Industry News With Descriptions | Headline Only      Opinion | Legislation Could Provide 'Useful Antidote' to Pharmaceutical Industry Influence on Physicians, Editorial States Sens. Herb Kohl (D-Wis.) and Richard Durbin (D-Ill.) plan to introduce a bill that could provide a "potentially useful antidote to drug company influence over the prescribing practices of doctors," a New York Times editorial states. more    Employer costs for paid leave in private industry, December 2007 Excerpt: "Employer costs for paid leave benefits were highest for management, professional, and related occupations, $3.93 per hour, or 8.4 percent of total compensation, in December 2007." (U.S. Bureau of Labor Statistics) more    More U.S. Health Insurers Slashing Costs by Sending Policyholders Overseas for Pricey Procedures Excerpt: "Yes, just like manufacturing facilities and call centers, health care is moving offshore. 'All of the largest U.S. insurers are starting to educate themselves or are putting [offshore] programs in place,' says Jonathan Edelheit, president of the Medical Tourism Assn., an industry group formed just last year. Companies that self-insure are also bombarding Edelheit's group with requests for information." (BusinessWeek) more    U.S. House Bill Seeks Parity in Prosthetic Coverage Excerpt: "Group health insurers would be required to offer coverage for prosthetic devices and components, under legislation calling for new parity standards in the Employee Retirement Income Security Act. Introduced as H.R. 5615, the Prosthetic Parity Act asks that health plans offer prosthetic care coverage on par with other medical or surgical care deemed 'essential' to a patient's health, restricting the ability to establish separate dollar caps or restrictions for prostheses." (BestWire Services via NewsEdge Corporation via Human Resource Executive Online) more    More States to Force Firms to Provide Paid Family Leave; Related Push Would Require Employers to Offer Paid Sick Leave Excerpt: "At least 14 more states will mull proposals in this year's legislative session. They are: Alaska, Arizona, Connecticut, Hawaii, Illinois, Indiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, New York, North Carolina and Pennsylvania." (Kiplinger) more    Health Insurers Collaborate With Providers to Develop Pay-for-Performance Standards for Specialists As insurers expand pay-for-performance (P4P) programs to cover specialists, they sometimes must collaborate with providers to establish standards if nationally recognized quality measures aren't available. more    How to Get Workers to Think and Act Like Owners Employee-Owned Firm Van Meter Industrial Prospered After Its Employees Were Persuaded to Take Their Company Stock Seriously more    Employer Costs for Employee Compensation, December 2007 - Summary Excerpt: "Employer costs for insurance benefits -- life, health, and disability -- averaged $2.34 per hour (8.3 percent of total compensation). Paid leave benefits (vacations, holidays, sick leave, and other leave) averaged $1.96 (7.0 percent); retirement and savings averaged $1.24 (4.4 percent); and supplemental pay averaged 72 cents (2.6 percent) per hour worked." (U.S. Bureau of Labor Statistics) more    Aetna Announces Plans to Offer New Online Search Engine to Provide Members with Access to Medical Information Excerpt: "Aetna officials . . . announced plans to offer a new online search engine that will allow members to access at no cost medical information, information on local physicians who can address their needs and cost information based on their medical histories and coverage levels, the San Francisco Chronicle reports . . . ." (Kaiser Family Foundation) more    Executive Pay - A Proposal to Protect Core Pay-for-Performance Programs [Opinion Article] Excerpt: "The U.S. executive pay-for-performance model is not only viable, it is essential to the continued success of corporations and the U.S. economy. That may not be what critics of the system want to hear, but the numbers tell a compelling story. Watson Wyatt's multi-year studies at 1,000 large U.S. companies find a consistently strong, positive relationship between realizable pay (i.e., pay earned for the year, including equity value appreciation) and performance." (www.boardmember.com via Watson Wyatt Worldwide) more    Roll Call Examines Prospects for Health Care Legislation This Year in Congress As presidential candidates debate their health care proposals, Congress is "unlikely to pass any major health bill," this year preferring instead "a bite-sized approach," Roll Call reports. Among issues targeted by lawmakers this year are changes to Medicare rules, mental health parity, health care information technology, comparative effectiveness and approval of generic versions of biotechnology drugs. more    438 million vacation days went unused by U.S. workers in '07 Excerpt: "Psychologists, demographers and others say we pass over time off for many reasons - an entrenched Puritan work ethic, fear of being seen as reckless slackers relaxing while the economy burns, squirreling away time for days we're stuck at home awaiting a repair call. The figure for time left behind comes from Harris Interactive, a polling and research group, which for