ERISAclaim.com

 

Home
Order FAQ & Disclaimer Copyright New Partners Discussion

 

 USHealthcareCrisis.com

Seminar Schedules in IL NC, PA, VA, OH, SD, Teleconference

 
What's New
ERISA or PPO
ERISA & Your Money
ERISA & Your Insanity
New Appeal Dept
Seminars
Appeal Book & Systems
On-site Education
Certification Program
ERISA, Who?
Rx for GM Health Crisis
ERISA for Hospitals
Medical Device Makers
CMS New Appeal Rules
Executive Brainstorming
"Failure of Imagination"
U.S. Healthcare Crisis Rx
Employers, Insurers, TPA's
Integrated Systems
ERISA 1-2-3
ERISA Demystified
Medicare & ERISA
HSA & ERISA
ERISA Criminal Enforcement
Consulting Service
Claim Recovery
Appeal Networks
950,000 MD's & ERISA
Medical Claim Denials
"Overpayment" Refund
Prompt Pay Crisis & Rx
Downcoding & Bundling
Pre-existing Cond. Denial
DOL Final Rules
DOL New Guidance
Court Watch
Company Info
Contact Us
 
 

Advertisement

 

Moukawsher & Walsh, LLC
Pension and Employee Benefit Law

Benefitlawyers.com

 
 

Pomerantz Haudek Block Grossman & Gross LLP ("PHBG&G")

ERISA and Healthcare-Related Class Actions

SPD's for FEHB

FEHB Open Season and FSA Open Season

Patients' Bill of Rights and the Federal Employees Health Benefits Program

HIPPA Consumer Bill of Rights and Responsibilities

Federal Employees Health Benefit Plan

 

Federal Employees Health Benefits Program
-
FEHB Plan Brochures

 

Links to Plan Brochures for 2003

 

Links to Plan Brochures for 2004

 

 

Federal Employees Health Benefits Program

FEHB HANDBOOK

 

Kaiser statehealthfacts.org

 

 

Icon
TRICARE Handbook


Icon
TRICARE Manuals

 

Health Benefits Summaries, SPD's, 
for  State
Employees

NJ STATE
HEALTH BENEFITS PROGRAM

SUMMARY PROGRAM DESCRIPTION (SPD)
for employees and retirees

January 2003 (pdf)

New Jersey State Health Benefits Program Home Page

 
SPD for MD State

2004 Health Benefits Booklet for Current Employees (pdf) View as HTML

 

Connecticut State Employees and Retirees Benefits Information

 

Ohio Benefits Package Summary for State Employees

DAS/HRD Benefits - Open Enrollment Manual - Table of Contents

Employee Benefits Handbook - HMO Benefit Summary

 

Virginia Healthcare for Employees

 

State of Colorado Benefits - Medical

-- Dental

 

ARKANSAS STATE EMPLOYEES GROUP BENEFIT SUMMARY PLAN DESCRIPTION [PDF]

DFA - Employee Benefits Division : Benefits Library - State

 

West Virginia Employee Benefits

 

Summary of EMPLOYEE BENEFITS for State of Hawaii Employees (pdf)

State of Hawaii - Department of Human Resources Development

 

NC Teachers and State Employees Comprehensive Major Medical Plan

 

Minnesota State Insurance benefits index - employees

State Employee Group Insurance Program (SEGIP) - agencies

 

 

[PDF] THE STATE OF NEW HAMPSHIRE SUMMARY OF BENEFITS (HMO)

[PDF] THE STATE OF NEW HAMPSHIRE SUMMARY OF BENEFITS (retiree)

 

Summary of Benefits Commonwealth of Massachusetts Employee/Retiree (pdf)

 

The State of Washington  State Employee Benefits

 

Texas  State Epmloyeee  Summary of Benefits

For Your Benefit for State Agency employees - Spring 2004 (PDF)

For Your Benefit for Higher Ed employees - Spring 2004 (PDF)

 

State of Michigan Employee Benefits Booklets

 

Kansas Active Employee Health Insurance Information

 

State of Idaho Handbooks and Manuals - Insurance Management - Department of Administration

 

 

 

Health Insurance Mandates in the States, 2004: a State-by-State Breakdown ... (PDF) (Council for Affordable Health Insurance)
 
 
 

U.S. Healthcare Crisis Turnaround?

U.S. A.

Drs. & Hospitals Employers

$1.0 Trillion / Year

$$$ ERISA $$$

50% Savings

The Only Company with Compliant Solutions for All of You

We Are Seeking New Strategic Partners

 

Our sister website, SleepApneaUSA.net, is finally here, and improving, updating every date.

