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Health & Welfare Plans Newsletter
December 17, 2009 
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CFOs love our budget-friendly benefit statements. And so will the rest of your employees.
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[Guidance Overview]
Health Care Provider's Tort Claims Preempted Under Fifth Circuit ERISA Jurisprudence
Excerpt: "In this opinion out of the Southern District of Texas, the Court finds the health care provider's claims for reimbursement preempted where the provider sued the health plan asserting 'tort claims flowing from the direct communications and business relationship between the parties.' The presence of an assignment of benefits and the absence of claims based upon a managed care contract contributed largely to the plan's successful defense." (Roy Harmon III via Health Plan Law)
[Guidance Overview]
New York State Insurance Law 36-Month COBRA Extension: New Effective Date and Special Enrollment Notices
Excerpt: "On November 19, 2009, New York State amended the 36-month COBRA extension by providing for a new effective date of November 1, 2009, regardless of when the group health contract was issued, modified or renewed. There is no special notice requirement for this change." (Epstein Becker & Green, P.C.)
U.S. House Approves COBRA Subsidy Extension for Involuntarily Terminated Employees
Excerpt: "Business Insurance said the COBRA measure was contained in a Defense Department spending bill, H.R. 3326, that passed on a 395 to 34 vote. The nine-month, 65% premium subsidy would be extended by six months to a total of 15 months." (PLANSPONSOR.com)
Health Information Technology Basics (PDF)
Excerpt: "Patient care processes in some hospitals have already been transformed by HIT, and many other hospitals will be adopting it in the next few years. Among other types, hospitals are adopting electronic medical records, clinical decision support systems, e-prescribing, medication dispensing, radio frequency identification and tracking, medical credit scoring, telemedicine, and robots." (Institute for Health & Socio-Economic Policy via California Nurses Association / National Nurses Organizing Committee.)
Health Care Reform Bills Have Important Implications for Retiree Health Plans
Excerpt: "If the Senate approves a bill, the House and Senate must negotiate a compromise agreement before legislation can be enacted. Issues with direct and indirect implications for employer-sponsored retiree health care plans will be on the table during those discussions. The business and labor communities have expressed strong opposition to the proposed changes to the tax treatment of the RDS and restrictions on the ability of plan sponsors to modify retiree health plans after an employee retires." (Watson Wyatt Worldwide)
Long-Term Care: Adverse Selection and the CLASS Act
Excerpt: "A proposal in the House and Senate healthcare reform bills, the CLASS Act, establishes a federal long-term care (LTC) program financed from participant premiums without any federal subsidy. The new LTC program is subject to guaranteed issue, and that, combined with its voluntary nature, subjects the CLASS Act to considerable adverse selection risk." (Milliman)
COBRA Extension Added to Dept. of Defense Appropriations Bill
Excerpt: "In an unusual move, the House will consider the COBRA subsidy (and eligibility) extension as part of the House Amendment to the Senate Amendment to HR 3326 (the Department of Defense Appropriations Act, 2010). The applicable provisions can be found [at http://www.rules.house.gov/111/LegText/111_hr3326_hamnd.pdf] as Section 1010 at page 153." (Gary Kushner's Benefits Blo)
One-Third of Health Care Dollars Wasted, According to Study
Excerpt: "A new study from Thomson Reuters Healthcare Analytics confirms one thing we all know about health care costs: fraud, paperwork, unnecessary care and other forms of waste combine to drain a mindboggling amount of money from the U.S. health care system. The new study pegs the total at around $700 billion a year -- about one-third of the total U.S. health care spend." (Employee Benefit Adviser; free registration required)
On the Rise of Health Spending and Longevity
Excerpt: "We use a calibrated stochastic life-cycle model of endogenous health spending, asset accumulation and retirement to investigate the causes behind the increase in health spending and life expectancy over the period 1965-2005. We estimate that technological change along with the increase in the generosity of health insurance may explain independently 53% of the rise in health spending (insurance 29% and technology 24%) while income less than 10%." (Social Science Research Network)
What Would Health Care Reform Mean for Small Employers and Their Workers?
