Health & Welfare Plans Newsletter |
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| September 24, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy | ||
Opal Events (Advert.)
The Future of Medicare Advantage under the New Administration Opal Events brings together the best and brightest of the Medicare Advantage community to discuss the problems and solutions facing the managed care industry today. Topics to be covered include: logistics of transitioning members from PFFS to a network; MIPPA interpretations; risk-adjusted reimbursement issues; compliance specific to Part D; and HR6331. |
[Guidance Overview]
Recent New York Laws Affect Health and Welfare Plans
Excerpt: "The State of New York recently enacted two laws that will dramatically impact insured employee benefit plans, and the group health insurance industry as a whole, in the Empire State. The first law effectively extends the maximum length of federal COBRA and state-mandated continuation coverage to three years, while the second law allows certain children to continue coverage under their parents' employer-based group health plans through age 29. Perhaps as important as the provisions of the new laws themselves is the possibility that other states may follow suit in the near future." (Miller Chevalier)
[Guidance Overview]
Summary Plan Description and Denial Letters Adequately Disclosed One-Year Limitations Period
Excerpt: "EBIA Comment: The courts have varied on what kind of notice, if any, must be given of plan-imposed limitations periods. . . . Although the case law is mixed on this question, plans may be able to avoid costly litigation by prominently including the limitations in a plan's SPD as well as its notice of benefits determination on review." (Employee Benefits Institute of America)
[Guidance Overview]
IRS Updates Its Website Sept. 2 to Provide More Guidance on COBRA Premium Subsidy
Excerpt: "The IRS updated its website to provide more guidance on the COBRA premium subsidy. New Q&A addresses changes in eligibility and the potential tax liability of high income individuals who receive the subsidy." (Deloitte via BenefitsLink.com)
[Guidance Overview]
Sixth Circuit Reviews ERISA Plan TPA Benefit Denial De Novo
Excerpt: "This recent Sixth Circuit case addresses several important legal issues, including the appropriate standard of review when a delegate makes a fiduciary decision and the application of an exclusion medical expenses incurred during performance of illegal acts." (Roy Harmon III via Health Plan Law)
Health Care Reform No Big Deal to Most Americans, According to Poll Results
Excerpt: "Want to know why President Obama continues to have trouble gaining traction in the national debate about health-care reform? A Franklin & Marshall College poll to be released today offers a few key clues. The national survey of 1,046 people, including 900 registered voters, found that only one in five considered health care to be the most important problem facing their families today. By comparison, half of those polled said the economy and their personal finances were their biggest day-to-day concerns." (Philadelphia Daily News via Philly Online, LLC)
What Will Employers Do If Health Reform Is Enacted?
Excerpt: "Employers say they will not absorb any additional costs that arise from health reform and, in fact, they plan to take action to avoid doing so, according to the survey. Among the steps they'd consider include reducing benefits, raising prices for customers, and/or reducing head count. Towers Perrin surveyed 433 HR and benefit executives from midsize and large organizations." (Wolters Kluwer)
Cisco Systems Links High Touch With Hi Tech to Engage Employees in Their Own Health
Excerpt: "Imagine attracting nearly 5,000 employees to a health screening in a heated competition to get their biometric numbers, hosting a secure messaging program where employees can conveniently communicate with their doctors via e-mail, or unveiling an on-site health center on YouTube. These are just a few of the many ways Cisco Systems, a leading provider of Internet technology solutions, is engaging its employees in managing and safeguarding their health for the long term." (Towers Perrin)
The Baucus Chairman's 'Mark' for Health Care Reform Legislation
Excerpt: "While the new proposal is similar to the framework released the previous week, differences include the cost of the package and a 'Sense of the Senate' provision that encourages the states to test pilot projects to reform the medical malpractice system. Moreover, additional changes are expected as Baucus seeks support, including more affordable plans and raising the limits on 'Cadillac' plans. In many respects, the outline of President Obama's reform principles, as outlined in his speech, bears a marked resemblance to the Finance Committee's framework, with a couple of exceptions. First, the President supported a pay-or-play employer mandate on non-small employers. Second, the President took a backdoor approach to the issue of whether or not to include a 'public option' as part of health care reform. After reciting all the reasons why a public plan option should be included, the President went on to say that it was possible that other ways of achieving the same objective would be 'worth exploring.'" (The ERISA Industry Committee)
CBO Letter Giving an Analysis of Premiums Under the Chairman's Mark of the America's Healthy Future Act (PDF)
8 pages. Excerpt: "This letter responds to your questions about the subsidies offered through insurance exchanges and enrollees' payments for that coverage under the specifications for the Chairman's mark for proposed health care legislation that were provided by the staff of the Senate Finance Committee on September 15, 2009. It also discusses the factors that affect a comparison of those figures to the amounts that individuals and families would pay, on average, for employment-based coverage or individually purchased policies under current law." (U.S. Congressional Budget Office)
Budgetary Effects of Prevention Programs Need Clinical Data Over a Long Time Period
