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Health & Welfare Plans Newsletter

July 23, 2010

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[Guidance Overview]
Federal Regulators Issue Rules for Group Health Plans on Claims and Appeals
Excerpt: "For purposes of compliance with the interim final regulations, a health insurance issuer offering health insurance coverage in connection with a group health plan is subject to the Department of Labor claims procedure regulation to the same extent as if it were a group health plan."
(PLANSPONSOR.com)

[Guidance Overview]
Health Insurance Open Enrollment Preparation: PPACA Notices
Excerpt: "Generally, the notices listed [on this page] must be provided no later than the first day of the first plan year beginning on or after September 23, 2010 (i.e., January 1, 2011 for calendar year plans). Practically, this means that these notices must be incorporated into 2011 open enrollment materials."
(Nelson Mullins Riley & Scarborough LLP)

[Guidance Overview]
Federal Agencies Rules Implementing Preventive Care Requirements Under Health Care Reform (PDF)
Excerpt: "The rules clarify the application of PPACA's first-dollar preventive care coverage requirements, which are effective as of the first day of the first plan year beginning on or after September 23, 2010 (Effective Date)."
(Sutherland Asbill & Brennan LLP)

[Guidance Overview]
Preventive Services Interim Final Rules Under Health Care Reform
Excerpt: "The rules are designed to make preventive health services accessible and affordable by (1) requiring coverage of recommended preventive health services that have strong scientific evidence of their health benefits and (2) not charging plan participants co-payments, co-insurances or deductibles for these services when they are delivered by an in-network provider."
(Proskauer Rose LLP)

Plan Sponsors and Pharmacy Benefit Managers: Are Changes in the Way Drugs Are Priced Coming?
Excerpt: "Questions remain as to whether a controversial benchmark for drug pricing known as AWP, or Average Wholesale Price, is going to be phased out and replaced with another approach."
(Human Resource Executive Online)

Health Care Reform: Summary of Mandates Affecting Traditional Group Health Plans
3 pages. The chart summarizes some of the main changes to traditional group health plans mandated by the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010.
(Davis Wright Tremaine LLP)

Analysis of a Proposal to Offer a Public Plan Through the New Health Insurance Exchanges (PDF)
5 pages. Excerpt: "Under the proposal, a public health insurance plan would be established and administered by the Secretary of Health and Human Services (HHS), and it would have to charge premiums that fully cover its costs for benefit payments and administrative expenses."
(U.S. Congressional Budget Office)

Obama Administration Rolls Out New Insurance Claims Appeals Rules
Excerpt: "The new rules apply to health plans that are self-funded by employers, which haven't always been subjected to external-review requirements, . . . . They do not, however, apply to plans 'grandfathered' in under health-care overhaul legislation, which means they're not subject to some of the provisions of the law."
(The Wall Street Journal)




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Benefits in General; Executive Compensation

[Guidance Overview]
An Overview of the Application of the Bankrup.tcy Law to IRAs and ERISA Retirement Plans
Excerpt: "In Patterson v. Shumate, . . . the Supreme Court held that the anti-assignment provision of ERISA section 206(d) is an enforceable nonbankrup.tcy law which results in the plan benefit being excluded from the bankrup.tcy estate of the plan participant."
(McKay Hochman Co.)

New Thinking on Executive Compensation: Pay CEOs with Debt
Excerpt: "Recovering US insurance giant AIG recently announced that 80% of their executives' bonuses will depend on the price of their firm's bonds and only 20% will depend on the price of their equity. This column argues that such moves will better align CEO fortunes with those of all investors - both shareholders and bondholders - and help prevent future financial crises."
(VoxEU.org)

Majority of Employers Offer Telecommuting, According to Survey
Excerpt: "Of those companies, two-thirds have offered telecommuting for three years or more."
(PLANSPONSOR.com)


Webcasts and Conferences

EFAST2: Amendments, Late Filings and Short Plan Years
Nationwide on August 19, 2010
presented by SunGard Relius


Press Releases

Parnassus Funds Added to CPI Retirement Platform
CPI Qualified Plan Consultants, Inc.

Securian Launches Facebook Page
Securian Financial Group


Click to post your job on EmployeeBenefitsJobs.com

Newly Posted Employee Benefits Jobs

Participant Education Consultant
for The Standard
in CA

Participant Education Consultant
for The Standard
in OH

Participant Education Consultant
for The Standard
in TX

Compliance Analyst - ERISA
for T. Rowe Price
in MD

Defined Contribution Plan Administrator
for Retirement, LLC
in OK

Pension Administrator
for Associated Pension Consultants
in CA

Fund Administrator- Benefits
for The Segal Company on behalf of a client
in NV

Pension Actuary
for Westchester Consulting Firm
in NY

Senior Client Consultant
for Prudential
in IA




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