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| January 9, 2009 |
| 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]
Strategic Decisions In Pleading (And Defending) Provider Reimbursement Claims - A Case Study
Excerpt: "[A] recent opinion from the Southern District of Texas provides an excellent insight into the strategic decisions involved in provider reimbursement litigation. In the final analysis, the provider's attempt to assert state law remedies in state court against the Blue Cross defendant failed for want of jurisdiction. All was not lost, however, since the ruling left open the avenue for an amended complaint stating a claim under ERISA on principles of derivative standing (via assignment of benefits)." (Health Plan Law)
[Guidance Overview]
Fully-Insured Benefit Plans in New York Must Recognize Out-of-State Same-Gender Marriages (PDF)
Excerpt: "All fully-insured benefit plans that offer spousal coverage must recognize a same-sex spouse of an employee if the marriage was performed in a jurisdiction in which such marriages are legal. The New York State Insurance Department issued a Circular Letter on November 21, 2008 . . . stating that it expects all New York insurers to recognize the marriages of same-sex couples legally performed in other jurisdictions for purposes of providing the same level of insurance coverage as is provided to opposite-sex spouses. This Client Alert reviews the developments that led to the Insurance Department's pronouncement and provides some general interpretive guidance to benefit plan sponsors." (Proskauer Rose LLP)
At Hearing, Daschle Lays Out a Plan to Overhaul Health Care
Excerpt: "Members of both parties offered a friendly welcome to Mr. Daschle, the man chosen by President-elect Barack Obama to be secretary of health and human services, in charge of a department with 65,000 employees and a budget of more than $700 billion a year. . . . Mr. Daschle said the Obama administration would not try to rush health care legislation through Congress under expedited budget procedures, which would limit the opportunity for debate and amendments." (The New York Times; free registration required)
If You Think Health Care is Expensive Now . . .
Excerpt: "Health care, says the man most concerned with that 17 percent of America's economy, can be 'a nation-ruining issue.' As Michael Leavitt ends four years as secretary of health and human services, he offers this attention-arresting arithmetic: Absent fundamental reforms, over the next two decades the average American household's health care spending, including the portion of its taxes that pays for Medicare and Medicaid, will go from 23 percent to 41 percent of average household income." (George Will via Townhall.com)
Health Care Overhaul Needn't Break Bank, According to Study
Excerpt: "An analysis of proposals to overhaul U.S. health care by President-elect Barack Obama and members of Congress suggests it is possible to insure all Americans without significantly raising total health spending. . . . The report, released on Friday by the Commonwealth Fund, suggests plans outlined by Obama and Senate Finance Committee Chairman Max Baucus could cover almost all Americans. But to hit that mark, they would need to require all Americans to obtain coverage and include efforts to cut administrative costs and boost purchasing efficiencies." (Reuters via The New York Times; free registration required)
New Studies on Timing and Extent of Maternity Leave Call for Expanded Access to Paid Leave
Excerpt: "The current issue of Women's Health Issues has published an important study about the effects of paid leave and the timing of that leave on the health of women and their babies. The study, entitled Maternity Leave in the Ninth Month of Pregnancy and Birth Outcomes among Working Women found that women who took leave beginning in the 35th week of pregnancy were four times more likely to avoid a C-section birth than women who worked right up until going into labor. A second study, published in this month's issue of the journal, Pediatrics, and entitled Juggling Work and Breastfeeding: Effects of Breastfeeding and Occupational Characteristics, found that the longer the leave after birth (up to and beyond 12 weeks), the substantially greater likelihood that the woman would have established breastfeeding." (Workplace Prof Blog)
Innovations in State Health Policy, December 2008/January 2009
This issue includes a feature article titled: 'The Prospects for Health Care Reform in 2009' and Snapshots of State Ballot Initiatives. (The Commonwealth Fund)
Arizona Health Care Market Report 2008 (PDF)
Excerpt: "The report focuses on the flow of dollars among the organizations that are involved in the financing and delivery of health care in Arizona. Section 1 of the report provides an overview of the major findings and themes in the report, while Section 2 provides additional detail about health care organizations in the state." (Allan Baumgarten via St. Luke's Health Initiatives)
Families Caught Between Unemployment Benefits and Health Care Costs
Excerpt: "This report shows that, to maintain their employer-based health coverage under COBRA, most unemployed people would have to devote an unrealistically high proportion of their incomes to health insurance. For many, it would take their entire unemployment check and more to continue coverage for themselves and their families. However, if laid-off workers do not continue their employer-based coverage by electing COBRA and instead seek coverage in the individual health insurance market, those with health problems are likely to find that no insurer will sell them a policy that will cover their pre-existing conditions at any price. Thus, many American workers find themselves in a catch-22." (Families USA Foundation)
America's Retirees Working to Protect Health Care Benefits They Earned
Excerpt: "'There are currently an estimated 18.5 million American retirees and baby boomers in the United States with health benefits being significantly threatened,' . . . . 'If cancelled by the corporations they once worked for, most would be dumped into the federal and state healthcare systems. In effect, this means their former employers would be getting an additional back-door federal bailout at the expense of the taxpayer.'" (Orlando-Press-Register.com)
