While large employers are getting an additional year to collect data and make other preparations to comply with the “pay-or-play” rules in the shared responsibility provisions of new Internal Revenue Code Section 4980H under the extension announced by the Administration in early July, all employers still have much to do stay on top of the developing rules and make the arrangements necessary to prepare to comply with the current and 2014 federal health plan mandates of the Patient Protection & Affordable Care Act (ACA) and other federal laws.

As the Departments of Health & Human Services, Labor and Treasury continue to refine and roll out guidance implementing these rules, the agencies recently released various updated resources discussing these evolving rules.   Among others, Publication 5093, Healthcare Law Online Resources, lists ACA resources from the IRS, the Departments of Health & Human Services and Labor, and the Small Business Administration.  Meanwhile, IRS.gov and HealthCare.gov also have new ACA webpages.

While these updated resources are intended by the agencies to help acquaint businesses with ACA’s requirements, businesses and the insurers and administrators that offer health benefit services need to keep in mind that these resources have risk and limitations.  As the agencies are continuing to refine the rules, these resources often do not reflect the most current or emerging guidance or status of rules.  Additionally, government provided explanations, model forms and resources often incorporate provisions or interpretations that are biased against the interests of the businesses,  or contain other provisions that may not fully inform the business to all of its options.  Furthermore, because of limitations in jurisdiction and other constraints, guidance issued by an agency or agency that reflects that certain approaches may satisfy the requirements of the rules specifically addressed by the guidance often do not disclose or adequately communicate potential concerns with certain types of actions under other applicable requirements.

For instance,  model exchange notices published by the Department of Labor this Spring to assist employers to provide the notifications about federal exchange coverage options that ACA requires employers distribute by October 1 contain many provisions beyond the content actually required to meet the notice requirements.  The Labor Department in announcing the model notices indicated that its model language includes discretionary provisions which the Department thought some employers might want to include to minimize questions from employees about employer provided benefits that employees interested in pursuing subsidized coverage could be expected to need to apply for subsidies.  While as of now, exchanges and subsidies still are scheduled to come on line January 1, 2014, the Obama Administration extended the employer “pay-or-play” mandate of Code Section 4980 and its associated employer reporting requirements, as well as has established that it does not plan to verify eligibility for subsidies requested by individuals enrolling in exchanges in 2014.  Given this, most employers will want to consider carefully the specific content that they wish to include in the exchange notice as they prepare the notice in anticipation of its distribution in October.Accordingly, all businesses dealing with these issues are encouraged to arrange for comprehensive advice from qualified legal counsel familiar with these requirements and other related human resources, health care, insurance and employee benefit issues.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with HIPAA and other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns.

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly.

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

“Pay Or Play” Reprieve Still Leaves Employers Facing Challenging 2014 Health Care Reform Deadlines

• HHS Continues Preparations For New Health Insurance Marketplace By Awarding Grants To Promote Kids Enrollment
• HHS Touts Enrollment Tools, Says Exchange Enrollment Ready Despite GAO Concerns
• HIPAA Sanctions Triggered From Covered Entity Statements To Media, Workforce
• Consider OCR Technical Corrections When Updating Privacy Practices & Agreements For Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• Id & Manage Hidden Employee Benefit Exposures In Business Insolvency Or Other Transactions
• Final Regulations Update HIPAA Health Plan Wellness Program Rules
• Beware:  Not All Products Marketed As “Fixed Indemnity Coverage” Products Are HIPAA/ACA Exempt
• Updated Kaiser Family Foundation Tool May Help Project Which Employees Will Get Exchange Subsidies
• New IRS Guidance On ESOP Investment Diversification Reminder To Tighten Compliance, Risk Management
• EBSA Releases Model ACA Notices Discussing Coverage Options
• Group Health Plans &No-Fault & Worker’s Comp Ruled Primary Plans When Coordinating With Medicare Advantage Plans
• Changing Plan Years Won’t Extend Health Plan’s Affordable Care Act Annual Limit Waiver Eligibility

• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

WellPoint $1.7 M HIPAA Settlement Expensive Lesson On HIPAA Risks Of Leaving PHI Too Accessible In Web-Based Applications

As health plans and health care organizations increasingly jump on the Web-based application bandwagon, managed care company WellPoint Inc. (WellPoint) is learning a $1.7 million lesson about the importance of ensuring Web-based applications and portals that allow access to members or other consumers protected health information (PHI) have the administrative, technical and other security safeguards required by the Health Insurance Portability & Accountability Act (HIPAA) Privacy and Security rules.

The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) announced late yesterday (July 11, 2013) that WellPoint has agreed to pay $1.7 million to settle OCR charges that WellPoint violated the HIPAA Security Rule and left the electronic protected health information (ePHI) of 612,402 individuals accessible to unauthorized individuals over the Internet by failing to implement appropriate administrative and technical safeguards in its Web-based applications. See WellPoint HIPAA Settlement Press Release.

Web-based application use is increasingly popular among health plans and their wellness programs, as well as health care providers.  Employers and health plans use them both in plan administration and offer them to members to use as member tools.  Health care providers use them for health care operations, as well as patient engagement and communication tools.  The WellPoint settlement illustrates that managed care and other health insurers, health plans and their employer or other sponsors, health care providers, health care clearinghouses (Covered Entities) and their business associates can’t let their enthusiasm for the ease of use of these products to compromise the security of PHI.

Rather, health plans and other Covered Entities, employer and other  health plan sponsors, their business associates, and the Web and other technology developers, providers and consultants marketing products, services or other solutions should learn from WellPoint’s hard lesson by ensuring that current and future Web-based applications, portals and other information system components that are or could be used to provide access to PHI incorporate the Security Rule safeguards both when originally implemented and with each subsequent upgrade.

HIPAA Privacy, Security & Breach Notification Rules Require PHI Safeguards & Other Protections

The Breach Notification Rule added to HIPAA under the Health Information Technology for Economic and Clinical Health, or HITECH Act requires HIPAA-covered entities to notify OCR, affected individuals and the media promptly of a breach of “unsecured protected health information” (UPHI) impacting more than 500 individuals.  For smaller breaches, the Breach Notification Rule still requires prompt notice to affected individuals, but allows Covered Entities to disclose the breach to OCR as part of an annual breach report and to forego notification to the media. UPHI generally includes any PHI, whether or not ePHI that is not either secured or destroyed in the way described by the Breach Notification Rules.

In addition to the Breach Notification Rule, most Covered Entities and their business associates also are subject to state laws or regulations that impose similar or additional breach notification and other standards and responsibilities on the protection of personal health or other data including required notification and other responses following a breach of the security of UPHI or other PHI.

WellPoint’s $1.7 HIPAA Security Mistake

WellPoint’s $1.7 million settlement lesson resulted from an OCR investigation started in response to a breach report WellPoint submitted to comply with the Breach Notification Rules.

According to OCR, the Breach Report indicated that security weaknesses in an online application database left the electronic protected health information (ePHI) of 612,402 individuals accessible to unauthorized individuals over the Internet.

OCR says its investigation indicated that WellPoint did not implement appropriate administrative and technical safeguards as required under the HIPAA Security Rule.  According to OCR, WellPoint did not:

• Adequately implement policies and procedures for authorizing access to the on-line application database;
• Perform an appropriate  technical evaluation in response to a software upgrade to its information systems; or
• Have technical safeguards in place to verify the person or entity seeking access to electronic protected health information maintained in its application database.

As a result, OCR concluded that from October 23, 2009 until March 7, 2010, WellPoint impermissibly disclosed the ePHI of 612,402 individuals by allowing access to their ePHI maintained in the application database. This data included names, dates of birth, addresses, Social Security numbers, telephone numbers and health information.

Under the resulting WellPoint HIPAA Resolution Agreement, WellPoint must pay OCR a $1.7 million settlement payment as well as take a series of corrective actions to correct the deficiencies in its policies and practices that resulted in the reported breach to minimize future risks of breaches resulting from these deficient.

OCR Warns Learn From WellPoint’s Experience

All Covered Entities and their business associates and leaders should heed the lesson sent to them by OCR in announcing the WellPoint settlement and take appropriate steps other to ensure that appropriate policies and safeguards are adopted and applied in selecting and implementing future application or system upgrades, as well as review existing systems to ensure that the security of existing systems and applications have incorporated and apply the requisite safeguards.

OCR made clear that the WellPoint settlement is intended to send a message to Covered Entities and their business associates to ensure that these steps are appropriately taken.  The settlement announcement states:

This case sends an important message to HIPAA-covered entities to take caution when implementing changes to their information systems, especially when those changes involve updates to Web-based applications or portals that are used to provide access to consumers’ health data using the Internet. Whether systems upgrades are conducted by covered entities or their business associates, HHS expects organizations to have in place reasonable and appropriate technical, administrative and physical safeguards to protect the confidentiality, integrity and availability of electronic protected health information – especially information that is accessible over the Internet.

The settlement announcement also reminds business associates that OCR will begin holding them directly accountable along with their Covered Entity clients for complying with many HIPAA requirements beginning in September, stating:

Beginning Sept. 23, 2013, liability for many of HIPAA’s requirements will extend directly to business associates that receive or store protected health information, such as contractors and subcontractors.

Take Documented Steps To Show You Hear OCR’s Messages

Covered entities and their business associates and leaders, and vendors and consultants offering services or products to them should take care to conduct careful and well-documented reviews and implement corrective actions necessary to show their applications and systems, policies and practices reflect their strong commitment and action to appropriately protect PHI in accordance with the expectations shown by the WellPoint HIPAA Resolution Agreement and other OCR settlements, OCR’s updated HIPAA regulations, and other OCR and industry information.

In addition to the guidance set forth in OCR’s Resolution Agreements with WellPoint and other Covered Entities, revisions to OCR’s Privacy and Security Rules in OCR’s 2013 restatement of its regulations here cause all Covered Entities and their business associates conduct a well-documented reassessment of the adequacy of their existing policies, systems and practices and steps taken to redress any uncovered gaps.

Among other things, the 2013 Regulations:

• Revise OCR’s HIPAA regulations to reflect the HITECH Act’s amendment of HIPAA to add the contractors and subcontractors of health plans, health care providers and health care clearinghouses that qualify as business associates to the parties directly responsible for complying with and subject to HIPAA’s civil and criminal penalties for violating HIPAA’s Privacy, Security, and Breach Notification rules;
• Update previous interim regulations implementing HITECH Act breach notification rules that require Covered Entities including business associates to give specific notifications to individuals whose PHI is breached, HHS and in some cases, the media when a breach of unsecured information happens;
• Update interim enforcement guidance OCR previously published to implement increased penalties and other changes to HIPAA’s civil and criminal sanctions enacted by the HITECH Act;
• Implement HITECH Act amendments to HIPAA that tighten the conditions under which Covered Entities are allowed to use or disclose PHI for marketing and fundraising purposes and prohibit Covered Entities from selling an individual’s health information without getting the individual’s authorization in the manner required by the 2013 Regulations;
• Update OCR’s rules about the individual rights that HIPAA requires that Covered Entities to afford to individuals who are the subject of PHI used or possessed by a Covered Entity to reflect tightened requirements enacted by the HITECH Act  that allow individuals to order their health care provider not to share information about their treatment with health plans when the individual pays cash for the care and to clarify that individuals can require Covered Entities to provide electronic PHI in electronic form;
• Revise the regulations to reflect amendments to HIPAA made as part of the Genetic Information Nondiscrimination Act of 2008 (GINA) which added genetic information to the definition of PHI protected under the HIPAA Privacy Rule and prohibits health plans from using or disclosing genetic information for underwriting purposes; and
• Clarifies and revises other provisions to reflect other interpretations and information guidance that OCR has issued since HIPAA was passed and to make certain other changes that OCR found appropriate based on its experience administering and enforcing the rules.

