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October 30, 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] Ordinance Requiring Mandatory Paid Sick Leave for All Milwaukee Employees to Be Decided by Referendum (PDF)
3 pages. Excerpt: "On November 4, 2008, the citizens of Milwaukee will vote on a referendum determining whether private employers must provide up to nine days of paid sick leave for every employee in the City of Milwaukee. Passage of this referendum would impact employers both in Milwaukee and in surrounding areas." (Reinhart Boerner Van Deuren s.c.)

[Guidance Overview] Final Regulation Establishing 'Minimum Creditable Coverage' under the Massachusetts Health Care Reform Act
Excerpt: "The final regulation achieves what appears to be a carefully constructed balance between the text of the statute and the will of the legislature, on one hand, and the legitimate needs and concerns of the regulated community, on the other. The Connector's board and staff are to be commended in this regard. Regrettably, these rules have been announced later in the year than many would have liked, so plan sponsors will need to scramble a bit." (Mintz, Levin, Cohn, Ferris, Glovsky and Popeo P.C.)

[Guidance Overview] Massachusetts Universal Health Care Update: Changes to Fair Share Contribution Requirement
Excerpt: "On October 1, 2008, the Massachusetts Division of Health Care Finance and Policy adopted regulations that change how employers comply with the Fair Share Contribution ('FSC') requirements of the Massachusetts Universal Health Care law." (K&L Gates LLP)

[Guidance Overview] Heroes Earnings Assistance and Relief Tax Act of 2008: Impact on Health Care Flexible Spending Accounts
Excerpt: "HEART added section 125(h) to the Internal Revenue Code (the Code) which permits cafeteria plans to provide qualified reservist distributions (QRD) to an employee of all or a portion of the balance of the employee's unused amounts in the health FSA." (ERISAdiagnostics, Inc.)

Limited-Benefit Plans - Expanding Coverage? (PDF)
8 pages. Excerpt: "[T]he consequences of allowing private insurers to circumvent state benefit mandates can be dire for health care consumers. While some limited-benefit plans only exclude coverage for one or two mandated benefits, others may be extremely skimpy, excluding coverage for many necessary services. This paper describes some of the damaging effects of limited-benefit plans in the private insurance market as well as issues for advocates to consider if policy makers propose to use public dollars to subsidize limited-benefit plans in their state." (Families USA)

Congressional Staffers Drafting Health Care IT Bill for 2009
Excerpt: "House Speaker Nancy Pelosi (D-Calif.) is committed to passing in the next session of Congress legislation that would require physicians nationwide to adopt health IT and could include negative consequences to encourage providers to do so, according to one of her senior advisers, CQ HealthBeat reports." (California HealthCare Foundation)

Agencies Request Comments on the Genetic Information Nondiscrimination Act of 2008
Excerpt: "On October 10, 2008, the three federal agencies responsible for enforcement of the group health plan requirements of the Genetic Information Nondiscrimination Act of 2008 (GINA) -- the U.S. Departments of Labor (DOL), Health and Human Services (HHS) and Treasury -- published a request for information (RFI) in the Federal Register.1 The RFI seeks comments on various aspects of GINA, and requests comments on or before December 9, 2008. Comments can be submitted via mail, e-mail, and hand delivery, and may be submitted online via the Federal eRulemaking Portal:" (The Segal Group, Inc.)

Massachusetts Health Reform: High Costs and Expanding Expectations May Weaken Employer Support
Excerpt: "HSC researchers recently conducted a follow-up site visit to Massachusetts to explore the impact of the state's reform effort on employers more than a year into its implementation . . . . While employer support for the reform has been relatively strong to date, findings . . . suggest two potential changes that may threaten employers' continued support. First, higher costs from increased take up of employer-sponsored coverage and rising premiums, coupled with improved access to the nongroup, or individual, insurance market, potentially weaken employers' motivation and ability to provide coverage. Second, employer frustration appears to be growing as the state pressures them to increase their responsibilities." (Center for Studying Health System Change)