seven years has examined trends in unused vacation days for Expedia.com, the Internet travel booker." (The Gazette) more    Wellness Programs: No Longer Just an Add-On Excerpt: "America's health plans have heard the message: Employers want wellness services, and the plans are delivering with gusto. The nation's biggest plans are rolling out slick programs that are designed to improve the health status of a client's workforce by picking off the incubating health problems of each worker -- one at a time if that's what it takes." (Managed Care Magazine) more    Employers Want Workers to Change Their Lifestyles, and They Expect Health Plans to Help Excerpt: "UnitedHealthcare last summer began to offer a high-deductible plan called Vital Measures to mid-sized employers in Rhode Island, Pennsylvania, Ohio, and Colorado. UnitedHealthcare offers $500 credits against a $2,500 annual deductible to members who meet specific standards for nicotine use, blood pressure, cholesterol level, and body-mass index. In other words, employees who do well in all four categories will see their deductible reduced from $2,500 to $500. In addition, reasonable alternatives are available when achieving a goal is medically inadvisable or unreasonably difficult because of a medical condition. An obvious example: A pregnant woman need not meet body-mass index goals." (Managed Care Magazine) more    Over 40% of big companies now offer consumer-driven health plans: survey While only a small portion of companies currently offer their employees consumer-directed health plans, that number is gradually increasing as employers search for ways to confront their rising health-care costs. more    http://www.ncsl.org/programs/health/dependentstatus.htm Excerpt: "In an attempt to directly address the fastest growing uninsured population (young adults), state lawmakers are proposing and enacting legislation that extends dependent benefits to older children. Typically, children lose health care coverage under a parent or other legal caregiver on their 19th birthday. Full-time students are often given an exception with dependent status ending at graduation or a specified age. States have addressed specific populations within this age group as well, ensuring that students who take a leave of absence from school due to illness, injury, or service in the armed forces do not lose their health insurance. [Chart of state laws on the issue was updated October 2007.]" (National Conference of State Legislatures) more    BlueCross postpones doctor ratings plan BlueCross BlueShield of Tennessee is delaying its plan to start rating individual doctors after the state's biggest physicians' group questioned the quality of the information used to measure health care performance. BlueCross, the largest health insurer in the state, had planned to give doctors until Tuesday to correct errors in data used to create ratings and to publish the ratings in April. more    Upon Replacing High-Deductible Health Plan with Traditional Coverage, What Happens to HSA Balance? Excerpt: "An HSA owner may use HSA assets to pay for or reimburse eligible medical expenses, even if he/she is no longer eligible to contribute to an HSA." (Wolters Kluwer Financial Services) more    Additional spending upfront can reduce health costs later Value-based benefits, the next big thing in employer-sponsored health care, contains some counterintuitive medicine some may find tough to swallow. With premium costs exceeding the inflation rate, value-based benefit plans call for employers to spend even more upfront to ensure employees get the drugs and preventive care they need. more    Companies taking an active role in employee health care With rising health care costs weighing heavily on employers' minds, more businesses are taking matters into their own hands by encouraging workers to eat right, exercise and stop practicing bad habits. more    Raising the standard of care: Evidence-based 'recipes' make sure doctors remember all vital ingredients Critics call them "cookbook medicine." But Dr. John Yeast, an advocate of standardized, evidenced-based care recipes, can make a compelling case for them by spinning an old aviation yarn. more    Employers Most Satisfied When Enrollment Systems, Related Resources Are Integrated Excerpt: "Employers are using their benefits enrollment systems to encourage employees to adopt healthier behaviors, a new survey by Watson Wyatt Worldwide has found. The survey of 117 U.S. companies conducted in December 2007, at the end of the annual enrollment process, found that more than half (53%) have incorporated health risk assessments into their enrollment systems or will incorporate these programs by 2009 . . . ." (Wolters Kluwer Financial Services) more    More Clarification About Google's Online Medical Records Service Google's CEO, Eric Schmidt comments to clarify their intent with the new Medical Records service they are testing. more    Proposed Kentucky Health Insurance Mandates Draw Fire A slew of bills proposed in the current session of the Kentucky General Assembly would require health insurers to expand services they must cover. The proposed mandates have sparked opposition from Kentucky doctors and health insurance providers. more    HIPAA