Covered Entities were required to begin complying with most of these rule changes earlier this year.  However, delayed compliance dates in the 2013 Regulations allowed Covered Entities and Business Associates to delay updates to pre-existing business associate agreements and the date that OCR would begin enforcing many of the HIPAA Rules directly against business associates to September 23, 2013.

Even without the necessity Settlements like that involving WellPoint, these 2013 Regulations make it imperative that Covered Entities to take the necessary steps to conduct an appropriate and well-documented review  and update as needed their systems, policies and practices,  business associate agreements, training and documentation.

With self-disclosures of breaches mandated by the Breach Notification Rules and OCR audits and enforcement rising, careful documentation of these activities and its analysis is necessary so that Covered Entities can be in a position to show OCR that the risk assessments required by the Security Rules was conducted as well as the efforts and commitment of the Covered Entity or business associate in the event of a breach investigation or audit. Yesterday’s WellPoint HIPAA announcement is just the latest in an ever-growing list of examples of the expensive consequences that can result if a Covered Entity or business associate cannot produce this documentation in response to an OCR audit or investigation. See, e.g.  OCR Hits Alaska Medicaid For $1.7M+ For HIPAA Security Breach; OCR Audit Program Kickoff Further Heats HIPAA Privacy Risks; $1.5 Million HIPAA Settlement Reached To Resolve 1st OCR Enforcement Action Prompted By HITECH Act Breach Report; HIPAA Heats Up: HITECH Act Changes Take Effect & OCR Begins Posting Names, Other Details Of Unsecured PHI Breach Reports On Website; Providence To Pay $100000 & Implement Other Safeguards.  In contrast, the OCR website also provides a multitude of examples showing how the ability to produce documentation and other evidence showing diligent efforts to comply has helped other covered entities that fall under OCR investigation to avoid or mitigate serious sanctions.

Coupled with statements by OCR about its intolerance, the WellPoint and other settlements provide a strong warning to covered entities of the need to carefully and appropriately manage their HIPAA encryption and other Privacy and Security responsibilities. Covered entities are urged to heed these warning by strengthening their HIPAA compliance and adopting other suitable safeguards to minimize HIPAA exposures.

In response to the 2013 Regulations and these expanding exposures, all Covered Entities should review critically and carefully the adequacy of their current HIPAA Privacy and Security compliance policies, monitoring, training, breach notification and other practices taking into consideration OCR’s investigation and enforcement actions against WellPoint and others, emerging litigation and other enforcement data; their own and reports of other security and privacy breaches and near misses; and other developments to decide if additional steps are necessary or advisable.  Covered Entities and business associates should document this review in a manner that both reflects the scope and diligence of their activities including relevant considerations and decision-making about identified potential susceptibilities and reasoning about the adequacy of safeguards and other solutions.

Because this review is likely to uncover existing or past deficiencies or breaches, most covered entities and business associates will want to discuss with qualified legal counsel the planned assessment within the scope of attorney-client privilege to understand when and how to conduct the assessment to preserve options to claim attorney-client privilege to protect sensitive work product or discussions that may result in the course of the investigation within the attorney-client communication, work product or other evidentiary privileges, evaluation of the adequacy and appropriateness of the audit and resulting investigations and its documentation, and other assistance in strengthening the defensibility of compliance and risk management activities.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with HIPAA and other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns.

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly.

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

“Pay Or Play” Reprieve Still Leaves Employers Facing Challenging 2014 Health Care Reform Deadlines

• HHS Continues Preparations For New Health Insurance Marketplace By Awarding Grants To Promote Kids Enrollment
• HHS Touts Enrollment Tools, Says Exchange Enrollment Ready Despite GAO Concerns
• HIPAA Sanctions Triggered From Covered Entity Statements To Media, Workforce
• Consider OCR Technical Corrections When Updating Privacy Practices & Agreements For Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• Id & Manage Hidden Employee Benefit Exposures In Business Insolvency Or Other Transactions
• Final Regulations Update HIPAA Health Plan Wellness Program Rules
• Beware:  Not All Products Marketed As “Fixed Indemnity Coverage” Products Are HIPAA/ACA Exempt
• Updated Kaiser Family Foundation Tool May Help Project Which Employees Will Get Exchange Subsidies
• New IRS Guidance On ESOP Investment Diversification Reminder To Tighten Compliance, Risk Management
• EBSA Releases Model ACA Notices Discussing Coverage Options
• Group Health Plans &No-Fault & Worker’s Comp Ruled Primary Plans When Coordinating With Medicare Advantage Plans
• Changing Plan Years Won’t Extend Health Plan’s Affordable Care Act Annual Limit Waiver Eligibility

• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

The Department of Health & Human Services Office of Civil Rights (OCR) on June 6, 2013 released an advance copy of to Technical Corrections  (Technical Corrections) to the Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notifications Rules Under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA Rules; Final Rule (Omnibus Rule) previously published on January 25, 2013.  Health plans, health care clearinghouses, health care providers and their business associates will want to be sure to take into account the Technical Corrections as they rush to update business associate agreements, policies, practices, training and other HIPAA compliance to comply with the Omnibus Rule changes by the September 2013 deadline.

Technical Corrections To Omnibus Rule Released

OCR published the Omnibus Rule to implement changes to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules (“the HIPAA Rules”) enacted by the Health Information Technology for Economic and Clinical Health Act (“the HITECH Act”) and section 105 of Title I of the Genetic Information Nondiscrimination Act of 2008, as well as to address public comment received on the interim final Breach Notification Rule and to other changes to the HIPAA Rules.  The Technical Corrections are scheduled for publication in the Federal Register on June 7, 2013.

The Technical Corrections correct various typographical errors and other oversights in the Omnibus Regulations as originally published.   While many of these corrections have limited material impact, certain corrections do have substantive implications.  For instance, by correcting errors in references to other provisions of the Omnibus Regulations, the Technical Corrections clarify that the authority of OCR to grant an extension of time pursuant to § 160.508(c)(5) for violations before February 18, 2009 also applies to violations occurring on or after February 18, 2009, as there is for violations occurring prior to February 18, 2009.

Health plans, health care clearinghouses and their business associates will need to review and take into account the Technical Corrections as they work to review and update their  policies and practices for handling and disclosing personally identifiable health care information (“PHI”) in response to the Omnibus Rule.

Get Moving To Update HIPAA Compliance For New Omnibus Rule Requirements As Amended By Technical Corrections

Covered entities and their business associates have a lot to accomplish between now and September to update their business associates and comply with other changes made by the Omnibus Rule by its September 2013 deadline. Among other things, the Omnibus Regulations:

• Revise OCR’s HIPAA regulations to reflect the HITECH Act’s amendment of HIPAA to add the contractors and subcontractors of health plans, health care providers and health care clearinghouses that qualify as business associates to the parties directly responsible for complying with and subject to HIPAA’s civil and criminal penalties for violating HIPAA’s Privacy, Security, and Breach Notification rules;
• Update previous interim regulations implementing HITECH Act breach notification rules that require Covered Entities including business associates to give specific notifications to individuals whose PHI is breached, HHS and in some cases, the media when a breach of unsecured information happens;
• Update interim enforcement guidance OCR previously published to implement increased penalties and other changes to HIPAA’s civil and criminal sanctions enacted by the HITECH Act;
•  Implement HITECH Act amendments to HIPAA that tighten the conditions under which Covered Entities are allowed to use or disclose PHI for marketing and fundraising purposes and prohibit Covered Entities from selling an individual’s health information without getting the individual’s authorization in the way required by the Omnibus Regulations;
• Update OCR’s rules about the individual rights that HIPAA requires that Covered Entities to afford to individuals who are the subject of PHI used or possessed by a Covered Entity to reflect tightened requirements enacted by the HITECH Act  that allow individuals to order their health care provider not to share information about their treatment with health plans when the individual pays cash for the care and to clarify that individuals can require Covered Entities to provide electronic PHI in electronic form;
• Revise the regulations to reflect amendments to HIPAA made as part of the Genetic Information Nondiscrimination Act of 2008 (GINA) which added genetic information to the definition of PHI protected under the HIPAA Privacy Rule and prohibits health plans from using or disclosing genetic information for underwriting purposes; and
• Clarifies and revises other provisions to reflect other interpretations and information guidance that OCR has issued since HIPAA was passed and to make certain other changes that OCR found appropriate based on its experience administering and enforcing the rules.

Liability & Enforcement Risks Heighten Need To Act To Review & Update Policies & Practices

The restated rules in the Omnibus Rule make it imperative that Covered Entities review the revised rules carefully and updated their policies, practices, business associate agreements, training and documentation to comply with the updated requirements and other enforcement and liability risks.  OCR even prior to the regulations has aggressively investigated and enforced the HIPAA requirements.  See, e.g.,  OCR Hits Alaska Medicaid For $1.7M+ For HIPAA Security Breach; OCR Audit Program Kickoff Further Heats HIPAA Privacy Risks; $1.5 Million HIPAA Settlement Reached To Resolve 1st OCR Enforcement Action Prompted By HITECH Act Breach Report; HIPAA Heats Up: HITECH Act Changes Take Effect & OCR Begins Posting Names, Other Details Of Unsecured PHI Breach Reports On Website; Providence To Pay $100000 & Implement Other Safeguards.

Coupled with statements by OCR about its intolerance, the HONI and other settlements provide a strong warning to covered entities of the need to carefully and appropriately manage their HIPAA encryption and other Privacy and Security responsibilities. Covered entities are urged to heed these warning by strengthening their HIPAA compliance and adopting other suitable safeguards to minimize HIPAA exposures.

All Covered Entities should review critically and carefully the adequacy of their current HIPAA Privacy and Security compliance policies, monitoring, training, breach notification and other practices taking into consideration OCR’s investigation and enforcement actions, emerging litigation and other enforcement data; their own and reports of other security and privacy breaches and near misses; and other developments to decide if additional steps are necessary or advisable.   In response to these expanding exposures, all covered entities and their business associates should review critically and carefully the adequacy of their current HIPAA Privacy and Security compliance policies, monitoring, training, breach notification and other practices taking into consideration OCR’s investigation and enforcement actions, emerging litigation and other enforcement data; their own and reports of other security and privacy breaches and near misses, and other developments to decide if tightening their policies, practices, documentation or training is necessary or advisable.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with HIPAA and other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns.

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly.

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• OCR Gives HIPAA Guidance On Safety Disclosures
• Id & Manage Hidden Employee Benefit Exposures In Business Insolvency Or Other Transactions
• Final Regulations Update HIPAA Health Plan Wellness Program Rules
• Beware:  Not All Products Marketed As “Fixed Indemnity Coverage” Products Are HIPAA/ACA Exempt
• Updated Kaiser Family Foundation Tool May Help Project Which Employees Will Get Exchange Subsidies
• New IRS Guidance On ESOP Investment Diversification Reminder To Tighten Compliance, Risk Management
• EBSA Releases Model ACA Notices Discussing Coverage Options
• Group Health Plans &No-Fault & Worker’s Comp Ruled Primary Plans When Coordinating With Medicare Advantage Plans
• Changing Plan Years Won’t Extend Health Plan’s Affordable Care Act Annual Limit Waiver Eligibility
• Former White House Cybersecurity Coordinator Schmidt, Stamer & Others Share Key HIPAA & Other Privacy & Data Security Insights 5/21 In LA
• Strengthen Health Plan Privacy Compliance & Risk Management Using Lessons From New OCR Provider & Consumer Tools
• Changing Plan Years Won’t Extend Health Plan’s Affordable Care Act Annual Limit Waiver Eligibility
• Deadline To Send ACA Summary of Benefits & Coverage Adds Pressure To Finalize 2014 Plan Designs As Agencies Add MEC & MV Disclosures To SBC
• Study Finds Down Economy, Not Health Care Reform Accounts For Slower Health Care Cost Increases; Projects Renewed Costs When Economy Improves
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

The U.S. Department of Health and Human Services (HHS) on February 22, 2013 released its Final Rule implementing many of the key market reform provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (the “Affordable Care Act”) applicable to non-grandfathered health plans and health insurance issuers. 