Excerpt: "Although preventive health measures will not necessarily save money on health care spending, over the long term, they at least will offset a large part of the costs of the prevention programs, according to a study published in the September 1 online journal Health Affairs. Health care reform proponents often claim that expanding coverage and preventive health measures will lower health care costs. The study researchers, from the University of Chicago's Medical School and the National Opinion Research Center, detail how an 'epidemiological' assessment over a period of 25 years, not the commonly used ten-year period, can more accurately project the actual costs of health care reform measures, because 'the positive effects of improved treatment often take decades to show clinically significant effects.'" (Wolters Kluwer)
Corporate Wellness Program Begins with the Company Culture
Excerpt: "The first step is to assess the current culture. How do you know if a company is ready for a wellness program? You don't, but understanding three things: trust, motivation and commitment, will help drive the process." (Employee Benefit Adviser; free registration required)
Proposed Amendment Would End Federal Health Benefits Plan
Excerpt: "Several of the more than 500 amendments the Senate Finance Committee is facing as it begins a marathon markup of health care reform legislation would affect public servants' health coverage -- and one would end the federal government's health insurance program. The provision, offered by ranking member Sen. Charles Grassley, R-Iowa, would force civil servants to leave the Federal Employees Health Benefits Program and purchase insurance through the state-based health exchanges that are a centerpiece of the health reform bill. Employees would move to the exchanges beginning in 2013." (GovernmentExecutive.com)
Ex-HR Chief Gets 57-Month Jail Term in $6M Benefits Plan Swindle
Excerpt: "Hitachi America's former HR director has been sentenced to a 57-month jail term in connection with his guilty plea to charges he defrauded the Hitachi America Group Health and Welfare Plan of more than $6 million. A news release from federal prosecutors in New York said the sentence was imposed by U.S. District Judge Colleen McMahon on defendant Dennis M. Dowd after Dowd's guilty plea in March to one count of health-care fraud and one count of money laundering . . . ." (PLANSPONSOR.com; free registration required)
Smoking Bans Cut Heart Attacks by a Third, According to Study
Excerpt: "'This study adds to the already strong evidence that secondhand smoke causes heart attacks, and that passing 100 percent smoke-free laws in all workplaces and public places is something we can do to protect the public,' James Lightwood of the University of California-San Francisco, whose study appears in the journal Circulation, said in a statement. The team pooled data from 13 studies of smoking bans in communities in the United States, Can.ada and Europe. They said heart attack rates fall immediately after smoking bans are put in place, dropping by 17 percent in the first year and by as much as 36 percent after three years." (Reuters)
Health Expense Accounts Could Face Cuts
Excerpt: "The health care bill proposed last week by the Senate Finance Committee would pare tax-free health expense accounts. . . . The legislation would limit FSA contributions to $2,000 a year beginning in 2013. And it would standardize the expenses that are qualified. 'The Finance Committee presumably decided that the revenue loss from FSAs is large in relation to the good it does,' says Paul Ginsburg, president of the Center for Studying Health System Change." (USA TODAY)
[Opinion]
Reform Plans Leave Health Savings Accounts in Limbo
Excerpt: "While Washington wrangles over health care, the nation's last big reform innovation faces an uncertain future. Health Savings Accounts, the hybrid of flex spending accounts and IRAs that President Bush created in 2003, are an afterthought in the current proposals on Capitol Hill -- with strenuous debate over whether their demise would be a disaster or a welcome end to a program that never lived up to its promise." (CNNMoney.com)
[Opinion]
Taxing Health Benefits Is Bad Policy
Excerpt: "Most of us think health benefits are between our employer and ourselves. In reality, the system of employer-provided insurance exists only because health benefits aren't taxed like wages. If they were, the government would take in as much as $200 billion a year in new revenues, more than enough to pay for reform. Not taxing benefits, in effect, is a giant subsidy for employer-provided health insurance. It's justified, proponents say, because it makes coverage affordable to most working people." (St. Louis Post-Dispatch)
ALM (Advert.)
Complete Benefits Law Guidance from Law Journal Press The nation's workforce and health care system are constantly evolving and so are the legal issues. Law Journal Press helps you handle any benefits law question with up-to-date, authoritative books on all aspects of the field. Get legal and practical advice from leading experts on everything from COBRA to ERISA, "contingent" employees to family and medical leave, and more. Browse our product listings for detailed information and special offers. |
Webcasts and Conferences
Smartcast -- New HIPAA Breach and HITech Rules w/ Craig J. Davidson, CEBSNationwide on October 20, 2009
presented by FutureOffice Network
The Medical Home Web Summit
Nationwide on October 29, 2009
presented by MCOL
(Click to post your webcast or conference)
Press Releases
Vast Majority of Employers Expect Health Care Reform to Increase Costs, Watson Wyatt Poll FindsWatson Wyatt
IRS Issues Guidance on 2009 Required Minimum Distribution Waiver
Internal Revenue Service (IRS)
Putnam Investments Offers Target Date Funds to Integrate Absolute Return Strategies
Putnam Investments
TRI-AD and Paylocity Integrate Their Payroll/HRIS and 401k Recordkeeping Services
TRI-AD
Employees and Employers Reveal High Satisfaction and Improved Cost Control with HSAs, Surveys Report
Buck Consultants, an ACS Company
McHenry Partners Add Staff in California
McHenry Partners
(Click to post your press release)
Employee Benefits Jobs
Plan Administrator for Retirement Plan & ERISA Specialistsfor Dana Consulting Group, Ltd.
in IL
Trust Counsel
for Northern Trust Company
in IL
(Click to post your job opening | View all jobs |
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EmployeeBenefitsJobs.com (Sponsor)
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Handy Links:
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