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| December 22, 2008 |
| Here are the Web's best new links about compliance and cost aspects of plan operation, design and policy. |
Today's sponsor is University Conference Services
(Click on company name or banner to learn more.)
| Weighing the Value of Your Health Care Plan |
| As health care costs continue to increase faster than inflation and the faltering economy exacts its toll on businesses, employers are struggling to balance the costs of their health care programs with the value these benefits provide to employees. The Orlando Health and Welfare Plan Management for Mid-Sized Employers Conference, March 1–4, 2009, gives you access to expert speakers and valuable information that will help you find the right solutions for your plan and equalize your costs and benefits. |
[Guidance Overview]
The Conflict Between ERISA Overpayment Claims and Statutory Protection of SSDI Benefits
Excerpt: "This district court opinion involves the common fact pattern in which plan participant and long term disability carrier dispute the carrier's rights to recoup benefits paid based on the LTD policy's provisions requiring reimbursement of LTD benefits where the participant has received Social Security Disability Income ('SSDI') benefits." (Health Plan Law)
[Guidance Overview]
Medicare Secondary Payer Mandatory Reporting (PDF)
Presentation. 8 pages. Excerpt: "This presentation focuses on group health plan requirements." (Morgan, Lewis & Bockius LLP)
[Guidance Overview]
IRS Addresses Timing of Employer's Deduction for Benefit Payments Under Self-Insured Medical Plans
Excerpt: "The IRS has released a Technical Advice Memorandum (TAM) that addresses the timing of an employer's tax deduction for self-insured medical plan payments to providers that are made more than 2-1/2 months after the end of the taxable year in which the medical services are provided. The employer at issue was an accrual-method taxpayer and maintained self-insured medical plans for its eligible employees. Plan benefits were paid from the employer's general assets with the assistance of a TPA. Sometimes, service providers delayed submitting bills to the plan, and payments were made more than 2-1/2 months after the end of the employer's taxable year in which the services were provided." (Employee Benefits Institute of America)
[Guidance Overview]
IRS Issues 2008 Version of Publication 502 for Medical and Dental Expenses
Excerpt: "The IRS has released the new version of Publication 502 (Pub. 502), which describes what medical expenses are deductible by taxpayers on their 2008 federal income tax returns. (Under Code Section 213(a), a taxpayer may claim a deduction for certain unreimbursed medical expenses to the extent they exceed 7.5% of the taxpayer's adjusted gross income.) There are only a few substantive changes in the 2008 version of Pub. 502 . . . ." (Employee Benefits Institute of America)
[Guidance Overview]
Third Party Administrator That Performed Ministerial Functions Was Not a Fiduciary
Excerpt: "Although this TPA was held not to be a fiduciary, it bears repeating that the DOL's examples of ministerial administrative functions should not be viewed as safe harbors. To the extent that the functions in the examples actually involve discretion, the person performing those duties will be a fiduciary. For example, although applying rules to determine eligibility for benefits generally is a ministerial administrative function, a person whose administrative function involves final authority to approve or deny benefit payments in cases where coverage is disputed due to the interpretation of plan provisions would not be performing merely ministerial functions and instead would be a fiduciary under ERISA." (Employee Benefits Institute of America)
[Guidance Overview]
Guidance Issued on HIPAA Privacy Rule, Electronic Exchange of Health Information
Excerpt: "The U.S. Department of Health and Human Services, Office for Civil Rights (OCR) issued new guidance documents on Dec. 15, 2008. The guidance consists of the Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information (the Framework) and the Health IT Privacy and Security Toolkit (the Toolkit), a document designed to assist health information exchange stakeholders in implementing the Framework. The OCR designed the Framework and the Toolkit to serve as guides for entities that exchange electronic protected health information in a networked environment in their efforts to comply with the Health Insurance Portability and Accountability Act's (HIPAA) privacy standards (the Privacy Rule)." (Davis Wright Tremaine LLP)
Massachusetts Nears Universal Health Coverage
Excerpt: "Some 97.4 percent of Massachusetts residents have health insurance, by far the highest coverage rate of any state, a survey shows." (Workforce Management; free registration required)
Hospital and Physician Cost Shift: Payment Level Comparison of Medicare, Medicaid, and Commercial Payers (PDF)
10 pages. (Milliman)
Study Shows Health Plans Need to Keep Quality of Care Focus
Excerpt: "The National Business Coalition on Health (NBCH) on Friday said its data show health coverage purchasers increasingly require plans to focus on the quality of care. A news release from NBCH, a non-profit organization of employer-based health coalitions, said those were the 2008 findings for the eValue8RFI (Request for Information) tool used by NBCH and its member coalitions to compare the quality and efficiency of America's health plans." (PLANSPONSOR.com; free registration required)
State of the U.S.A. Health Indicators
Excerpt: "In 2008, [the nonprofit State of the USA, Inc.] asked the Institute of Medicine's Committee on the State of the USA Health Indicators to provide guidance on 20 key indicators to be used on the organization's website that would be valuable in assessing health. Each indicator was required to demonstrate: a clear importance to health or health care, the availability of reliable, high quality data to measure change in the indicators over time, the potential to be measured with federally collected data, and the capability to be broken down by geography, populations subgroups including race and ethnicity, and socioeconomic status. Taken together, the selected indicators reflect the overall health of the nation and the efficiency and efficacy of U.S. health systems. The complete list of 20 can be found in the report brief and report." (National Academy of Sciences)
Health Care Reform Up in Air As Economy Sinks
Excerpt: "Health policy consultant Robert Laszewski, a former insurance industry executive, is among those who expect only small changes, such as increases in the number of low-income children who get Medicaid. After all, these experts say, Clinton had a Democratic majority and popular support for change in 1993. Yet the plan crafted by his wife -- Hillary Rodham Clinton -- failed. Other presidents, including Democrat Harry Truman and Republican Richard Nixon, also have tried unsuccessfully to enact major health care changes. 'There is no consensus in Congress or the country on what a comprehensive health care bill would look like,' Laszewski says. 'Plus we don't have the money.' Making substantive changes to the $2.4 trillion health care economy isn't easy. Here is a look at the factors for and against a makeover of the system." (USA TODAY)
[Opinion]
DOL Office of the Solicitor's Brief for Secretary of Labor as amicus curia (PDF)
22 pages. Excerpt: "The Court should grant en banc review because there is an intra and an inter-Circuit conflict concerning who is a proper defendant in a claim for benefits under ERISA section 502(a)(1)(B) [in Cyr v. Reliance Standard Life Insurance Company.]" (U.S. Department of Labor)
EmployeeBenefitsJobs.com (Sponsor)
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Fill your employee benefits job openings fast by advertising on EmployeeBenefitsJobs.com. What better place to find qualified candidates?
