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Health & Welfare Plans Newsletter

November 23, 2010

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No matter how benefits-savvy your employees may be, today's health care environment can confuse the most sophisticated consumer. That's why companies large and small use BeneCom for their benefits communication. We know benefits and we understand what employees need to know to make them work - for themselves and for you. And while we're at it, we make your life a little easier, too.

For more information visit our site or call (860) 674-2626, Ext. 2001

[Guidance Overview]
Sixth Circuit Upholds Plan Administrator's Termination of Disability Benefit Due to Substantial Evidence Showing No Disability As Defined by Plan
Excerpt: "In reviewing the case, the Sixth Circuit Court said that where, as here, the plan administrator-Guardian- has discretionary authority to determine eligibility and construe policy terms, the courts apply the deferential arbitrary and capricious standard when reviewing the plan administrator's decision to terminate benefits."
(ERISA Lawyer Blog)

Health Insurers Must Pay More for Medical Care or Give Refunds
Excerpt: "If insurers don't meet the new rule for premium usage, then companies will be required to provide a rebate to their customers beginning in 2012 . . . ."

Two Surveys Show 'Huge Variation' in Health Costs in U.S.
Excerpt: "The Wall Street Journal: Two studies out Monday - one is a country-by-country survey by the International Federation of Health Plans, and the second from Change: healthcare - "attempt to bring some clarity to how costs stack up, both between different countries and among U.S. providers that might be just a few blocks apart.'"
(Henry J. Kaiser Family Foundation)

Massachusetts Posts Industry Payments to Health Care Providers
Excerpt: "Massachusetts health officials published online today the most comprehensive state database in the country listing payments drug companies and medical device makers made to hospitals, doctors, nurses, pharmacists, and other health care providers in the state."
(The Boston Globe)

Deficit-Panel Chiefs Draw Resistance to Health-Spending Proposals
Excerpt: "The leaders of President Barack Obama's deficit-reduction commission have called for broader cuts in medical spending than contained in this year's health-care overhaul, stirring opposition among health-care companies, doctors and some consumer groups."
(The Wall Street Journal)

Group Health Care Plan Costs Climbed 6.9 Percent This Year, According to Survey
Excerpt: "Group health care plan costs jumped an average of 6.9 percent in 2010, the biggest increase since 2004, according to a survey of more than 2,800 employers released Nov. 17 by Mercer . . . ."
(Workforce Management; free registration required)

Efforts to Repeal Form 1099 Rules to Move to Senate Floor on Nov. 29
Excerpt: "The Senate is set to vote Nov. 29 on two versions of legislation that would fully repeal a new law requiring businesses to file Form 1099 information reports to the government whenever they spend more than $600 on a single vendor."
(Tax Management, Inc.)

Vermont May Be First State in the Nation to Pass Single-Payer Health Coverage
Excerpt: "When the bill is implemented, let the states use the money the federal government would already be paying to implement single-payer. The CBO came up with one of the weirder counter arguments we've ever heard. The CBO said we think the states are smarter than the federal government and they'll outmaneuver the feds to get more money. So we were forced by the CBO -- not by anybody in the Congress -- to push it back to 2017."
(The Washington Post via Physicians for a National Health Program)

New Rules Tell Health Insurers: Spend More on Care
Excerpt: "The rules, intended to benefit consumers, vastly expand federal authority to direct the use of premiums collected by companies like Aetna, Humana, UnitedHealth and WellPoint. While some states have had such requirements, Monday's announcement is the first such mandate by the federal government . . . ."
(The New York Times; free registration required)

Healthy Employees Foster Healthy Profits
Excerpt: "Many employers are realizing that an employee not being on the job can be a much bigger problem than simply paying doctor bills and hospital costs -- direct costs. Injuries and illnesses, whether arising at work or at home, drive health care costs and result in absences from the workplace and reduced levels of productivity."
(Risk & Insurance)

The Higher Mass Transit Tax Benefit That's Expiring
Excerpt: "[I]f Congress doesn't act soon, the increase for mass transit riders to $230 a month is set to expire at the end of the year, and the benefit will return to $120 a month."
(The New York Times; free registration required)

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Webcasts and Conferences

Need to Know Updates About Recent Retirement Regulations
Nationwide on December 8, 2010
presented by International Foundation of Employee Benefit Plans

Public Fund Plan Sponsors: Valuable Insight into Possible Solutions to Rising Pension Costs
Nationwide on December 2, 2010
presented by International Foundation of Employee Benefit Plans

Press Releases

Newly Posted Employee Benefits Jobs

Participant Education Platform Manager
for SEI Investments
in PA

Participant Counselor - Alabama
for Diversified Investment Advisors
in AL

401K/Qualified Plan Sales Consultant
for Brown & Brown of Detroit, Inc.
in MI

Employee Benefits Producer
for Brown & Brown of Detroit, Inc.
in MI

Product Services Supervisor
for Sentry Insurance
in WI

Pension Administrator
for Associated Pension Consultants
in CA

Actuarial Consultant
for Swerdlin & Company
in GA

Retirement Solutions Proposal Manager
for CUNA Mutual Group
in WI

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