Recent developments in employee benefits

The latter part of 1996 and the first part of 1997 produced continuing changes to the laws concerning employee benefits, as both Congress and the courts continued to focus on this area of the law. This article highlights some of the more important developments during the period with particular focus upon those of concern to the insurance industry.     

The annual employee earnings and benefits letter

Considering the investment that companies make in establishing and improving fringe benefits, it appears that many of these same companies do very little to translate benefits into a value dimension that employees will understand and appreciate. One answer to the problem is a simple, easily customized form letter that can be given to employees along with their W-2 forms.     

Recent developments in employee benefits law

The first part of this article highlights important judicial developments involving employee benefits and the Employee Retirement Income Security Act of 1974 ("ERISA"), as amended, during the latter part of 2003 and the first part of 2004, including the most significant U.S. Supreme Court and federal circuit court decisions. The second part covers recent legislative and regulatory developments in employee benefits law. This article is not meant to be exhaustive, but discusses the more important developments during 2003-2004, with particular focus on issues of concern to the insurance industry.     

Legal implications of employee assistance programs.

Employers who offer EAPs should be aware of their rights as well as the rights of employees. Appropriate steps should be taken to assure that employees are fully informed of the conditions of participating in a program prior to volunteering for treatment. An issue that must be considered is the confidentiality of information arising during the course of treatment. Several court cases involving the physician-patient relationship offer guidelines in this area.     

Minimizing employee benefits litigation through effective claims administration procedures

With the marked increase in employee benefits litigation, employers and benefit plan sponsors are searching for ways to avoid such lawsuits, minimize their exposure in such lawsuits, and maximize their ability of prevailing in such lawsuits. Benefit claim processing and administration have become fertile areas for lawsuits. Consequently, improving benefit claim processing and administration obviously becomes important, and an area where affirmative actions by the employer and plan sponsor will produce many litigation-related benefits. This article will discuss, in a very simple and straightforward manner, various actions an employer or plan sponsor can take which will decrease the number of lawsuits, minimize the potential exposure if a lawsuit is filed, and maximize the ability of prevailing if a lawsuit is filed.     

Public Health Service--Grants for graduate programs in health administration. Final rule

This rule sets forth requirements for Programs for Grants for Graduate Programs in Health Administration under section 791 of the Public Health Service Act (42 U.S.C. 295h), as amended by the Health Professions Educational Assistance Act of 1976 (Pub. L. 94-484).     

Public Health Service--Health maintenance organizations; employees' health benefits plans. Final regulations

This rule amends the Public Health Service regulations by setting forth revised requirements for certain employers, States, and political subdivisions of States to include in any health benefits plans offered to their employees the option of membership in qualified health maintenance organizations (HMOs). These changes are made as a result of public comments received on the notice of proposed rulemaking (NPRM) published on July 18, 1979. Certain minor technical and editorial changes have also been made.     

Public Health Service--Special project grants for graduate programs in public health. Final rule

This rule sets forth requirements for programs for Special Project Grants for Graduate Programs in Public Health under section 792 of the Public Health Service Act (42 U.S.C. 295h-1).     

Special report on health care reform. ERISA preemption, Traveler's and health care reform

Although S. 308 reportedly has some bipartisan support, its passage is by no means certain. ERISA has for years provided employers with the freedom to design their own benefit plans without state interference, as well as the ability to operate such plans in a uniform manner throughout the country. large employers are thus not likely to cede the advantages of ERISA preemption without a battle. When strong business interests are pitted against the states' equally strong interests in enacting health care reforms, the outcome cannot be predicted.