E M P L O Y E E B E N E F I T S ,
C O M P E N S A T I O N
A N D P E N S I O N L A W
Vol. 2, No. 23: December 13, 2001
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Publisher: LSN Subject Matter Journals
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Social Science Electronic Publishing, Inc. (SSEP)
and Social Science Research Network (SSRN)
Editor: PAMELA J. PERUN
Urban Institute
Mailto:pamela@planetnow.com
Copyright: SSEP, Inc. 2001. All rights reserved.
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T A B L E of C O N T E N T S
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NEW and FORTHCOMING ARTICLES
"Pegram v. Herdrich: On Peritonitis, Preemption, and the Elusive
Goal of Managed Care Accountability"
Journal of Health Politics, Policy
and Law, Vol. 26, No. 4,
August 2001
PETER J. HAMMER
University of Michigan
Law School
"Defined Contribution Health Benefits"
EBRI Issue Brief, No. 231, March
2001
PAUL FRONSTIN
Employee Benefit Research
Institute (EBRI)
"Defined Contribution Health Benefits: The Next Evolution?"
EBRI Notes, Vol. 22, No. 8, August
2001
STEVE BLAKELY
Employee Benefit Research
Institute (EBRI)
"Employee Benefits Considerations in Joint Ventures"
Tax Lawyer, Vol. 54, No. 3, Spring
2001
SUSAN P. SEROTA
Pillsbury Winthrop
LLP
"Phased Retirement: Leaving the Labor Force"
EBRI Notes, Vol. 22, No. 9, September
2001
DAVID RAJNES
Employee Benefit Research
Institute (EBRI)
STANFORD/YALE JUNIOR
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EDITORIAL POLICIES
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Benefits, Compensation and Pension Law we do not referee working
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N E W and F O R T H C O M I N G
Articles
_________________________________________________________________
"Pegram v. Herdrich: On Peritonitis, Preemption, and the Elusive
Goal of Managed Care Accountability"
Journal of Health Politics, Policy
and Law, Vol. 26, No. 4,
August 2001
BY: PETER J. HAMMER
University of Michigan Law School
Paper ID: U of Michigan Law, Public Law Working Paper No. 9
Contact: PETER J. HAMMER
Email: Mailto:hammerp@umich.edu
Postal: University of Michigan Law School
625 South State Street
Ann Arbor, MI 48109-1215 USA
Phone: 734-763-4586
Fax: 734-764-8309
ABSTRACT:
Manages care presents the paradox of organizations having real
power over people's lives without there being clear or
consistent means of ensuring accountability. In Pegram v.
Herdrich, the United States Supreme Court struggled with whether
"fiduciary duties" under the federal Employee Retirement Income
Security Act (ERISA) could be used to counterbalance the
incentives that HMOs may have to deny necessary care. Given
press coverage of the case, however, it was easy to get the
impression that the managed care industry itself was on trial
in
Pegram. This report examines the political and legal forces
underlying the dispute and analyzes the Supreme Court's
unanimous rejection of the notion of federally imposed duties
for HMOs. In the absence of ERISA fiduciary obligations,
attention must now shift to developments in state tort law,
the
scope of federal ERISA preemption, and the prospect of
legislative reform. The report concludes with an exploration
of
how the elusive goal of managed care accountability might be
pursued in the wake of Pegram.
______________________________
"Defined Contribution Health Benefits"
EBRI Issue Brief, No. 231, March
2001
BY: PAUL FRONSTIN
Employee Benefit Research Institute (EBRI)
Document: Available from the SSRN Electronic Paper Collection:
http://papers.ssrn.com/paper.taf?abstract_id=267290
Contact: PAUL FRONSTIN
Email: Mailto:fronstin@ebri.org
Postal: Employee Benefit Research Institute (EBRI)
Suite 600
2121 K Street, NW
Washington, DC 20037-1896 USA
Phone: 202-775-6352
Fax: 202-775-6312
Paper Requests:
Contact Alicia Willis at Mailto:publications@ebri.org, or 2121
K
St., NW, Suite 600, Washington, DC 20037-1896.
Phone:(202)775-9132, Fax:(202)775-6312. Full-Text downloads
are
available from SSRN Online for $7.50.
ABSTRACT:
This Issue Brief discusses the emerging issue of "defined
contribution" (DC) health benefits. The term "defined
contribution" is used to describe a wide variety of approaches
to the provision of health benefits, all of which have in common
a shift in the responsibility for payment and selection of
health care services from employers to employees. DC health
benefits often are mentioned in the context of enabling
employers to control their outlays for health benefits by
avoiding increases in health care costs. DC health benefits
may
also shift responsibility for choosing a health plan and the
associated risks of choosing a plan from employers to
employees.
There are three primary reasons why some employers currently
are considering some sort of DC approach. First, they are once
again looking for ways to keep their health care cost increases
in line with overall inflation. Second, some employers are
concerned that the public "backlash" against managed care will
result in new legislation, regulations, and litigation that
will
further increase their health care costs if they do not distance
themselves from health care decisions. Third, employers have
modified not only most employee benefit plans, but labor market
practices in general, by giving workers more choice, control,
and flexibility.
