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October 21, 2008

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

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[Guidance Overview] New Laws Expand Mental Health/Substance Abuse Parity, Extend Coverage for Ill College Students (PDF)
4 pages. Excerpt: "Congress recently passed two bills that will apply new requirements to insured and self-funded employer health plans. A requirement that health plans provide greater mental health parity was included in the financial rescue package approved by Congress on Friday and signed by the President that afternoon. A separate bill, HR 2851, would extend health plan coverage for ill college students. That legislation is expected to be signed by the President." (Lockton, Inc.)

New BCBSA Survey Finds Enrollment in CDHPs is Up; Consumers Are More Health and Cost Conscious
Excerpt: "According to an annual BCBSA survey, the number of consumers using Consumer Directed Health Plans (CDHP) has grown significantly since last year, and across all demographics. The survey findings, released at the Consumer Driven Healthcare Summit in Washington, D.C. on Oct. 20, found CDHP enrollment is up 25 percent and consumers enrolled in CDHPs were 30 percent more likely to track their health expenses than consumers in more traditional health insurance plans." (Blue Cross Blue Shield Association)

Kaiser Health Tracking Poll: Election 2008 -- October 2008
Excerpt: "The final Kaiser Health Tracking Poll: Election 2008 finds more people are reporting problems with health care bills, and paying for health care retains a solid hold on the public's list of their top economic concerns. About one in three Americans now report their family has had problems paying medical bills in the past year, up from about a quarter saying the same two years ago. Almost one in five (18%) of Americans report household problems with medical bills amounting to more than $1,000 in the past year." (Kaiser Family Foundation)

Connecticut Employers Won't See Health Insurance Change After Same-Sex Marriage
Excerpt: "For the past eight years, state government has allowed its employees in same-sex relationships to extend health benefits to their partners. Since 2005, Connecticut towns have had to offer health coverage to same-sex couples who entered a formal, civil union. But despite the recent state Supreme Court ruling legalizing same-sex marriage in this state, most private businesses in Connecticut remain free to extend or deny benefits to same-sex couples. That's because the federal government doesn't recognize such marriages. Therefore, the federal statute that requires private-sector employee insurance to be available for workers' spouses isn't affected by any state court ruling, and still applies only to heterose.xual couples." (Journal Inquirer)

Comparison of Individual and Family Premiums Nationally and by State: 2004 - 2008
Excerpt: "The increased cost of health insurance is a central fact in any discussion of health policy and health delivery. As annual premiums surge above $12,000 for an average family, costs are blamed for rising uninsured and 'under-insurance.' For those Americans who are fully-covered, these cost realities affect employers, both large and small, not to mention the 'pocket-book impact' on ordinary families. In 2008 the average fully insured individual faced an employee share of $725 for 1-person coverage and a $3,983 annual share for family coverage." (National Conference of State Legislatures)

The Politics of Paying for Health Reform: Zombies, Payroll Taxes, and the Holy Grail
Excerpt: "This paper analyzes the politics of paying for health care reform. It surveys the political strengths and weaknesses of major options to fund universal coverage and explores obstacles to changing how the United States finances health care. Finding a politically viable means to finance universal coverage remains a central barrier to enacting health reform." (Health Affairs)

Myths and Misconceptions About U.S. Health Insurance
Excerpt: "Several myths about health insurance interfere with the diagnosis of problems in the current system and impede the development of productive reforms. Although many are built on a kernel of truth, complicated issues are often simplified to the point of being false or misleading. Several stem from the conflation of health, health care, and health insurance, while others attempt to use economic arguments to justify normative preferences. We apply a combination of economic principles and lessons from empirical research to examine the policy problems that underlie the myths and focus attention on addressing these fundamental challenges." (Health Affairs)

America's Eroding Model for Health Insurance
Excerpt: "Working Americans once could rely on employer-based benefits. But more people are being forced into the individual market, where coverage is costly, bare-bones and precarious." (Los Angeles Times)

Health Care Has Managed to Avoid the Information-Technology Revolution, But It Won't for Much Longer
Excerpt: "In the future, there will be three often overlapping modes of delivering health-care services: services performed in person by humans, services that can be performed by people at a remote location, and services performed by computers without direct human involvement. Offshore outsourcing in combination with a 24-hour work cycle will be appropriate when certain conditions are met -- mainly, if the information involved in the task can be digitized, and if workers at different sites can do their jobs independently from one another." (The Wall Street Journal)

