BenefitsLink
Health & Welfare Plans
Newsletter
January 5, 2009
Here are the Web's best new links about compliance and cost
aspects of plan operation, design and policy.
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[Official Guidance]
Massachusetts 2009 Employee Health Insurance Responsibility Disclosure Form (PDF)
2 pages. Excerpt: "Employers may recreate their own version of the Employee Health Insurance Responsibility Disclosure (HIRD) form. However, all information must be included, with the same wording and order, and the sequence and numbering of the Questions must be exactly as it appears on the version provided by the Commonwealth of Massachusetts." (The Commonwealth of Massachusetts)
[Guidance Overview]
More Confusion with Review of ERISA Denial of Benefits
Excerpt: "In taking the case of Metlife v. Glenn, the Supreme Court attempted to bring some clarity to ERISA denial of benefit cases when the insurer is both the one to determine the benefits and pay them. Instead, things are now even more confused. We already reported how the Fourth Circuit took the new language of Glenn and used it to reverse a decision for the plaintiff. Now comes the Second Circuit in McCauley v. First Unum Life Ins. Co., No. 06-5100 (2d Cir. Dec. 23, 2008), doing the exact opposite." (Workplace Prof Blog)
[Guidance Overview]
ERISA Bars Medical Expense Lien Against Child's Trust
Excerpt: "From Law.com: In a huge win for lawyers representing children injured in auto accidents, a federal judge has ruled that an ERISA insurer has no right to enforcement of a lien for medical expenses when the minor's settlement funds are placed in a 'special-needs trust.'" (Carroll & Carroll, P.C.)
Maternity-Leave Alternative: Bring the Baby to Work
Excerpt: "More companies are allowing women -- and some men, too -- to bring their babies to work. The advantages are clear: The women don't lose money by taking maternity leave. They can breastfeed conveniently. And they can bond with the baby rather than worry that he or she will develop a closer connection with a nanny or a day-care provider. Of course, disadvantages are clear, too. The needs and noises of babies have the potential to be highly disruptive and to stir resentment among co-workers." (The New York Times; free registration required)
Maternity Leave Linked with Fewer Cesarean Sections Also Increased Breastfeeding
Excerpt: "Two new studies led by researchers at the University of California, Berkeley, suggest that taking maternity leave before and after the birth of a baby is a good investment in terms of health benefits for both mothers and newborns. One study found that women who started their leave in the last month of pregnancy were less likely to have cesarean deliveries, while another found that new mothers were more likely to establish breastfeeding the longer they delayed their return to work." (Huliq.com)
Patient Outreach Could Help Inoculate Health Plans Against Flu-Related Utilization Rate Hikes
Excerpt: "While it's still, too early to tell if the upcoming influenza season will be mild, moderate or severe, health plans [say] that they're extending their outreach efforts to get as many of their members vaccinated as possible. And a researcher associated with the strain-selection process used in developing each year's vaccine [says] that this year's version should be right on target." (AISHealth.com)
UnitedHealth Group's Vast New Web Portal Could Prompt Other Health Plans to Launch Online Tools and Services
Excerpt: "UnitedHealth Group on Dec. 1 became the first health plan to fully launch itself into the increasingly crowded field of online health content, personal health records (PHRs) and e-commerce. That same day, Blue Cross Blue Shield of Massachusetts said a new partnership with Google Health would allow its members to import claims-based health information into a PHR. Last month, Aetna Inc. said it would give members access to Microsoft Corp.'s HealthVault PHR." (AISHealth.com)
One Health Plan's Experience With a Part D Audit
Excerpt: "When CMS came to audit CIGNA HealthCare of Arizona's Medicare Advantage prescription drug (MA-PD) plan in May, the company was prepared, said Jody Miller, operations manager in the Medicare administration and compliance department. And the best piece of advice she could give other plans is to do the same. Put everything that CMS wants to look at together, and have it ready for the auditors when they get there, she advised attendees at the recent Medicare Enrollment and PDE Data Summit sponsored by CBI in Alexandria, Va." (AISHealth.com)
National Health Information Network Set to Launch, Sort Of
Excerpt: "The Nationwide Health Information Network will become reality very soon when the Social Security Administration performs a preliminary test of the new system in February 2009. The NHIN's trial run will be used to determine benefits eligibility for the SSA's 2.6 million annual disability claims. The NHIN's rollout -- even in its limited form -- is considered a major milestone because until now, the public-private 'NHIN Cooperative' has only performed trial implementations based on fictitious patients." (HealthLeaders Media)
Smoking Ban in a Colorado City Leads to Major Drop in Heart Attacks
Excerpt: "A smoking ban in one Colorado city led to a dramatic drop in heart attack hospitalizations, according to a new study that is considered the best and longest-term research to show such a link. The rate of hospitalized cases dropped 41 percent three years after the ban of workplace smoking in Pueblo, Colo., took effect. There was no such drop in two neighboring areas, and researchers believe it's a clear sign the ban was responsible." (AP via The Atlanta Journal-Constitution)
[Opinion]
Obama Will Ration Your Health Care
Excerpt: "People are policy. And now that President-elect Barack Obama has fielded his team of Tom Daschle as secretary of Health and Human Services and Melody Barnes as director of the White House Domestic Policy Council, we can predict both the strategy and substance of the new administration's health-care reform. The prognosis is not good for patients, physicians or taxpayers. If Mr. Daschle meant what he wrote in his book 'Critical: What We Can Do About the Health-Care Crisis,' Americans can expect a quick, hard push to build more federal bureaucracy, impose price controls, restrict medicines and technology, boost taxes, mandate the purchase of health insurance, and expand government health care." (The Wall Street Journal)
