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July 15, 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. www.ifebp.org/memberkit

[Guidance Overview] Conflict of Interest in Claims Decisions – A Critical Analysis of MetLife v. Glenn
Excerpt: "As a result of the heightened scrutiny that conflicts of interest will be subject to, it is important to take notice of the Supreme Court's position that steps can be taken to minimize the potential adverse effect of financial conflicts of interest. Although these steps are not required, it is likely that employers or insurers who fail to take these steps will be at a distinct disadvantage when a claim denial is challenged in court." (Kilpatrick Stockton LLP)


[Guidance Overview] District Court Opinion Provides Additional Analysis of Post-Sereboff Counterclaims
Excerpt: "I recently noted what appears to be a tendency in disability cases to permit counterclaims against benefit claimants to proceed without significant analysis of the counterclaims' theoretical basis. (See, :: Seventh Circuit Holds That Sereboff Supports Disability Carrier's Counterclaim) In the recent decision in Raybourne v. Cigna, however, the court gives the issue more detailed analysis and is therefore worthy of note." (Health Plan Law blog by Attorney Roy F. Harmon III)


[Guidance Overview] Insurer Not Liable for Participant's Claims-Related Copy Costs or for Penalties for Failure to Provide Claims Documents
Excerpt: "Most of the court's conclusions seem unremarkable to us, but this case is noteworthy because the Ninth Circuit seems to be establishing a rule that participants may sue a plan administrator (usually the employer) for penalties under ERISA Section 502(c)(1) for failure to provide relevant documents under the claims regulations. Not all courts would agree with this approach." (Employee Benefits Institute of America)


[Guidance Overview] State Law Placing Limits on Discretionary Language in Insurance Policies Found to Be Preempted by ERISA
Excerpt: "The issue in this case has practical significance because, if ERISA preemption makes this kind of state law unenforceable, affected insurers will be free to include discretionary language that would otherwise be precluded. As a result, benefit denials will, in general, be subject to a more favorable standard of judicial review when challenged in court, making them more likely to be upheld." (Employee Benefits Institute of America)


GM to Cut Salaried Workers, Health Benefits, Production, Dividend
Excerpt: "Chief Operating Officer Fritz Henderson said GM wants to reduce its total salaried costs in the U.S. and Can.ada by 20 percent. A large chunk of the reduction, he said, would come from cutting health care benefits for salaried retirees. Those people would get a pension increase from the company's overfunded pension fund to help compensate for Medicare and supplemental insurance, the company said." (AP via The New York Times; free registration required)


More Bosses Help Workers Quit Smoking and Financial Savings Are Often Available
Excerpt: "Your company's health plan may lower your monthly insurance premium, provide a coach to help you stop or help pay for prescription smoking-cessation medicines. Many businesses have become more aggressive and creative in helping workers quit." (Detroit Free Press via The Courier-Journal)


Wellness Programs Require More Than Education
Excerpt: "Company programs that encourage weight loss, a healthy diet and exercise are more likely to be embraced by workers if employers motivate them to sign up and give them tools to record their progress, according to a study released in Washington on Monday, July 14, by a major health insurer." (Workforce Management; free registration required)


Blue Cross Blue Shield Wellness Press Briefing
Excerpt: "Large employers like DTE energy and Food Lion LLC are getting hands-on with wellness to help manage skyrocketing health care costs. In conjunction with Blue Cross Blue Shield, a new report, 'Engaging Consumers at Work,' found that workplace education can increase employee participation by 21% and above." (Employee Benefit News; free registration required)


Building a Value-Based Health Benefit Culture - Manatee County, FL As an Example
Excerpt: "Manatee County's Your Choice medical and drug benefit plan designs offer strong financial incentives for healthy behaviors and cost-effective decision making. The medical benefit offers three levels of cost sharing linked to health management activities. Employees and insured family members qualify for the Basic, Better or Best cost-sharing options based on their participation in health screenings, wellness programs and condition management programs." (Pharmacy Benefit Management Institute, LP)


The 2008 Presidential Candidates on Health Care Reform, Updated June 4, 2008 (PDF)
Excerpt: "While it is still early in the campaign process and plan details are incomplete for most candidates, these summaries provide a snapshot of the candidates and their blueprint for reform. Our intent is to be thorough and accurate in compiling what they have said or indicated they want to do." (Council for Affordable Health Insurance)


Sen. Sununu Outlines Six-Part Health Care Plan That Includes Small-Business Purchasing Pools
Excerpt: "New Hampshire Sen. John Sununu (R) on Thursday said that his six-part health care plan would make health coverage more affordable for uninsured individuals and small businesses, the Nashua Telegraph reports." (Kaiser Family Foundation)


[Opinion] Health Plans get Judicial Support and Bad Press - Again
Excerpt: "In a nutshell, the media, attorneys, politicians and the insureds see Plans recovering all of the money they are entitled to according to the Plan Document, but the Plan Participants cannot recover all of the money they would be entitled to if they were to receive benefits in accordance with the Plan Document." (Passion for Subro)



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Links to Items on Executive Comp, Benefits in General

Technical Issues Related to Accelerated Vesting of Restricted Stock Units at Retirement (PDF)
4 pages. Excerpt: "The accelerated vesting of RSUs can make them a form of nonqualified deferred compensation, subject to a variety of tax issues. This letter discusses three tax issues arising from the accelerated vesting of RSUs of which employers should be aware." (Frederic W. Cook & Co., Inc.)




Newly Posted Press Releases
(Post Yours!)

U.S. Department of Labor Issues Guidance on Schedule C Reporting for 2009 Form 5500
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Ernst & Young Study Finds Most Middle Class Retirees Will Outlive Retirement Savings
Americans for Secure Retirement (ASR)

Mark Iwry Named One Of The “100 Most Influential People In Finance”
Retirement Security Project



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