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Health & Welfare Plans Newsletter

August 16, 2010

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This one-hour e-learning course will examine the grandfathered health plan regulations that determine whether health plans have to comply with the full scope of PPACA, or whether certain important provisions can be avoided. You’ll learn the 12 main ways grandfathered status can be lost, special rules for collectively bargained plans and whether the law applies to retiree-only plans, dental, vision and more.

[Guidance Overview]
Court Rules That Physician's Extra Pay Is Overtime, and Is Therefore Excluded in Determining Amount of His Disability Benefit
Excerpt: "The Court analyzed the case by reviewing ReliaStar's conclusion that the $80,000 pay was overtime. In reviewing this conclusion, the Court applied a deferential standard, giving only some weight to ReliaStar's conflict of interest (as both plan administrator and benefit payor) since the plaintiff was unable to say how the conflict adversely affected ReliaStar's conclusion."
(Stanley D. Baum of Fellheimer & Eichen LLP)

[Guidance Overview]
HHS Relief for Incomplete Applications to the Early Retiree Reinsurance Program
Excerpt: "HHS has provided three methods of correcting problems . . . ."
(Wolters Kluwer)

[Guidance Overview]
Proposed Modifications to HIPAA Privacy and Security Rules
Excerpt: "A determination of whether a business associate or subcontractor is an agent for whom the principal is vicariously liable under the Proposed Rule or is instead an independent contractor requires a case-by-case inquiry based on the facts of the relationship, including the covered entity's level of control over the vendor's conduct."
(Merion Matters)

[Guidance Overview]
Being a Grandfathered Health Insurance Plan Brings Certain Advantages (PDF)
3 pages.
(The National Law Journal via Proskauer Rose LLP)

[Guidance Overview]
Court Rules COBRA Election Notice and Subsequent Letters Were Not Misleading
Excerpt: "EBIA Comment: Once the plan administrator has notified a qualified beneficiary of the COBRA premium payment obligations (e.g., how much to pay and when), the qualified beneficiary has the responsibility to make timely payment. Any further notification about premiums via billing statements, late-payment reminder letters, coupons, etc., is optional."
(Employee Benefits Institute of America)

What Are the Provisions in the New Health Law for Containing Costs and How Effective Will They Be?
Excerpt: "Policymakers are trying a wide array of approaches in an attempt to control costs, including competition among health plans, taxes on high-cost plans, delivery system and payment reforms, wellness programs, and controls over Medicare provider payments."
(Urban Institute)

Companies Increasingly Requiring Employees to Make More Decisions Regarding Their Benefits and Assume Greater Financial Responsibility
Excerpt: "The recession coupled with the historic passage of federal healthcare reform is dramatically changing the way companies are handling employee benefits, according to preliminary findings of a survey of employers, employees, insurance brokers and consultants by Prudential Group Insurance."
(Human Resource Executive Online)

Review of Insurers on Soldiers' Death Benefits Requested
Excerpt: "Sen. Richard Shelby, R-Ala., the ranking Republican on the Senate Banking Committee, requested that the panel review the practice of insurers earning income by retaining soldiers' death benefits rather than sending lump-sum payments to survivors."
(Bloomberg via Business Insurance)

How Will Reform Affect Health Care Costs?
Excerpt: "A series of brief reports . . . explores the effects that the Patient Protection and Affordable Care Act . . . will likely have on consumers, state governments, the economy and health care costs. In the reports released [August 12th], Urban Institute researchers examine how cost controls in the legislation, new rules for allowing purchase of health insurance across state lines, and malpractice reform could affect the amount of money Americans spend on health care and insurance."
(Robert Wood Johnson Foundation)

Audio and Text: Unlimited Vacation Time Not a Dream for Some
Excerpt: "Why the uptick in unlimited paid leave now? Studies have long shown that -- believe it or not -- such flexibility actually makes workers more productive and engaged. But Lenny Sanicola, with the human resources group World at Work, which surveys company benefits, suspects something more. Sanicola notes that with all the perks being cut during the recession, vacation time has held its own."
(National Public Radio)

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.
Sponsored by ALM

Benefits in General; Executive Compensation

FAA May Ease Stance on Reimbursements for Personal Use of Company Jet
Excerpt: "The FAA announced on July 8 it is revisiting a longstanding interpretation that effectively blocks flight operators -- employers, as the case may be -- from accepting reimbursement for the cost of personal, non-business flights operated under the non-commercial rules of Part 91 of the Federal Aviation Regulations (FARs). The FAA is digesting public comments on the re-interpretation before making the revision final."
(Thompson Publishing Group Inc.)

The Deal Lawyer's Guide to Hidden Employee Benefit Issues (PDF)
5 pages.
(Executive Press, Inc. via Dechert LLP)

California's Ban on Same-S.ex Marriage Found Unconstitutional
Excerpt: " An appeal to the Ninth Circuit has already been filed, but as we said in our article on the Massachusetts case, it is impossible to predict how the issues will fare in the court of appeals (or potentially in the U.S. Supreme Court)."
(Employee Benefits Institute of America)

U.S. ESOP Company Database Now Available
The NCEO compiles databases of ESOP companies from data collected by the U.S. Department of Labor. These databases are now available for purchase, either for the entire United States ($400 for members; $600 for non-members) or for a specific region ($125 for members; $200 for non-members). Each database is provided as a spreadsheet in Microsoft Excel format and includes a brief codebook describing the data and how to use it.
(National Center for Employee Ownership)

Press Releases

ACOPA Honors Actuary Robert H. Schramm for Distinguished Service
American Society of Pension Professionals & Actuaries (ASPPA)

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