Health & Welfare Plans Newsletter |
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| September 14, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy | ||
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[Guidance Overview]
Ohio Health Reforms Mandate Cafeteria Plans, Expand Access for Adult Children and Increase State COBRA Coverage Period (PDF)
3 pages. Excerpt: "Ohio's recently enacted state budget (Am. Sub. H.B. 1) includes several provisions that may affect employer-sponsored plans. The new law requires employers with 10 or more employees to offer full-time employees the opportunity to pay for health insurance with pre-tax dollars, requires insurers and public employee benefit plans to offer coverage to dependents up to age 28, and extends the period of health continuation under the state COBRA law from 6 to 12 months." (Buck Consultants)
[Guidance Overview]
Employee Entitled to Benefits for Weight Loss Surgery to Treat Work Injury
Excerpt: "The Indiana Court of Appeals has agreed with the state's Worker's Compensation Board that an employee who sustained a work-related injury is entitled to short-term disability and medical benefits for weight loss surgery as a precursor to back surgery to treat his work-related injury. In its opinion, the court said the existence of pre-existing conditions is no bar to recovery under Indiana law. 'When a claimant's physical condition combines with an accident at work to produce a single injury, the Board may find that the injury arose out of that claimant's employment within the meaning of the Worker's Compensation Act,' the opinion said." (PLANSPONSOR.com; free registration required)
[Guidance Overview]
'Retrospective Claim Denial' Litigation Challenges Circumvention Of Procedural Requirements
Excerpt: "Recent class action litigation challenges a practice of health insurance carriers whereby the carrier seeks refunds from providers. This retrospective claims review is conducted by investigative teams that purportedly employ criteria designed to identify claims that should not have been paid. According to a Reuters press release, a class action lawsuit has been filed against the Blue Cross Blue Shield Association ('BCBSA') and 22 leading BCBS insurers across the country on behalf of a putative nationwide class of health care providers, as well as the Pennsylvania Chiropractic Association ('PCA'), the New York Chiropractic Council (the 'Council'), and the Association of New Jersey Chiropractors ('ANJC')." (Roy Harmon III via Health Plan Law)
[Guidance Overview]
Ninth Circuit Rejects Application of 'Reasonable Expectations' Doctrine to Self Funded ERISA Plans
Excerpt: "This Ninth Circuit decision is in line with the other courts of appeal that have faced the question of 'contractual' limitations periods. The Raytheon disability plans provided for a one-year statute of limitations. Having filed her claim outside this period, the plaintiff sought refuge in the doctrine of 'reasonable expectations' and argument that California regulatory requirements should be incorporated into the federal common law." (Roy Harmon III via Health Plan Law)
[Guidance Overview]
IRS's Final Regulations on Excise Tax Reporting and HSA Comparability
Excerpt: "EBIA Comment: The deadline for excise tax reporting and payment for failure to comply with the group health plan mandates is the federal income tax return due date without extensions, which may take some filers by surprise, especially employers who routinely obtain filing extensions. For employers and others concerned about potential excise tax liability for failure to comply with the group health plan mandates, we note that these excise taxes do not apply for periods where failures are not discovered exercising reasonable diligence, or to failures due to reasonable cause (and not willful neglect) that are timely corrected. However, the regulations underscore the importance of having (and following) procedures to identify and correct compliance failures." (Employee Benefits Institute of America)
Bill Would Divert Stimulus Funds to Pay for Delphi Retirees' Health Care
Excerpt: " A Senate bill introduced Friday would pay for health care coverage for tens of thousands of Delphi Corp. retirees who have lost their insurance. U.S. Sen. Sherrod Brown, D-Ohio, introduced legislation that would shift up to $3 billion from the $787 billion stimulus bill approved in February to pay for health care coverage for about 65,000 retirees and their dependents. The bill would create a Voluntary Employees' Beneficiary Association, or VEBA, to provide health coverage to hourly workers in the IUE-CWA, United Steelworkers and other unions along with salaried Delphi retirees." (The Detroit News)
Work Disability, Work, and Justification Bias in Europe and the U.S.
