Health plans - reimbursement; enforcing plan provisions; preemption; statute of limitations

Article Abstract:

Blue Cross and Blue Shield of Alabama filed a case against Mr. and Mrs. Sanders who were participants in a Blue Cross health benefits plan for their refusal to reimburse the amount given to them for medical expenses. The plaintiff cited the fact that the Sanders won a car accident case in an Alabama state court, but did not inform the insurer. The court ruled in favor of Blue Cross, saying that an action enforcing a reimbursement provision is analogous to a simple contract action.

Cases, Health insurance industry, Blue Cross and Blue Shield of Alabama

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Communicating the need for additional savings in the face of retiree health benefit cutbacks

Article Abstract:

Demographic data show that the aging workforce will be increasingly forced to rely on their respective retirement savings plans and employers will have to fully inform employees of what they face after retirement. Medicare reductions and retiree health benefits cutbacks necessitate increased savings while employees who are not fully aware of retirement health benefit costs need to be informed.

Medical Insurance NEC, Finance, Retirement benefits

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Total system costs and the case of the executive's hernia

Article Abstract:

Managers who use a total system cost approach when developing benefits plans can address not only expenses but productivity as well. Although some procedures, such as a laparoscopic hernia surgery, may be more costly, improved return-to-work times for employees can offset the actual cost of the procedure. Using this approach, overall costs of plans can be determined.

Economic aspects, Employee benefits

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