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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
Do Benefit Plan Recoupment Claims Trigger Internal Appeal Rights?
"The issue turns on the significance of a claim for refund or 'recoupment' by a group health plan after services have been rendered and benefits paid. In the end, the court in this case decides that the refund request does not trigger any additional obligations under the ERISA claims regulations."
(Roy Harmon III, Health Plan Law)
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ERISA Preemption of Michigan Paid Claims Assessment Act
"Since its enactment, several plan sponsors have wondered whether the Act will be preempted by ERISA. The courts will now weigh in on that issue in Self-Insurance Institute of America v. Snyder . . . . In that case, the Self-Insurance Institute of America, Inc. . . . seeks both a declaration that the Act is preempted by ERISA and an injunction against implementation or enforcement of the Act."
(Faegre Baker Daniels LLP)
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CCIIO Illustrative List of the Largest Three Small Group Products by State (PDF)
"This document provides illustrative information to complement the bulletin on essential health benefits (EHB) under the Affordable Care Act released on December 16, 2011. Specifically, it provides a list of the products with the three largest enrollments in the small group market in each State using data from HealthCare.gov. It provides the names of the three largest products in each State ranked by enrollment. In addition, we are providing a list of the top three nationally available Federal Employee Health Benefit Program (FEHBP) plans based on enrollment. This information is being provided to facilitate a better understanding of the intended approach to EHBs."
(U.S. Department of Health & Human Services, Office of Center for Consumer Information and Insurance Oversight)
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Kaiser Tracking Poll on Health Care Reform: January 2012
"The public doubts the Supreme Court renders judgments based solely on the law. Three-quarters (75%) say they think that, in general, Justices let their own ideological views influence their decisions while 17 percent say they usually decide cases based on legal analysis without regard to politics and ideology."
(The Henry J. Kaiser Family Foundation)
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America's 'Screwed Up' Health Care Spending
"Speaking at [a conference, the] co-director of the Emory Center on Health Outcomes and Quality in Atlanta explained that health care costs can be broken down into two simple areas: the change in the prevalence of treated diseases, such as hypertension and diabetes, and how much does it cost to treat those problems. To fix it simply, he says, there needs to be averting, detecting and managing chronic diseases."
(Employee Benefit News)
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[Opinion]
It Takes a CEO to Save the U.S. Health Care System
"Forget Washington and the political debate over Obamacare. The real battle for the future of health care is being fought in the world of business, where tens of thousands of companies have seen their financial well-being undermined by skyrocketing employee health costs."
(Bloomberg L.P.)
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Benefits in General; Executive Compensation
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Kodak Bankrup.tcy Shows the Risks of Nonqualified Deferred Compensation
"The biggest risk with a nonqualified deferred compensation plan . . . is the possibility of the company's bankrup.tcy. The Chapter 11 bankrup.tcy filing by Eastman Kodak raises questions about what will happen to the amounts deferred into its nonqualified retirement plan and what actions the company and its executives have been taking in relation to the plan during the past several years."
(myStockOptions.com)
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Press Releases
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Lois Baker, J.D., President
Holly Horton, Business Manager
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