The 145 page regulations and associated guidance package scheduled for official publication in the Federal Register on February 27, 2013 clarifies and implements the Affordable Care Act’s provisions relating to Guaranteed Availability and Renewability; Health Insurance Premiums; Single Risk Pool; Catastrophic Plans, Utilization Data Collection and Reporting under the Federal Rate Review Program and certain other matters. 

Among other thing, the Final Regulations:

• Clarify the approach HHS will use to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are nonfederal governmental plans
• Amend the standards for health insurance issuers and states on reporting, utilization, and collection of data under the federal rate review program
• Revise the timeline for states to propose state-specific thresholds for review and approval by the Centers for Medicare & Medicaid Services (CMS)
• Allow health insurance issuers to vary the premium rate for health insurance coverage in the individual and small group markets only based on family size, geography, and age and tobacco use within limits
• Direct health insurance issuers to offer coverage to and accept every employer or individual who applies for coverage in the group and individual market, subject to certain exceptions including how these requirements inter-relate with the Affordable Care Act’s restrictions on pre-existing condition limitations and exclusions
• Direct health insurance issuers to renew or continue in force coverage in the group and individual market, subject to certain exceptions
• Codify the requirement that issuers maintain a single risk pool for the individual market and a single risk pool for the small group market (unless a state decides to merge the markets into a single risk pool)
• Outline standards for enrollment in catastrophic plans for young adults and people who cannot otherwise afford health insurance
• Amend the standards under the rate review program in 45 CFR part 154 by among other things, changing the timeline for states to propose state-specific thresholds for review and approval by CMS, requiring health insurance issuers to submit data relating to proposed rate increases in a standardized format specified by the Secretary of HHS and modifying criteria and factors for states to have an effective rate review program

Along with responding to these regulations, health insurers, group health plans and their insurers and others need to stay tuned.  These regulations are just one of a deluge of regulations and other interpretations that HHS and other agencies are rolling out in the rush to meet the impending deadlines for the implementaton of the Affordable Care Act.  For instance, along with this guidance, HHS along with the Internal Revenue Service and Employee Benefit Security Administration also last week issued FAQ XII, which discusses the co-pay, deductible and certain other aspects of the cost sharing limits of the Affordable Care Act.  In previous weeks, the agencies also have issued or proposed regulations about waiting period, employer shared responsibility, essential health benefits, and various other elements of the rules.   Additional guidance is impending.  

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized as a knowledgable and innovative health benefit thought leader by business and government leaders for her extensive work, publications and leadership on health benefit and insurance and other related employee benefits, insurance, human resources and health care matters, Ms. Stamer has advised and defended employer and other health plan sponsors, administrators and fiduciaries, insurers, and others about benefit design, compliance, administration and defense for more than 25 years.  Her work includes highly pragmatic, leading edge work helping clients to design, deploy, administer and defend catastrophic, mini-med, expatriate and medical tourism, occupational injury and 24-hour coverage, HRA, HSA HFSA and other defined contribution, Medicare Advantage, and other health plans, policies and practices to comply with the Affordable Care Act, HIPAA, ERISA, COBRA, Mental Health Parity, Internal Revenue Code, labor and employment, privacy, managed care and insurance and other federal and state laws and regulations.

In addition to her extensive legal resume, Ms. Stamer also is a highly regarded industry thought leader and author with extensive involvement in the leadership of a broad range of professional and civic organizations.  For instance, Ms. Stamer is the founder and executive director of the Coalition for Responsible Health Care Policy and its PROJECT COPE; The Coalition on Patient Empowerment; a Fellow in the American College of Employee Benefits Counsel, the American Bar Association and the State Bar of Texas; Past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group; the Immediate Past Chair of the ABA RPTE Employee Benefit & Other Compensation Committee and the  current ABA RPTE Employee Benefit & Other Compensation Committee Welfare Benefits Committee Co-Chair; a Council Member of the ABA Joint Committee on Employee Benefits; Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee; Immediate Past Gulf States Area TEGE Council Exempt Organization Coordinator; a current or former Editorial Advisory Board Member of Insurance Thought Leadership, HR.com, Employee Benefit News, the BNA Employee Benefits CD-Rolm and various other BNA HR and Employee Benefits publications; a former national board member and Dallas Chapter President of WEB, Network of Benefits Professionals; a former Southwest Benefits Association Board Member; the past Dallas HR Government Relations Committee Chair; a former SHRM Region IV Board Member and National Consultants Forum Board Member,; past  Dallas Bar Association Employee Benefits & Compensation Committee Chair, and a former Texas Association of Business State Board and Regional and Dallas Chapter Chair.

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. 

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• FTC, HIPAA Rules Require Health Plans & Employers Strengthen Data Security on Mobile Devices and Applications
• 3/13 JCEB Teleconference Explores Foreign Transferees: Outbound, Inbound, Equity And Treaty Issues
• Stamer Talks on “What the Wind Blew In: Coping with Health Care Reform: 2013 and Beyond” May 2 At 24th Annual RPTE Spring Symposia In Washington, D.C.
• IRS Will Begin Accepting Returns Claiming Education Credits By Mid-February
• IRS Shares Procedures Employers Use To Claim Increased Monthly Transit Benefit Exclusion Allowed By Administrative Taxpayer Relief Act
• Employers ACA Health Reforms Prohibit Using HRAs To Pay Individual Medical Policy Premiums & Impact Other HRA Arrangements
• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Thinking about or using mobile devices and applications in your heath care, health plan, workforce or related operations or struggling to meet the demands of employees, plan members or others to allow use of these tools?  Be sure that you’ve taken appropriate steps to design, implement and manage legal responsibilities and risks associated with the development and use of these tools.

While the popularity, accessibility and cost-effectiveness of mobile devices and applications provides a strong incentive for health and other employee benefit plans, employers, their business associates, workforce members and customers to use mobile devices and applications, the use of these technologies and applications to collect, access, or use personal health care, financial, or other sensitive information presents special challenges and risks. Unfortunately, as the use of these tools proliferates, federal officials are increasingly concerned that the data security protections afforded by many of the devices and applications in use on these highly popular smart phone, tablet and other mobile devices and applications is highly lacking.  See FTC Settlement With Mobile Device & App Developer Shows Developers & Businesses Need To Manage Mobile App & Data Security.

As federal regulators and law enforcement responds to growing concerns about cyber security and other risks, heath care, health plan and other businesses, their employees, customers, and other business partners jumping on the mobile device and application bandwagon, health, application bandwagon, and the device and application developers developing and offering these tools must take appropriate steps to manage the personal health, financial, and other sensitive information and data that these tools use, create, access or disclose.

Of course,  most health plan sponsors, fiduciaries, administrators and service providers already recognize the need to use care when dealing with health plan data.  The Health Insurance Portability & Accountability Act (HIPAA) generally requires that health care providers, health plans, health care clearinghouses and their businesses associates safeguard personal health care information or “PHI” and restrict its use, access and disclosure in accordance with the extensive and highly detailed requirements of the Privacy, Security and Breach Notification Regulations of the Department of Health & Human Services Office of Civil Rights (OCR).

OCR’s collection of several multi-million dollar settlements as well as its statements in its recent restated HIPAA regulations and other OCR guidance make clear that OCR views HIPAA as imposing significant responsibilities upon covered entities and their business associates to safeguard and restrict access to PHI on mobile devices and applications. OCR’s Long-Anticipated Omnibus HIPAA Privacy, Security, Breach Notification & Enforcement Rule Tightens Privacy Requirements, Require Action;  Breaches resulting from the loss or theft of unencrypted ePHI on mobile or other computer devices or systems has been a common basis of investigation and sanctions since that time, particularly since the Breach Notification rules took effect.  OCR Pops Idaho Hospice In 1st HIPAA Breach Settlement Affecting < 500 Patients; Providence To Pay $100000 & Implement Other Safeguards;   OCR Hits Alaska Medicaid For $1.7M+ For HIPAA Security Breach; OCR Audit Program Kickoff Further Heats HIPAA Privacy Risks; $1.5 Million HIPAA Settlement Reached To Resolve 1st OCR Enforcement Action Prompted By HITECH Act Breach Report; HIPAA Heats Up: HITECH Act Changes Take Effect & OCR Begins Posting Names, Other Details Of Unsecured PHI Breach Reports On Website.  These actions and statements of OCR provide a clear warning to HIPAA-covered entities and their business associates to expect significant consequences for failing to properly encrypt and safeguard ePHI used, accessed or disclosed on mobile devices and applications.

Of course, HIPAA isn’t the only law and health plans should not be the only area of concern when employers or their health or other employee benefit plan fiduciaries and service providers are considering mobile device and application use.  In addition to HIPAA’s health plan requirements concerning PHI, mobile devices and applications used in connection with employment, benefit plan, and related operations also can trigger a host of privacy, data security and other rules requiring data security and other safeguards.  Federal laws like the Internal Revenue Code, the Fair Credit Reporting Act, Graham-Leech-Biliey, the  Fair & Accurate Credit Transactions Act (FACTA) or other Federal Trade Commission (FTC) Rules, state data security, data breach, identity theft or other privacy rules or both  are just a few of the many and constantly expanding regulatory requirements that can apply.  Depending on the nature of the data and the circumstances of the unanticipated use or disclosure, invasion of privacy or other common or statutory laws also may come into play.

With the use of these applications by consumers and business proliferates, Congress, OCR, the FTC, state regulators and others are upping the responsibilities and the liability of businesses that fail to appropriately consider and implement security in their mobile devices and applications.  Following on OCR’s restatement of its HIPAA regulations, the Obama Administration’s announcement of new cyber security initiatives, and a plethora of other federal and state regulatory and enforcement actions against businesses for data security missteps, the FTC recently launched a campaign to ensure that companies secure the software and devices mobile device and application providers provide consumers.

Earlier this month, the FTC introduced Mobile App Developers: Start with Security, a new business guide that encourages app developers to aim for reasonable data security.

On June 4, 2013, the FTC also plans to host a public forum on malware and other mobile security threats in order to examine the security of existing and developing mobile technologies and the roles that various members of the mobile ecosystem can play in protecting consumers.

Along side this educational outreach, the FTC also is moving to punish businesses that fail to act responsibly to protect sensitive data.  This trend is illustrated by the FTC’s announcement this week of its first settlement with a mobile device manufacturer. 

FTC Charges Against HTC America

This week, the FTC announced that mobile device giant HTC American, Inc.  will to settle FTC charges that the company failed to take reasonable steps to secure the software it developed for its smart phones and tablet computers and introduced security flaws that placed sensitive information about millions of consumers at risk.  

A leading mobile device manufacturer in the United States, HTC America develops and manufactures mobile devices based on the Android, Windows Mobile, and Windows Phone operating systems. HTC America has customized the software on these devices in order to differentiate itself from competitors and to comply with the requirements of mobile network operators.   

