Insurance

‘Utilization review’ is exclusive way to challenge treatment

07/18/2008

The California Supreme Court has ruled that there is only one way for employers to challenge the medical treatment injured workers and their doctors want to pursue. All challenges must use a process created by the California Legislature called “utilization review.”

Same-sex marriage: What the trend means for employers and HR

07/17/2008

No federal law mandates that employees who are in state-sanctioned same-sex unions must receive the same employee benefits that heterosexual married couples receive. But the writing is on the wall. And even employers in states that ban same-sex unions may find themselves targeted by advocates for greater benefits …

Must we offer EAP services to those on COBRA?

07/17/2008

Q. Currently, we offer our employee assistance program (EAP) to those who elect COBRA coverage. But are we required by law to offer the EAP to COBRA participants? This is the first time I’ve seen a company offer an EAP through COBRA. Participants pay $3.08 plus a 2% administrative fee if they elect. — T.A., Maryland …

States settle deceptive practices lawsuit against Express Scripts

07/14/2008

Pharmacy benefits management giant Express Scripts has agreed to pay $9.5 million to 28 states, including Florida, to settle lawsuits alleging deceptive business practices. The lawsuits claimed the company convinced doctors to change patients’ cholesterol drug prescriptions to brands that offered Express Scripts a rebate …

Back pain and workers’ compensation

07/11/2008

Q. We have an employee who has a “bad back.” We have medical reports indicating he has a congenital back problem that frequently causes severe pain. Although he has a light-duty job, he frequently misses work because of his back pain and often seeks workers’ compensation benefits during his absences. Are we always going to be liable for workers’ compensation benefits when his back prevents him from working? …

Before canceling health insurance, beware FMLA trap that could cost big bucks

07/09/2008

If, like many employers, you provide health insurance benefits to full-time employees but not part-time ones, you may be tempted to cancel coverage as soon as an employee falls to part-time status. But what if the employee is eligible for FMLA leave? Canceling may not be an option—and can lead to a big jury award …

Metropolis kicks butts

07/09/2008

The city of Metropolis—Illinois’ adopted home of Superman—has offered to pay its employees $1,000 each if they can give up smoking for one year …

Roseville company sued for pocketing health insurance funds

07/08/2008

The U.S. Department of Labor (DOL) has filed suit against Catherine Ellingen, owner and president of Plywood Industries in Roseville, over violations of the Employee Retirement Income Security Act (ERISA) …

Companies try doctors’ bonuses to reduce employee depression

07/08/2008

A group of Minnesota employers is piloting a pay-for-performance program to combat employee depression. The program is sponsored by the Buyers Health Care Action Group (BHCAG) …

Preserve flex, work/life benefits during tough economy

07/03/2008

The stormy economy hasn’t dampened employers’ interests in offering work/life benefits to their employees, says a new study. Even as organizations severely cut contributions to health care, disability programs and pension plans, they continue to offer flexible schedules, child and elder care support, and employee assistance with family and personal problems …