Privacy Check Up Excerpt: "It may be hard to believe, but the HIPAA Privacy rules have been in effect for nearly five years!! Is it time for a Compliance Check-up? Although the Group Health Plan is the covered entity under HIPAA, many TPAs provide HIPAA Privacy related services on behalf of the Plan Sponsor/Employer." (SunGard Corbel LLC) more    Department of Labor Proposes Overhaul of FMLA Rules Excerpt: "It is important to keep in mind that the revisions proposed by the DOL are just that, mere proposals, and that the 1995 rules remain in effect for now. The final rules that will emerge at the end of the year may be significantly different from this proposal. However, employers may want to consider how these proposed rules, along with the new FMLA leaves created for employees with family members in the military, would impact their employee leave practices and begin planning for changes." (Perkins Coie LLP) more    House Bill Would Eliminate Pre-Existing Exclusions in Group & Individual policies. Excerpt: "Under the No Discrimination in Health Insurance Act of 2008, Section 701 of ERISA (added by HIPAA in 1996) would be amended 'to eliminate the application of pre-existing condition exclusions in all group health coverage policies and all individual health insurance policies.'" (Workplace Prof Blog) more    Google to Store Patients' Health Records Excerpt: "Google Inc. will begin storing the medical records of a few thousand people as it tests a long-awaited health service that's likely to raise more concerns about the volume of sensitive information entrusted to the Internet search leader." (AP via National Public Radio) more    San Francisco Enacts Mandatory Health for All Employees, or Pay Fees. Could this happen in Nashville? Shortly after a federal court ruled last month that organizations whose employees work in San Francisco must comply with the city’s health care law, an e-mail arrived in the inboxes of many benefits managers around the country portending the administrative hurdles now facing employers. more    Terminating Employee for Off-Premises Smoking May Violate ERISA §510 and State Privacy Law Excerpt: "In a recent decision, Rodrigues v. The Scotts Co., LLC, a federal district court in Massachusetts held that the termination of an employee for violating his employer's policy prohibiting smoking entirely, including outside the workplace, may constitute an interference with that employee's right to participate in the company's benefits plan in violation of Section 510 of the Employee Retirement Income Security Act (ERISA). The court also left alive the claim that the broad no-smokers policy was an invasion of privacy under the Massachusetts Privacy Act." (Nixon Peabody) more    Capitol Hill Watch | Lawmakers Introduce Universal Health Care Plan Modeled After Federal Employee Health Benefits Program Reps. Jim Langevin (D-R.I.) and Christopher Shays (R-Conn.) on Tuesday proposed legislation that would create a nationwide health insurance plan similar to the Federal Employee Health Benefits Program, available to all citizens and documented immigrants, CongressDaily reports. Under the plan, uninsured residents would be required to enroll in a health plan that meets national standards and would be responsible for up to 28% of premiums. more    Reporting Requirements for a Qualified HSA Funding Distributions Excerpt: "The use of the term trustee-to-trustee transfer as it relates to qualified HSA funding distributions has created confusion for some owners of health savings account (HSA)s and IRAs, and even some custodians. This uncertainty stems from the fact that the term 'trustee-to-trustee transfer' is typically used by financial institutions to refer to a nonreportable movement of assets between retirement accounts of the same type, such as transfers between two traditional IRAs or between two Roth IRAs. And HSAs and IRAs are (obviously) two different types of accounts." (Appleby Retirement Dictionary) more    Employers Experiment with Tough Get-Healthy Regimes Excerpt: "The conflicts playing out as employers try to contain skyrocketing medical costs mirror tensions in society's views about privacy, personal responsibility and shared risk. They reflect growing intolerance for smokers and the obese. And they signal an erosion of a belief that once stood at the bedrock of employer health plans: costs ought to be shared equally regardless of health history or habits." (Chicago Tribune) more    Federal Agency Reveals Top Outpatient Drugs Ranked by Expense Excerpt: "The U.S. Agency for Healthcare Research and Quality has released statistics showing that the drugs topping the spending list for adult consumers are diabetes, cholesterol and anti-obesity drugs. U.S. adult consumers spent nearly $36 billion for prescription drugs to lower blood sugar, reduce cholesterol, or help with other metabolic problems in 2005. The four other classes of drugs that topped spending among adults were: . . . ." (International Foundation of Employee Benefit Plans) more    Blue Cross and Blue Shield Association Unveils Five-Point Plan for Health Care Coverage for All Americans Excerpt: "Stating that 'a system that is unaffordable for many today won't work for even more people tomorrow,' Blue