Health & Welfare Plans Newsletter
December 31, 2009

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[Guidance Overview]
Seventh Circuit Overturns Plan Administrator's Benefit Denial, Since the Plan Administrator Ignored Important Evidence Submitted by Participant

Excerpt: "In Majeski v. Metropolitan Life Insurance Co., No. 09-1930 (7th Cir. 2009), the plaintiff, Kirsten Majeski, had been employed by Metropolitan Life Insurance Company ('MetLife'), and had participated in MetLife's Short Term Disability Plan (the 'Plan'). The case centers on the decision of MetLife, as plan administrator, to reject Majeski's claim for short-term disability benefits, after determining that Majeski had failed to submit enough evidence to support her claim." (Stanley D. Baum of Fellheimer & Eichen LLP)


Hospitals, Physicians and Health Care Reform: How Your Organization Can Prepare
Excerpt: "[T]his article reviews some practical considerations likely to merit substantive attention by the affected health care provider community." (Faegre & Benson LLP)


Health Plans Try to Rein in Specialty Pharmacy Spending by Managing the Medical Benefit
Excerpt: "Oftentimes more than half -- and possibly as much as 70% -- of a health plan's specialty drug spend may fall under the medical benefit. But with physicians buying and billing drugs they administer in their offices and using ambiguous billing codes, it can be notoriously difficult for payers not only to manage these therapies but also to even understand how much they are spending." (AIS Health.com)


Blues Plans Build On-Site Health Clinics to Help Reduce Employee Medical Costs
Excerpt: "In an attempt to cut employee health care costs by millions and boost productivity, some Blue Cross and Blue Shield plans are opening on-site medical clinics. Such clinics allow employees access to care where they work at lower out-of-pocket costs, and include treatments for illness and primary care and pharmacy services." (AIS Health.com)


States' Use of 'Cafeteria Plans' to Provide Health Insurance
Updated: May 2009; reposted November 2009. Excerpt: "2009 Activity: For this year's sessions, bills to expand use of section 125 cafeteria plans are being discussed in at least eight states, including Alaska, California, Iowa (enacted), Kansas, Mississippi, New Jersey, Oklahoma and Washington (as of August 4, 2009)." (National Conference of State Legislatures)




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Executive Compensation; Benefits in General

[Guidance Overview]
SEC's Proxy Disclosure Enhancements

Excerpt: "What You Should Do Now. We suggest that you: Update your board or compensation committee on the new rules. Consider whether your company's compensation policies and practices for employees generally are reasonably likely to have a material adverse effect on the company. If so, you should consider the information that will be needed to prepare appropriate disclosure based on the particular facts and circumstances of your company." (Wilson Sonsini Goodrich & Rosati)


[Guidance Overview]
2010 Annual Meeting Season Preparations (PDF)

17 pages. Excerpt: "In this issue, we are including our customary articles on recent SEC and NYSE/NASDAQ developments. We are also including more in-depth articles on the elimination of broker discretionary voting in director elections and recent developments in the enforcement arena. In our view, the big items for the 2010 annual meeting season are the elimination of broker voting in director elections and the trends and considerations related to executive compensation." (Snell & Wilmer L.L.P.)


[Guidance Overview]
February 1, 2010 Deadline and Final Regulations on Return and Information Statement Requirements for ISOs and ESPPs

Excerpt: "This Update summarizes key highlights from the existing and new final regulations and offers practical guidance." (Perkins Coie LLP)


[Guidance Overview]
IRS Guidance on Application of 409A Rules to Deferred Comp Payments Under TARP Advisory Opinion

Excerpt: "The guidance only applies to TARP recipients and their service providers and only to the extent that the compensation paid by the TARP recipient to a service provider is addressed by an advisory opinion of the Special Master, pursuant to the Emergency Economic Stabilization Act of 2008 (EESA; P.L. 110-343), as amended by the American Recovery and Reinvestment Act of 2009 (ARRA; P.L. 111-5), and regulations thereunder, issued after September 30, 2009." (Wolters Kluwer)


Best Employee Benefits' Stories of 2009
Excerpt: "Snip, snip, snip. That's the sound of employee benefits being trimmed, often to save the very jobs of the employees in question, and a sound that was heard almost continuously in 2009." (CFO Publishing Corporation)


Overlooked Workplace Trends of the Decade
Excerpt: "Revisions to the notion of work and the evolution of benefits are two workplace concepts that have quietly changed during the past 10 years. A more individualized legal view, a new emphasis on 'engaging' employees, the growing reluctance of workers to 'live to work' and the new concept of HR branding round out the list." (Human Resource Executive Online)



Webcasts and Conferences

Medicare A-Z: Part I with Craig J. Davidson, CEBS
Nationwide on December 30, 2009
presented by FutureOffice Network

( Click to post your webcast or conference )

Press Releases

COBRAGuard Offers Free Action Plan Webinar to Assist Employers with COBRA Subsidy Extension
CobraGuard, Inc.

( Click to post your press release )

Click to post your job on EmployeeBenefitsJobs.com

Newly Posted Employee Benefits Jobs

Attorney - Employee Benefits Specialist
for Established Chicago Loop Firm, AV Rated
in IL

COBRA/FSA/Welfare Benefits Operations Director
for Goldleaf Partners
in AZ, MN

Dedicated Retirement Counselor - Long Island, NY
for Prudential
in NY

( Click to post your job on EmployeeBenefitsJobs.com | View all jobs | RSS feed for jobs RSS feed of all jobs )


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