In its first-ever complaint against a mobile device or application developer, the FTC charged HTC America failed to incorporate and administer appropriate safeguards for personal financial and other sensitive data accessed and used in these applications when designing or customizing the software on its mobile devices. Among other things, the complaint alleged that HTC America failed to provide its engineering staff with adequate security training, failed to review or test the software on its mobile devices for potential security vulnerabilities, failed to follow well-known and commonly accepted secure coding practices, and failed to establish a process for receiving and addressing vulnerability reports from third parties.

To illustrate the consequences of these alleged failures, the FTC’s complaint details several vulnerabilities found on HTC America’s devices, including the insecure implementation of two logging applications – Carrier IQ and HTC Loggers – as well as programming flaws that would allow third-party applications to bypass Android’s permission-based security model.

Due to these vulnerabilities, the FTC charged, millions of HTC devices compromised sensitive device functionality, potentially permitting malicious applications to send text messages, record audio, and even install additional malware onto a consumer’s device, all without the user’s knowledge or consent. The FTC alleged that malware placed on consumers’ devices without their permission could be used to record and transmit information entered into or stored on the device, including, for example, financial account numbers and related access codes or medical information such as text messages received from healthcare providers and calendar entries about doctor’s appointments. In addition, malicious applications could exploit the vulnerabilities on HTC devices to gain unauthorized access to a variety of other sensitive information, such as the user’s geolocation information and the contents of the user’s text messages.

Moreover, the FTC complaint alleged that the user manuals for HTC Android-based devices contained deceptive representations, and that the user interface for the company’s Tell HTC application was also deceptive. In both cases, the security vulnerabilities in HTC Android-based devices undermined consent mechanisms that would have otherwise prevented unauthorized access or transmission of sensitive information.

HTC America Settlement

The settlement not only requires the establishment of a comprehensive security program, but also prohibits HTC America from making any false or misleading statements about the security and privacy of consumers’ data on HTC devices. Under the settlement agreement, HTC American must:

• Fix vulnerabilities found in millions of HTC devices;
• Establish a comprehensive security program designed to address security risks during the development of HTC devices; and
• Undergo independent security assessments every other year for the next 20 years.

HTC America and its network operator partners are also in the process of deploying the security patches required by the settlement to consumers’ devices. Many consumers have already received the required security updates. The FTC is encouraging consumers using HTC America applications to apply the updates as soon as possible.

The FTC Commission vote to accept the consent agreement package containing the proposed consent order for public comment was 3-0-2, with Chairman Jon Leibowitz not participating and Commissioner Maureen Ohlhausen recused. The FTC will publish a description of the consent agreement package in the Federal Register shortly.

In accordance with FTC procedures, the settlement agreement will be subject to public comment through March 22, after which the Commission will decide whether to make the proposed consent order final. Interested parties can submit comments electronically or in paper form using instructions in the “Invitation To Comment” part of the “Supplementary Information” section. Comments in paper form should be mailed or delivered to: Federal Trade Commission, Office of the Secretary, Room H-113 (Annex D), 600 Pennsylvania Avenue, N.W., Washington, DC 20580. The FTC is requesting that any comment filed in paper form near the end of the public comment period be sent by courier or overnight service, if possible, because U.S. postal mail in the Washington area and at the Commission is subject to delay due to heightened security precautions.

Act To Manage Mobile Application Device & Security

Given the expanding awareness, expectations and enforcement of OCR, FTC and others, health care, health plan and other industry participants deciding whether and when to use, or allow others to use mobile devices or applications to access data or carry out other activities and the mobile device or other technology developers and providers offering products or services to these organizations must get serious about security. 

These and other related activities send a clear message that health care, health insurance mobile device and application users and developers must incorporate and administer appropriate processes and safeguards to protect PHI, personal financial and other sensitive data.  In response to these developments, industry mobile device and application developers and the health care, health insurance and other businesses must consider carefully before deploying or allowing others to deploy or use these tools in relation to data within their operations or systems.  Before and when using or permitting customers, business partners, employees or others to use tools, these organizations must ensure the adequacy of the design and security safeguards for their devices, software and applications, as well as their disclaimers and associated consumer disclosures and consents.  Because of the special legal and operational expectations for these organizations, health care, health insurance and other industry provides must resist pressure to allow the use of these tools unless and until they can verify that these legal and operational requisites are fulfilled.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. 

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Employers ACA Health Reforms Prohibit Using HRAs To Pay Individual Medical Policy Premiums & Impact Other HRA Arrangements
• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• Hear Stamer Speak On “Coping With Health Care Reform Now” At 2/14 Dallas ICEBS Meeting
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Cynthia Marcotte Stamer will share her insights on health and welfare benefit challenges for multinational employers as one of the featured panelists on the “Foreign Transferees:  Outbound, Inbound, Equity And Treaty Issues” Teleconference hosted by the American Bar Association Joint Committee on Employee Benefits on March 13, 2013 from 10:00-11:30 a.m. Central Time.

• Intended to help broad-based U.S. and European community benefits attorneys and others seeking to understand common and unique issues associated with employee transferees, granting of equity compensation and associated treaty issues, including:
• Basic issues associated with transfers including granting of past service credits, vesting and distribution issues
• Case studies involving employee transfers between the U.S. and the UK.
• Use of international deferred compensation programs.
• Unique health and welfare issues associated with international transfers.
• Interesting/Global equity issues to avoid.

 Moderated by Elizabeth Drigotas, PriceWaterhouseCoopers, Washington, DC, the program will feature a diverse and highly experienced group of distinguished government and private speakers including:

• M. Grace Fleeman, Senior Technical Reviewer, Branch 1, (Associate Chief Counsel International)), Internal Revenue Service, U.S. Department of the Treasury, Washington, DC (invited)
• Andrew C. Liazos, McDermott Will & Emery, Boston, MA
• Matthew Preston, Clifford Chance, London, UK
• Cynthia Marcotte Stamer, Cynthia Marcotte Stamer, PC, Addison, TX.

To register or for additional information, see here.   

About Ms. Stamer

Sought out nationally and internationally as an industry thought leader and problem solver, attorney, Cynthia Marcotte Stamer has more than 25 years experience helping domestic and foreign private and public businesses, employer and union plan sponsors, health and other employee benefit plans, associations, their fiduciaries, administrators, and vendors, group health, Medicare and Medicaid Advantage, and other insurers, governmental and community leaders and others develop, implement, administer and defend creative, legally compliant and operationally effective health and other employee benefit, employment, insurance, pension and retirement, health care, workers’ compensation and workforce plans, practices, and policies. 

Recognized in International Who’s Who, the founder and Executive Director of Project COPE:  The Coalition on Patient Empowerment and its affiliate, the Coalition on Responsible Health Policy; a Fellow in the American College of Employee Benefits Counsel, American Bar Association, and State Bar of Texas; Past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Immediate Past Chair of the ABA RPTE Employee Benefit & Other Compensation Committee, current ABA RPTE Employee Benefit & Other Compensation Committee Welfare Benefits Committee Co-Chair and Substantive Groups Committee Member, and a Council Member of the ABA Joint Committee on Employee Benefits, Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee, and Immediate Past Gulf States Area TEGE Council Exempt Organization Chair, Ms. Stamer helps these and other clients. to design, document, administer and defend managed care and insurance programs, processes, and products; to monitor and manage evolving regulatory, contractual and fiduciary obligations and risks; to draft, negotiate, interpret and enforce managed care and other contracts, plan documents, insurance policies, administrative services agreements, and other agreements, policies, procedures and controls; to credential, monitor and manage fiduciaries, service providers, consultants and others providing services relating to programs; to conduct and defend litigation, audits, and other enforcement actions; to deal with legislators, regulators, auditors and others; and to fulfill legal obligations, mitigate legal risks and improve operational effectiveness.

As a core focus of her practice, Ms. Stamer continuously counsels, represents and defends self-insured and insured managed care and health, disability and welfare, pension, deferred compensation and other employee benefit plans; employer, association, insurer, and other employee benefit and insurance program sponsors; plan fiduciaries, administrators, brokers, consultants and other service providers; Medicare and Medicaid Advantage and other group, individual, stop-loss and other reinsurance, fiduciary liability and other insurers; health and insurance technology and other outsourcing companies; human resources, insurance and employee benefit consulting organizations; and other insurance, employee benefit and human resources industry clients, domestic and foreign governments and others about a diverse range of employee benefit, insurance, employment, tax, regulatory, risk management, public policy and related matters.

Ms. Stamer’s health benefit experience includes extensive and highly-innovative dealings with insured and self-insured managed care, defined contribution, indemnity and other health benefit, disability, life, occupational injury, Medicare and Medicaid Advantage, and other welfare benefit and insurance plans and policies; and a wide range of other employee benefits, compensation, insurance, equity and other related arrangements. Her work includes leading edge development and use of 24-hour coverage and other occupational injury, ex-pat and other medical tourism products, HRA, HSA, HRA and other defined contribution, hi-deductible, deductible reimbursement, min-med and other limited benefit plans, 24-hour and occupational benefit, fraternal benefit and association, and other medical programs as well as a broad range of claims, appeals, audit, and other administrative processes and tools designed to promote defensibility and mitigate risks.

Along side this domestic work, Ms. Stamer also has extensive international experience.  A primary drafter of the Bolivian Social Security privatization law with extensive domestic and international regulatory and public policy experience, Ms. Stamer also has worked extensively domestically and internationally on design, administration, operations, compliance, public policy and regulatory, and other challenges arising in the administration of multinational workforces and populations.  Throughout her career, Ms. Stamer has advised both U.S. based businesses and foreign owned or operated businesses about design and administration of employment, employee benefit, worker’s compensation, employment tax, occupational safety, discipline and promotion, collective bargaining, recruiting, compliance, risk management and other personnel practices for multinational workforces. She has worked extensively on the design and administration of pension, severance, health and other benefit and compensation programs for their multinational workforce. She assists businesses with cross-border and domestic employment, consulting, independent contractor, subcontractor, employee leasing and other staffing and vendor agreements; multinational Foreign Corrupt Practices Act, Federal Sentencing Guidelines, and other compliance programs and practices; design, drafting, interpretation, implementation, and coordination pension, health care, severance, education, insurance, employment, tax, unemployment, disability, and other programs and requirements; represents and advises businesses, associations and government agencies before U.S. and foreign governments in connection with tax, employment, and other compliance matters, trade relationships and missions, public policy advocacy.

A widely published author and highly sought out speaker whose HR & Benefits Update  has been recognized as among the “Top 50” HR Blogs To Watch, Ms. Stamer also regularly authors materials and conducts workshops and professional, management and other training on employee benefits, human resources, health care and other compliance and management topics for the ABA, Aspen Publishers, the Bureau of National Affairs (BNA), SHRM, World At Work, Insurance Thought Leadership, Government Institutes, Inc., Solutions Law Press, Inc., the Society of Professional Benefits Administrators, HealthLeaders, Managed Care Executive, CEO Magazine, Business Insurance and many other industry, professional and business publications. An Editorial Advisory Board Member of the Institute of Human Resources (IHR/HR.com), Employee Benefit News, and other publications, Ms. Stamer also regularly serves on the faculty and planning committees of a multitude of symposium and other educational programs.  For more details about Ms. Stamer’s services, experience, presentations, publications, and other credentials or to inquire about arranging counseling, training or presentations or other services by Ms. Stamer, see www.CynthiaStamer.com.  Ms. Stamer also is widely recognized for her regulatory and public policy advocacy, publications, and public speaking on privacy and other compliance, risk management concerns.  For the past two years, Ms. Stamer has serve as the appointed scribe for the ABA Joint Committee on Employee Benefits annual agency meeting with OCR and has lead numerous programs for the ABA and others on this topic.  Her insights on HIPAA risk management and compliance frequently appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, the American Bar Association, the Health Care Compliance Association, a multitude of health industry, health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Employers ACA Health Reforms Prohibit Using HRAs To Pay Individual Medical Policy Premiums & Impact Other HRA Arrangements
• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Solutions Law Press, Inc. (SLP) readers qualify for up to a $400 discount on their registration to learn key insights from on strategies for charting the path forward to drive employee wellness, strengthen the workforce and impact global business competitiveness in the face of the impending health care reforms of the Patient Protection & Affordable Care Act from SLP Editor/Author Cynthia Marcotte Stamer and other leading employer health care decision makers at the 8^th Annual Employer Health & Human Capital Strategy Congress that the World Health Congress is hosting on February 21-22, 2013 at The Westin Lake Mary, Orlando North Conference Center in Lake Mary, Florida.

