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May 30, 2008

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


Today's sponsor is BeneCom Associates, LLC

(Click on company name or banner to learn more.)
Banner ad for BeneCom Associates, LLC

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[Guidance Overview] Refund Requests Prove Shortest Route to Group Health Plan Reimbursement
Excerpt: "This district court opinion illustrates a risk often overlooked by participants when engaging in disputes over their benefit plan's claims for reimbursement from other insurance coverages. In this case, the group health plan simply recouped the amount in dispute by obtaining refunds from the health care providers previously paid for the plaintiff's medical care." (Health Plan Law blog by Attorney Roy F. Harmon III)


[Guidance Overview] Wisconsin Supreme Court Finds Denial of Health Benefits Arbitrary and Capricious, Lacking Specificity
Excerpt: "Yesterday, the Wisconsin Supreme Court decided Summers v. Touchpoint Health Plan Inc., No. 2005AP2643 (May 28, 2008), affirming the Wisconsin Court of Appeals decision ordering the case remanded and the participant's benefits in the Kimberly Clark health plan reinstated as of the date that the benefits were terminated." (Pension Protection Act Blog)


Employer Group Launching Depression Treatment Plan
Excerpt: "Employer coalition Bridges to Excellence is launching a pay-for-performance program that will reward physicians for optimal treatment of depression. The Depression Management Care Link will be piloted in Minnesota among members of the Buyers Health Care Action Group, a statewide employer coalition. BHCAG was also an early adopter of BTE's diabetes and cardiovascular care programs." (Workforce Management; free registration required)


Cost Trends for Chronic-Condition Cohorts with Medicare Benefits (PDF)
36 pages. (Milliman)


An Assessment of Health Care Trends Based Upon PAC and Individual Donation Allocations
Excerpt: "'From Jan. 1, 2007 through March of this year, people and political action committees in the health sector have contributed $42 million and to Democratic candidates for congress and the presidency, compared with $34.6 million to Republicans . . . The biggest donors are the American Dental Association, the American Hospital Association and PACs and people associated with Pfizer.'" (Health Plan Law blog by Attorney Roy F. Harmon III)


Health Care and Behavioral Economics
CBO Director Peter Orszag's presentation to the National Academy of Social Insurance (U.S. Congressional Budget Office)


17 Wisconsin Insurers To Provide Members Out-of-Pocket Cost Estimates
Excerpt: "The Wisconsin Association of Health Plans on Tuesday announced that 17 member companies will begin offering policyholders estimates of out-of-pocket health care costs before undergoing a test or procedure, the Milwaukee Journal Sentinel reports." (Kaiser Family Foundation)


Report Ranks Aetna, Cigna Most Efficient, Accurate Among Health Insurers in Reimbursements to Physicians
Excerpt: "Aetna ranked first among 130 large health insurers in efficiency and accuracy in reimbursements to physicians, and Cigna ranked second, according to a report scheduled for release on Thursday by Athenahealth, the Wall Street Journal reports." (Kaiser Family Foundation)


[Opinion] What 'Shared Responsibility' Is About Is Maintaining Insurance Company Profits
Excerpt: "Under pressure from Wall Street for disappointing earnings during the first quarter of 2008, CEOs from the two largest health insurance plans, United Health Group and Wellpoint, told investors last week that they would 'continue to protect their (profit) margins' and 'not sacrifice profitability for membership' i.e., they aren't going to hold down premium increases to keep members on their rolls." (Dr. Susanne King via Physicians for a National Health Program)


[Opinion] AHIP's Proposal to Reduce Health Care Costs - Five Core Principles to Ensure Patients Receive High-Value Health Care
60 pages. Excerpt: "This paper presents the data on why health care costs are rising, where private sector strategies have succeeded in slowing rising costs, and what health insurance plans and all other members of the health care community need to do -- together -- to solve this problem." (America's Health Insurance Plans)


[Opinion] American Benefits Council Statement for the Record for Ways and Means Committee Hearing on HSAs (PDF)
10 pages. Regarding the May 14, 2008, Hearing entitled 'Health Savings Accounts and Consumer Driven Health Care: Cost Containment or Cost-Shift?' before the Subcommittee on Health of the U.S. House of Representatives Ways and Means Committee (American Benefits Council)



Sponsored by: ALM

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Banner ad for ALM

Complete Benefits Law Guidance from Law Journal Press

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

[Guidance Overview] California Same-Sex Marriage and Genetic Testing Laws Affect Health & Welfare Plans (PDF)
6 pages. Excerpt: "A recent California Supreme Court decision to recognize same-sex marriages and recent federal legislation banning discrimination based on genetic testing may warrant a 'checkup' for group health, life, and other welfare benefits." (Seyfarth Shaw LLP)


[Guidance Overview] Abstract of June 2008 Bulletin, 'Health Plan Implications of the California Court Ruling Allowing Same-Gender Marriage'
Excerpt: "Employers and other plan sponsors based in California or with California employees should carefully review their benefit offerings and plan documents to determine whether and how to accommodate participants' same-gender spouses, and then clearly communicate the decisions they make to participants." (The Segal Group, Inc.)


