Compliance February 3, 2005

DoL Releases Proposed Rules Relating to Pension Funding Equity Act

February 3, 2005 (PLANSPONSOR.com) - The Department of Labor (DoL) has announced proposed rules to implement provisions of the Pension Funding Equity Act of 2004.
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>The proposed rules would require administrators of multiemployer pension plans to annually report on the funding status of the plans, according to a DoL press release.

>A notice would have to be sent annually to participants, beneficiaries, labor organizations, contributing employers and the Pension Benefit Guaranty Corporation (PBGC) and must be written in easy to understand language and include financial information about the plan, according to the announcement. If a plan is less than 100% funded, the notice must also include he current funded liability percentage. On top of this, the notice must include a comparison of the plan’s assets to benefits payments, a description of the law governing insolvent plans and information about the PBGCs guarantees, according to the news release.

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“This Administration is taking concrete steps to improve the financial integrity of the pension insurance system, including more disclosure of information on the funding of defined benefit plans,” said Assistant Secretary of Labor, Ann Combs, in the release.   “We believe these rules will result in greater transparency for workers, employers and the government on how well these plans are funded.”

>Public comments on the proposed regulations should be submitted to the U.S. Department of Labor, Employee Benefits Security Administration (EBSA), Room N5669, 200 Constitution Ave., N.W., Washington, D.C.   20210, Attention: PFEA ’04 Project or by email to  e-ORI@dol.gov .   The proposed regulation is to be published in Friday’s Federal Register.  

Compliance February 2, 2005

Court: Plan Adm. Correct in Denying Dental Benefits for Denture Implants

February 2, 2005 (PLANSPONSOR.com) - A health and dental plan administrator who refused to pay over $100,000 for dental surgery did not act incorrectly, a federal court has ruled.
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>US District Judge Petrese Tucker of the US District Court for the Eastern District of Pennsylvania ruled that Independent Blue Cross, the health and dental plan administrator for Patricia Roberts, did not unfairly refuse to pay for over $100,000 in dental surgery.

>In 2001, Roberts, who suffered from pemphigus vulgaris – a systemic disease that usually brings on blistering and ulceration of mucous membranes and skin – had surgery to receive dental implants after her teeth fell out. Of the total cost, Independent offered to pay only $1,055, informing Roberts that her employer’s plan did not cover such procedures.

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>Roberts appealed to the administrator, who again denied to pay the costs, saying that the plan documents stated clearly that no benefits would be given for services having to do with care, filling, removal or replacement of teeth, nor with the treatment of injuries or disease of the teeth or gum structure supporting teeth.

>In court, Tucker ruled that the language was clear, and that is should be obvious to any plan participant that this service was not included in the plan. She rejected Roberts’s assertion that this was a medical problem being solved with a dental solution.

>The ruling in the case is available  here .

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