cmonfils | August 31, 2011
By Geoffrey C. Beckwith Aug 28, 2011
On July 12, dozens of lawmakers, municipal leaders, community groups and union officials stood together and watched as Massachusetts Gov. Deval Patrick signed a new law reforming the way that cities and towns design health insurance plans for their employees. (more…)
cmonfils | August 31, 2011
August 24, 2011 By Stanley D. Baum
In Kough v. Teamsters’ Local 301 Pension Plan, No. 10-2128 (7th Cir. 2011) (Nonprecedential Opinion), the plaintiff had suffered a disability, and then returned to work in 2005. He soon (in that year) suffered a heart attack and abandoned his attempt to work. He filed a claim for disability benefits under a union pension plan subject to ERISA (the “Plan”), but the claim was denied by the Plan. The plaintiff then filed this suit. (more…)
cmonfils | August 31, 2011
www.hreonline.com By Tom Starner
The healthcare reform law is placing added pressures on employers, as it adds direct and indirect costs to providing healthcare benefits to workers. “Employers need to look for creative solutions, because rising costs are not going to go away … . If you want to continue providing healthcare benefits, you need to think outside the traditional box,” an expert says. (more…)
cmonfils | August 31, 2011
From the August 18, 2011 EBIA Weekly
[State of Florida ex rel. Atty. Gen. v. HHS, 2011 WL 3519178 (11th Cir. 2011)]
Available at http://www.uscourts.gov/uscourts/courts/ca11/201111021.pdf
The 11th Circuit Court of Appeals has held that Congress exceeded its power to regulate interstate commerce when it enacted health care reform’s individual mandate, which beginning in 2014 will require individuals to maintain health coverage or pay a penalty. Conceding that the individual mandate cannot be neatly classified as either economic or noneconomic activity, the 11th Circuit examined the unprecedented nature and far-reaching implications of the mandate, as well as numerous limits on Congress’s commerce authority, and concluded that the federal government cannot mandate that individuals purchase and maintain health insurance from a private company. (more…)
cmonfils | August 31, 2011
www.dorsey.com August 23, 2011
The Patient Protection and Affordable Care Act (“health care reform” or “PPACA”) changed the annual coordinated election period for Medicare Part D (prescription drug coverage). The annual election period for Medicare Part D is now October 15 through December 7. (Prior to PPACA’s enactment, the election period was November 15 to December 31). An updated model notice of creditable coverage is available on CMS’s website. (more…)
cmonfils | August 31, 2011
August 22, 2011
Proposed health care reform regulations issued on August 17, 2011, by the Departments of Labor, Health and Human Services, and Treasury (the “Departments”) impose new rules on group health plans and individual and group health insurers that are intended to enable consumers to more easily understand the health coverage they have, and make apples-to-apples comparisons of available options. These rules are intended to carry out certain provisions of last year’s health care reform that required the Departments to develop standards for plans and insurers to compile and provide an accurate summary of benefits and coverage. These rules apply to both grandfathered and non-grandfathered health plans. Failure to comply may result in significant monetary penalties. (more…)
cmonfils | August 31, 2011
August 19, 2011 Peter Wand, David Manch
The Department of Labor recently announced plans to substantially increase the number of ERISA compliance audits it conducts each year. This is the first in a series of Client Alerts that Lewis and Roca LLP will publish over the coming months to help our clients evaluate their compliance with ERISA and related federal mandates, including COBRA, HIPAA and the Patient Protection and Affordable Care Act of 2010. (more…)
cmonfils | August 31, 2011
www.healthcare-legislation.blogspot.com Friday, August 19, 2011
Most health care organizations expect health care reform to boost costs significantly, while increasing access to care and improving quality through a renewed focus on organizational effectiveness, according to a new survey of more than 200 health care professionals. (more…)
cmonfils | August 31, 2011
www.ama-assn.org By Emily Berry, amednews staff. Posted Aug. 22, 2011.
A survey finds only about 2% will “very likely” stop offering health benefits when insurance exchanges kick in.
Enrollment in employer-sponsored health insurance plans already is on the rise, and most companies surveyed by New York-based consulting firm Mercer say they will continue to cover workers and their families even after state-based health insurance exchanges launch in 2014. (more…)
cmonfils | August 30, 2011
August 26, 2011 | 4:39 pm
A case to watch as residential treatment was excluded. Obviously, this is applying state parity on top of federal parity (as there are not 9 conditions mandated for coverage under federal parity). Just another reason to be self-funded!
From the LA Times… (more…)
cmonfils | August 30, 2011
www.thedaily.com Tom Murphy August 25, 2011
Nearly 10% of employers to let feds carry health-care burden
Almost one of every 10 midsized or big employers expects to stop offering health coverage to workers once federal insurance exchanges start in 2014, according to a new survey from a large benefits consultant. (more…)
cmonfils | August 30, 2011
MyHealthGuide Source: David Slaughter, Thompson Publishing, 8/26/2011, http://smarthr.blogs.thompson.com/
Todd Leeuwenburgh, Editor, Employer Health Benefits, Thompson Publishing Group, says, “David Slaughter’s Blog reports an interesting and unprecedented use of ERISA (not HIPAA) by Liberty Mutual to resist Vermont’s health claims data-reporting mandate. The state agency’s top attorney tells David in an exclusive interview that it is backing down from its initial demand for claims data about the company’s ERISA plan participants.” (more…)
cmonfils | August 30, 2011
MyHealthGuide Source: Mary V. Bauman, Miller Johnson Attorneys and Counselors, 8/25/2011, Miller Johnson Article
Article recommend by John H. Eggertsen, Esq., Eggertsen Consulting, P.C., www.jhelaw.com
Currently, Michigan imposes a 6% use tax on Medicaid HMOs and plans providing Medicaid mental health services. The purpose of the use tax is to finance the state’s share of Medicaid. The federal government has indicated it will bar Michigan from continuing this financing approach. As a result, Michigan needed to repeal the use tax and come up with a replacement revenue stream. (more…)
cmonfils | August 30, 2011
MyHealthGuide Source: Rebecca Moore, PlanSponsor, 8/25/2011, PlanSponsor Article
Case: Baker v. Pennsylvania Economy League Inc. Retirement Income Plan, E.D. Pa., No. 2:10-cv-06738-AB, 8/23/11
Editor’s Note: While the subject of case is a pension plan, the court’s ruling against plan administrator and fiduciary breach has application for self-funded ERISA plans. Court rules that plaintiff./ claimant could continue with her claim against plan administrators’ actions constituted a fiduciary breach. (more…)
cmonfils | August 30, 2011
MyHealthGuide Source: United Benefit Advisors (UBA) via PRweb, 8/22/2011, www.UBAbenefits.com
INDIANAPOLIS, IN — Consumer Driven Health Plans (CDHPs) in the U.S. experienced continued growth this year — albeit at a slower rate than in 2009 and 2010 — according to preliminary results released by United Benefit Advisors (UBA) from its 2011 UBA Health Plan Survey, the nation’s largest health plan benchmarking survey, with 16,421 plans from 10,744 employers. (more…)