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Links to Items on Executive Comp, Benefits in General
[Guidance Overview]
The Legal Implications of Nontraditional Workweeks
Excerpt: "As employers consider adopting nontraditional schedules, what some of them are not doing is taking a clear-eyed look at the wage and hour ramifications of these arrangements. There are potential pitfalls -- under both federal wage and hour law and the requirements of other jurisdictions -- that demand close attention." (Workforce Management; free registration required)
U.S. Capital Market Update: Plunging Interest Rates Causing Issues for Pension and Postretirement Welfare Plans (PDF)
5 pages. Excerpt: "The stream of bad financial news for pension plan sponsors continues for the fourth straight month. While the downturn in equity values calmed a bit in December, corporate bond yields - which initially spiked upwards with the credit crisis - have fallen dramatically in recent weeks. Before the crisis began, a combination of moderate equity losses and a 40 to 50 basis point increase in long-term high quality corporate bond yields had already caused a reduction in the funded ratio of a typical U.S. defined benefit plan (as measured for U.S. GAAP financial reporting purposes) of approximately 6% through August. Since then, the funded position of U.S. pension plans has worsened each month. By the end of November, the funded ratio for Towers Perrin's benchmark plan (presumed to be invested in a diversified 60/40 portfolio) had declined from 92.7% to 72.9%. The decline was fueled by a crash in equity values . . . ." (Towers Perrin)
More Companies Are Cutting Labor Costs Without Layoffs
Excerpt: "A growing number of employers, hoping to avoid or limit layoffs, are introducing four-day workweeks, unpaid vacations and voluntary or enforced furloughs, along with wage freezes, pension cuts and flexible work schedules. These employers are still cutting labor costs, but hanging onto the labor." (The New York Times; free registration required)
Employers Opening up Communications on Economy Crisis Effects
Excerpt: "Recognizing the significant amount of employee anxiety about the nation's continuing economic crisis, a new survey found most U.S. employers are communicating with their workforce about their financial picture in a variety of ways. Watson Wyatt said its poll found that 77% of respondents have already sent, or are planning to send out, communications on the impact of the financial crisis - and that more than two-thirds (69%) of these employers cited easing employee anxiety as one of the top two goals of their crisis-related internal communication. The second, at 32%, was earning employees' trust." (PLANSPONSOR.com; free registration required)
Chronological Summary of Major Post-ERISA Benefit Legislation (PDF)
17 pages. (Hewitt Associates)
List of Employee Benefits Legislation since ERISA
Chronological [list] of Major Post-ERISA Benefit Legislation (The One-Stop ESOP Blog)
New Jersey Could Be First State to Legalize Marriage for Same-Sex Couples Through Legislative Action
Excerpt: "Civil unions are an inadequate substitute for marriage. Creating a separate, new legal structure to confer some benefits on same-sex couples neither honors American ideals of fairness, nor does it grant true equality. The results are clearly visible in New Jersey, which continues to deny same-sex couples some of the tangible civil benefits that come with marriage." (The New York Times; free registration required)
[Opinion]
Predictions and Forecasts for Human Resource Management
Excerpt: "One thing is certain about the coming year: It probably won't turn out as forecasted. This year certainly didn't! Benefits-related items on the agenda include health reform and issues affecting retirement savings. With money tight, however, proposals will likely be less expansive than once anticipated." (Dallas Salisbury via Human Resource Executive Online)
Newly Posted Events
2009 RMD Relief Imminent!
Nationwide on January 6, 2009
presented by Convergent Retirement Plan Solutions, LLC
Newly Posted Press Releases
ASPPA Applauds Congress for Passing Pension Relief Measures
American Society of Pension Professionals & Actuaries (ASPPA)
Newly Posted or Renewed Job Openings
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DC Plan Administrator
for Campbell Albrecht
in CA
MEP/PEO Client Relationship Manager (southeast region)
for Transamerica Retirement Services
in AL, AR, FL, GA, LA, MS, NC, SC, VA
Retirement Plan Consultant
for Fiserv Investment Support Services
in CO
Client Consultant, Emerging Corporate
for Prudential Financial
in IA
Handy Links:
- View Today's Active Message Threads
- Using the Web for Employee Benefits Research (hypertext article)
- Employee Benefits Library
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