The Issue Brief also includes a discussion of various issues
related to both the current system and a DC health benefit
system, such as adverse selection, choice of plans, portability,
health care costs, employers' advocacy role, delivery innovation
and quality, tax treatment of health benefits, future public
policy, and employees' access to information. These issues must
be addressed in order for a transition to DC health benefits
to
occur. The most salient of these issues most likely will be
adverse selection, since, absent a government mandate on
individuals to purchase health insurance, it will be difficult
to build an infrastructure that does not encourage healthy
individuals to go without health insurance or to choose less
extensive plans.
Keywords: Defined contribution plans, Employment-based
benefits, Health care attitudes and opinions, Health care costs,
Health insurance coverage, Health insurance surveys
JEL Classification: J32
______________________________
"Defined Contribution Health Benefits: The Next Evolution?"
EBRI Notes, Vol. 22, No. 8, August
2001
BY: STEVE BLAKELY
Employee Benefit Research Institute (EBRI)
Document: Available from the SSRN Electronic Paper Collection:
http://papers.ssrn.com/paper.taf?abstract_id=282591
Contact: STEVE BLAKELY
Email: Mailto:blakely@ebri.org
Postal: Employee Benefit Research Institute (EBRI)
Suite 600
2121 K Street, NW
Washington, DC 20037-1896 USA
Phone: 202-775-6341
Fax: 202-775-6312
Paper Requests:
Contact Alicia Willis at Mailto:publications@ebri.org, or 2121
K
St., NW, Suite 600, Washington, DC 20037-1896.
Phone:(202)775-9132, Fax:(202)775-6312. Full-Text downloads
are
available from SSRN Online for $7.50.
ABSTRACT:
"Defined contribution" (DC) health benefits are an emerging
alternative that employers are starting to examine for
controlling the resurgence of health care cost inflation.
While
there is no agreed-upon definition of what exactly constitutes
DC health benefits, under this strategy, employers would
make a
fixed, periodic contribution to a worker's health care
account,
and the worker would assume full responsibility for
self-insuring the care he or she needs by acquiring commercial
insurance individually or through other groups. This article
summarizes discussion and presentations at EBRI's May
3, 2001,
policy forum on defined contribution health benefits,
at which
policymakers, leading thinkers on benefits, employers,
and labor
representatives examined some of the implications of DC
health
plans. They discussed whether DC health benefits would
be able
to produce long-term health care cost control, which managed
care has not succeeded in doing; whether they would offer
workers more choice over how their health care money is
spent
and more flexibility in choosing their providers; and
how policy
issues, such as adverse selection, equity, and regulation,
would
be addressed.
Keywords: Employment-based benefits, Health care costs,
Health
care policy, Health insurance
JEL Classification: J32
______________________________
"Employee Benefits Considerations in Joint Ventures"
Tax Lawyer, Vol. 54, No. 3, Spring
2001
BY: SUSAN P. SEROTA
Pillsbury Winthrop LLP
Contact: SUSAN P. SEROTA
Email: Mailto:sserota@pillsburywinthrop.com
Postal: Pillsbury Winthrop LLP
One Battery Park Plaza
New York, NY 10004-1490 USA
Phone: 212-858-1125
Fax: 212-858-1500
ABSTRACT:
In structuring corporate transactions, companies are
increasingly utilizing joint ventures as a form of operating
a
business. It is necessary to understand the implications of
joint ventures on employee compensation and benefit issues.
This
Article discusses the tax consequences to both the employer
and
employee which may differ if the entity is taxed as a
partnership or a corporation. Also discussed are qualified plan
considerations, plans sponsor liabilities under Title IV of
ERISA, multiple employer plans, nondiscrimination requirements,
the use of pre-participation and imputed service and
compensation credits under qualified plans, and the issues
relating to participation by joint venture employees in ESOPs
and other individual account plans with investment in securities
of one of the partners. The Article also discusses incentive
compensation and executive compensation issues in joint
ventures, including the availability of ISOs and nonqualified
options and recent issues arising under the final section 1032
regulations, and welfare plans in joint ventures, including
issues relating to MEWAs.
______________________________
"Phased Retirement: Leaving the Labor Force"
EBRI Notes, Vol. 22, No. 9, September
2001
BY: DAVID RAJNES
Employee Benefit Research Institute (EBRI)
Document: Available from the SSRN Electronic Paper Collection:
http://papers.ssrn.com/paper.taf?abstract_id=288460
Contact: DAVID RAJNES
Email: Mailto:rajnes@ebri.org
Postal: Employee Benefit Research Institute (EBRI)
Suite 600
2121 K Street, NW
Washington, DC 20037-1896 USA
Phone: 202-775-6329
Fax: 202-775-6312
Paper Requests:
Contact Alicia Willis at Mailto:publications@ebri.org, or 2121
K
St., NW, Suite 600, Washington, DC 20037-1896.
Phone:(202)775-9132, Fax:(202)775-6312. Full-Text downloads
are
available from SSRN Online for $7.50.
ABSTRACT:
The more traditional view of retirement as a one-time event
has
been superseded in recent years by the idea that, for many
workers, leaving the work force may involve a less abrupt
transition to full-time retirement. This article examines the
process of exiting the labor force referred to in the media
and
academic literature as phased retirement. It explores the topic
through an examination of trends in labor force participation
and retirement and presents research highlights drawn from
recent surveys on the subject. Reasons why employees and
employers become involved in either formal or informal
arrangements are a focus of the discussion and serve to explain
the relative scarcity of formal programs in the private sector.
Also mentioned are recommended implementation strategies for
employers considering a formal phased option program.