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June 5, 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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Be Smart by Association with the International Foundation

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. www.ifebp.org/memberkit

[Guidance Overview] Towers Perrin U.S. Legislative Tracking Charts -- Health and Welfare -- Updated June 4, 2008 (PDF)
23 pages. Excerpt: "These charts summarize selected federal legislation that would affect employee benefit programs. The bills included on the charts are based on judgments regarding the prominence of the issue, the likelihood of enactment, and the influence of the sponsors." (Towers Perrin)


[Guidance Overview] California Court of Appeal Interprets 'Kin Care' Provisions for the First Time
Excerpt: "In McCarther v. Pacific Telesis Group, No. A115223 (May 23, 2008), a case of first impression, a California Court of Appeal held that California's kin care statute – Labor Code section 233 – applies where an employer provides employees with an indefinite number of paid sick days on an as-needed basis. In essence, the court held that whenever an employer provides paid sick leave, it must comply with kin care obligations – no matter how it structures and calculates the sick leave entitlement." (Littler Mendelson P.C.)


[Guidance Overview] Washington, DC's 'Accrued Sick and Safe Leave Act' Receives Congressional Approval (PDF)
Pages 3-4 of 4 pages. Excerpt: "The District of Columbia Accrued and Safe Leave Act of 2008 took effect on May 13, 2008. The Act applies to all DC employers, for profit and not for profit, regardless of the size of their work forces." (Dow Lohnes PLLC)


[Guidance Overview] New Jersey Becomes Third State to Enact 'Paid Family Leave' Law (PDF)
Pages 1-2 of 4 pages. Excerpt: "On May 2, 2008, New Jersey Governor Corzine signed the 'Paid Family Leave Law,' which allows New Jersey employees to take up to six weeks of partially paid leave to care for sick family members or to care for and bond with newborn or newly-adopted children. This law specifically excludes providing paid leave to employees for their own illnesses. Paid leave under this new law is to run concurrently with leave under the New Jersey Family Leave Act ('NJFLA') and the federal Family and Medical Leave Act ('FMLA')." (Dow Lohnes PLLC)


[Guidance Overview] District Court States That Workers Compensation Must Reimburse ERISA Plan
Excerpt: "In the case of Graphic Communications National Health and Welfare Fund v. Tackett, 2008 WL 2020504 (S.D.Ill.) (May 09, 2008), the District Court held that workers' compensation awards are subject to ERISA plan reimbursement rights, to protect the Plan and the plan participants and prevent undue cost shifting." (The personal subrogation blog of Attorney Adam V. Russo)


Sen. Baucus and Rep. Stark Opinion Pieces Address Efforts To Overhaul U.S. Health Care System
Excerpt: "The Hill on Tuesday published two opinion pieces by Senate Finance Committee Chair Max Baucus (D-Mont.) and House Ways and Means Subcommittee on Health Chair Pete Stark (D-Calif.)." (Kaiser Family Foundation)


Federal Health IT Office Unveils Five-Year Strategic Plan
Excerpt: "HHS' Office of the National Coordinator for Health IT on Tuesday released a five-year strategic plan to serve as a guide to coordinate the federal government's health IT efforts, Digital Healthcare & Productivity reports." (California HealthCare Foundation)


Limited Benefit Plan Adds Overseas Hospitals
Excerpt: "BasicPlus Insurance Services L.L.C. is helping insureds use its limited benefit plan coverage to pay for care received outside the United States." (The National Underwriter Company; free registration or paid subscription required)


IRS Issues IRA-to-HSA Transfer Rules
Excerpt: "Holders of individual retirement accounts can shift some cash into health savings accounts without paying income taxes or penalties on the distributions. Officials at the Internal Revenue Service explain the procedures for carrying out 'qualified HSA funding distributions' in IRS Notice 2008-51." (The National Underwriter Company; free registration or paid subscription required)


ERIC Writes to Congress about Benefits of e-Prescribing
Excerpt: "ERIC was one of 20 organizations that signed an educational letter to key House and Senate committee leaders about the benefits of e-prescribing in terms of safety and efficiency for physicians, pharmacists, and patients. The letter sought to dispel the notion that the U.S. healthcare system lacks uniform or complete e-prescribing standards, or that those standards have yet to be adopted broadly by physician technology vendors." (The ERISA Industry Committee)


Employees Less Likely to Retire Without Access to Health Coverage, Watson Wyatt Study Finds
Excerpt: "Workers who lack other health care insurance options are more likely to defer retirement in order to stay covered under their employer's plan, according to an analysis by Watson Wyatt Worldwide." (Wolters Kluwer)