About the Program

Nationally recognized industry thought leader and attorney SLP Editor attorney Cynthia Marcotte Stamer will help kick off the program when she joins a panel of prominent HR leaders discussing “Assessing Alternatives and Opportunities:  Defined Contribution and Exchanges-What are the Long-Term Implications on Your Human Capital Strategy” beginning at 9:30 a.m. on February 21, 2013.

Following this keynote panel, attendees also will learn other key ideas and strategies to help their organizations cope with Health Care Reform as they participate in a host of other insightful and timely presentations by dynamic team of prominent HR and other industry experts and network with other management and human resources leaders .including:

• John Rother, National Coalition on Health care
• Shawn Leavitt, Carlson Companies
• Rebecca Mariet Lynn-Crockford, Suntrust Banks, Inc
• Jo-Ann Gastin, Lockton Companies, LLC
• Paul Grundy, M.D., Patient-Centered Primary Care Collaborative
• Roger C. Merring, M.D., Perdue Farm Inc.
• Sam Nussbaum, Wellpoint, Inc.
• Benjamin H. Hoffman, M.D., GE Energy
• Bruce Sherman, MD, Employers Health Coalition

For a full agenda and other details on the program, see here.

SLP Reader Registration Discount

SLP is delighted to announce that the World Health Congress is offering SLP readers the opportunity to claim a $400 discount off the otherwise applicable registration fee when registering for the program.  To register and claim this discount, enter registration code “GHH925” at the designated location when registering for the program here.

About Ms. Stamer

Sought out nationally and internationally as an industry thought leader and problem solver, SLP Editor and author attorney, Cynthia Marcotte Stamer has spent more than 25 years helping private and public employers, employer and union plan sponsors, health and other employee benefit plans, associations, their fiduciaries, administrators, and vendors, group health, Medicare and Medicaid Advantage, and other insurers, governmental and community leaders and others develop, implement, administer and defend creative, legally compliant and operationally effective health and other employee benefit, employment, insurance, health care and workforce plans, policies, practices, operations and policies. 

Recognized in International Who’s Who, the founder and Executive Director of Project COPE:  The Coalition on Patient Empowerment and its affiliate, the Coalition on Responsible Health Policy; a Fellow in the American College of Employee Benefits Counsel, American Bar Association, and State Bar of Texas; Past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Immediate Past Chair of the ABA RPTE Employee Benefit & Other Compensation Committee, current ABA RPTE Employee Benefit & Other Compensation Committee Welfare Benefits Committee Co-Chair and Substantive Groups Committee Member, and a Council Member of the ABA Joint Committee on Employee Benefits, Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee, and Immediate Past Gulf States Area TEGE Council Exempt Organization Chair, Ms. Stamer helps these and other clients. to design, document, administer and defend managed care and insurance programs, processes, and products; to monitor and manage evolving regulatory, contractual and fiduciary obligations and risks; to draft, negotiate, interpret and enforce managed care and other contracts, plan documents, insurance policies, administrative services agreements, and other agreements, policies, procedures and controls; to credential, monitor and manage fiduciaries, service providers, consultants and others providing services relating to programs; to conduct and defend litigation, audits, and other enforcement actions; to deal with legislators, regulators, auditors and others; and to fulfill legal obligations, mitigate legal risks and improve operational effectiveness.

As a core focus of her practice, Ms. Stamer continuously counsels, represents and defends self-insured and insured managed care and health, disability and welfare, pension, deferred compensation and other employee benefit plans; employer, association, insurer, and other employee benefit and insurance program sponsors; plan fiduciaries, administrators, brokers, consultants and other service providers; Medicare and Medicaid Advantage and other group, individual, stop-loss and other reinsurance, fiduciary liability and other insurers; health and insurance technology and other outsourcing companies; human resources, insurance and employee benefit consulting organizations; and other insurance, employee benefit and human resources industry clients, domestic and foreign governments and others about a diverse range of employee benefit, insurance, employment, tax, regulatory, risk management, public policy and related matters.

Ms. Stamer’s health benefit experience includes extensive and highly-innovative dealings with insured and self-insured managed care, defined contribution, indemnity and other health benefit, disability, life, occupational injury, Medicare and Medicaid Advantage, and other welfare benefit and insurance plans and policies; and a wide range of other employee benefits, compensation, insurance, equity and other related arrangements. Her work includes leading edge development and use of 24-hour coverage and other occupational injury, ex-pat and other medical tourism products, HRA, HSA, HRA and other defined contribution, hi-deductible, deductible reimbursement, min-med and other limited benefit plans, 24-hour and occupational benefit, fraternal benefit and association, and other medical programs as well as a broad range of claims, appeals, audit, and other administrative processes and tools designed to promote defensibility and mitigate risks.

A primary drafter of the Bolivian Social Security privatization law with extensive domestic and international regulatory and public policy experience, Ms. Stamer also has worked extensively domestically and internationally on public policy and regulatory advocacy on health and other employee benefits, human resources, insurance, tax, compliance and other matters and representing clients in dealings with the US Congress, Departments of Labor, Treasury, Health & Human Services, Federal Trade Commission, HUD and Justice, as well as a state legislatures attorneys general, insurance, labor, worker’s compensation, and other agencies and regulators.  Her Patient Empowerment Toolkit™, Play4Life Community Program™, and other patient empowerment, health care quality, and other industry thought leadership, advocacy and solutions have drawn the attention of business, government and community leaders for their insightfulness and practicality.

A widely published author and highly sought out speaker whose HR & Benefits Update  has been recognized as among the “Top 50” HR Blogs To Watch, Ms. Stamer also regularly authors materials and conducts workshops and professional, management and other training on employee benefits, human resources, health care and other compliance and management topics for the ABA, Aspen Publishers, the Bureau of National Affairs (BNA), SHRM, World At Work, Insurance Thought Leadership, Government Institutes, Inc., Solutions Law Press, Inc., the Society of Professional Benefits Administrators, HealthLeaders, Managed Care Executive, CEO Magazine, Business Insurance and many other industry, professional and business publications. An Editorial Advisory Board Member of the Institute of Human Resources (IHR/HR.com), Employee Benefit News, and other publications, Ms. Stamer also regularly serves on the faculty and planning committees of a multitude of symposium and other educational programs.  For more details about Ms. Stamer’s services, experience, presentations, publications, and other credentials or to inquire about arranging counseling, training or presentations or other services by Ms. Stamer, see www.CynthiaStamer.com or contact Ms. Stamer directly via email here or (469) 767-8872.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Employers ACA Health Reforms Prohibit Using HRAs To Pay Individual Medical Policy Premiums & Impact Other HRA Arrangements
• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• Hear Stamer Speak On “Coping With Health Care Reform Now” At 2/14 Dallas ICEBS Meeting
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Cynthia Marcotte Stamer will a featured panelists discussing “What the Wind Blew In: Coping with Health Care Reform: 2013 and Beyond” on Thursday, May 2, 2013 at 24th Annual RPTE Spring Symposia at the Capital Hilton in Washington, DC. The Symposia scheduled to take place on May 2–3, 2013 will cover a broad range of timely topics on real estate, trusts and estates and other related concerns. To register, review the full agenda or get additional information about the Symposium, see here.  

About Ms. Stamer

A noted Texas-based employee benefits and employment lawyer with extensive involvement in the leadership of the ABA and other professional organizations involved in employee benefits, health care and workforce matters, is nationally and internationally known for her innovative leadership and work as an attorney, consultant, policy advocate, speaker and author helping businesses, governments, and communities on health and other insurance and employee benefits, patient education and empowerment, wellness and disease management, and other programs, policies, and processes.  For more than 24 years, Ms. Stamer’s legal practice has focused on advising and representing employers, insurers, health care providers, community leaders and governments about health care and employee benefits policy and process improvement, quality, performance management, education, compliance, communications, risk management, reimbursement and finance, and other related matters.  In addition to her legal practice, Stamer also extensively consults and provides leadership to a broad range of clients, professional and civic organizations, and others on strategies for improving the health care system and the ability of health care providers, payers, employers, community organizations, government agencies to promote the ability of patients and their families to access cost-effective, quality, affordable health care and other resource needs.  She also has worked extensively with a broad range of business and government clients on health care, pension, social security, workforce, insurance and many other related policy matters.

In addition to her service with the ABA, Ms. Stamer also is active in the leadership of a broad range of other professional and civil organizations. For instance, Ms. Stamer presently serves as Executive Director of Project COPE, the Coalition on Patient Empowerment and the Coalition for Responsible Healthcare Policy; Vice President of the North Texas Healthcare Compliance Professionals Association; Immediate Past Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Committee and its representative to the ABA Joint Committee on Employee Benefits and Vice Chair of its Welfare Benefits Committee; Past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group and a current member of its Healthcare Coordinating Council; and as the Gulf Coast TEGE Council TE Committee Coordinator.  She previously served as a founding Board Member and President of the Alliance for Healthcare Excellence, as a Board Member and Board Compliance Committee Chair for the National Kidney Foundation of North Texas; the Board President of the early retirement intervention agency, The Richardson Development Center for Children; Chair of the Dallas Bar Association Employee Benefits & Executive Compensation Committee; a member of the Board of Directors of the Southwest Benefits Association; on numerous seminar faculties and in many other professional and civic leadership and volunteer roles. 

Author of the hundreds of publications and workshops these and other employment, employee benefits, health care, insurance, workforce and other management matters, Ms. Stamer’s insights on employee benefits, insurance, health care and workforce matters in Atlantic Information Services, The Bureau of National Affairs, HealthLeaders, Modern Healthcare, Business Insurance, Employee Benefits News, World At Work, Benefits Magazine, the Wall Street Journal, the Dallas Morning News, the Dallas Business Journal, the Houston Business Journal, and many other publications. Nationally known for her work on health care reform and related matters, Ms. Stamer also regularly conducts training and speaks on these and other  management, compliance and public policy concerns.  For additional information about Ms. Stamer, upcoming training, publications or other materials or events, see here  or contact Ms. Stamer directly via email here or (469) 767-8872.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Employers ACA Health Reforms Prohibit Using HRAs To Pay Individual Medical Policy Premiums & Impact Other HRA Arrangements
• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• Hear Stamer Speak On “Coping With Health Care Reform Now” At 2/14 Dallas ICEBS Meeting
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

As preparations continue for the Jan. 30 opening of the 2013 filing season for most taxpayers, the Internal Revenue Service has announced that it beginprocessing of tax returns claiming education credits n by the middle of February. 

Taxpayers using Form 8863, Education Credits, can begin filing their tax returns after the IRS updates its processing systems. Form 8863 is used to claim two higher education credits — the American Opportunity Tax Credit and the Lifetime Learning Credit.

