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Health & Welfare Plans Newsletter

October 8, 2010

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An employer writes:

"I have to tell you that of all the job boards I've ever used, this one has the best quality of candidates. I don't get flooded with tons of resumes, and even the candidates who aren't fit for the jobs we have don't miss the mark by much."

[Guidance Overview]
Iowa Court Upholds Calculation of Disability Benefit by Plan Administrator
Excerpt: "Under the Plan, in general, a participant's LTD benefit is a percentage of 'Total Monthly Earnings' (up to a maximum amount), and is reduced by 'Other Income' . The plaintiff claimed that Sun Life, as plan administrator, miscalculated plaintiff's benefits by failing to include the value of his cafeteria plan benefits in ' Total Monthly Earnings ', and by including in 'Other Income' his LTD benefits from Social Security."
(Stanley D. Baum of Fellheimer & Eichen LLP)

[Guidance Overview]
HHS Guidance on the HIPAA Opt-Out for Self-Funded Nonfederal Governmental Plans (PDF)
3 pages. Excerpt: "It appears that HHS recognizes that the timing of this guidance does not give plans sufficient time to properly communicate any rule changes . . . ."
(Buck Consultants)

Are 'Mini-Med' Plan Waivers a Good Idea?
Excerpt: "The administration has been very careful to, on the waivers from the restrictions on annual benefit limits, make them year-by-year waivers. So these are not blanket waivers, these are not eternal waivers."
(Henry J. Kaiser Family Foundation)

The 2010 Health Care Legislation: Here Today, Gone Tomorrow?
Excerpt: "Drastic health care reform legislation was voted into law less than six months ago by the 111th Congress. Is it possible that it will be voted out of law by the 112th Congress? It is possible. But it would take a trifecta [of events] to pull [it] off . . . ."
(Alvin D. Lurie, Esq. via

Researchers Pinpoint More Obesity Costs In Workplace
Excerpt: "One hidden cost of obesity is lost productivity in the workplace -- a problem with a price tag as high as $73.1 bil.lion, according to a new study, Agence France-Presse reports."
(Henry J. Kaiser Family Foundation)

Program Perspectives on Fee-for-Service Medical Plans (PDF)
Excerpt: "Fee-for-service medical plans make up the majority of (78 percent) of employer provided medical plans in private industry."
(U.S. Bureau of Labor Statistics)

What Changes In Survival Rates Tell Us About U.S. Health Care
Excerpt: "Many advocates of US health reform point to the nation's relatively low life-expectancy rankings as evidence that the health care system is performing poorly. Others say that poor US health outcomes are largely due not to health care but to high rates of smoking, obesity, traffic fatalities, and homicides."
(Health Affairs)

Federal Judge in Michigan Rules That the New Health Care Overhaul Law Is Constitutional
Excerpt: "[T]he decision issued Thursday . . . is the first to reject a claim based on the merits, marking a notable victory for the Obama administration."
(The Washington Post; free registration required)

Smaller Percentage of Employees Say They Have Health Coverage from Their Employer
Excerpt: "A news release about the Gallup and Healthways survey said the year-to-date average for employer-based coverage is 46% and trending down compared with 2009 and 2008. The dropoff in employer-based coverage began in the fall of 2008 with the economic downturn and corresponding large-scale layoffs."

HHS to Allow Medical Loss Ratio 'Discretion' as NAIC Action Approaches
Excerpt: "The National Association of Insurance Commissioners' Health Insurance and Managed Care Committee will evaluate draft MLR rules in an Oct. 14 conference call meeting. The committee could finalize a draft to be approved by the full body at the NAIC's fall national meeting Oct. 18-21."
(A.M. Best Company, Inc.)

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Benefits in General; Executive Compensation

Large Employers Planning Summary Plan Description Updates Are Unsure of Costs
Excerpt: "The 2010 survey, which included responses from Fortune 1000 companies, noted that the biggest change expected in the next few years is updating SPDs for plan design and health care reform changes, with 71% of respondents expecting to do so within the next year."
(Wolters Kluwer)

Boomers' Shrunken 401(k)s Spark Interest in Reverse Mortgages
Excerpt: "Ten years ago, reverse mortgages were primarily used by widowed or single women well into their 70s with little other means of retirement income. Now, big losses to retirement savings as a result of the financial crisis have stoked interest among younger retirees of both sexes."

California Faces $379 Bil.lion Retirement Liability, According to Study
Excerpt: "A new study released by the Foundation for Educational Choice and the Pacific Research Institute estimates California's unfunded liability for state (CalPERS and CalSTRS) pensions and retiree health care at $379 bil.lion."
(The Reason Foundation)

S.&P. Says Cost to Care for World's Elderly Will Spiral
Excerpt: "Credit analysts at Standard & Poor's said on Thursday that the cost of caring for the world's aging populations would be 'on an explosive path' and could swamp the budgets of many countries in the next 40 years unless governments accelerated belt-tightening efforts that are already proving highly unpopular."
(The New York Times; free registration required)

One Man's Story About the Origins of ERISA
Interview with Jeffrey Mamorsky. Excerpt: "Do you know who came up with the name 'Employee Retirement Income Security Act'? That's quite a mouthful and I was curious as to its origin."

Webcasts and Conferences

"ERISA Workshop" - Boston
in Massachusetts on November 5, 2010
presented by SunGard Relius

"ERISA Workshop" - New Orleans
in Louisiana on November 4, 2010
presented by SunGard Relius

"ERISA Workshop" - Philadelphia
in Pennsylvania on November 4, 2010
presented by SunGard Relius

"ERISA Workshop" - Seattle
in Washington on November 4, 2010
presented by SunGard Relius

"QDROs - From Confrontation to Clarity" Web Seminar
Nationwide on November 16, 2010
presented by SunGard Relius

"The Ins and Outs of Multiple Employer Plans" Web Seminar
Nationwide on November 3, 2010
presented by SunGard Relius

"To Roth or Not To Roth" Web Seminar
Nationwide on October 13, 2010
presented by SunGard Relius

Press Releases

ASPPA Urges IRS to Clarify Circular 230 Requirements
American Society of Pension Professionals & Actuaries (ASPPA)

Newly Posted Employee Benefits Jobs

Compliance Specialist (Form 5500)
for ERISA Pros
in GA

Retirement Plan Administrator
for Qualified Plans, LLC
in GA

Defined Contribution Pension Plan Administrator
for The Angell Pension Group, Inc.

Retirement Services Consultant
for Administaff
in TX

Benefits Analyst
for Broadridge Financial Solutions
in NJ

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