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Health & Welfare Plans Newsletter

October 20, 2010

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[Guidance Overview]
Health Care Reform Regulations: Internal Claims and Appeals and External Review Processes
Excerpt: "The Departments of Health and Human Services, Labor, and Treasury have provided model notices that can be used to satisfy the notice requirements under the Interim Regulations. These model notices are available at and"
(Ford & Harrison LLP)

Business Groups Seek Health Care Payment Reforms
Excerpt: "'[T]here are no set rules for payment reform. Ideas up for discussion include the bundling of what would be normally be mass billings into fewer invoices, the establishment of bonus systems to reward hospitals for quality service and setting up medically centered homes for patients' . . . ."
(Henry J. Kaiser Family Foundation)

Employers Not Dropping Coverage As Mental Health Parity Law Is Enacted
Excerpt: "The full effects won't be felt until early 2011 as health plans begin their new enrollment years, but '[e]arly indications ... are that relatively few employers are dropping mental health coverage in response to the law's mandate, a concern of some of the bill's opponents.'"
(Henry J. Kaiser Family Foundation)

Implementation Timeline for Health Care Reform Provisions
Excerpt: "The implementation timeline is an interactive tool designed to explain how and when the provisions of the health reform law will be implemented over the next several years."
(Henry J. Kaiser Family Foundation)

New Research Shows Just How Costly Obesity Is to Employers
Excerpt: "The severity of the condition matters. Individuals with a body-mass index greater than 35 represent 37 percent of the obese population, but are responsible for 61 percent of excess costs, the study finds."
(Human Resource Executive Online)

Government Plans' Methods to Keep Health Care Expenses Down
Excerpt: "The battle to contain seemingly relentless increases in health costs has taken different forms among the nation's local governments. Like Asheville, some are pushing wellness programs. Others are holding down their own costs by passing more of the insurance bill to employees."
(American City & County)

Insurers Test New Cancer Pay Systems
Excerpt: "The insurers have begun tightening oversight of the care provided to patients with many different types of cancer, hoping to lower expenses by experimenting with new ways to pay specialists."
(The New York Times; free registration required)

The Impact of the COBRA Premium Subsidy on Coverage (PDF)
Pages 10-14 of 16 pages. Excerpt: "There are widely conflicting estimates of how many people benefited from the COBRA subsidy, but generally there has been lower-than-expected take-up of the subsidy. This may be due to the fact that, even after the subsidy, COBRA premiums may not be affordable for many families, especially at a time when they have seen a decline in income and since health insurance is expensive even with the subsidy."
(Employee Benefit Research Institute)

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."

Benefits in General; Executive Compensation

[Official Guidance]
Text of Notice of Meeting of Advisory Council on Employee Welfare and Pension Benefit Plans (PDF)
2 pages. Excerpt: "[T]he 154th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans will be held on November 3-4, 2010."
(U.S. Employee Benefits Security Administration)

[Guidance Overview]
Ninth Circuit Holds That Top Hat Plan of Insolvent Employer Could Not Distribute Its Funds to Participants
Excerpt: "In accordance with the parties' express intent to create an unfunded top hat plan, Article 10.6's prohibition on distributing the Plan's assets when the employer is insolvent must be interpreted to apply even in the event of plan termination. Thus, the Court held that the Plan could not distribute its funds, if the employer was in fact insolvent."
(Stanley D. Baum of Fellheimer & Eichen LLP)

Companies Should Consider Early Bonus Payments
Excerpt: "Many companies are considering paying bonuses that normally would be paid in early 2011 by December 31, 2010 to ensure that employees receive the benefit of the current, lower tax rates."
(Vorys, Sater, Seymour and Pease LLP)

Employee Benefits Update, October 2010 (PDF)
The six-page newsletter presents select compliance deadlines and reminders; retirement plan developments; and, health and welfare plan developments.
(Reinhart Boerner Van Deuren s.c.)

Webcasts and Conferences

Retirement Plan Connections
Nationwide on December 7, 2010
presented by Pensions & Investments

U.S. Department of Laborís ERISA Advisory Council Meeting
in District of Columbia on November 3, 2010
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Press Releases

PBGC Takes Responsibility for Chardon Rubber Co. Pension Plan
Pension Benefit Guaranty Corporation (PBGC)

U.S. Department of Laborís ERISA Advisory Council to Meet November 3-4, 2010
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Change Medicare Eligibility Age? Public Is Skeptical
Employee Benefit Research Institute (EBRI)

Trends in Confidence About Future of Health Insurance Benefits
Employee Benefit Research Institute (EBRI)

Newly Posted Employee Benefits Jobs

Benefit Analyst (Indianapolis, IN)
for AUL/OneAmerica Financial Partners, Inc.
in IN

Education Consultant
for AXA Equitable
in CA, CO, FL, GA, IL, MI, MN, MT, TN, UT, WY

Pension Administrator
for The Benefits Consulting Group, Inc.
in IL

Internal Sales Director
for Transamerica
in CA

Associate Attorney
for Littler Mendelson, PC
in NY, PA

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