The IRS emphasized that the delayed start will have no impact on taxpayers claiming other education-related tax benefits, such as the tuition and fees deduction and the student loan interest deduction. People otherwise able to file and claiming these benefits can start filing Jan. 30, 2013

As it does every year, the IRS reviews and tests its systems in advance of the opening of the tax season to protect taxpayers from processing errors and refund delays. The IRS discovered during testing that programming modifications are needed to accurately process Forms 8863.  Filers who are otherwise able to file but use the Form 8863 will be able to file by mid-February. No action needs to be taken by the taxpayer or their tax professional.  Typically through the mid-February period, about 3 million tax returns include Form 8863, less than a quarter of those filed during the year.

The IRS remains on track to open the tax season on January 30 for most taxpayers. The January  30 opening includes people claiming the student loan interest deduction on the Form 1040 series or the higher education tuition or fees on Form 8917, Tuition and Fees Deduction. Forms that will be able to be filed later are listed on IRS.gov.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. 

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Employers ACA Health Reforms Prohibit Using HRAs To Pay Individual Medical Policy Premiums & Impact Other HRA Arrangements
• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• Hear Stamer Speak On “Coping With Health Care Reform Now” At 2/14 Dallas ICEBS Meeting
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Since the enactment of the Patient Protection & Affordable Care Act (ACA), many employers  searching for health plan solutions may have been asked to consider replacing or modifying their existing insured or self-insured group health plan with a “health reimbursement arrangement” (HRA) or other arrangement which would reimburse employees for premiums paid for individual health insurance policies. New guidance released on Thursday, January 24, 2013 indicates that such arrangements are prohibited as part of the ACA health care reforms.

 “FAQS About Affordable Care Implementation (Part XI)” (FAQ) available here issued by the Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Agencies) on January 24, 2013 sends a clear message to employers that trying to escape ACA or other federal group health plan mandates by replacing their traditional insured or group health plans or policies with health reimbursement arrangements (HRAs) or other arrangements under which the employer agrees to provide a fixed defined contribution to be used to buy or reimburses employees for buying individual health insurance generally won’t pass legal muster.  The FAQ also indicates that employers sponsoring HRAs that only reimburse medical expenses, not individual health insurance premiums also need to review their arrangements to verify that those programs also comply with ACA and other applicable rules.

Concerning the use of HRAs to pay for individual  health insurance policy premiums, the FAQ states that  PHS Act Section 2711 generally prohibits an employer-sponsored HRA cannot be integrated with individual market coverage or with an employer plan that provides coverage through individual policies.  Under ACA, employers that improperly offer arrangements that violate PHS Section 2711 or other group health plans risk exposing themselves to liability for significant unanticipated health benefit claims, as well as other penalties and costs. Therefore, employers that have or are contemplating arrangements that provide or reimburse premiums for individual health insurance coverage are urged to contact qualified legal counsel with documented experience with ACA and other group health plan requirements for advice before establishing or continuing such arrangements.

The FAQ’s guidance about the use of individual insurance policies to arrange coverage for employees is one of several issues addressed in the FAQ and part of a wave of new guidance that has and is emerging as the Obama Administration moves to full implementation of the ACA reforms.  Employers, plan fiduciaries, insurers, and others involved in the design or administration of health benefit programs need to monitor carefully this emerging guidance as they move quickly to tailor their programs in response to these evolving rules.  For help monitoring or responding to these evolving rules, contact the author of this  update, Cynthia Marcotte Stamer.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. 

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• Hear Stamer Speak On “Coping With Health Care Reform Now” At 2/14 Dallas ICEBS Meeting
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

The Department of Labor has extended the deadline for employers to notify employees about the existence of and their rights under the health exchanges required by new Section 18B of the Fair Labor Standards Act (FLSA), as added by Section 1512 of the Patient Protection & Affordable Care Act (ACA).  The extension announced in Frequently Answered Question (FAQ) here provides a welcome temporary reprieve to employers who otherwise would have been required to notify employees by March 1, 2013.

As part of the impending implementation of ACA’s health care reform, FLSA § 18B generally requires each applicable employer provide each employee a written notice (Exchange Notice) in accordance with regulations promulgated by the Secretary of Labor:

• Informing the employee of the existence of Exchanges including a description of the services provided by the Exchanges, and the way the employee may contact Exchanges to request assistance; 
• If the employer plan’s share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code (the Code) if the employee purchases a qualified health plan through an Exchange; and
• If the employee purchases a qualified health plan through an Exchange, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes. The Department of Labor expects that the timing for distribution of notices will be the late summer or fall of 2013, which will coordinate with the open enrollment period for Exchanges. 

Before the Department’s announcement in the FAQ, the deadline for employers to begin giving employees Exchange Notices was the later of March 1, 2013 or at the time of hiring. The FAQ extends this deadline until a date to be set by the Department in future guidance, which the Department expects will require employers to distribute the notices in the late summer or fall of 2013 to coordinate with the open enrollment period for Exchanges. 

According to the announcement of the delay, the Department delayed the impending March 1, 2013 deadline to give the (Exchange Notice) to better coordinate with related Health and Human Service and Internal Revenue Service efforts and to allow more time to comply and to distribute the Exchange Notices to employees at a meaningful time. 

In addition to providing added time to provide the Exchange Notice, the Department also has announced that it is considering providing model, generic language that employers could use to provide the Exchange Notice. to satisfy the notice requirement.  As a compliance alternative, the Department also is considering allowing employers to meet the Exchange Notice requirement by providing employees with information using the employer coverage template as discussed in the preamble to the Proposed Rule on Medicaid, Children’s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 FR 4594, at 4641), which will be available for download at the Exchange web site as part of the streamlined application that will be used by the Exchange, Medicaid, and CHIP. 

The Exchange Notice is just one of a multitude of notices and other mandates that ACA requires that employers or their health plans, insurers, or both to meet.  Although the Exchange Notice gives employers a little more time to provide the Exchange Notices, employer and other health plan sponsors, fiduciaries, administrators and insurers are urged to continue to diligently move forward to update their plans, communications, processes and other arrangements to comply with existing and impending ACA mandates while keeping a watchful eye on for additional guidance that may require additional tailoring of these arrangements. 

Stay tuned for updates about future guidance on complying with the notice requirement under FLSA section 18B and other developments.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. 

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Employers ACA Health Reforms Prohibit Using HRAs To Pay Individual Medical Policy Premiums & Impact Other HRA Arrangements
• ADA May Require Food Allergy Accommodation By Employers, Schools & Businesses
• Employer Deadline To Give ACA Notice of Exchange Coverage Options Delayed
• Hear Stamer Speak On “Coping With Health Care Reform Now” At 2/14 Dallas ICEBS Meeting
• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Cynthia Marcotte Stamer will share key information and practical strategies for  “Coping with Health Care Reform Now” at the Dallas Chaper ICEBS Valentines Day luncheon meeting on February 14, 2012.  The meeting is scheduled from 11:30 a.m. to 1:30 p.m on February 14, 2012 at Haggar Clothing Company at 11511 Luna Road, Dallas, Texas .  Interested persons may register or get other details at http://www.dfwiscebs.org.

With the initial debate about the Constitutionality of the Patient Protection & Affordable Care Act (ACA) decided and making a Congressional reprieve highly improbable, employer and other health plan sponsors, insurers, fiduciaries and administrators are scrambling to update plan documents, communications, processes and procedures to meet current ACA and other health plan rules, while bracing to cope with the sweeping health care reforms slated to take effect in 2014.  These already daunting tasks are made more challenging by the continuing uncertainty of the constantly evolving regulations, evolving marketplace, increases in health plan costs and ever-shrinking corporate budgets.

To help health plan sponsors, fiduciaries, administrators and insurers deal with the tough business of implementation, attorney Cynthia Marcotte Stamer will discuss practical strategies, legal updates and other information needed for to cope with health care reform now and to prepare to meet future health plan regulations and challenges including:

• The Latest On Key ACA & Other Health Care Reform Regulations Such As ACA’s Requirements On Fees Employers Sponsoring Self-Insured Health Plans & Insurers Must Pay To Fund The Patient-Centered Outcomes Research Institute, Contraceptive and Other Preventive Services, Nondiscrimination, Essential Health Benefits, Internal Claims and Appeals and External Review, Medical Loss Ratios, Large Employer Automatic Enrollment, Summary of Benefits & Coverage, Culturally & Linguistically Appropriateness, Value-Based Insurance Design, Wellness Programs, Exchanges, the Employer Pay-Or-Plan Mandates, Wellness Reporting, Wellness Programs, W-2 Reporting of Employer Provided Health Coverage, Employer Plan Minimum Value & The Premium Tax Credit And Other ACA & Other Federal Health Plan Mandates;
• Key Changes To HIPAA Privacy Regulations & What Health Plans & Employers Should Expect To Be Required To Do To Comply With These Changes By the September, 2013 Deadline;
• What’s Happened, Happening & Likely To Happen With Exchanges;
• A 12-Step Practical Process For Helping Employers Managing ACA & Other Health Plan Compliance Responsibilities & Risks; and
• Tips On What To Watch For And Options For Maintaining Flexibility To Respond To Evolving Rules; and
• Answer Common Questions That Health Plan Sponsors and Administrators Are Struggling With Submitted By Audience Members

Registrants are encouraged to help shape the program to reflect their questions and concerns by e-mailing their proposed questions prior to the program to cstamer@solutionslawyer.net. The program’s educational* discussion will be tailored taking into account this input with significant time set aside to share practical information and possible approaches for addressing questions and concerns of shared concern identified from this audience input.

About Ms. Stamer

A Fellow in the American College of Employee Benefits Counsel, the American Bar Association & the State Bar of Texas, recognized in International Who’s Who, and Board Certified in Labor & Employment Law, Cynthia Marcotte Stamer is nationally and internationally recognized for her extensive and highly practical, solutions-oriented health plan work, advocacy, publications, programs and leadership.

For more than 25 years, Ms. Stamer has advised and represented private and public employers, employer and union plan sponsors, employee benefit plans, associations, their fiduciaries, administrators, and vendors, group health, Medicare and Medicaid Advantage, and other insurers, governments and others on health and other employee benefit, employment, insurance and health care compliance, risk management, public policy, administration and defense. Throughout her career, Ms. Stamer has worked extensively with employer and other health plan sponsors, insurers, plan administrators and other service providers, outsourcers and others to develop innovative health benefit programs and solutions and to document, administer and defend those arrangements in the mist of rising costs, evolving regulations and changing markets.

A primary drafter of the Bolivian Social Security privatization law with extensive regulatory and public policy experience, Ms. Stamer has been involved domestically and internationally as an advocate and advisor on health care, pension and Social Security, workforce and insurance reform and regulation.  She presently serves as the scribe for the ABA JCEB Annual Agency Meeting with the Office of Civil Rights. She also represents clients in dealings with the US Congress, Departments of Labor, Treasury, Health & Human Services, Federal Trade Commission, HUD and Justice, as well as a state legislatures attorneys general, insurance, labor, worker’s compensation, and other agencies and regulators.

Past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group and the ABA RPTE Employee Benefits Group, Ms. Stamer presently serves as Co-Chair of the ABA RPTE Section Welfare Plan Committee; Vice Chair of the ABA TIPS Employee Benefit Committee; as a Council Representative of the ABA Joint Committee on Employee Benefits; an Editorial Advisory Board Member for the Institute of Human Resources (IHR/HR.com), Employee Benefit News and Insurance Thought Leadership; Editor and Publisher of various Solutions Law Press, Inc. publications, and previously served on the Editorial Advisor Board of the the BNA Employee Benefits CD-Rolm.