Worksite Clinics a Popular Way to Control Health Care Costs
Excerpt: "More than one-third of large employers sponsor worksite or 'near-site' medical clinics and most are satisfied with the return on their investment, a Mercer survey found. While large employers are still more likely to offer 'old-fashioned' occupational health clinics (31%), according to Mercer's National Survey of Employer-Sponsored Health Plans (see Employers Held Health Plan Costs Down by Shifting More to Employees),14% offer a clinic to provide primary care services and an additional 10% indicated they were considering providing a primary care clinic by 2009." (PLANSPONSOR.com; free registration required)
PBS 'NewsHour with Jim Lehrer' Series Examines Health Care Challenges for Obama/Congress
Excerpt: "PBS' 'NewsHour with Jim Lehrer' recently aired a three-part series on the health care challenges that face President-elect Barack Obama and the new Congress. Summaries of the three segments of the series [are on the target page]." (Kaiser Family Foundation)
[Opinion]
Daschle Hearing Gives Little Info on How the Incoming Obama Administration Intends to Pay for Emerging Health Care Programs
Excerpt: "The main thing we learned from Tom Daschle's confirmation hearing in the Senate on Thursday was that President-elect Barack Obama sure picked the right man to stage manage his health care reforms as secretary of health and human services and as health czar at the White House." (The New York Times; free registration required)
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Links to Items on Executive Comp, Benefits in General
[Official Guidance]
Text of Notice 2009-08: Guidance on 457A; Deferred Compensation by Foreign Corporations and Partnerships (PDF)
38 pages. Excerpt: "Notice 2009-08 [which is scheduled to appear in IRB 2009-4, dated January 26, 2009] provides interim guidance on recently enacted §457A which became effective January 1, 2009. Section 457A generally provides that compensation deferred under a nonqualified deferred compensation plan of a nonqualified entity is includible in gross income when there is no substantial risk of forfeiture of the right to such compensation. For this purpose, the term nonqualified deferred compensation plan has the meaning provided under §409A(d), subject to some modifications, and the term nonqualified entity means (a) any foreign corporation unless substantially all of its income is (i) effectively connected with the conduct of a trade or business in the U.S., or (ii) subject to a comprehensive foreign income tax, and (b) any partnership unless substantially all of its income is allocated to persons other than (i) foreign persons with respect to whom such income is not subject to a comprehensive foreign income tax, and (ii) tax-exempt organizations. The guidance focuses on identifying which plans are covered by §457A, including identifying the plan sponsor and whether the sponsor is a nonqualified entity." (Internal Revenue Service)
[Guidance Overview]
Recoverability of Equity-Based Compensation Deferred Tax Assets
Excerpt: "As the stock market slides, more stock options and related deferred compensation instruments are 'underwater,' and the related deferred tax assets may no longer be recoverable. The balance sheets and tax footnotes of many entities highlight the magnitude of these equity-based compensation deferred tax assets. When and how they are written off could have a significant impact on the income statement. As a result, and in light of the recent trends in market prices, equity-based deferred compensation plans need to be monitored quarterly for events that trigger the fixing of the corporate tax deduction and the recoverability of the related tax asset." (Journal of Accountancy)
General Motors Corp. Chief Executive Rick Wagoner says automaker can survive long-term without cutting benefits to retired workers
Excerpt: "Wagoner made the remarks on NBC's Today Show, where he was joined by United Auto Workers President Ron Gettelfinger. The two made the appearance from Detroit ahead of their renewed labor negotiations scheduled to begin next week." (AP Online via NewsEdge via Human Resource Executive Online)
The Public Sector Workforce - Past, Present, and Future
Excerpt: "This paper outlines past and current demographics of the state and local government workforce, contrasted against the demographics of the private sector, and explores the projected public sector workforce needs of the future as the baby boomer generation begins to retire. This paper also briefly details issues that state and local government executives describe as major challenges their governments are facing as they look to recruit and retain the next wave of public servants." (Center for State and Local Government Excellence)
New York City Employee Pay Is Outpacing Private Sector, Report Says
Excerpt: "Bolstered in part by Mayor Michael R. Bloomberg's spending, the average New York City employee cost the city $107,000 a year in wages, health insurance, pension and other benefits in the 2008 fiscal year, an increase of 63 percent since 2000, according to a new report." (The New York Times; free registration required)
Newly Posted Events
Section 409A(a) Proposed Income Inclusion Regulations: Revealing the Real Sting of 409A - Webcast
Nationwide on January 14, 2009
presented by BNA, Inc.
Newly Posted Press Releases
U.S. Department Of Labor Sues Mondsview, Minnesota, Trucking Company For Abandoning Profit-sharing And 401(k) Plan
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)
SLIA Employee Benefits Division Appoints New VP Sales & Marketing for New York Region
Sumitomo Life Insurance Agency America, Inc.
Newly Posted or Renewed Job Openings
(Post a Job | View All Jobs |
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Senior Defined Benefit Data Analyst
for Diversified Investment Advisors, Inc.
in MA
401(k) Enrollers/Independent Contractors – Part Time
for Diversified Investment Advisors
in ANY STATE
Consulting Actuary
for New York Life Retirement Plan Services
in MA
Handy Links:
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- Using the Web for Employee Benefits Research (hypertext article)
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