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May 29, 2008

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


Today's sponsor is Employee Benefits Institute of America (EBIA)

(Click on company name or banner to learn more.)
Banner ad for Employee Benefits Institute of America (EBIA)

EBIA Adds a One-Two Punch to Your Employee Benefits Library!

Our Cafeteria Plans manual is the nation’s #1 resource for cafeteria plan sponsors and administrators. The Cafeteria Plans manual provides detailed coverage of all legal requirements for cafeteria plans, health FSAs, and DCAPs. Our Consumer-Driven Health Care manual is the country's best HSA and HRA Guidebook. With both manuals, subscribers get EBIA's top-notch analysis, copies of critical source documents, examples, administration tips, and sample documents. For more information, visit our manuals page.

[Guidance Overview] IRS Releases 2009 Health Savings Account Limits
Excerpt: "On May 13, 2008, the Internal Revenue Service (IRS) released Revenue Procedure 2008-29, establishing the 2009 annual Health Savings Account (HSA) contribution limitations and High Deductible Health Care (HDHC) plan limitations (adjusted for inflation) for qualified Health Savings Accounts (HSA). The limitations are effective for calendar year 2009." (Littler Mendelson P.C.)


[Guidance Overview] Futility Doctrine Applied in Aid of Class Action Claims Against HMO Defendants
Excerpt: "In this recent decision, the plaintiffs alleged that the defendant HMO's routinely overcharged for services. The defendants met these claims with a motion to dismiss for lack of subject matter jurisdiction and failure to exhaust administrative remedies. The plaintiffs prevailed on most issues in an decision that sheds light on Article III standing requirements and application of the futility doctrine." (Health Plan Law blog by Attorney Roy F. Harmon III)


[Guidance Overview] Case Summers v. Touchpoint Health Plan, Inc. Decision
Excerpt: "Where a termination of benefits under an ERISA-governed plan was arbitrary and capricious, benefits must be reinstated." (Wisconsin Law Journal)


[Guidance Overview] Court Suspends Deadline for Filing Lawsuit While Participant Exhausted Plan's Administrative Appeals
Excerpt: "As this case illustrates, whether or not the deadline for filing a claim is 'tolled' while a participant pursues a plan's administrative appeals procedures can make the difference between a claim going forward or being thrown out as untimely. Plans should anticipate the prolonged period during which a court claim could be filed as a result of tolling during an appeal -- keeping in mind, as this court pointed out, that some courts have refused to apply tolling principles to claims arising under ERISA." (Employee Benefits Institute of America)


More Churches Start Paying for Health-Care Services, Leaving States to Confront the Question: Are These Groups Insurers?
Excerpt: "Faith-based groups have long been active in health-care delivery, most visibly through religion-based hospitals and running community clinics. In recent years, religious groups have expanded their forays into the health-care arena, and some are now looking for ways to set up formal, quasi-insurance organizations, funded by parish members, to help other parishioners pay their medical bills. 'I absolutely think it's the wave of the future,' said Representative Joe Armstrong of Tennessee. This is especially the case as more congregations combine into large mega-churches that serve thousands of parishioners. 'As they grow larger they will be looking to provide some level of care to fill a gap for people who aren't insured,' said Rep. Armstrong." (National Conference of State Legislatures)


The Urban Institute's Microsimulation Model for Reinsurance: Model Construction and State-Specific Application (PDF)
12 pages. Excerpt: "This report describes the Urban Institute's microsimulation model of reinsurance, which was built to simulate the impacts of various state-specific ways of using state-funded reinsurance to subsidize primary insurance premiums." (State Coverage Initiatives)


Reinsurance in State Health Reform (PDF)
18 pages. Excerpt: "An overall conclusion is that reinsurance is not cost-effective if intended solely to increase coverage, unless it follows Healthy NY and targets the subsidy only to the previously uninsured. However, participating states' modeling requests clearly reflected other goals, which included solidifying existing coverage and addressing risk segmentation. Greater clarity about the importance of other goals is needed in order to more rigorously assess benefits and costs of reinsurance." (State Coverage Initiatives)