Excerpt: "According to a new report . . ., high administrative costs and limited ability to spread risk result in small businesses paying substantially higher premiums than their larger counterparts for the same benefits. Urban Institute researchers . . . conclude that the health insurance exchanges proposed in both the House and Senate bills, along with associated insurance market reforms, will substantially improve the ability of small employers to obtain affordable coverage. . . . The report also looks at the requirement that employers 'play or pay' -- either provide coverage for their employees or pay an assessment to the government." (Robert Wood Johnson Foundation)
For Employers, the Pros and Cons of Health Care Reform Emerge
Excerpt: "Which version of health care reform is most likely to bolster the employer-based health care system, which many employers claim to support? While fully predicting the consequences of legislation not yet enacted is impossible, the two preliminary estimates created by the CBO and the Joint Committee on Taxation show that increasing coverage is not the best measure -- at least in employers' eyes -- of the success of health care reform." (Workforce Management; free registration required)
[Opinion]
Why Health Reform Legislation Cannot Lay Out a 'Master Plan:' Part 2
Excerpt: "While many uninsured and underinsured patients receive too little care, a great many well-insured patients -- including Medicare patients -- receive too much of the wrong kind of care. Gawande explains: 'Our system neglects low-profit services like mental-health care, geriatrics, and primary care, and [is] almost giddy in its overuse of high-cost technologies such as radiology imaging, brand-name drugs, and many elective procedures.' It's remarkable how those who have investigated reform agree. It's not that we don't know what to aim for. We're just not at all sure how to achieve those goals in a profit-driven health care system." (The Century Foundation)
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Links to Items on Executive Comp, Benefits in General
[Guidance Overview]IRS Provision of Another Year to Comply with Guidance on Transportation Benefit Debit Cards (PDF)
Excerpt: "The IRS has again delayed the effective date of previously issued guidance on using smartcards, debit or credit cards, or other electronic media to provide qualified transportation fringe benefits under Section 132(f)." (Buck Consultants)
Cool Workplaces Offer Flexible Work Schedules
Excerpt: "One of the qualities of a cool workplace is a flexible work schedule, according to Bob Nelson, a worker engagement expert. In an article that ran in early December in Crain's Detroit Business, Nelson said businesses that are genuinely committed to providing flexible work policies attract and retain employees - and produce better results in the marketplace." (Examiner.com)
Benefits Becoming Crucial in Recruiting Contingent Staffers
Excerpt: "Many staffing firms are offering health insurance as well as an array of benefits because these are great ways to attract and retain workers." (Workforce Management; free registration required)
Tax Technical Corrections Bill with Employee Benefit Provisions Introduced in House
Excerpt: "The legislation would make technical corrections to the nonqualified deferred compensation rules under Code Sec. 457A. Among other things, the bill would clarify congressional intent concerning when a partnership is a nonqualified entity for purposes of complying with the rules of Code Sec. 457A that any compensation that is deferred under the plan of a nonqualified entity is includible in the employee's gross income when there is no substantial risk of forfeiture." (Wolters Kluwer)
Webcasts and Conferences
Retirement Planning Workshopin Maryland on January 13, 2010
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)
(Click to post your webcast or conference)
Press Releases
More Employers Considering Annuities in 401(k) Plans, Watson Wyatt Survey FindsWatson Wyatt
PBGC Protects Fairchild Corp. Pensions
Pension Benefit Guaranty Corporation (PBGC)
Newport Appoints Ann Ennis As Head of Financial Institution Service
Newport Group, The
MassMutual to Launch New RetireSmart Participant Engagement Platform
MassMutual Retirement Services
SEI Releases 2010 Update of FAS 87 Disclosure Assumption Research for Pension Plan Sponsors
SEI
The SPARK Institute Releases Draft 2009 Form 5500 Data Guidelines For 403(b) Plans, Seeks Public Comment
The SPARK Institute
The Pension Inspector Adds an Economy Priced Market Research Service
AtPrime Media, Inc.
(Click to post your press release)
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