[Guidance Overview] Remember to Distribute Annual Medicare Part D Notices by November 15, 2009 Excerpt: "Just a reminder that it's time once again to make sure that you have distributed the Notice of Creditable Coverage required under Medicare Part D, which informs participants whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. Once again, the Centers for Medicare and Medicaid Services (CMS) has issued updated forms that you may use to provide this notice. Employers who sponsor a health plan offering prescription drug benefits must provide an annual notice to all Medicare-eligible participants that explains whether the prescription drug benefits offered under the plan are at least as good as the benefits offered under the Medicare Part D plan. The only employers exempt from this notice requirement are those that establish their own Part D plan or who contract with a Part D plan." (Warner Norcross & Judd LLP) [Guidance Overview] Insurer May Consider Relevant Nonmedical Information in Deciding Disability Claim, According to Court Excerpt: "EBIA Comment: As this case illustrates, it is not necessarily an abuse of discretion for a plan decisionmaker deciding a disability claim to provide its consulting physicians with nonmedical information about a claimant's relevant employment history (provided the plan gives the decisionmaker wide discretion in the types of evidence it may consider). Furthermore, a determination that a claimant satisfies the SSA's standard for disability benefits does not mean the claimant is automatically entitled to benefits under an ERISA plan. But although an ERISA plan administrator is not bound by an SSA disability determination when reviewing a claim for benefits under an ERISA plan, some courts have concluded that a plan's failure to consider an SSA determination is a factor in reviewing a claim denial." (Employee Benefits Institute of America) AARP Could Benefit from the Health Insurance Reforms It Advocates Excerpt: "From 2007 to 2008, AARP royalties from insurance plans, credit cards and other branded products shot up 31 percent -- from less than $500 million to $652 million -- making such fees the primary source of revenue for the group last year, the records show." (The Washington Post; free registration required) Small Businesses Facing the Largest Health Insurance Premium Increases in Massachusetts Excerpt: "Three years after Massachusetts enacted its sweeping health-reform legislation, rising health costs continue to bedevil the state and threaten to derail reform efforts. Despite a significant restructuring of the state's health sector and dominance of nonprofit health plans, Massachusetts still has the highest health-insurance costs in the nation, averaging $13,788 for a family, according to the Kaiser Family Foundation. One of the reasons so many people supported the reform effort in Massachusetts is that they were told universal coverage would lead to lower costs. With universal coverage, Massachusetts politicians argued, as many in Washington do today, people would no longer have to pay the medical bills of those who don't have insurance -- the 'free riders' -- and therefore health-insurance premiums would fall, or at least level off." (The Wall Street Journal via Galen Institute) Now-Secret Medical Care Claims Denial Rates Could Tell Consumers a Lot About Their Insurance Company Excerpt: "There is no reliable estimate of the total number of health care claims that insurers deny annually. But Mark Rieger, chief executive of National Health care Exchange Services, which collects claims data from physicians, says the number certainly is in the millions annually. Rescissions are estimated to be only in the thousands." (California Nurses Association / National Nurses Organizing Committee) Senate Passes Defense Authorization Bill Which Includes FMLA Military Leave Provisions Excerpt: "The bill includes an expansion of Family and Medical Leave Act (FMLA) provisions related to qualifying exigency leave and military caregiver leave. Qualifying exigency leave would be available to family members of active duty military and military caregiver leave would be available to family members of veterans. The House approved the conference report on October 8. The bill is expected to be signed into law by President Obama." (Hewitt Associates) Employer-Sponsored Health Insurance Erosion Continues (PDF) 22 pages. Excerpt: "This new EPI report shows that employer-sponsored health insurance (ESI) has declined every year since 2000, currently leaving 45.7 million people under 65 without any coverage and estimates suggest another 10 million people will be without ESI by 2010 unless the economy makes an unpredicted swift rebound or there is large-scale health reform." (Economic Policy Institute) The New Health Participation and Access Data from the National Compensation Survey Excerpt: "New data on participation in and access to health care benefits allow for the study of the correlation between health care cost and health plan participation. This article compares this correlation between two occupational groups: management, professional, and related workers and service workers. Although participation is a significant factor in determining the estimates of average employer costs for health care benefits, other factors, such as annual hours worked, mix of jobs and industries, and the percentage paid by the employer can also have substantial effects." (U.S. Bureau of Labor Statistics) Integrate Workers Compensation to Cut Health Costs, According to Study Excerpt: "Integrating occupational and nonoccupational treatment would produce savings between $490 billion and $560 billion during the first 10 years, according to the report by researchers at the University of California, Berkeley. 