[Opinion]
Simple, State-Law Tort Suit Over Car Wreck Turned Into Federal Preemption Case Revolving Around the Unfathomable Morass Called ERISA
Excerpt: "The year of the West Virginia Supreme Court of Appeals has ended with a series (seven, by my count) of dissents and one reluctant concurrence from Justice Starcher. In a case involving a hospital's subrogation claim: 'I dissent because, in my 12 years on the appellate bench, I have too often seen arcane procedural decisions like this one flow forth from this Court. These decisions brilliantly and eloquently describe the trees, while failing to recognize the surrounding forest. These kinds of decisions may be technically correct, but they wholly miss the public policy waves that will ripple from the Court's decision...'" (Legal Profession Blog)
[Opinion]
President Bush's Health Care Legacy
Excerpt: "It is only fair to note that President Bush can . . . lay claim to some signal achievements in health care -- achievements that we urge President-elect Barack Obama to continue and develop further." (The New York Times; free registration required)
[Opinion]
Massachusetts Probes High Insurance Payments to Favored Hospitals
Excerpt: "The governor of Massachusetts is convening a bunch of top state officials to look into why a powerful hospital group has been able to charge more than its competitors. The Boston Globe has the story. The Globe recently reported that Partners HealthCare -- which includes the prestigious Mass. General and Brigham and Women's hospitals -- cut a deal a few years ago with the state's Blue Cross Blue Shield, leading to the higher prices." (The Wall Street Journal Health Blog)
Health Benefits Conference & Expo (HBCE) (Sponsor)
(Click on company name or banner to learn more.)
Sessions by: Intel, Corning, Toyota, TECO Energy, Broward County Schools, Burger King, SAS, Gulf Power/Southern Company, Pepco Holdings, Inc. (PHI), Univ. of Pittsburgh Medical Center, U.S. Xpress, PSEG, Mayo Clinic, University of Rochester, Pinellas County, CEO Roundtable on Cancer, City of Clearwater, C-Change, Manatee County...and more. Satisfaction guaranteed...or your registration refunded. Best Value in Health Benefits Continuing Education (HBCE) - highest quality and registration only $295 - $345. SHRM credits. www.HBCE.com
Links to Items on Executive Comp, Benefits in General
[Guidance Overview]
Saving Severely Underwater Stock Options
Excerpt: "Falling share prices have left many option holders -- both senior management and rank-and-file employees -- with severely underwater options. If these options remain underwater for a significant period of time, employee morale and retention could be negatively affected. To help avoid such consequences, companies may wish to consider repricing options to better reflect current share prices. Before doing so, however, a number of important securities, tax and accounting issues should be considered." (Faegre & Benson)
Benefit Managers Enter 2009 with Host of Concerns Regarding Departmental Operations and Employee Benefit Offerings in Wake of Dismal Economy
Excerpt: "From curbs on benefits offerings as companies look to cut budgets, to retirement savings issues as workers see their 401(k) accounts shrink, and health care reform as a new administration takes office, benefit managers face numerous uncertainties as the year begins. . . . Just as benefits managers are waiting to see how their benefits departments will be affected by the economic downturn, they are pondering if and when health care reform will occur and how their organizations will be affected . . . ." (Business Insurance)
The Kroger Company to Union: Health, Pension Costs Too High
Excerpt: "The Kroger Co. has warned rising health-care and pension costs could be sticky issues in labor negotiations that will affect about 12,000 employees in the Peach State. The union said it plans to fight potential demands for health-care cost-sharing and other concessions." (Atlanta Business Chronicle via bizjournals.com; free registration required)
[Opinion]
Should Congress Put a Cap on Executive Pay?
Excerpt: "One popular proposal would cap the chief executive's pay at each company at 20 times its average worker's salary. But while Congress may well have compelling reasons to limit executive pay in companies seeking bailout money, voter anger is not a good reason to extend pay caps more generally. To be sure, executive pay in the United States is vastly higher than necessary. Executives in other countries, whose pay is often less than one-fifth that of their American counterparts, seem to work just as hard and perform just as well. The same was true of American executives in the 1980s." (The New York Times; free registration required)
[Opinion]
The End of the Financial World as We Know It
Excerpt: "AMERICANS enter the New Year in a strange new role: financial lunatics. We've been viewed by the wider world with mistrust and suspicion on other matters, but on the subject of money even our harshest critics have been inclined to believe that we knew what we were doing. They watched our investment bankers and emulated them . . . . This is one reason the collapse of our financial system has inspired not merely a national but a global crisis of confidence. Good God, the world seems to be saying, if they don't know what they are doing with money, who does?" (Michael Lewis and David Einhorn via The New York Times; free registration required)
Newly Posted Events
Mind Your Ps and Qs?and ks?: Fiduciary Responsibilities in 401(k) and Other Retirement Plans
in Georgia on January 15, 2009
presented by WEB (Worldwide Employee Benefit Network) Atlanta Chapter
Newly Posted Press Releases
PBGC Publishes Pension Insurance Data Book 2007
Pension Benefit Guaranty Corporation (PBGC)
Newly Posted or Renewed Job Openings
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