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August 12, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy

University Conference Services (Advert.)

What?s Your Next Move? (clickable image)

What?s Your Next Move?

Managing your organization?s health and welfare plans can seem like a game of chess. You always want to be one move ahead of your "opponent"?cost increases that outpace inflation, employees who ignore the principles of good nutrition and healthy living, or regulators who impose ever more complicated rules. The Las Vegas Health and Welfare Plan Management for Mid-Sized Employers conference, September 13?16, is an unmatched educational opportunity to evaluate your health care programs and create a winning strategy for keeping costs under control.


[Guidance Overview]
EEOC Guidance on Employer Best Practices for Workers with Caregiving Responsibilities

Excerpt: "The best practices suggested by the EEOC are proactive measures that go beyond the requirements of federal non-discrimination laws, but which may reduce the chance of EEO violations against caregivers, and which the EEOC believes can enhance employee productivity, reduce absenteeism, reduce costs, and positively affect profits, recruitment, and retention, even in today's challenging economic climate." (Troutman Sanders Strategies)


[Guidance Overview]
Eleventh Circuit Affirms Benefit Denial Under 'Multi-Step' Analysis

Excerpt: "'This court uses a multi-step analysis to guide these reviews of Administrator decisions and the various standards of review. HCA Health Services of Georgia, Inc. v. Employers Health Ins. Co., 240 F.3d 982, 993-95 (11th Cir. 2001). The analysis involves six steps . . . .'" (Roy Harmon III via Health Plan Law)


[Guidance Overview]
Employee Who Signed Up Ineligible Individual for Health Plan Must Repay Benefits

Excerpt: "EBIA Comment: Numerous reported decisions have permitted ERISA plans and administrators to recover benefit overpayments made to plan participants and beneficiaries. And although the Knudson case took a narrow view of the remedies available under ERISA . . ., the Ninth Circuit made quick work of this case, citing ample support for restitution where fraud or wrongdoing is involved. " (Employee Benefits Institute of America)


A Roman Catholic College Discriminated Against Employees by Denying Them Health Care Coverage for Contraceptives
Excerpt: "A Roman Catholic college in North Carolina discriminated against employees by denying them health care coverage for contraceptives, and then retaliated against those who complained, the U.S. Equal Employment Opportunity Commission has determined. Belmont Abbey College, which was founded by Benedictine Monks, changed health care coverage in December 2007 to exclude oral contraceptives, abortions, vasectomies and tubal ligations. That decision drew the rebuke of at least eight faculty members, who filed a discrimination complaint with the EEOC. After first denying the discrimination complaint in March, the commission reversed its decision in a July 30 letter." (Inside Higher Education)


Unions in U.S. Guarantee More Vacation
Excerpt: "The United States has been called 'the no-vacation nation.' In fact, it is alone among industrialized countries in having no statutory paid leave. European Union rules entitle all workers to a minimum of 20 paid days of leave per year, and many European countries do better than that. In the United States, one out of four workers has no paid vacation or public holiday leave at all. Belonging to a union, however, is a clear advantage in this regard. The average non-unionized worker will work a lifetime and still never reach the European minimum amount of paid annual leave (see chart). A study of the entire workforce -- adjusted for occupation, industry, and other factors -- found that, after 25 years, union members receive 26.6% more vacation weeks than non-union workers." (Economic Policy Institute)


More Employers Offer Employees Incentives for Health and Wellness Program Participation
Excerpt: "Employers have increased incentives to keep employees healthy, from an average of $204 in 2008 to $329 in 2009, according to a recent survey conducted by Vienna, Va.-based Health2 Resources, a health care and e-health specialty public relations and communications firm providing market trend research and analysis. Nearly two out of three U.S. companies offer programs to keep employees healthy, and 66% of those offering programs also use incentives, with many reporting a return on investment of more than $1 for each $1 spent." (Wolters Kluwer)


PBMs Say Plan Sponsors Can Achieve 70%+ Generic Rates Without Aggressive Tactics
Excerpt: "Pharmacy benefit managers (PBMs) that have achieved generic drug fill rates of 70% or more say aggressive management tactics are not as important as a focus on educational and communication tools and an overall formulary design aimed at obtaining the lowest unit price rather than the highest rebate revenue." (AISHealth.com)


Technology Diffusion in Health Care
Excerpt: "Health care spending in the U.S. accounts for 16 percent of GDP, a much larger share than in other developed countries. Is this money well spent? On the one hand, several studies have concluded that increases in health care spending over time have yielded dramatic increases in life expectancy. Yet other studies have found that there are marked differences in spending across hospitals and regions and that higher spending is not associated with better outcomes. These latter studies suggest that there are inefficiencies in the U.S. health care system and that the U.S. may be on the 'flat of the curve' of the medical production function." (National Bureau of Economic Research)


Value of Provider Networks Survey: Health Care Delivery Cost Comparisons
Excerpt: "This report provides a snapshot, state-by-state, of exorbitant charges billed by out-of-network physicians in the 30 largest states by population. It is designed to illustrate the value of provider networks and a growing problem faced by consumers who want affordable, meaningful, access to out-of-network providers." (America's Health Insurance Plans)


High Fees Common in Medical Care, According to Survey
Excerpt: "]A long list of high fees are] cited in a survey released online Tuesday by America's Health Insurance Plans, which represents 1,300 health insurance companies. The group said it had used Medicare payments for comparison because Medicare was so familiar and payments are, on average, about 80 percent of what private insurers pay. The survey, insurers and some economists say, shows the sort of irrational pricing of medical care that is an integral part of the nation's health care problems and that is largely being ignored, some say, in the current debate." (The New York Times; free registration required)



ALM (Advert.)

