute Receives CDC Grant
National Business Coalition on Health

Gilreath to Lead ING Employee Benefits Business
ING Group

Integrated Benefits Institute Releases Research on True Cost of Absence for Employers
Integrated Benefits Institute

More Women Than Men Lack Confidence in Preparing for Retirement
Wachovia Corporation

Mercer Urges Changes to FASB Disclosure Proposal for Retirement Plan Assets

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DC Plan Administrator
for Campbell Albrecht
in CA

Legal / Compliance Specialist
for Beneco, Inc.
in AZ

ERISA Associate
for Archer, Byington, Glennon & Levine, LLP
in NY

Retirement Plan Administrator
for Fred S. Shapiro & Associates, Inc.
in MD

DC/DB Project Support Analyst
for New York Life Retirement Plan Services
in MA

Retirement Plan Analyst
for BeneTrends, Inc.
in PA

Benefits Specialist
for Saks Fifth Avenue
in NY

Attorney - Health & Benefits
for Mercer
in IA, IL, MI, MN, MO

Director of Benefits
for AAA Mid-Atlantic
in DE

Mutual Fund Analyst
for Kravitz, Davis, Sansone
in CA

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