'Savings would result from the much greater efficiency with which health insurance delivers care compared to workers compensation insurance,' according to the report released late last week that was funded by a grant from the Oakland-based California HealthCare Foundation. 'Only 12% to 14% of health insurance premiums go toward administration and profit,' researchers said in the report. 'Workers compensation turns this ratio on its head, spending the majority (50-60%) of premiums on these same overhead costs,' the researchers found." (Business Insurance) 'Cadillac' Tax on Health Insurance Worries Unions Excerpt: "Unions representing thousands of teachers and state and local government workers are bracing for the worst if Congress adopts a proposed 'Cadillac' tax on health insurance. The 40 percent levy on health care costs above $8,000 for individuals and $21,000 for families passed the U.S. Senate Finance Committee on Oct. 13. If the tax were to become law, experts said, government employees in New York would be hit hard because their powerful unions have negotiated benefits that go beyond medical and prescription drug coverage to include, among others, dental and vision. The tax would be paid by insurers who then are expected to pass it along in the form of higher premiums, deductibles and co-pays. 'A lot of state workers would qualify because of the dental and vision, and the fact that health care is the fastest growing expense,' said Kenneth Brynien, head of the 59,000-member state Public Employees Federation." (Newsday)
Webcasts and ConferencesAnnouncing the Results of Buck Consultants' 2009 Global Wellness SurveyNationwide on November 19, 2009 presented by Buck Consultants, an ACS Company Boosting Employee Morale - Webinar Demonstrates How To Produce Personalized Employee Benefit Statements In House On Your Own Computer Nationwide on November 4, 2009 presented by Benefit Software Inc. Discover The Keys To Improving Employee Morale - Total Rewards Webinar Nationwide on October 29, 2009 presented by Benefit Software Inc. Employee Benefit Enrollment Made Easy! Webinar Demonstrates How To Simplify Complex Benefits Enrollment Nationwide on October 29, 2009 presented by Benefit Software Inc. Legislative and Regulatory Overview and Legal Update in District of Columbia on November 19, 2009 presented by Capital Chapter ISCEBS The New Pension Funding Regulations: It's Not All It Appears To Be Webcast Nationwide on November 4, 2009 presented by International Foundation of Employee Benefit Plans (Click to post your webcast or conference) Press ReleasesPBGC Announces Maximum Insurance Benefit for 2010Pension Benefit Guaranty Corporation (PBGC) New Charles Schwab Data Reveals Increase in 401(k) Plan Participation Charles Schwab & Co., Inc. Transamerica Recovery Action Plan Receives Top Honors from the Profit Sharing/401k Council of America Transamerica Retirement Services New Benefits and Compensation Glossary Provides Essential Definitions For Benefits Professionals International Foundation of Employee Benefit Plans Donald J. Segal Honored by the American Academy of Actuaries American Academy of Actuaries CDM Retirement Consultants, Inc. Announces Defined Benefit and Cash Balance Plan Services. CDM Retirement Consultants, Inc. (Click to post your press release) Employee Benefits JobsDC / 401(k) Compliance Consultantfor The Savitz Organization in DE, NJ, PA Pension Administrator for Chambers Benefit Group in NM Recordkeeping Manager for Prudential in IA Plan Administrator/Conversion Analyst for Employee Fiduciary in AL Defined Benefit Plan Administration Professional for Goldleaf Partners in AZ, FL, MN Wellness Program Administrator for Blood Systems in AZ Sr Benefits Administrator for DePaul University in IL Executive Director - New Business Development for GuideStone Financial Resources of the Southern Baptist Convention in TX Consultant-TPA (Third Party Administrator) Services, #0901438 for John Hancock Financial Services in MA Business Development Director - ESOP for RSM McGladrey in IL, MN Staff Consultant - Retirement Plan Administrator for BKD, LLP in MO Qualified Plan Administrator for Howard Feinstein & Associates in IL (Click to post your job opening | View all jobs | RSS feed of all jobs ) EmployeeBenefitsJobs.com (Sponsor) (Click on banner to learn more.)
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