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[Guidance Overview] Ninth Circuit Rules Claimant Not Required to Exhaust Issues During ERISA Claims Review (PDF) At page 4 of 9 pages. Excerpt: "Although it is unclear how broad Vaught should be read in light of the confused administrative claims review record that led to the decision, Vaught risks creating an unfortunate road map for participants seeking to evade abuse of discretion review. The necessary consequence of allowing plaintiffs to 'hold their cards' and raise new issues in district courts is that the district courts will be considering issues de novo." (Proskauer Rose LLP) [Guidance Overview] District of Columbia Accrued Sick and Safe Leave Act Becomes Effective Soon (PDF) 4 pages. Excerpt: "The District of Columbia Accrued Sick and Safe Leave Act of 2008 (the Sick Leave Act) will make the District of Columbia one of the first jurisdictions in the United States to mandate paid leave for an employee's sickness, to care for a family member (as broadly defined) who is sick, and for other purposes relating to medical conditions or domestic violence (sick leave). The Sick Leave Act will have a significant impact on employers, whether or not they currently provide paid sick leave." (Hogan & Hartson LLP) The Organizational Benefits of Employee Health Promotion Programs Excerpt: "This article focuses on how organizational leaders may improve physical and financial worker wellness in the worksite." (The American Chronicle) A Letter to Employers on Making Wellness Initiatives Painless Excerpt: "This open letter to employers offers ways that companies can help motivate healthcare-behavior changes -- without annoying their workers. As companies deal with the customary open-enrollment period, HR leaders should consider providing specific goals instead of fuzzy concepts, pinpointing reasons to care about preventative processes and removing administrative roadblocks." (Human Resource Executive Online) Limited-Benefit Plans: Expanding Coverage or Holding Your State Back? (PDF) 8 pages. Excerpt: "At first glance, limited-benefit plans may seem like a good way to offer previously uninsured people financial protection for a portion of their health care costs. However, the 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) Health Information Technology: More than a Tool to Save Costs (PDF) 4 pages. Excerpt: "Many policymakers, health professionals and other stakeholders envision health information technology (HIT) primarily as a cost-saving tool. Other analysts, however, believe that the main importance of HIT lies in its potential for improving health care quality and reducing health care disparities. HIT as a tool to enhance quality, patient safety and efficiency appears in the campaign platforms of the presidential candidates and in analyses and reports by the Congressional Budget Office, the Institute of Medicine (IOM) and others." (Alliance for Health Reform) Report Finds Lax Enforcement of HIPAA Security Regulations Excerpt: "CMS has taken 'limited actions' to ensure that health care providers are effectively protecting patients' medical records, but the agency's efforts fall short of ensuring compliance with the HIPAA security rule, according to a report from HHS Office of the Inspector General, Government Health IT reports (Moore, Government Health IT, 10/31)." (California HealthCare Foundation) A Guide for Americans Seeking Affordable Medical Treatment Abroad Excerpt: "Nearly 200 institutions outside the U.S. have been certified by the Joint Commission International, an affiliate of the organization that accredits U.S. hospitals. Medical travel companies are springing up to link American patients with foreign providers eager to boost their profits. Add a rapidly aging U.S. population and a shrinking medical safety net, and the notion of Americans looking elsewhere for treatment no longer seems such a stretch." (Los Angeles Times) CDHP, Version 2.0: Compliance-Driven health Excerpt: "['Compliance-driven health' is defined] as 'both a patient's commitment to following accepted protocols of disease management [and] a health plan member's commitment to following accepted standards of wellness, health maintenance and improvement.'" (Employee Benefit News; free registration required) Health Care and Defense Sectors Will Weather Recession, But Analysts Say Future Is Hazy Excerpt: "With an aging population and the largest health care spending in the world, the nation's medical sector could fare perhaps best of all. During economic downturns, sales of prescription drugs and medical devices tend to hold up better than nonessential goods, noted David Wyss, chief economist of Standard and Poor's. 'Generally, you're looking for things that are necessities, not luxuries,' Wyss said. 'People get sick and need medical care regardless of the state of the economy.'" (AP via Star Tribune) [Opinion] Level Playing Fields and Inconsistent Rules for Health Insurance is Risky Combination (PDF) 2 pages. Excerpt: "'Employer-sponsored health insurance is tax-free, but people who buy their own coverage receive no tax breaks. Policymakers should level the playing field by giving every form of health coverage the same tax treatment.' This initially appealing claim misses some key facts. Insurance companies will not sell to employers unless at least 75 percent of workers accept coverage offers. Currently, according to the Treasury Department, the unequal tax treatment of employer-sponsored insurance (ESI) and nongroup coverage 'can increase the after-tax cost of [nongroup] insurance … by as much as 50 percent.' If this inequality ended and many workers left ESI for nongroup coverage, some companies would no longer meet insurers' minimum participation requirements and would lose the ability to offer coverage." (The Urban Institute) [Opinion] Text of Court Brief by ERISA Industry Committee Seeking Full Ninth Circuit Review of San Francisco Employer 'Play-or-Pay' Ordinance (PDF) 22 pages. Excerpt: "This past Friday, October 31, 2008, The ERISA Industry Committee (ERIC) and the National Business Group on Health (NBGH) -- two organizations representing large, national employers providing health benefits to tens of millions of Americans -- filed an amicus brief supporting the Golden Gate Restaurant Association's call for a full Ninth Circuit Court of Appeals review of the city of San Francisco's controversial play or pay ordinance on employers." (The ERISA Industry Committee/National Business Group on Health) [Opinion] American Benefits Council Amicus Brief in Golden Gate Restaurant Association v. City and County of San Francisco (PDF) 24 pages. Excerpt: "This case is of significant nation-wide importance to employer-sponsors of health benefits plans and their employees. Council members offer some of the Nation's most generous and well-managed health benefit plans, virtually all of which cover employees that reside in many states, counties, and cities. These multi-state plans are complex undertakings. If the Ordinance and other similar 'pay-or-play' laws are allowed, it will create a 'regulatory balkanization' that would strike at the heart of the purpose of ERISA preemption, which is to encourage employers to establish comprehensive health plans for their employees without regard to the particular state or locality in which they live." (American Benefits Council) Sponsored by: EmployeeBenefitsJobs.com (Click on company name or banner to learn more.)
