Health & Welfare Plans Newsletter |
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| June 9, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy | ||
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[Guidance Overview]
Insurer Properly Denied Claim for LTD Benefits Where Beneficiary Was Not 'Disabled' Under the Plan
Excerpt: "An insurance company did not abuse its discretion when it denied a claim for long term disability benefits filed by a beneficiary who did not meet the LTD plan's definition of 'disabled.' This was the ruling of the Third Circuit U.S. Court of Appeals in Taylor v. Union Security Insurance Company and Titus & McConomy Long Term Disability Benefits Plan (No. 08-3692)." (Wolters Kluwer)
[Guidance Overview]
Recent Additional Guidance Issued on COBRA Subsidy Rules
Excerpt: "As employers shift their focus with regard to the COBRA subsidy rules introduced by the American Recovery and Reinvestment Act of 2009 (ARRA) from the implementation to the administration of compliance programs, the federal government continues to issue useful guidance. The Department of Labor and Department of Health and Human Services have each published information and forms regarding an individual's right to appeal an employer's decision to deny the individual a reduction in the COBRA premium under ARRA." (Ballard Spahr Andrews & Ingersoll, LLP)
[Guidance Overview]
Employee's COBRA Notice Claim Dismissed: Employer Offered Sufficient Evidence That Notice Was Properly Sent
Excerpt: "EBIA Comment: This case has only a short discussion of the COBRA claim, but it gives us the chance to reiterate a few important points about providing election notices. First of all, the plan administrator has the burden of proving that an election notice was provided (and remember that the plan administrator is the plan sponsor unless another person or entity is designated)." (Employee Benefits Institute of America)
[Guidance Overview]
CMS Form and Instructions for Requesting Expedited Review of COBRA Premium Assistance Denial
Excerpt: "EBIA Comment: The CMS application is similar to the application posted by the DOL, which is for use by individuals covered by group health plans of private employers subject to the federal COBRA requirements who are requesting DOL review of their premium assistance denial . . . . Neither agency has yet posted instructions for employers to indicate how they might become involved in the review process, although the forms and instructions of both agencies request information about the employer and indicate that the information provided in the application may be shared with 'other parties to this review,' including the health plan and the employer." (Employee Benefits Institute of America)
Medicare Beneficiaries' Out-of-Pocket Spending for Health Care Services
Excerpt: "Beneficiaries spent an average of $4,394 of their own money on health care services in 2005 -- about 28 percent of income." (AARP)
Salaried GM Retirees Request Bankrup.tcy Court Voice
Excerpt: "With a reduction in some retiree benefits by about two-thirds a possibility, a group of retired General Motors salaried employees has asked to be granted a say in the auto giant's restructuring. A Detroit Free Press story said the retiree group has asked a bankrup.tcy judge to appoint an official panel to represent their interests as GM reorganizes its business. 'The unfairness of hourly retirees keeping their benefits and even getting a stake in New GM to fund their health benefit trust, while salaried retirees receive no protections, also cries out for the need for salaried retiree representation,' the group's court filing said, according to the newspaper." (PLANSPONSOR.com; free registration required)
Supreme Court Asked to Decide Legality of San Francisco Health Care Rule
Excerpt: "The Golden Gate Restaurant Association filed a petition v on Monday asking the U.S. Supreme Court to make the final decision on whether San Francisco's mandate that employers pay for health care coverage is legal. The city's first-of-its-kind universal health care program, dubbed Healthy San Francisco, began two years ago and requires that employers with at least 20 employees provide health insurance, set up health care spending accounts or pay into the city's fund." (San Francisco Chronicle)
Taxing Health Benefits
Excerpt: "[T]oday employers are Americans' primary and most affordable source for health insurance. But in myriad ways, the system is far from perfect. For starters, tax and health experts say, it's inequitable. High-income workers and those with the most expensive health insurance plans enjoy the biggest break as a result of the tax exclusion. Not that anyone's really aware of that, though, which is part of the problem, experts say. Workers don't know how much their health benefits really cost because they only pay a portion of the bill." (CNNMoney.com)
Audio and Text: The Risks and Rewards of Taxing Health Benefits
Excerpt: "For lawmakers looking for a way to fund a health care overhaul, employee benefits are a juicy target. Taxing those benefits could raise as much as $150 billion a year. But that's not what excites heath care economists: They say taxing benefits also could make the system work better." (Morning Edition via National Public Radio)
[Opinion]
ERIC Expresses Concern Over Proposals that Could Undermine Employer-Based Health System (PDF)
30 pages. Excerpt: "ERIC is concerned that proposals addressing the following issues have the potential to seriously undermine the current employment-based system: Taxation of health care benefits, The creation of a public plan, Employer mandates, Employee opt-outs, and National uniformity and ERISA preemption." (The ERISA Industry Committee)
[Opinion]
The President's Main Case for Reform Is Rooted in False Claims and Little Evidence