Wisconsin Health Care Plans Pledge To Make Health Care Costs More Transparent
Excerpt: "The 17 members of the Wisconsin Association of Health Plans have pledged to make their health care costs more transparent. Each of the association-member health care plans signed a pledge to begin providing, by Sept. 1, 2008, estimates of out-of-pocket costs to enrollees who request them before receiving services. Also by September 1, each plan will inform its enrollees that the out-of-pocket cost estimates are available." (Wolters Kluwer)


PBMs Allegedly Manipulate Definition of 'Brand' and 'Generic' Rx at Payers' Expense
Excerpt: "By miscategorizing drugs . . . PBMs achieve a number of financial aims. These include charging brand prices for generic products, retaining rebates for brand drugs by calling them generics, and misstating a health plan's generic drug utilization rate." (AISHealth.com)


Health Plans, PBMs Consider Strategies for Increasing Health Literacy of Their Members
Excerpt: "Nearly half all U.S. adults lack the 'health literacy' skills necessary to understand and act on basic health information - a problem that costs pharma.ceutical payers billions of dollars annually on misused medications and contributes to roughly 1.5 million adverse drug events every year, experts say." (AISHealth.com)


Bank of America to Help Fund Employees' Health Care Accounts for Expenses
Excerpt: "Charlotte, N.C.-based Bank of America (BoA) is sweetening its transition to consumer-directed health care (CDH) by offering some employees extra money to help defray out-of-pocket health care expenses. Beginning in 2009, employees who earn less than $100,000 per year will be eligible to receive up to $100 a month in a 'health care account' to use at their discretion, according to company spokesperson Kelly Sapp." (AISHealth.com)


Regional Coalitions for Healthcare Improvement: Definition, Lessons, and Prospects (PDF)
34 pages. Excerpt: "Reports about quality problems by the Institute of Medicine and others have engendered a national debate about how to improve healthcare quality. This conversation has produced points of consensus on the value of evidence-based healthcare, systematic improvement of care processes, measurement and reporting of performance, and reward for results. This report examines the role of regional coalitions in leading and implementing such initiatives, based on their understanding of local marketplace issues and ability to mobilize local energy for change." (Robert Wood Johnson Foundation)


Medical Expenditures of the Non-Elderly by Age and Insurance Status, 2004 (PDF)
Excerpt: "This Statistical Brief describes medical expenditures of the non-elderly (under age 65) by age group and insurance status in 2004." (U.S. Agency for Healthcare Research and Quality)


Health Insurance: Market Failure or Government Failure?
Excerpt: "The reform proposals vary in their specificity, but all (either implicitly or explicitly) identify the source of the problem as market failure - and promise new regulations and more taxes to fix the problem. This article makes the case that government failure should occupy center-stage in understanding how things came to look the way they do. Rather than market failure, it is our inefficient and perverse regulation of health insurance that should be the focus of our ire, and of regulatory reform." (Social Science Research Network)


California Cap on Chiropractic Treatment Survives Court Challenge
Excerpt: "A state appeals court has ruled that California's 24-visit cap on chiropractic treatments for workers compensation injuries is constitutional." (PLANSPONSOR.com; free registration required)


JAMA Commentary Examines Legal Barriers to Improving Health Care Delivery System
Excerpt: "'Legal Reforms Necessary To Promote Delivery System Innovation,' Journal of the American Medical Association: The JAMA commentary by Timothy Stoltzfus Jost of the Washington and Lee School of Law and Ezekiel Emanuel of NIH examines how the current legal environment has created significant barriers to improving the U.S. health care delivery system." (Kaiser Family Foundation)


Senate Finance Committee Hears Testimony in Preparation for Major Health System Overhaul Efforts Next Year
Excerpt: "Lawmakers should not overstate the ability of health care information technology, quality improvement efforts and medical liability reform to reduce health care costs, Paul Ginsburg, president of the Center for Studying Health System Change, testified on Tuesday at a Senate Finance Committee hearing, CQ HealthBeat reports." (Kaiser Family Foundation)


HHS Releases Comprehensive Plan To Encourage Nationwide Adoption of Health IT
Excerpt: "The Office of the National Coordinator for Health Information Technology at HHS on Tuesday released a cross-agency directive to speed up the adoption of a nationwide health information technology system that would improve health care quality, increase efficiency, reduce medical errors and address concerns of patient privacy and data security, CQ HealthBeat reports." (Kaiser Family Foundation)



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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] Towers Perrin U.S. Legislative Tracking Charts -- Human Resources -- Updated June 4, 2008 (PDF)
14 pages. Excerpt: "These charts summarize selected federal legislation that would affect employee benefit programs. The bills included on the charts are based on judgments regarding the prominence of the issue, the likelihood of enactment, and the influence of the sponsors." (Towers Perrin)


