Several states enacted laws expanding coverage for children. Connecticut, Illinois, New York, Pennsylvania and Tennessee require extending dependent coverage to ages ranging from 23 to 30 sometimes without regard to student status.

Five states include grandchildren in their dependent definition, making it mandatory for insurance policies to cover these children (Maryland, Minnesota, New York, Texas and Wisconsin).

New Hampshire has passed a bill to extend health insurance coverage to divorced spouses. The bill would require health insurers to allow the spouse of divorced members to remain covered under the policies of their former spouses for up to 3 years or until one of them remarries.

Seven states enacted laws allowing insurers to offer subscribers premium rebates or other incentives through their wellness programs, those seven states are Arizona, Indiana, Maryland, Iowa, Oregon, Texas and Utah.

Many states in their hope to curtail rising health costs, including Arizona, Connecticut, Florida, Illinois, Maine and Washington are reviewing proposals requiring insurers to cover screening tests for breast, cervical, colorectal and prostrate cancers. Lawmakers in states like Missouri will also consider mandating coverage for obesity treatments, while states like Indiana and New York will debate bills mandating coverage for smoking-cessation programs.

Arizona also revised a 2006 law known as Mandate-Lite, which allows insurers to offer small businesses health plans without some previously State mandated benefits, making them less expensive. Since 2001, Arkansas and North Dakota have also permitted insurance companies to sell policies without all of the benefits they mandate. In many cases, these mandate exemptions are allowed only for certain types of policies, such as small employer plans.

A number of states are also debating new or expanded employee leave laws. Pending proposals would provide paid sick days or paid leave to care for sick family members. Other bills would require offering paid leave to employees for certain events related to a family member’s active military duty.

Paid sick leave. In the wake of San Francisco’s successful ballot initiative last year, similar measures in Connecticut, Massachusetts and other states would require employers to provide paid sick leave, mandate year-to-year accrual of sick leave up to a certain cap and allow employees to use that time for their own illness or to care for an ailing family member.

Paid family leave. A few states, including Arizona, Massachusetts, New Jersey and Washington, will consider providing limited income support to residents taking leave from work because of their own serious illness or the need to care for a seriously ill family member.

Military family leave. Hawaii, Indiana, Maine and New York are considering bills that would allow employees to take an unpaid leave when a family member in the military is deployed, returns from duty, or suffers injury or dies while performing military service.

The Mayo Clinic is recommending to the presidential candidates and members of Congress that every individual have basic universal insurance as a step toward gradually replacing the current employer based system.

The Mayo Clinic is not advocating a government run single payer system, but rather that private insurance companies be required to offer standard plans with many options like the Federal Employees Health Benefits Plan available to government workers.

The Mayo Clinic and a panel of over 400 health policy experts worked on this proposal for over 18 months.

Under the proposal, smaller employers would no longer sponsor coverage but would contribute to plans that their employees could select from an outside insurer. 

Also under the proposal, employees could keep their individual policies when they changed jobs under the proposal.

The panel does not believe in relinquishing the employer-sponsored health care system, rather they believe that the employer has a role, the government has a role, and individuals also have a responsibility to provide health care for all.

Linda M. Dillman, a panelist who is an executive vice president in charge of health and environmental issues at Wal-Mart said health care should be a shared responsibility.

Without a shared financial responsibility and commitment across stakeholders, it will be difficult for the United States to achieve universal coverage.

Even someone with a $50,000 income would need help paying for insurance that now costs $11,000 or $12,000 a year.

Two democratic candidates, Mr. Obama and John Edwards both put forth health plans that would encourage individuals to join insurance purchasing groups and pool their power to get better coverage.

Recent polls show that opinion leaders and the public both view expanded access to affordable health insurance as the most critical domestic policy challenge facing the nation. Policymakers at the state and federal levels are listening. Massachusetts and other states are taking the lead on expanding coverage for all.

Franks v. Central Garden & Pet Co.

In this case the employer provided the terminated employee with a COBRA election notice and the employee elected COBRA. 

The employee later sued the employer on a number of employment related issues, including COBRA. The employee claimed that the court should award statutory penalties because the notice laced certain information required by the DOL final COBRA regulations which made the election notice insufficient to permit her to make an informed decision about whether to elect to continue coverage through COBRA.

The court disagreed with the employee and dismissed the COBRA claim. The court conceded that the election notice was technically deficient under the DOL regulations because it did not provide either the date on which health coverage would terminate (in the absence of a COBRA election) or the date by which the election must be made. However, as the terminated employee successfully elected COBRA, the court concluded that these technical deficiencies did not render the notice insufficient to permit an informed COBRA decision and did not impose any penalties against the employer.

Although the employer did not have to pay any COBRA penalties, it is still important to note that the COBRA election notice was found to be insufficient and was missing key data.