Excerpt: "The main White House argument for health-care reform goes something like this: If we spend now on a hugely expensive new insurance program for the middle class, we can save later by reducing overall U.S. health spending. This 'tastes great, less filling' theory could stand some scrutiny, not least because it is being used to rush through the greatest social spending program in American history. What if this particular theory turns out to be a political illusion? What if the speculative cost savings never report for duty, while the federal balance sheet is still swamped with new social obligations that will be impossible to repeal? The only possible outcome will be the nationalization of U.S. health markets, which will mean that almost all care will be rationed by politics." (The Wall Street Journal)
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Links to Items on Executive Comp, Benefits in General
[Guidance Overview]Federal Government's Acquisition of Equity Interests Does Not Constitute 409A Payment Event
Excerpt: "On June 4, 2009, the Internal Revenue Service (IRS) released Notice 2009-49 clarifying that, for purposes of Section 409A of the Internal Revenue Code, the U.S. Department of the Treasury's acquisition of equity interests in a financial institution or other entity under the Emergency Economic Stabilization Act of 2008 (EESA) does not constitute a permissible change in control payment event. The notice, which is immediately effective, is available at http://www.irs.gov/pub/irs-drop/n-09-49.pdf." (McDermott Will & Emery)
[Guidance Overview]
SEC's Interpretive Guidance on New Executive Compensation Disclosure Rules (PDF)
6 pages. Excerpt: "The staff of the Securities and Exchange Commission (SEC) on January 24, 2007, issued interpretive guidance on the new executive and director compensation proxy disclosure rules. The guidance was updated on August 8, 2007, July 3, 2008, and further updated on May 29, 2009. The guidance is in the form of questions and answers of general applicability to the disclosure rules, as well as interpretive responses regarding particular situations. The guidance replaces staff interpretations issued in previous years, and is drafted in a manner that facilitates periodic future updates. The interpretative guidance is briefly summarized [on the target page] with the May 29, 2009 guidance presented in italics." (Frederic W. Cook, Inc.)
Shartsis Friese versus JP Morgan Over Funding Fiasco
Excerpt: "Shartsis Friese squared off against JP Morgan Retirement Services in San Francisco federal court Monday over who was responsible for six years of miscalculated contributions to the San Francisco firm's deferred compensation and profit-sharing plan. The firm says its plan contributions didn't meet IRS rules because of bad advice from its outside benefits consultant. The firm said it has had to spend $1.2 million to bring the fund back into compliance." (Law.com)
Higher Income Taxes and Economic Uncertainty Make It Harder to Decide When to Defer Compensation: Here Are Some Guidelines
Excerpt: "While deferred comp plans may encompass both salary and bonus for high-paid employees, most deferrals are just for bonuses. June 30 is the deadline for deciding whether to defer 2009 performance-based bonuses. But the economic uncertainties are so great that many people are deciding to take the cash. After all, if you defer, you won't have access to that money if you need it." (BusinessWeek)
[Opinion]
More Funny Business with Executive Stock Trading?
Excerpt: "As a follow up to [the June 4] Blog on 10b5-1 plans gone bad, I wanted to draw readers' attention to the results of another academic study reported in The Wall Street Journal yesterday ('Executives' Stock Deals Preceded Price Drops,' p. C1). This study found a 'statistically significant' difference (8% in this study) between the stock prices of companies in the year following the date an executive entered into a prepaid variable forward contract, when compared to a peer group of similar companies where no executive entered into such a contract." (Michael Melbinger via Winston & Strawn LLP)
Webcasts and Conferences
Annual Roundtable Discussionsin Illinois on June 25, 2009
presented by WEB - Chicago West
Can Benefits Lawyers and Other Service Providers be Sued for Malpractice for Services to ERISA Plans
Nationwide on June 25, 2009
presented by ABA Joint Committee on Employee Benefits
WEB West Golf Open
in Illinois on July 23, 2009
presented by WEB - Chicago West
(Click to post your webcast or conference)
Press Releases
Watson Wyatt Data Services Releases its 2009/2010 Survey Report on Health Care Administrative & Support Personnel CompensationWatson Wyatt Data Services
Owner of Defunct North Carolina Sign Company Sentenced for Embezzling 401(k) and Health Plan Assets
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)
Health Reform �Exchange� Plan Would Restructure Health Insurance Market, Has Big Implications for Current Employment-Based Benefits
Employee Benefit Research Institute (EBRI)
ERIC Expresses Concern Over Proposals that Could Undermine Employer-Based Health System
ERIC (ERISA Industry Committee)
CPI Creates Program for Same-Day Investment of Payroll Contributions
CPI Qualified Plan Consultants, Inc.
Social Media an Increasingly Important Tool in Keeping Employees Engaged During Tough Economic Times, Survey Finds
Buck Consultants, an ACS Company
The Phia Group to Utilize Benefit Informatics Data Analysis Services to Increase Claim Recovery for Clients
Benefit Informatics
Survey Reveals Employees' Most Prized Summer Benefits
OfficeTeam
New Nutrisystem Works(TM) Offers Corporate America New Weapon in the Fight Against Obesity
Nutrisystem, Inc.
Munger, O'Melveny, and Oaktree to Open Child Care Center for Employees
O'Melveny & Myers LLP
(Click to post your press release)
Employee Benefits Jobs
401(k) Wholesalerfor Howard Simon & Associates, Inc.
in IL
Investment Advisor And Enrollment Manager
for American Pensions, Inc.
in SC
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