[Guidance Overview] Plaintiff's Professional Liability Claims Against Insurance Agent Avert ERISA Preemption Defense
Excerpt: "This recent district court case illustrates an important distinction in ERISA preemption caselaw that prevents defendants in professional liability cases from turning to ERISA as an affirmative defense." (Health Plan Law blog by Attorney Roy F. Harmon III)


[Guidance Overview] The Constraint of Promissory Estoppel Versus the Broad Ambit of Deferential Review
Excerpt: "To prevail on an estoppel claim under ERISA, plaintiffs must ordinarily show: (1) a knowing misrepresentation; (2) made in writing; (3) reasonable reliance on that representation by them; (4) to their detriment." (Health Plan Law blog by Attorney Roy F. Harmon III)


[Guidance Overview] Code Section 409A Remedial Amendment Period Scheduled to End December 31, 2008 (PDF)
2 pages. Excerpt: "The final regulations under §409A relating to the deferral of compensation of employees (other than through tax-qualified plans), consultants, directors, and other service providers will be effective January 1, 2009." (Dechert LLP)


[Guidance Overview] IRS Deferral of Amendment Deadlines for Deferred Compensation Plans (PDF)
5 pages. Excerpt: "This article will provide a bit of historical context for Section 409A, will describe its basic provisions as seen through the lens of the final regulations, and will conclude with a list of what most businesses should be doing to prepare themselves for the January 1, 2009, moment of reckoning." (Adams and Reese LLP)


What the 2008 Trustees' Reports Tell Us About the Financial Status of Social Security and Medicare: Some Implications for Plan Sponsors
Excerpt: "This article reviews briefly the results of this year's reports and comments on their implications for employer sponsors of retirement and health plans." (Watson Wyatt Worldwide)


Employers Dealing with Workers' Commuting Costs
Excerpt: "As gas prices skyrocket, some workers are changing jobs to be closer to home, while others won't even apply to ones that require a long commute. Experts say employers must develop strategies to deal with these threats -- and many companies are already taking action." (Human Resource Executive Online)


Solicitor General Recommends High Court Review of ERISA Remedies Case
Excerpt: "U.S. Solicitor General Paul Clement on May 23 urged the U.S. Supreme Court to grant certiorari in Amschwand v. Spherion Corp. in order to address 'equitable relief' under ERISA Section 502(a)(3)." (The ERISA Industry Committee)


Obtaining Quality Employee Benefit Plan Audit Services—The Request for Proposal
Excerpt: "Employee benefit plan sponsors and ­administrators can save time selecting an audit firm and evaluating the quality of its services by writing a thorough Request for Proposal (RFP)." (The American Institute of Certified Public Accountants)


California Court Refuses to Stay G.ay Marriage Ruling
Excerpt: "Conservative religious and legal groups had asked the California Supreme Court to stop its May 15 order requiring state and local officials to sanction same-sex unions from becoming effective until voters have the chance to consider the issue in November. The justices' decisions typically become final after 30 days." (AP via Yahoo!News)


Naming a Defendant in an ERISA Action
Excerpt: "This article argues that courts should permit suit against any entity that played a role in denying the claim. This approach (1) is consistent with the plain language of ERISA, (2) is consistent with the legislative intent behind ERISA which was to protect employees from underfunded plans and from erroneous benefit denials, (3) is consistent with Supreme Court precedent permitting fiduciaries to be sued under ERISA, and (4) creates an incentive for entities making benefits determinations to make those determinations correctly." (Social Science Research Network)




Newly Posted Events
(Post Yours!)

2008 Benefits Forum & Expo
in Maryland on September 21, 2008
presented by SourceMedia

ERISA Audits: What We All Knew but Forgot
Nationwide on August 13, 2008
presented by Lorman Education Services

ERISA Audits: What We All Knew but Forgot
Nationwide on August 27, 2008
presented by Lorman Education Services

Important Update on the Current Fiduciary Duties of Plan Sponsors
in Illinois on June 11, 2008
presented by ASPPA Benefits Council of Chicago

Wellness Programs: Rewards, Penalties and Legal Risks
Nationwide on August 6, 2008
presented by Lorman Education Services



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Regulatory Policy Analyst
for National Business Group on Health
in DC

PART-TIME DC Plan Administrator
for Platinum Pension Group, LLC
in MA

Vice President for Compliance and Fiduciary Review
for Unified Trust Company, N.A.
in KY

Plan Implementation Consultant
for Federated Investors, Inc.
in PA

CRTMA - Senior Participant Accountant - ABA
for Citi
in ME

Records Analyst
for Citi
in ME

Internal Participant Relationship Consultant
for Gallagher Retirement Services
in MO

401(k) Administrator
for West Pension Solutions, LLC
in MD

Pension Administrator - Senior
for Pension Planners, Inc.
in FL




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