Cross and Blue Shield Association (BCBSA) president and chief executive officer Scott P. Serota on January 23 unveiled a five-point plan -- The Pathway to Covering America -- for building on the employer-based health care system to improve quality, rein in costs, and expand coverage to all Americans." (Wolters Kluwer Financial Services) more    FMLA Allows Additional Leaves of Absence On 1/28/08, President Bush signed the National Defense Authorization Act for Fiscal Year 2008. Section 585 of this new law amends the FMLA to allow 2 new types of leaves of absences (“LOA”) as qualified FMLA leaves of absences for employees who are relatives of service members. more    Medicare | Hospitals Participating in Medicare Pay-for-Performance Pilot Project Improving Quality, Reducing Costs, CMS Says Hospitals participating in a Medicare pay-for-performance demonstration project have been successful in lowering costs while reducing patient mortality and improving in other quality measures, officials said on Thursday, CQ HealthBeat reports. The project, a partnership between CMS and the hospital consortium Premier, involves 250 hospitals, which report on 30 clinical quality measures. more    Some Large Companies Making Lifetime Personal Health Records Available Electronically to Employees Excerpt: "Wal-Mart is among a group of large companies that has begun rolling out personal electronic health records to a handful of employees, as part of a plan to eventually provide more than a million of the retailer's workers and their dependents with digitized health records." (Human Resource Executive Online) more    Fifth Circuit Holds That Health Insurance Policy Purchased on Employee Is Not Covered by ERISA Excerpt: "Shearer v. Southwest Service Life Ins. Co. presented the question of whether an insurance policy purchased on an employee was covered by ERISA. The Fifth Circuit held that, because the employer did no more than pay the premiums on the policy, the plaintiff's claims were not preempted by ERISA, and the district court lacked jurisdiction over the case." (Health Plan Law blog by Attorney Roy F. Harmon III) more    Expanded COBRA Continuation Coverage for Small Firm Employees, 2007 Excerpt: "Updated information on continuation and conversion coverage offered to employees of small firms is now available for all states. Information on states that offer expanded COBRA continuation coverage to employees who are not currently covered by COBRA under federal law has been added and includes information on maximum duration amounts and rating restrictions. Updated information on conversion coverage rights for people leaving small firms that offer fully insured group health plans is also available for all states." (Kaiser Family Foundation) more    2008 Presidential Candidate Health Care Proposals Side-by-Side Summary Excerpt: "This side-by-side comparison of the candidates' positions on health care was prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc. and is based on information appearing on the candidates' websites as supplemented by information from candidate speeches, the campaign debates and news reports. The sources of information are identified for each candidate's summary (with links to the Internet). The comparison highlights information on the candidates' positions related to access to health care coverage, cost containment, improving the quality of care and financing. Information will be updated regularly as the campaign unfolds." (Kaiser Family Foundation) more    Reward/Penalty Plans for Wellness: Coming Soon to an Office Near You? (PDF) 8 pages. Excerpt: "[S]ome reward/penalty plans might actually make it harder for you to visit the doctor. For example, if your employer has created a plan in which you are charged higher premiums as a penalty for not meeting a particular wellness goal, your health insurance could become unaffordable. The result may be that you could no longer get the health care you need because of the high cost. Furthermore, when people have to pay more for health care, they are more likely to forgo services that they need." (Families USA) more    Overcoming 401(k) negativity The struggling economy has caused a lot of fear and misinformation to spread about the security of retirement benefit plans. Every time employees turn on the TV or read the newspaper, they’re bombarded with reports such as the recent one that said that U.S. 401(k) accounts have lost $2 trillion in the past 15 months. more         IMPORTANT: Benefit Solutions, Inc. takes every step reasonably possible to ensure news posted here is accurate and appropriate. However, because we do not control the content and websites outside of our own we cannot guarantee the accuracy or appropriateness of articles not produced by Benefit Solutions staff. Without the resources of a major news organization, we cannot always check every fact or statistic used in outside articles. Some articles may contain statements based on opinion or may even be opinion based articles.  We do not suggest by posting such articles that they represent the opinions or beliefs of Benefit Solutions or our staff, but simply that it is relevant to our industry and our business.

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