Links to Items on Executive Comp, Benefits in General [Guidance Overview] No Jury Trial in ERISA Claims for Benefit Case Excerpt: "Most readers are aware that the federal courts long ago settled that ERISA 29 U.S.C. § 1132(a)(1)(B) claims for benefits were equitable in nature. 'Equitable' is a word that bears more than its share of freight in legal matters. In this instance, the word is shorthand for centuries of legal history that culminates in the practical conclusion that the plaintiff gets no jury trial." (Health Plan Law blog by Attorney Roy F. Harmon III) [Guidance Overview] Granting Stock Options in Turbulent Times: Choosing Valuation Assumptions (PDF) 6 pages. Excerpt: "Admittedly, stock option valuation is an inexact science, and the primary sources of this imprecision are the volatility and yield assumptions used in the Black-Scholes model. The other four inputs are either explicitly stated (exercise price) or empirically observable from historical data (risk-free rate, expected term and fair market value). Volatility and yield, on the other hand, are based on future expectations, and thus historical or current data patterns are not the only -- or even the most relevant -- factors that should be considered." (Towers Perrin) Employment Costs in Private Industry, September 2008 Excerpt: "Private industry wages and salaries increased 2.9 percent in September 2008. In September 2007 the increase was 3.4 percent. Benefit costs increased 2.4 percent in the 12-month period ended September 2008, the same as in the previous period." (U.S. Bureau of Labor Statistics) To Get Employees' Attention, How You Communicate Is Just As Critical As the Message Itself Excerpt: "Most benefits communication experts agree; the four corners to effective employee communication are: 1. Keep it simple - no jargon allowed. 2. Use a communication vehicle your employees understand. 3. Get the message out decisionmakers, who are sometimes people other than employees - like spouses. 4. Communicate on a year-round basis. One-hit wonders don't provide lasting impact." (Employee Benefit News; free registration required) Employee Ownership Update for November 3, 2008 NCEO Executive Director Corey Rosen discusses the results of a new NCEO survey on the effects of the credit crunch on ESOP companies; five research fellowships in employee ownership sponsored by the Beyster Institute and Rutgers; a renewed push for broader employee ownership in France; and the 2009 cost-of-living increases for benefit plan dollar limitations from the IRS. (National Center for Employee Ownership) Banks Owe Billions in Pay and Pensions to Executives Excerpt: "Troubled financial giants getting cash infusions from the U.S. government owed executives more than $40 billion for deferred pay and pensions as of the end of 2007, the Wall Street Journal reported in an analysis. The sums owed are mostly for special executive pensions and deferred compensation, including bonuses, for prior years, according to the paper's website." (Reuters) Brief Overview of Some Common Executive Health and Welfare Benefit Programs Excerpt: "While retirement benefits have received much attention, the focus here is on the non-retirement benefit components, often referred to as 'health and welfare' programs. This terminology groups together the benefits received for certain specific life events -- death, disability, illness, injury, and paid time off -- each addressing common health and welfare needs." (Hay Group) Newly Posted Events E-Seminar: Communicating with Plan Participants in Times of Market Volatility Nationwide on November 12, 2008 presented by University Conference Services Webinar -- Before You Sign -- Ten key contract provisions which can save your organization 10% on your health plan. Nationwide on November 5, 2008 presented by Optimatum Group LLC Newly Posted Press Releases ERIC & NBGH File Joint Amicus Brief Supporting Full Ninth Circuit Court of Appeals Review of San Francisco Employer "Play-or-Pay" Ordinance ERIC (ERISA Industry Committee) CRR Funding Opportunity: 2009 Sandell Grant Program Center for Retirement Research at Boston College CDM Retirement Consultants, Inc. Offers Savings Incentive On Conversions CDM Retirement Consultants, Inc. Guardian Enhances Spanish Language Enrollment Capabilities Guardian Does Your Company Have What it Takes to Make the Dave Thomas Foundation for Adoption's Third Annual Top 100 Adoption-Friendly Workplace List? Dave Thomas Foundation for Adoption Wachovia Extends Customer Service Hours to 401k Participants Wachovia Retirement Services Newly Posted or Renewed Job Openings
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