[Guidance Overview] Is Your ERISA Plan Up-to-Date?
Excerpt: "The Employee Retirement Income Security Act was enacted in 1974. Since then, more than 75 laws have been passed that affect employee benefit plans and the protections afforded them by ERISA. Many of these subsequent laws have mandated extensive changes to benefit plans. [This paper presents] a few of the provisions contained within the statute . . . ." (Aiken & Aiken)


Employees' Commuter Benefit Opportunities Grow
Excerpt: "Responding to workers' frustration with soaring prices at the gas pump, employers are beefing up commuter benefits as a way to offer some financial relief, reports the Society of Human Resource Management." (Employee Benefit Adviser; free registration required)


House Committee OKs Extenders Package with Pension, Deferred Compensation Provisions
Excerpt: "The House Ways and Means Committee, on May 15, 2008, approved the Energy and Tax Extenders Bill of 2008 (H.R. 6049), legislation that includes provisions affecting IRAs, qualified plan distributions, and nonqualified deferred compensation. The measure was scheduled to be considered by the full House on May 20, 2008." (Wolters Kluwer)


California Lawmakers Sign Off on Mandatory Paid Sick Leave
Excerpt: "On Wednesday, the California Assembly passed a bill that would require paid sick leave for all workers, poising California to be the first state to adopt such a requirement, the Sacramento Bee reports." (California HealthCare Foundation)


H.R. 6081: Heroes Earnings Assistance and Relief Tax Act of 2008
Excerpt: "On May 22, 2008, Congress passed the Heroes Earnings Assistance and Relief Tax Act of 2008 (Heroes Act or HEART Act) which will now go to the President for his signature. A lot of great links here on the Act. Benefits-related provisions are as follows (as taken directly from the Congressional Research Service Summary) . . . ." (Attorney B. Janell Grenier via Benefitsblog.com)


GM Says 19K U.S. Hourly Workers Taking Its Buyout Offers
Excerpt: "Under the program, retirement-eligible workers were offered financial incentives to retire with their full pension and benefits, while workers who were within four years of their 30th anniversary with the company were allowed to retire early and get reduced pay until their benefits kicked in. Workers could also take up to $140,000 to leave the company with no ties, including pension or health benefits." (AP via The New York Times; free registration required)


What Is Your Firm Doing About Rising Fuel Costs? Survey Results
Excerpt: "With the rising cost of fuel – and, for many, the cost of getting to work – [PLANSPONSOR] asked readers what, if anything, their firm had done to help folks deal with those rising costs." (PLANSPONSOR.com; free registration required)


Employees Want Employer Help with Benefit Decisions
Excerpt: "Employers and their human resource departments are now the number one source consulted for advice during open enrollment season (63%), according to MetLife's 2008 Open Enrollment Survey." (PLANSPONSOR.com; free registration required)


[Opinion] When to Take a Severance Package
Excerpt: "Companies offering severance packages are generally established companies who sold the concept of lifetime employment. They are not places that fire employees without warning. I've found that people leaving old-line companies, even with a severance package, were more bitter than those where companies treated employees like interchangeable parts." (Richmond Register)




Newly Posted Events
(Post Yours!)

Form 5500 for Health and Welfare Plans: A Guided Tour for Employers, Form 5500 Preparers, and Advisors
Nationwide on May 15, 2008
presented by Employee Benefits Institute of America (EBIA)/Thomson Tax & Accounting



Newly Posted Press Releases
(Post Yours!)

MassMutual Offers Free Research Paper on Target Retirement Date Investments as QDIAs
MassMutual



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Employee Benefits Attorney
for Hershner Hunter, LLP
in OR

Employee Benefits / ERISA Attorney
for Hill Ward Henderson
in FL

401(k) Daily Administrator – Contribution Processing
for Pension and Investment Firm
in TX

Actuary
for Nova Actuarial Associates
in TX

Senior Benefits Administration and Technology Consultant
for The Segal Company
in CA, DC

Retirement Plan Specialist
for Diversified Investment Advisors
in TX




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