Complete Benefits Law Guidance from Law Journal Press (clickable image)

Complete Benefits Law Guidance from Law Journal Press

The nation's workforce and health care system are constantly evolving and so are the legal issues. Law Journal Press helps you handle any benefits law question with up-to-date, authoritative books on all aspects of the field. Get legal and practical advice from leading experts on everything from COBRA to ERISA, "contingent" employees to family and medical leave, and more. Browse our product listings for detailed information and special offers.

Links to Items on Executive Comp, Benefits in General

[Guidance Overview]
IRS Filing Extension for the Report of Foreign Bank and Financial Accounts (PDF)

2 pages. Excerpt: "On August 7, 2009, the Internal Revenue Service issued Notice 2009-62, extending the filing deadline for Form TD F 90-22. (commonly referred to as 'FBAR') for calendar year 2008 and prior years, from June 30, 2009 to June 30, 2010, for (i) persons with signature or other authority over, but no financial interest in, a foreign financial account, and (ii) persons with a financial interest in, or signature or other authority over, a foreign commingled fund (such as foreign investment entities) . . . . According to the notice, the IRS intends to issue formal guidance before June 2010 regarding the scope of the FBAR filing requirement for such persons." (Paul, Hastings, Janofsky & Walker LLP)


[Guidance Overview]
Wisconsin Requirement that Professional Employer Organizations to Register with the State and Maintain $100,000 in Working Capital

Excerpt: "Effective July 1, 2009, professional employer organizations ('PEOs') must register with the State of Wisconsin and maintain $100,000 in working capital as demonstrated by audited financial statements prepared in accordance with generally accepted accounting principles ('GAAP'). PEOs are required to register within 180 days of July 1, 2009." (Michael Best & Friedrich LLP)


[Guidance Overview]
EEOC Technical Assistance Regarding Waivers and Releases of Discrimination Claims in Severance Agreements (PDF)

Pages 3-4 of 6 pages. Excerpt: "Can an employer validly require an employee to sign an agreement waiving his or her right to sue the employer under federal employment discrimination laws in exchange for severance benefits? Technical guidance issued by the Equal Employment Opportunity Commission ('EEOC') on July 15, 2009 timely answers this question -- with a qualified 'yes' -- and discusses the legal requirements governing release agreements for terminated employees. Laid out in an employee-friendly question and answer format and containing a checklist and a sample release, the technical guidance highlights essential elements of valid waivers while clarifying for employees their rights under federal employment law." (Trucker Huss)


[Guidance Overview]
Electronic Delivery of Plan Information (PDF)

Excerpt: "DOL regulations govern electronic delivery of certain information, including Summary Plan Descriptions and Summaries of Material Modifications. IRS regulations govern electronic delivery of other information, including loan documentation, distribution option notices, rollover notices, and beneficiary designations. In general, the IRS electronic disclosure regulations are less stringent than the DOL electronic disclosure regulations with respect to affirmative consent requirements imposed on potential recipients." (Trucker Huss)


[Guidance Overview]
On a Scholarly Overview of Split Among Circuits on What It Means to Be a 'Prevailing Party:' It Depends on What the Meaning of the Word Prevail Is

Excerpt: "In this opinion . . ., Judge Young gives a scholarly overview of the split among the circuits on what it means to be a 'prevailing party' entitled to recover attorneys' fees in an ERISA case. The particular issue before him was whether a participant who does not recover benefits, but instead attains a remand to the administrator for further review has prevailed, for purposes of ERISA's attorney fee shifting provision. The court's conclusion, after surveying the cases throughout the country, is: (1) maybe; and (2) sometimes. I am being a bit flippant, but the truth is it is an excellent analysis of an issue you don't see that often and the court's conclusion, in a nutshell, is that you have to look and see if the plaintiff, beyond just getting that relief, accomplished some significant goal of the suit; if so, then the plaintiff is a prevailing party entitled to an award of attorney's fees." (Stephen Rosenberg of The McCormack Firm, LLC)


Milliman's Monthly Benefit News and Developments, August 2009 (PDF)
2 pages. The newsletter provides a summary of the previous month's legislative, regulatory, and judicial information on employee benefits. (Milliman)



Webcasts and Conferences

Planning for Open Enrollment: Compliance Solutions for Cafeteria Plans and Component Benefits
Nationwide on September 10, 2009
presented by EBIA / Thomson Reuters

Voluntary Fiduciary Correction Program Workshop
in California on September 23, 2009
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

( Click to post your webcast or conference )

Press Releases

President Names David Strauss to Chair PBGC Advisory Committee
Pension Benefit Guaranty Corporation (PBGC)

PBGC Moves to Protect Pensions at Proliance International Inc.
Pension Benefit Guaranty Corporation (PBGC)

Milliman Analysis Indicates Continued Pension Funding Declines Despite Asset Gains
Milliman USA

The NTSAA 403(b) Compliance Resolution Summit Final Report Released
National Tax Sheltered Accounts Association

SEI Roundtable Research: Financial Executives Look For Answers To Critical Pension Questions
SEI

The SPARK Institute Releases White Paper on Roles and Responsibilities in Valuing Plan Investment Under FAS 157
The SPARK Institute

IFLC Looks Into BrightScope, Inc.
Investment Fiduciary Leadership Council (IFLC)

RelayHealth Teams with Identity Force to Help Hospitals Meet Red Flags Rule Compliance
RelayHealth

( Click to post your press release )

Employee Benefits Jobs

TPA - Third Party Administrator
for Integrated Retirement Solutions, LLC
in FL

( Click to post your job opening | View all jobs | RSS feed for jobs RSS feed of all jobs )


EmployeeBenefitsJobs.com (Sponsor)

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