Welcome

 

ERISAclaim.com (also now "USHealthcareCrisis.com") with its principal and founder, Dr. Jin Zhou, is committed to providing unique and practical solutions to our nation's health care crisis, in case the Congress and the President of the United States fail to stop our health-care crisis, probable health care crash and future federal budget deficits of $44.2 trilion;

 

We will provide educational and consulting solutions to healthcare providers, clinics and hospitals for maximum reimbursement or crisis turnaround only through compliance of ERISA;

We will provide educational and consulting solutions to employers/plan sponsors, insurers and TPA's with compliance assistance to minimize administrative costs and risks through compliance of ERISA;

 

We will provide educational and consulting solutions to the nation to establish or restore the hope, faith and the Law & Order  for our health-care system through education and compliance of ERISA, the federal law designed to regulate about 80% of the health-care claims and 60% of the U.S. health-care expenditure, ERISA is the only "nuclear power" capable of stopping our escalating health-care costs. Compliance is the only common ground for everyone, and it is the only way that we can bail out of our worst health-care crisis since World War II.

 

Our strategy is to solve US health-care crisis through:

 

  1. Scientific identification of the most accurate causation for skyrocketing medical inflation and fundamental failure of US health care delivery system - ERISA Failure;

  2. Identification of common ground for everyone involved, governing federal law for employer-sponsored health-care system that has been already on the book for the past 30 years - ERISA; and

  3. Providing a solution to

 

ü     Establish Prudent "Personal Responsibility" without Eliminating Employer-Sponsored Health-Care System and without "Skipping Necessary Health Care" and "Personal Bankruptcy";

ü      Keep Employer-Sponsored Health-Care System with Quality Health Care but without Skyrocketing Medical Cost Disaster.


Our mission is to prevent another "Failure of Imagination" in US healthcare crisis triggered economic recession or even disaster, and
"John Q. ERISA Enforcement"!

 

Unanimous US Supreme Court Ruling

In US Health Care Crisis

by Jin Zhou, 02/11/2005

© 2005, Jin Zhou, ERISAclaim.com


Managed-Care Nightmares?

Health-Care Crisis without True Solutions?

 

What Does an Unanimous US Supreme Court Say?

 

On June 21, 2004, an unanimous US Supreme Court ruled that claim processing and denials of benefits under the employer-sponsored health plans, ERISA-regulated benefit plans, for both self-insured and fully-insured (through purchase of insurance) health plans, are completely governed by federal law ERISA, that supersedes and invalidates state laws.

 

How Can Anyone in USA, from Congress to General Motor to the White House, from Industry Experts to Patient Advocates, Solve US Health Care Crisis without Even Thinking of ERISA?


"Failure of Imagination" As a Nation Is the Real Tragedy

 

ERISAclaim.com - Supreme Court Managed Care ERISA Watch

 

Unanimous US Supreme Court Ruling In US Health Care Crisis

 

Aetna Health Inc. v. Davila

06/21/04

Opinion of the Court

 

"Held: Respondents’ state causes of action fall within ERISA§502(a)(1)(B), and are therefore completely pre-empted by ERISA §502 and removable to federal court. Pp. 4–20."

 

"We hold that respondents’ causes of action, brought to remedy only the denial of benefits under ERISA-regulated benefit plans, fall within the scope of, and are completely pre-empted by, ERISA §502(a)(1)(B), and thus removable to federal district court. The judgment of the Court of Appeals is reversed, and the cases are remanded for further proceedings consistent with this opinion.7 It is so ordered."

 

Health-Care 9/11 Report of 2005

Health-care WMD

 

by Jin Zhou, 02/05/2005

© 2005, Jin Zhou, ERISAclaim.com

Unanimous US Supreme Court:

Employer-Sponsored Health-Care Is Completely Governed by ERISA laws and rules; Aetna Health Inc. v. Davila, 06/21/04

Congressional Leaders:

One Administration = One Voice = ERISA Self Enforcement only, or No Enforcement?

Health-care Terrorists?

"ERISA Advantage" bogus plans, "unlimited and frequent premium increases, and the potential for rampant fraud with little, if any, regulatory recourse" in 30 years of ERISA self enforcement.

Health-care WMD (Weapons of Mass Destruction)

"Medical Inflation,  WMD" for "ERISA Advantage" from ERISA Failure - "Failure of Imagination" Again for US Healthcare:

USA: $1.9 Trillion, 15.7% of GDP

GM:  $5.6 Billion, $1,500 Per Car

Economists: Federal deficit a bigger risk than terrorism (USA Today)

"The survey, taken between Feb. 28 and March 8, found U.S. businesses had three nearly equal concerns about longer-term risks: health care, the aging population and the federal deficit."

USA 2005:
  1. Personal Bankruptcy

  2. GM Chapter 11,

  3. National healthcare expenditure $$1,9 trillion

  4. One nation under debt

  5. GAO Report: Tax Expenditures Represent a Substantial Federal Commitment and Need to Be Reexamined (PDF) (U.S. Government Accountability Office) Abstract Highlights-PDF PDF 

White House Rx:

 $1,000 HSA personal responsibility + AHP with More "ERISA Advantage" for "widespread plan insolvencies and fraud" and "A Prescription For Disaster".