A popular and prolific author and speaker, Ms. Stamer’s Solutions Law Press, Inc. HR & Benefits Update publication was recognized as one of the Top 50 Human Resources Blogs To Watch in 2012. Ms. Stamer regularly authors materials and conducts workshops and professional, management and other training on employee benefits, human resources and related topics for the ABA, Aspen Publishers, the Bureau of National Affairs (BNA), SHRM, World At Work, Government Institutes, Inc., the Society of Professional Benefits Administrators and many other organizations. She also regularly serves on the faculty and planning committees of a multitude of symposium and other educational programs. For more details about Ms. Stamer’s services, experience, presentations, publications, and other credentials or to inquire about arranging counseling, training or presentations or other services by Ms. Stamer, see www.CynthiaStamer.com.

* Registrants are reminded that this discussion is provided for general information and educational purposes. Accordingly, registrants are reminded that the discussion does not constitute legal advice, a substitute for legal advice or establish an attorney-client or other professional relationship.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• BNSF OSHA Whistleblower Settlement Gives Employers Insights About Policies OSHA View As Prohibited
• OCR Publishes Long-Anticipated Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Health plans, their employer or other sponsors, insurers, fiduciaries, administrative service providers and other business associates have a lot of work to do.

 Health plans, health care clearinghouses and their business associates will need to review and update their  policies and practices for handling and disclosing personally identifiable health care information (“PHI”) in response to the omnibus restatement of the Department of Health & Human Services (“HHS”) Office of Civil Rights (“OCR”) of its of its regulations (the “2013 Regulations”) implementing the Privacy and Security Rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  The Rulemaking announced January 17, 2013 may be viewed here.

The 2013 Regulations Overview

Since 2003, HIPAA generally has required that health care providers, health plans, health care clearinghouses and their business associates (“Covered Entities”) restrict and safeguard individually identifiable  health care information (“PHI”) of individuals and afford other protections to individuals that are the subject of that information.  The 2013 Regulations published today complete the implementation of changes to HIPAA that Congress enacted when it passed the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 as well as make other changes to the prior regulations that OCR found desirable based on its experience administering and enforcing the law over the past decade.

Since passage of the HITECH Act, OCR officials have warned Covered Entities to expect an omnibus restatement of its original regulations.  While OCR had issued certain regulations implementing some of the HITECH Act changes, it waited to publish certain regulations necessary to implement other HITECH Act changes until it could complete a more comprehensive restatement of its previously published HIPAA regulations to reflect both the HITECH Act amendments and other refinements to  its HIPAA Rules. The 2013 Regulations published today fulfill  that promise by restating OCR’s HIPAA Regulations to reflect the HITECH Act Amendments and other changes and clarifications to OCR’s interpretation and enforcement of HIPAA.

Among other things, the 2013 Regulations:

• Revise OCR’s HIPAA regulations to reflect the HITECH Act’s amendment of HIPAA to add the contractors and subcontractors of health plans, health care providers and health care clearinghouses that qualify as business associates to the parties directly responsible for complying with and subject to HIPAA’s civil and criminal penalties for violating HIPAA’s Privacy, Security, and Breach Notification rules;
• Update previous interim regulations implementing HITECH Act breach notification rules that require Covered Entities including business associates to give specific notifications to individuals whose PHI is breached, HHS and in some cases, the media when a breach of unsecured information happens;
• Update interim enforcement guidance OCR previously published to implement increased penalties and other changes to HIPAA’s civil and criminal sanctions enacted by the HITECH Act;
• Implement HITECH Act amendments to HIPAA that tighten the conditions under which Covered Entities are allowed to use or disclose PHI for marketing and fundraising purposes and prohibit Covered Entities from selling an individual’s health information without getting the individual’s authorization in the manner required by the 2013 Regulations;
• Update OCR’s rules about the individual rights that HIPAA requires that Covered Entities to afford to individuals who are the subject of PHI used or possessed by a Covered Entity to reflect tightened requirements enacted by the HITECH Act  that allow individuals to order their health care provider not to share information about their treatment with health plans when the individual pays cash for the care and to clarify that individuals can require Covered Entities to provide electronic PHI in electronic form;
• Revise the regulations to reflect amendments to HIPAA made as part of the Genetic Information Nondiscrimination Act of 2008 (GINA) which added genetic information to the definition of PHI protected under the HIPAA Privacy Rule and prohibits health plans from using or disclosing genetic information for underwriting purposes; and
• Clarifies and revises other provisions to reflect other interpretations and information guidance that OCR has issued since HIPAA was passed and to make certain other changes that OCR found appropriate based on its experience administering and enforcing the rules. 

Liability & Enforcement Risks Heighten Need To Act To Review & Update Policies & Practices

The restated rules in the 2013 Regulations make it imperative that Covered Entities review the revised rules carefully and updated their policies, practices, business associate agreements, training and documentation to comply with the updated requirements and other enforcement and liability risks.  OCR even prior to the regulations has aggressively investigated and enforced the HIPAA requirements.  

The commitment of OCR to enforcement most recently was demonstrated by its recent settlement with Hospice of North Idaho (HONI).  On January 2, 2013, OCR announced HONI will pay OCR $50,000 to settle potential HIPAA violations that occurred in connection with the theft of an unencrypted laptop computer containing ePHI. The HONI settlement is the first settlement involving a breach of ePHI affecting fewer than 500 individuals. 

While the HONI settlement marks the first settlement on a small breach, this is not the first time OCR has sought sanctions against a covered entity for data breaches involving the loss or theft of unencrypted data on a Laptop, storage device or other computer device.  Rather, OCR continues to rollout a growing list of enforcement actions demonstrating the potential risks of HIPAA violations are significant and growing.  OCR Hits Alaska Medicaid For $1.7M+ For HIPAA Security Breach; OCR Audit Program Kickoff Further Heats HIPAA Privacy Risks; $1.5 Million HIPAA Settlement Reached To Resolve 1st OCR Enforcement Action Prompted By HITECH Act Breach Report; HIPAA Heats Up: HITECH Act Changes Take Effect & OCR Begins Posting Names, Other Details Of Unsecured PHI Breach Reports On Website; Providence To Pay $100000 & Implement Other Safeguards.

Coupled with statements by OCR about its intolerance, the HONI and other settlements provide a strong warning to covered entities of the need to carefully and appropriately manage their HIPAA encryption and other Privacy and Security responsibilities. Covered entities are urged to heed these warning by strengthening their HIPAA compliance and adopting other suitable safeguards to minimize HIPAA exposures. 

In response to the 2013 Regulations and these expanding exposures, all Covered Entities should review critically and carefully the adequacy of their current HIPAA Privacy and Security compliance policies, monitoring, training, breach notification and other practices taking into consideration OCR’s investigation and enforcement actions, emerging litigation and other enforcement data; their own and reports of other security and privacy breaches and near misses; and other developments to decide if additional steps are necessary or advisable.   In response to these expanding exposures, all covered entities and their business associates should review critically and carefully the adequacy of their current HIPAA Privacy and Security compliance policies, monitoring, training, breach notification and other practices taking into consideration OCR’s investigation and enforcement actions, emerging litigation and other enforcement data; their own and reports of other security and privacy breaches and near misses, and other developments to decide if tightening their policies, practices, documentation or training is necessary or advisable.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with HIPAA and other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. 

For help  with these or other compliance concerns, to ask about compliance audit or training, or for legal representation on these or other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• OCR Gives HIPAA Guidance On Safety Disclosures
• IRS Offers New Simplified Option For Businesses Claiming Home Office Deductions For Home-Based Business Owners & Workers
• IRS Announces Cost of Living & American Taxpayer Relief Act Income Tax Adjustments
• Tax-Related ID Theft Growing Problem For IRS, Taxpayers
• Tax Saver’s Credit Helps Low & Moderate Income Workers Save For Retirement; Possible Tool To Help Boost Their Participation In Employer Plans
• Self-Insured Health Plan Sponsors, Health Insurers Brace To Pay New ACA-Imposed Fees
• 1st OCR Small HIPAA Breach Settlement Shows Plans, Other Covered Entities At Risk From Small Breach Reports Too
• Labor Department Targeting Businesses Violating Overtime, Other Wage & Hour Laws
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

IRS Says Eligible Home-Based Businesses May Deduct up to $1,500; Saves Taxpayers 1.6 Million Hours A Year

The Internal Revenue Service (IRS) has announced a simplified option that many owners of home-based businesses and some home-based workers may use to figure their deductions for the business use of their homes.

In tax year 2010, the most recent year for which figures are available, nearly 3.4 million taxpayers claimed deductions for business use of a home (commonly referred to as the home office deduction).

The new optional deduction, capped at $1,500 per year based on $5 a square foot for up to 300 square feet, will reduce the paperwork and recordkeeping burden on small businesses by an estimated 1.6 million hours annually.

“This is a common-sense rule to provide taxpayers an easier way to calculate and claim the home office deduction,” said Acting IRS Commissioner Steven T. Miller. “The IRS continues to look for similar ways to combat complexity and encourages people to look at this option as they consider tax planning in 2013.”

The new option provides eligible taxpayers an easier path to claiming the home office deduction. Currently, the IRS generally requires a home-based business to fill out a 43-line form (Form 8829) often with complex calculations of allocated expenses, depreciation and carryovers of unused deductions.  Taxpayers claiming the optional deduction will complete a significantly simplified form.

Though homeowners using the new option cannot depreciate the portion of their home used in a trade or business, they can claim allowable mortgage interest, real estate taxes and casualty losses on the home as itemized deductions on Schedule A. These deductions need not be allocated between personal and business use, as is required under the regular method.

Business expenses unrelated to the home, such as advertising, supplies and wages paid to employees are still fully deductible.

Current restrictions on the home office deduction, such as the requirement that a home office must be used regularly and exclusively for business and the limit tied to the income derived from the particular business, still apply under the new option. 

The new simplified option is available starting with the 2013 return most taxpayers file early in 2014. Further details on the new option can be found in Revenue Procedure 2013-13, posted on IRS.gov. Revenue Procedure 2013-13 is effective for taxable years beginning on or after January 1, 2013, and the IRS welcomes public comment on this new option to improve it for tax year 2014 and later years. There are three ways to submit comments.

• E-mail to: Notice.Comments@irscounsel.treas.gov. Include “Rev. Proc. 2013-13” in the subject line.
• Mail to: Internal Revenue Service, CC:PA:LPD:PR (Rev. Proc. 2013-13), Room 5203, P.O. Box 7604, Ben Franklin Station, Washington, DC 20044.
• Hand deliver to: CC:PA:LPD:PR (Rev. Proc. 2013-13), Courier’s Desk, Internal Revenue Service, 1111 Constitution Avenue NW, Washington, DC, between 8 a.m. and 4 p.m., Monday through Friday.

The deadline for comment is April 15, 2013.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with these or other health benefit or other human resources, employee benefit, insurance, compensation or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, and Past Chair of the ABA Health Law Section Managed Care & Insurance Section, Ms. Stamer is nationally and internationally recognized for her experience and skill aiding clients with a diverse range of employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of leading edge experience helping employers; health and other employee benefit plans and their sponsors, administrators, fiduciaries; TPAs, insurers, governments, employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Her experience includes extensive work representing advising these and other clients, governmental bodies, insurance and financial services organizations, third party administrators and others to develop, design, defend and administer creative health, disability, severance and other employee benefit and compensation arrangements, products and services.  She also helps these and other clients monitor, address and respond to federal, state, and international health care and insurance and other regulatory, legislative, audit and enforcement developments. Ms. Stamer  has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. Ms. Stamer regularly works with agencies, publishes and speaks extensively on human resources and employee benefits,  medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.    You can get more information about her HIPAA and other experience here.