Employers Could Maximize Returns on Their Health and Productivity Programs, According to Survey
Excerpt: "Even though employers' bottom lines would better benefit from attaining positive outcomes in wellness programs, employers most frequently focus incentives on program participation rather than on outcomes. This is one of the conclusions reached by the Integrated Benefits Institute (IBI) in a survey, jointly conducted with Harris Interactive, of the incentives and disincentives provided by more than 500 employers with a total of approximately 5 million workers . . . ." (Wolters Kluwer)

Program Perspectives on Health Benefits: Recent Data on Employers' Costs and Employees' Access (PDF)
4 pages. Excerpt: "[This BLS product shows] trends in employer costs for health benefits. The latest data on access, participation, and premiums are also included. This is the inaugural issue of 'Program Perspectives,' a new publication in which BLS programs showcase their latest data." (U.S. Bureau of Labor Statistics)

Aging Baby Boomers Pushing Health Plans to Design New Products, Retool Existing Ones
Excerpt: "In this article, [Health Plan Week] profiles the strategies being pursued by Aetna Inc. and Blue Cross Blue Shield of Nebraska to tap into both the pre-Medicare (age 50 to 64) and the retiree (65+) markets." (

Premium Hikes May Hit Small Firms That Adopt Consumer-Directed Health Plans for the Wrong Reason
Excerpt: "'People are buying these [CDH] plans for two reasons,' Jerry Ripperger, national practice lead for consumer health at Principal Financial Services, Inc., tells ICDC. 'Some believe in them and take a thoughtful, long-term strategic approach. Others adopt them without a carefully thought-out long-term strategy. They want the least expensive option, are looking for short-term savings, and they don't invest in anything that will change their employees' health behaviors. So at renewal time, their premiums look just like they did before.'" (

Women Buying Health Policies Pay a Larger Premium than Men
Excerpt: "Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual insurance policies providing identical coverage, according to new data from insurance companies and online brokers." (The New York Times; free registration required)

Health Plan Trade Group Suggests HSA Contribution Tax Law Changes
Excerpt: "A health plan trade group has asked the Internal Revenue Service (IRS) to delay the deadline for filing excise tax returns and payments for noncompliance under Sections 4980B and 4980D of the tax code. Thomas Wilder, senior regulatory counsel at America's Health Insurance Plans (AHIP), suggested in a letter to the tax agency that the final version of its rules concerning employer contributions to employee health savings accounts and related excise tax returns and payments should include a date for compliance that is three months after the end of the current non-compliance period. The deadline could also be 90 days after the employer's income tax return due date -- whichever is later." (; free registration required)

Full Text of Appeal to Full Ninth Circuit Over San Francisco Employer Healthcare Spending Mandate
28 pages. Excerpt: "An employer group has appealed to the full Ninth US Circuit Court of Appeals a Sept. 30 decision by a three-judge panel that ERISA doesn't pre-empt San Francisco's health care mandate. . . . The panel's decision overturned a lower court's finding that ERISA does preempt the mandate. The appeal marks the next step toward the US Supreme Court possibly reviewing whether ERISA bars states and localities from imposing employer play-or-pay health care mandates." (Golden Gate Restaurant Association via Mercer LLC)

Massachusetts Insurer To Offer Bonus Payments to Physicians for E-Prescribing
Excerpt: "Blue Cross and Blue Shield of Massachusetts will require physicians to adopt electronic prescription systems by 2011 to qualify for bonus payments, the Boston Globe reports. The move is similar to a federal requirement that will tie e-prescribing use to Medicare payments." (California HealthCare Foundation)

Insurers Entice Doctors to Prescribe Generic Drugs
Excerpt: "[I]nsurance companies are allowed to push doctors toward cheaper prescriptions, frequently by offering the physician a form of bonus, a cut from the savings that insurance companies get when doctors prescribe generic drugs." (AP via The New York Times; free registration required)

PPO Law May Violate ERISA
Excerpt: "Thanks to the Self-Insurance Institute of America, Inc. (SIIA) for bringing this news to our attention. It seems that a 'model law' has been drafted by the National Conference of Insurance Legislators, with the purpose of ratification by member States in mind. The law addresses concerns over PPO rental networks; situations where PPO networks negotiate discounts with non-payer, third party entities (such as third party administrators)." (Passion for Subro)