Excerpt: "To analyze the effect of health on work, many studies use a simple self-assessed health measure based upon a question such as 'do you have an impairment or health problem limiting the kind or amount of work you can do?' A possible drawback of such a measure is the possibility that different groups of respondents may use different response scales. This is commonly referred to as 'differential item functioning' (DIF)." (University of Michigan Retirement Research Center)
Supplemental Information on Potential Effects of the Affordable Health Choices Act (PDF)
7 pages. Letter of September 10, 2009, to Honorable Michael B. Enzi, Ranking Member, Committee on Health, Education, Labor, and Pensions, United States Senate. (U.S. Congressional Budget Office)
Employers Balance Disease Management and Wellness Efforts to Cut Costs
Excerpt: "If employers focus only on employees with chronic conditions, 'they will get some savings a bit faster, but what they will not be addressing is that people who have those conditions in two to five years are people who have lifestyle problems today,' said Bruce Kelley, national leader of data services at Watson Wyatt Worldwide in Minneapolis.'We have seen some tendency to put more emphasis on the short-term (savings), but I can't think of a client who has abandoned the longer-term strategy' of fostering employee wellness, he said. Watson Wyatt data show that just 5% of the workforce -- those with complex chronic conditions and catastrophic cases -- spend about 50% of the health care dollars . . . ." (Business Insurance)
Nonprofit Groups Upset at Exclusion from Health Bills
Excerpt: "Nonprofit organizations say they are upset that Congress and the Obama administration have not addressed their rising health care costs in the various health care proposals being floated on Capitol Hill. The main bill in the House would award a tax credit to small businesses that provide their employees with health insurance -- but nonprofits do not pay income taxes and thus would not benefit. 'Why should employees of nonprofits be treated worse than employees of for-profit businesses?' said Jonathan A. Small, government affairs consultant at the Nonprofit Coordinating Committee of New York." (The New York Times; free registration required)
Equitable Prescription Drug Coverage in Employer-Provided Health Plans
Excerpt: "Steve Befort (Minnesota) and Elizabeth Canney Borer (former UM student) have posted on SSRN their piece in the Louisiana Law Review entitled: 'Equitable Prescription Drug Coverage: Preventing Sex Discrimination in Employer-Provided Health Plans.'" (Workplace Prof Blog)
IRS's New Webpage With Q&As for Employees and Former Employees on COBRA Premium Subsidy
Excerpt: "EBIA Comment: These Q&As appear on a new IRS webpage that houses COBRA premium subsidy information for employees and former employees. Although the information in these Q/As is not new . . ., it may be more accessible to employees in this new location." (Employee Benefits Institute of America)
Public Option Fades from Debate Over Health Care
Excerpt: "It was just one line in a campaign manifesto, and it hardly seemed the most significant or contentious. As a presidential candidate, Barack Obama said he would 'establish a new public insurance program' alongside private health care plans. That proposal took on a life of its own, but it now appears to be dying, a victim of an ineffectual White House strategy, the president's failure to argue passionately for the 'public option' and all-out opposition by the insurance industry and much of the health care industry." (The New York Times; free registration required)
[Opinion]
Health Insurance Reform and ERISA Preemption
Excerpt: "One simple reform to the healthcare system which would be simple, budget-neutral and actually conservative would be to repeal the part of ERISA that immunizes health insurance providers from state common law actions in tort and contract. I honestly do not know whether the plans being considered by the Congress would provide this repeal, or whether they simply maintain the federal preemption but provide for federal remedies with more teeth than the current system. The current federal remedies -- reimbursement of out-of-pocket expenses by a victorious beneficiary or injunctive relief -- are useless for most people, and certainly lack the deterrent effect of state tort and even contract remedies." (TortsProf Blog)
BenefitsLink Newsletter (Advert.)
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Links to Items on Executive Comp, Benefits in General
Employer Costs for Employee Compensation, June 2009 (PDF)Excerpt: "Employers spent an average of $1.29 for employee retirement and savings plans for every hour worked in June 2009, the U.S. Department of Labor's Bureau of Labor Statistics reported . . . . This accounted for 4.4 percent of total compensation. Retirement and savings, which includes both defined benefit and defined contribution plans, is one benefit category included in the Employer Costs for Employee Compensation series, along with wages and salaries." (U.S. Bureau of Labor Statistics)
Recovery Act Tax Benefits Include Work-Related Education Deduction
Excerpt: "The Internal Revenue Service (IRS) has established an information center describing the various tax credits, deductions, and savings plans available under the American Recovery and Reinvestment Act (ARRA) to assist with higher education expenses. The tax benefits include a business deduction for work-related education expenses. Individuals who are employees and can itemize deductions, may be able to claim a deduction for the expenses paid for work-related education." (PLANSPONSOR.com; free registration required)
Webcasts and Conferences
Advisory Council on Employee Welfare and Pension Benefit Plans Meetingin District of Columbia on September 29, 2009
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)
Health Care Reform Webcast Series: What It Means for Employers and Employees - Session Three
Nationwide on October 13, 2009
presented by Buck Consultants, an ACS Company
Planning for Open Enrollment: Compliance Solutions for Cafeteria Plans and Component Benefits
Nationwide on September 10, 2009
presented by EBIA / Thomson Reuters
SPARK Forum 2009
in Florida on November 8, 2009
presented by SPARK Institute
(Click to post your webcast or conference)
Press Releases
ExpertPlan Launches Trading Platform with Charles Schwab Trust CompanyExpertPlan
Plan Sponsors and Participants Stay Strong, Crave Basics Moving Forward
Principal Financial Group
Survey Finds Employers Plan to Continue or Expand Health & Productivity Programs in Spite of Tough Economy
Integrated Benefits Institute
Benefit Informatics and Eldorado Computing Join Forces to Offer Health Plan Payers a Comprehensive Solution
Benefit Informatics
(Click to post your press release)
Employee Benefits Jobs
Benefits Analystfor Haynes and Boone, LLP
in TX
Pension Administrators
for Ingham Retirement Group
in ANY STATE
401(k) Plan Administrator
for Professional Capital Services, LLC
in PA
401(k) Plan Administrator
for PASI, LLC
in CT
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