BenefitsLink Health & Welfare Plans Newsletter for February 22, 2010

[Guidance Overview]
Health Plan TPA Still a Fiduciary Despite Disclaimer
Excerpt: "A Pennsylvania benefit plan third-party administrator breached its fiduciary duties by overpaying three medical claims, a federal judge in New Jersey has ruled. U.S. District Judge William J. Martini of the U.S. District Court for the District of New Jersey made the ruling in a suit filed by a Jersey City, New Jersey, municipal securities brokerage firm against the TPA for its health plan. Martini rebuffed an argument by defendant Loomis Company of Wyomissing, Pennsylvania, that it was not a fiduciary . . . ."
(PLANSPONSOR.com)

Evidence-Based Dentistry Changing How Some Employers Offer Dental Benefits to Employees
Excerpt: "Dental coverage, traditionally a one-size-fits-all benefit, is becoming more complex. For interested employers, though, the more nuanced options may provide better prevention and related cost savings than does the cookie-cutter approach. The plan designs, which range from new covered services to better coverage of existing treatments, have emerged from an evolving body of research called evidence-based dentistry. As the field develops, one of its central tenets is risk stratification."
(Workforce Management; free registration required)

Obama's Health Care Proposal as Released by the White House, February 22, 2010
Excerpt: "The proposal President Barack Obama will bring to his Thursday health 'summit' with Congressional leaders contains many of the ideas from the bills already passed by the Democratic House and Senate, including a mandate that individuals buy insurance and a promise to 'end discrimination' from pre-existing conditions."
(Kaiser Family Foundation)

Senator Feinstein to Introduce Legislation to Curb Health Insurance Premium Hikes
Excerpt: "Feinstein to introduce legislation to curb premium hikes Sen. Dianne Feinstein (D-Calif.) announced her intentions to introduce legislation . . . to prevent insurance companies from raising their premiums unfairly. The bill would create a national Medical Insurance Rate Authority, which would regulate 'egregious premium rate increases,' according to a statement put out Friday by the senator's office."
(Capitol News Company LLC)

Cost, Coverage, Insurance Reforms Lead Agenda for February 25 Health Reform Meeting
Excerpt: "In a letter addressed to the four top congressional leaders, White House Chief of Staff Rahm Emanuel and Health and Human Services Secretary Kathleen Sebelius outlined the format of the scheduled February 25 health care reform meeting requested by President Barack Obama."
(Wolters Kluwer)

A Plan for Employers to Improve Employee Health and Medical Plan Efficiency by Eliminating Disparities in Care (PDF)
12 pages. Excerpt: "We use the term 'Culturally Competent Health Care' to describe an approach to health care that offers all participants equal access and opportunity to receive quality care and medical purchasing efficiency through elimination of structural barriers and respect for the cultural context of each individual."
(Aon Consulting)

Obama to Urge Oversight of Health Insurers' Rate Increases
Excerpt: "President Obama will propose on Monday giving the federal government new power to block excessive rate increases by health insurance companies, as he rolls out comprehensive legislation to revamp the nation's health care system, White House officials said Sunday."
(The New York Times; free registration required)

[Opinion]
HR Leaders Urge the President and Congress to Consider the Views of the Employer Community in Designing Comprehensive Health Care Reform (PDF)
4 pages. Excerpt: "Statement By Jeffrey C. McGuiness, President and CEO of the HR Policy Association, Representing the Views of Association Members on Reform of the U.S. Health Care System"
(HR Policy Association)

[Opinion]
Our Broken Health Insurance System: Insurance Companies Prosper, Families Suffer
Excerpt: "Our broken health insurance system has allowed these premium increases to occur. More than 94 percent of insurance markets in the United States are now highly concentrated./19/ Without competition, insurers have no reason to drive costs down, and without additional choices in the marketplace, consumers have no choice but to continue to pay, or lose coverage. As premiums go up in the current economic climate, more and more families are priced out of the market altogether, making a bad situation worse."
(U.S. Department of Health & Human Services)

[Opinion]
Responsible Health Care Reform (PDF)
Pages 16-19 of 30 pages. Excerpt: "This article is the first in a four-part series about what actuaries see as ideal components of a health care reform package."
(Society of Actuaries)

[Opinion]
Podcast: Most Employers Skeptical of Healthcare Reform
Excerpt: "Towers Watson's Steve Raetzman discusses the firm's study, which found that employers are skeptical about the cost savings of healthcare reform."
(PLANSPONSOR.com)

Executive Compensation; Benefits in General

[Guidance Overview]
Employee Benefits Update, February 2010 (PDF)
The nine-page newsletter presents select compliance deadlines and reminders; retirement plan developments; and, health and welfare plan developments, with comments from Reinhart.
(Reinhart Boerner Van Deuren s.c.)

[Guidance Overview]
Who is Entitled to Life Insurance Benefits and Top-Hat Benefits from an ERISA Plan Following Divorce or Marital Separation?
Excerpt: "ERISA plans generally need not follow state-court orders. On the other hand, ERISA plans must follow the designation terms of those DROs that are qualified domestic relations orders ('QDROs'). Questions have been raised about whether life insurance plans and top-hat plans (which are pension plans maintained primarily for the purpose of providing deferred compensation for a select group of management or highly compensated employees) must follow the designation terms of a DRO that 'satisfies the QDRO requirements,' but contradicts a designation made pursuant to the plan terms."
(Social Science Research Network)

Flextime May Hold Surprising Benefits for Employee Health, a Study Finds
Excerpt: "Workers who had more control over their schedules and work days saw improvements in both physical and mental health, according to a review published in The Cochrane Library."
(ABC News)

Annual Statistical Supplement to the Social Security Bulletin, 2009
Excerpt: "The Supplement is a major resource for data on our nation's social insurance and welfare programs. The majority of the statistical tables present information about programs administered by the Social Security Administration -- the Old-Age, Survivors, and Disability Insurance program, known collectively as Social Security, and the Supplemental Security Income program. In addition, data are presented on the major health care programs -- Medicare and Medicaid -- and social insurance programs, including workers' compensation, unemployment insurance, temporary disability insurance, Black Lung benefits, and veterans' benefits."
(U.S. Social Security Administration)

[Opinion]
Bipartisan Commission To Tackle Social Security and Medicare Reform Issues
Excerpt: "In the wake of the failure by Congress to agree to a binding commission to restore fiscal stability by recommending changes to Social Security, Medicare, and Medicaid, President Barack Obama has established by executive order the National Commission on Fiscal Responsibility and Reform."
(Wolters Kluwer)

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