Employer-Sponsored Health Insurance for State and Local Governments, by Census Division, 2006 (PDF)
6 pages. Excerpt: "This Statistical Brief presents estimates, by census division, of overall enrollment rates, premiums, and contributions for employer-sponsored health insurance provided by state and local governments. Only those estimates that had a statistically significant difference from the national average at the 0.05 percent significance level are noted in the text." (U.S. Agency for Healthcare Quality and Research)

[Opinion] Targeting Subsidies: Employers versus Individuals
Excerpt: "Recent congressional proposals and reforms advocated by the presidential candidates have renewed the debate about whether the problem of the uninsured is best addressed through subsidies to employers or to individuals. In this brief, the authors argue that it is more efficient to provide subsidies directly to individuals and families than to employers. Individual subsidies will lead to less displacement of private spending and will be more equitable. Employers have limited information about their workers, making employer subsidies more difficult to target to individuals with the greatest needs. In addition, employer subsidies do not eliminate the need for individual subsidies." (The Urban Institute)

[Opinion] Candidates Aren't Telling Voters the Real Story About Our Health Care
Excerpt: "Sen. Barack Obama and Sen. John McCain are promising voters tax cuts, new programs and other goodies. But, as often happens in public debates, there is a little-discussed back story to many of the issues. And, as usual, that back story goes deeper than the 20-second sound bites heard in attack ads." (

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Links to Items on Executive Comp, Benefits in General

[Guidance Overview] Treasury's Executive Compensation Rules Under the Emergency Economic Stabilization Act (PDF)
13 pages. Excerpt: "As widely publicized, EESA contains limits on executive compensation for financial institutions that participate in the Troubled Asset Relief Program (TARP). Depending on the type and level of participation by the financial institution, these limitations include prohibition of incentives that encourage 'unnecessary and excessive risks'; substantial new limits on tax deductibility; prohibition of certain severance payments; new excise taxes and loss of deduction on 'golden parachute' payments; and 'clawback' provisions to recoup incentive compensation paid based on inaccurate financial criteria." (Alston & Bird LLP)

A Legislative and Political History of ERISA Preemption, Part 3
Excerpt: "The preemption language in section 514(a) of the Employee Retirement Income Security Act of 1974 (ERISA) is exceedingly broad. The preemption language in the law ERISA replaced - the Welfare and Pension Plans Disclosure Act of 1958 (WPPDA) - was exceedingly narrow. There were four stages in Congress's journey from the narrowly circumscribed preemption of state law under the WPPDA to the sweeping suppression of state law under ERISA. This article covers the first three stages, tracing the evolution of ERISA's preemption language from the enactment of the WPPDA to the end of the Ninety-Second Congress." (Journal of Pension Benefits via Social Science Research Network)

Optimal Taxation and Social Insurance with Endogenous Private Insurance
Excerpt: "This paper characterizes the welfare gains from redistributive taxation and social insurance in an environment where the private sector provides partial insurance. We analyze stylized models in which adverse selection, pre-existing information, or imperfect optimization in private insurance markets create a role for government intervention. We derive simple formulas that map reduced-form empirical estimates into quantitative predictions for optimal tax and social insurance policy. Applications to unemployment and health insurance show that taking private market insurance into account matters significantly for optimal benefit levels given existing empirical estimates of the key parameters." (National Bureau of Economic Research; paid subscription or individual purchase required to retrieve fulltext)

Newly Posted Events
(Post Yours!)

Executive Compensation Strategy and Disclosure After the Credit Crisis Webcast
Nationwide on November 23, 2008
presented by Katten Muchin Rosenman LLP

Key Issues Facing Not-for-Profit Boards
in New York on October 29, 2008
presented by Directors Roundtable

Mining Your Health Plan Data for Jewels
in Virginia on October 29, 2008
presented by WEB (Worldwide Employee Benefits Network) Washington Chapter

Newly Posted Press Releases
(Post Yours!)

Step-by-Step Guide Explains How to Collect Delinquent Employer Contributions
International Foundation of Employee Benefit Plans

ASPPA Honors Jordan and Shultz
American Society of Pension Professionals & Actuaries (ASPPA)

White Paper Issued on Changing Focus of IRS and DOL Audits
David K. Young Consulting, LLC

403(b) Compliance Pledge From Security Benefit
Security Benefit

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Pension Administrator
for Pension Administration Firm located in Westchester, NY
in NY

Institutional Services Employee Benefit Operations Administration Analyst II
for BB&T
in NC

Client Services Associate
for Milliman, Inc.
in CO, TX

401k Administrator
for Vanguard
in PA

Senior Claim Audit Manager
for Towers Perrin
in CA

Total Absence and Disability Management Associate
for Towers Perrin
in IL

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