ERISA Equitable Relief Case Recommended to Supreme Court
Excerpt: "U.S. Solicitor General Paul D. Clement is recommending the Supreme Court hear a case involving a test of Employee Retirement Income Security Act (ERISA) Section 502(a)(3), which allows beneficiaries to sue 'to enjoin any act or practice which violates' ERISA or 'to obtain other appropriate equitable relief to redress such violations.'" (PLANSPONSOR.com; free registration required)


Hospitals Hire 'Nocturnists' To Improve Patient Care During Night, Weekend Hours, Wall Street Journal Reports
Excerpt: "The Wall Street Journal on Wednesday examined how some hospitals have begun 'taking steps to improve safety and reduce their own legal liability from mishaps' that occur during 'thinly staffed' night and weekend shifts, when patients 'suffer higher rates of death, complications and medical errors.'" (Kaiser Family Foundation)


Insurer, Physicians Fight Over ERISA Limits
Excerpt: "For nearly three decades, courts have debated how the Employee Retirement Income Security Act, or ERISA, the federal law governing a variety of employee retirement and health benefits, intersects with state laws regulating other health plans. Related to physicians and hospitals, the courts have often found they are still free to sue the insurer administering the benefit -- United in this case -- as a breach of their contract with the hospital or doctor, said Stan Schroeder, an attorney with the Lowenbaum Partnership who specializes in these issues." (St. Louis Post-Dispatch)



Sponsored by: University Conference Services

(Click on company name or banner to learn more.)
Banner ad for University Conference Services

Trimming the Benefits Tab Without Cutting the Value

If you’re like most employers, you struggle with how to contain the cost of your health care programs without diminishing their value to employees. There are many remedies to consider, but you do you know what’s best for your organization? Health and Welfare Plan Management for Mid-Sized Employers, September 7–10, at Caesars Palace in Las Vegas, is the perfect place to find out if you have the right "dosage" for your benefit plans.

(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

New York to Back Same-Sex Unions from Elsewhere
Excerpt: "Gov. David A. Paterson has directed all state agencies to begin to revise their policies and regulations to recognize same-sex marriages performed in other jurisdictions, like Massachusetts, California and Can.ada." (The New York Times; free registration required)


Program Providing Reimbursement of Phone Services for Retirees is an ERISA Plan
Excerpt: "The U.S. District Court for the Western District of Texas has determined that a telephone company's program that provides reimbursement for phone services to retirees constitutes a pension plan governed by the Employee Retirement Income Security Act (ERISA)." (PLANSPONSOR.com; free registration required)




Newly Posted Events
(Post Yours!)

10th Annual Conference of the Retirement Research Consortium (RRC)
in District of Columbia on August 7, 2008
presented by Center for Retirement Research at Boston College

ERISA Health and Welfare Compliance for Rookies: Understanding Basic Documentation, SPD, Form 5500, and Other Rules
Nationwide on May 1, 2008
presented by Employee Benefits Institute of America (EBIA)/Thomson Tax & Accounting

Fundamentals of 401(k) and Other Qualified Plans
in Washington on June 25, 2008
presented by SunGard Relius



Newly Posted Press Releases
(Post Yours!)

Andrew D. Sherman Elected President of New England Employee Benefits Council
New England Employee Benefits Council

IRS Announces Public Meeting of ACT, Names New Members
Internal Revenue Service (IRS)

Council Testifies Before IRS: Asset Smoothing Critical for Defined Benefit Plan Sponsors
American Benefits Council

New York Life Retirement Plan Services Introduces New 401(k) Institutional Product For $5-30 Million Plans
New York Life Investment Management

National Retirement Partners Announces Partnership with SalesForce.com
National Retirement Partners, Inc.



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