[Opinion] Only 17 Percent of Emergency Room Visits in This Country Are Made by Uninsured Patients
Excerpt: "A provocative new study in the Journal of the American Medical Association calls [the belief that uninsured people are clogging the nation's emergency rooms to receive free care for minor ailments] into question but leaves another troublesome implication: that many uninsured patients are simply going without needed care until they become so sick that they can't stay away. Emergency rooms are legally obligated to treat real emergencies without regard to a patient's ability to pay, and many end up providing care that is less than urgent." (The New York Times; free registration required)

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Links to Items on Executive Comp, Benefits in General

[Guidance Overview] Executive Compensation Rules for the TARP Capital Program (PDF)
5 pages. Excerpt: "On October 20, 2008, the Department of the Treasury ('Treasury') released an interim final rule describing the executive compensation provisions that will govern all financial institutions that participate in the TARP Capital Program. The provisions generally apply as long as the Treasury holds an equity or debt position, including warrants and the common stock underlying the warrants, in a participating institution." (Powell Goldstein LLP)

[Guidance Overview] Issues to Consider: To Participate in the Treasury's Capital Purchase Program or Not - Implications (PDF)
5 pages. Excerpt: "On October 13, 2008, the nine largest financial institutions in the United States 'volunteered' for the Treasury Department's voluntary capital purchase program ('CPP'). Treasury used half of its initial $250 billion under the Troubled Asset Relief Program ('TARP') to purchase stock in these nine institutions. Now the thousands of other depository institutions and their holding companies in the U.S. need to consider whether to avail themselves of the remaining $125 billion. The fact that the big nine are participating is supposed to assure other institutions (and their nervous customers) that there will be no stigma attached to participating in this program, but other considerations remain." (Pillsbury Winthrop Shaw Pittman LLP)

Despite Cutbacks, Automakers Continue to Offer Subsidized Vehicles for Many Managers
Excerpt: "As Detroit's Big Three shutter factories, slash jobs and trim benefits, one executive perk remains: subsidized cars and trucks for management, often with insurance, maintenance and gasoline included. Bonuses have been frozen, health care co-pays increased and retirement plan contributions curtailed, but until recently, these management lease programs have remained largely untouched." (The Detroit News)

Prevalence of Long-Term and Stock-Based Grant Practices for Executives at 250 Largest Companies, 2008 (PDF)
38 pages. Excerpt: "Key findings from the Frederic W. Cook & Co. 2008 Top 250 report include the following: Stock option usage continues to decline, although options remain the single most common long-term incentive vehicle. Stock options are being replaced primarily by full-value shares that are earned by continued service and achievement of performance contingencies (performance shares). Full-value shares with performance contingencies (performance shares) are now as common as full-value shares that vest by continued service alone (restricted stock). Long-term performance awards (performance shares and performance units) . . . ." (Frederic W. Cook & Co., Inc.)

Newly Posted Events
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Aon Consulting’s 2008 Replacement Ratio Study™
in Colorado on November 11, 2008
presented by Western Pension and Benefits Conference-Denver Chapter

Are you ready for EGTRRA restatements?
Nationwide on November 12, 2008
presented by

Learn how to use's plan document software
Nationwide on November 11, 2008
presented by

Newly Posted Press Releases
(Post Yours!)

The SPARK Institute Issues New Version Of Best Practices For 403(b) Plans Information Sharing
SPARK Institute

Postponing Retirement: Chief Concern and Growing Employee Reality
International Foundation of Employee Benefit Plans

The Royce Funds Added to CPI Retirement Platform
CPI Qualified Plan Consultants, Inc.

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Senior Pension Processor (TPA/Employee Benefits)
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DB Implementation Project Manager
for Milliman, Inc.
in TX

Benefits Administrator
for Construction Industry Taft-Hartley Fringe Benefit Fund Office
in CT

Account Executive -- DC Plans
for Retirement Management Services, LLC
in KY

Client Service Partner - DB/DC
for Lincoln Financial Group
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