2005 for Michael Moore? "John Q. ERISA Enforcement"???
Congressional conclusion 2008:

"Failure of Imagination" Again, with No One's Responsibility and Accountability.

 

 

Discount for March 2005: $35
 

$450 ERISA CD Book

ERISA Claim Appeal Books & Systems

Click here or the CD-Picture to enter our Secured Online Order page

 

With New 2005 Update (including New ERISA Assignment Form Required for ERISA Appeals, DOL, FAQ, B2-3)

 

ERISA Failure Syndrome

U.S. Healthcare Crisis Trilogy

(Copyright © 2004 by Jin Zhou,  ERISAclaim.com)

 

ERISA
Medical Killing
ERISA
Medical Inflation
ERISA
Insurance Robbery
"Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance

Read Making a Killing

?

 

?

Bar graph showing trends in hospital charges and revenues in California from 1995-2002

?

 

?

GAO-04-312

?
?

American Job ExportING!

Mass layoffs up in January 2004

Weirton Steel cancels 10,000

GM: $67.5 billion in 2003

One Nation under Debt: U..S. economy threatened by aging of America

 

Healthcare Disaster at Fault Verdict Index:

U.S. Government 30%

U.S. Employers & Insurers 30%

Healthcare Providers 30%

Consumers 10%

(ERISA Failure + Managed-Care) Destroyed US Healthcare
(ERISA Failure + Managed-Care + HSA) Invite US Federal Budget Deficit & Social Security Disasters = 100X 9/11 Attacks

 

GAO: Current and Emerging Fiscal and Retirement Security Challenges, American Benefits Council/MetLife Conference, Washington, DC, on January 14, 2005

  1. Rising Health care Costs Have Many Implications (Direct)

  2. Rising Healthcare Costs Have Many Implications (Indirect)

 

Rx-1  $$$$$$$$$ERISA"Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance
$$$$$$$$$$  Rx-2

 

 

 

 

 

DOJ: Criminal Resource Manual 2432 Coercive or Fraudulent Interference with ERISA Rights -- 29 U.S.C. 1141

2432 Coercive or Fraudulent Interference with ERISA Rights -- 29 U.S.C. 1141

Title 29 U.S.C. § 1141 states:

 

"It shall be unlawful for any person through the use of fraud, force, violence, or threat of the use of force or violence, to restrain, coerce, intimidate, or attempt to restrain, coerce, or intimidate any participant or beneficiary for the purpose of interfering with or preventing the exercise of any right to which he is or may become entitled under the plan, this title, section 3001, or the Welfare and Pension Plans Disclosure Act. Any person who willfully violates this section shall be fined $10,000 or imprisoned for not more than one year, or both. The amount of fine is governed by 18 U.S.C. § 3571. The U.S. Sentencing Guidelines address 29 U.S.C. § 1141 under the guidelines for "Fraud and Deceit" (U.S.S.G. § 2F1.1) or for "Extortion by Force or Threat of Injury or Serious Damage (U.S.S.G. § 2B3.2)......"

 

"For example, Section 1141 would reach the use of deception directed at misleading a welfare plan beneficiary as to the amount of health benefits owed to the beneficiary under the terms of the plan or at misleading a pension plan participant as to the amount of retirement benefits to which he would become entitled under the plan upon his retirement."

 

ERISA in the United States Code

ERISA 510 29 USC 1140 Interference with protected rights.
ERISA 511 29 USC 1141 Coercive interference.

 

ERISAclaim.com

Happy
Birthday Sept. 2,
1974
30th
Birthday

 

Happy or Sad 30th Birthday To ERISA?

(Copyright © 2004 by Jin Zhou,  ERISAclaim.com)

Sept. 2, 2004

On Sept. 2, 1974, exactly 30 years ago today, ERISA, The Employee Retirement Income Security Act, was signed into law by President Gerald R. Ford. The congressional intent in enacting ERISA was to protect employees in pension and welfare plans, to provide uniform federal protections in response to the failure of the Studebaker Co. in December 1963, with thousands of long-service employees cheated out off their promised pensions, and to preempt any state laws when the employees pension and welfare benefits were threatened. 30 years later, ERISA Failure in its compliance and enforcement left thousands of retirees without medical benefits, and resulted in a skyrocketing national healthcare expenditure explosion with 45 million uninsured and a possible national pension bailout.

ERISA Failure Syndrome

U.S. Healthcare Crisis Trilogy

 

Jin Zhou Identifies "ERISA Failure" That Killed U.S. Healthcare

"Failure of Imagination" Again?

 

 

 

 

ERISA Celebrates 30th Anniversary As Trouble Brews For the Pension Insurance Program (Spencer Benefits Reports)

Excerpt: "The seed for ERISA was planted with the failure of the Studebaker Company in December 1963, leaving thousands of long-service employees without their promised pensions."

 

ERISA Shield Explosion!!!

ERISA Patient's Bill of Right from Supreme Court

(Copyright © 2004 by Jin Zhou,  ERISAclaim.com)

04/28/2004