If you need help with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Learn Latest On OCR New HIPAA De-Identification Guidance
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business and management information, tools and solutions, training and education, services and support to help organizations and their leaders promote effective management of legal and operational performance, regulatory compliance and risk management, data and information protection and risk management and other key management objectives.  Solutions Law Press, Inc.™ also conducts and assists businesses and associations to design, present and conduct customized programs and training targeted to their specific audiences and needs.  For additional information about upcoming programs, to explore becoming a presenting sponsor for an upcoming event, e-mail your request to info@Solutionslawpress.com   These programs, publications and other resources are provided only for general informational and educational purposes. Neither the distribution or presentation of these programs and materials to any party nor any statement or information provided in or in connection with this communication, the program or associated materials are intended to or shall be construed as establishing an attorney-client relationship, to constitute legal advice or provide any assurance or expectation from Solutions Law Press, Inc., the presenter or any related parties. If you or someone else you know would like to receive future Alerts or other information about developments, publications or programs or other updates, send your request to info@solutionslawpress.com.  CIRCULAR 230 NOTICE: The following disclaimer is included to comply with and in response to U.S. Treasury Department Circular 230 Regulations.  ANY STATEMENTS CONTAINED HEREIN ARE NOT INTENDED OR WRITTEN BY THE WRITER TO BE USED, AND NOTHING CONTAINED HEREIN CAN BE USED BY YOU OR ANY OTHER PERSON, FOR THE PURPOSE OF (1) AVOIDING PENALTIES THAT MAY BE IMPOSED UNDER FEDERAL TAX LAW, OR (2) PROMOTING, MARKETING OR RECOMMENDING TO ANOTHER PARTY ANY TAX-RELATED TRANSACTION OR MATTER ADDRESSED HEREIN. 

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Revenue Procedure 2013-15 provides the 2013 cost-of-living adjustments for inflation for certain items.  The guidance includes adjustments to the tax tables, including items whose values were specified in the American Taxpayer Relief Act of 2012 (ATRA), such as:

• The beginning of the 39.6% income tax brackets;
• The beginning income levels for the limitation on certain itemized deductions; and
• The beginning income levels for the phaseout of the personal exemptions[ 

In addition Revenue Procedure 2013-5 modifies Revenue Procedure 2011-52 to reflect an amendment to section 132(f)(2) made by ATRA concerning qualified transportation fringe benefits.  Specifically, for 2012, the monthly limitation regarding the aggregate fringe benefit exclusion amount for transit passes and transportation in a commuter highway vehicle is $240. 

Revenue Procedure 2013-15 will be published in Internal Revenue Bulletin 2013-5 on January 28, 2013.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with these or other health benefit or other human resources, employee benefit, insurance, compensation or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, and Past Chair of the ABA Health Law Section Managed Care & Insurance Section, Ms. Stamer is nationally and internationally recognized for her experience and skill aiding clients with a diverse range of employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of leading edge experience helping employers; health and other employee benefit plans and their sponsors, administrators, fiduciaries; TPAs, insurers, governments, employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Her experience includes extensive work representing advising these and other clients, governmental bodies, insurance and financial services organizations, third party administrators and others to develop, design, defend and administer creative health, disability, severance and other employee benefit and compensation arrangements, products and services.  She also helps these and other clients monitor, address and respond to federal, state, and international health care and insurance and other regulatory, legislative, audit and enforcement developments. Ms. Stamer  has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. Ms. Stamer regularly works with agencies, publishes and speaks extensively on human resources and employee benefits,  medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.    You can get more information about her HIPAA and other experience here.

If you need help with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Learn Latest On OCR New HIPAA De-Identification Guidance
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business and management information, tools and solutions, training and education, services and support to help organizations and their leaders promote effective management of legal and operational performance, regulatory compliance and risk management, data and information protection and risk management and other key management objectives.  Solutions Law Press, Inc.™ also conducts and assists businesses and associations to design, present and conduct customized programs and training targeted to their specific audiences and needs.  For additional information about upcoming programs, to explore becoming a presenting sponsor for an upcoming event, e-mail your request to info@Solutionslawpress.com   These programs, publications and other resources are provided only for general informational and educational purposes. Neither the distribution or presentation of these programs and materials to any party nor any statement or information provided in or in connection with this communication, the program or associated materials are intended to or shall be construed as establishing an attorney-client relationship, to constitute legal advice or provide any assurance or expectation from Solutions Law Press, Inc., the presenter or any related parties. If you or someone else you know would like to receive future Alerts or other information about developments, publications or programs or other updates, send your request to info@solutionslawpress.com.  CIRCULAR 230 NOTICE: The following disclaimer is included to comply with and in response to U.S. Treasury Department Circular 230 Regulations.  ANY STATEMENTS CONTAINED HEREIN ARE NOT INTENDED OR WRITTEN BY THE WRITER TO BE USED, AND NOTHING CONTAINED HEREIN CAN BE USED BY YOU OR ANY OTHER PERSON, FOR THE PURPOSE OF (1) AVOIDING PENALTIES THAT MAY BE IMPOSED UNDER FEDERAL TAX LAW, OR (2) PROMOTING, MARKETING OR RECOMMENDING TO ANOTHER PARTY ANY TAX-RELATED TRANSACTION OR MATTER ADDRESSED HEREIN. 

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Employers and others collecting, retaining or reporting employee or other tax identification numbers or other sensitive information for tax withholding or reporting purposes should take appropriate steps to protect that information against possible identity theft or other misuse. 

The wealth of sensitive personal identification information and financial records makes tax records a highly attractive source of data for identity thieves.  According to the Internal Revenue Service (IRS), tax-related identity theft incidents have risen significantly in recent years. Identity theft case receipts increased by more than 650 percent from FY 2008 to FY 2012. At the end of FY 2012, the IRS had almost 650,000 identity-theft cases in its inventory servicewide. The IRS reports the problem has grown worse as organized criminal actors have found ways to steal the Social Security numbers (SSNs) of taxpayers, file tax returns using those taxpayers’ names and SSNs, and obtain fraudulent tax refunds. Then, when the real taxpayer files a return claiming the refund, that return is rejected. The impact on victims is significant. More than 75 percent of taxpayers filing returns are due refunds, which average some $3,000 and are not paid until the IRS fully resolves a case.

When the IRS Commissioner testified in 2008 about identity theft before a Senate Finance Committee hearing. he stated: “My overall goal as the IRS Commissioner is that when a taxpayer [who is an identity theft victim] contacts us with an issue or concern, we have in place a seamless process that gets the issue resolved promptly.” Later that year, the IRS established an “Identity Protection Specialized Unit” (or “IPSU”), which was designed to provide centralized assistance to victims of identity theft. The National Taxpayer Advocate supported the commitment to centralized and prompt victim assistance.

Since that time, the IRS has created numerous task forces and other teams in recent years in an attempt to improve its identity theft processes, yet victims still face the same “labyrinth of procedures and drawn-out timeframes for resolution” that they faced five years ago. The IRS is instructing its employees to advise identity theft victims that it will take 180 days – half a year – to resolve their cases. Complicated cases inevitably will take longer. Thus, the IRS’s procedural changes are not providing faster relief.

The report also says the IRS has decided to reverse course and decentralize victim assistance. It recently created specialized units within each of 21 individual functions to work on identity theft cases, apparently under the belief that most identity theft cases involve a single issue that the relevant specialized unit can work most efficiently. The report expresses concern about this backtracking from a centralized approach.

The Taxpayer Advocate Service (TAS) itself handled nearly 55,000 identity theft cases in FY 2012, most of which involved multiple issues that required actions by multiple units. The report expresses concern that creation of 21 specialized units will erode the centralized role of the IPSU, require taxpayers to speak with multiple functions, increase the time it takes to resolve cases, and heighten the risk that some issues may not be addressed.

“Taxpayers need ‘one-stop shopping’ – a single point of contact they can work with to resolve all issues in their cases – and the IRS needs a ‘traffic cop’ to make sure that all units complete their actions and that parts of cases do not fall through the cracks,” Olson said. “And six months is an unacceptable period of time to expect taxpayer-victims to wait. The IRS must do more to provide the prompt and seamless assistance to identity theft victims that Commissioner Shulman promised.”

While the IRS continues to work on protecting taxpayer data against theft and investigating and resolving tax-related identity theft cases, businesses that collect, retain and report employee, contractor or other personal financial information for tax related or other purposes are urged to take steps to protect the data that they collect and retain against identity theft.  Since identity theft may begin when a worker misrepresents his or her identity at the commencement of employment, many employers find it beneficial to take reasonable steps to verify the identity and veracity of the documentation that a worker presents when commencing employment.  Once data is collected, businesses and others that have access to personal financial information or other data collected for tax purposes need to recognize their responsibility to safeguard that information against improper use and disclosure under the Internal Revenue Code as well as other applicable laws.  If  confronted with a “no-match” letter from the Social Security Administration or a complaint or other indication that a worker may have misrepresented his or her identity, or another indication of a breach of this data, businesses should contact experienced legal counsel to aid in the proper investigation of these concerns and the resolution of concerns resulting from this investigation.  Where appropriate, the business may need to report its concerns to the IRS or advise a worker or other party reporting a likely identity theft of taxpayer information to the TAS or other appropriate officials. 

Businesses needing assistance with investigation or mitigation of a potential theft of tax or other sensitive data, see www.cynthiastamer.com or contact attorney Cynthia Marcotte Stamer.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with these or other health benefit or other human resources, employee benefit, insurance, compensation or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, and Past Chair of the ABA Health Law Section Managed Care & Insurance Section, Ms. Stamer is nationally and internationally recognized for her experience and skill aiding clients with a diverse range of employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of leading edge experience helping employers; health and other employee benefit plans and their sponsors, administrators, fiduciaries; TPAs, insurers, governments, employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Her experience includes extensive work representing advising these and other clients, governmental bodies, insurance and financial services organizations, third party administrators and others to develop, design, defend and administer creative health, disability, severance and other employee benefit and compensation arrangements, products and services.  She also helps these and other clients monitor, address and respond to federal, state, and international health care and insurance and other regulatory, legislative, audit and enforcement developments. Ms. Stamer  has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. Ms. Stamer regularly works with agencies, publishes and speaks extensively on human resources and employee benefits,  medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.    You can get more information about her HIPAA and other experience here.

If you need help with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Learn Latest On OCR New HIPAA De-Identification Guidance
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business and management information, tools and solutions, training and education, services and support to help organizations and their leaders promote effective management of legal and operational performance, regulatory compliance and risk management, data and information protection and risk management and other key management objectives.  Solutions Law Press, Inc.™ also conducts and assists businesses and associations to design, present and conduct customized programs and training targeted to their specific audiences and needs.  For additional information about upcoming programs, to explore becoming a presenting sponsor for an upcoming event, e-mail your request to info@Solutionslawpress.com   These programs, publications and other resources are provided only for general informational and educational purposes. Neither the distribution or presentation of these programs and materials to any party nor any statement or information provided in or in connection with this communication, the program or associated materials are intended to or shall be construed as establishing an attorney-client relationship, to constitute legal advice or provide any assurance or expectation from Solutions Law Press, Inc., the presenter or any related parties. If you or someone else you know would like to receive future Alerts or other information about developments, publications or programs or other updates, send your request to info@solutionslawpress.com.  CIRCULAR 230 NOTICE: The following disclaimer is included to comply with and in response to U.S. Treasury Department Circular 230 Regulations.  ANY STATEMENTS CONTAINED HEREIN ARE NOT INTENDED OR WRITTEN BY THE WRITER TO BE USED, AND NOTHING CONTAINED HEREIN CAN BE USED BY YOU OR ANY OTHER PERSON, FOR THE PURPOSE OF (1) AVOIDING PENALTIES THAT MAY BE IMPOSED UNDER FEDERAL TAX LAW, OR (2) PROMOTING, MARKETING OR RECOMMENDING TO ANOTHER PARTY ANY TAX-RELATED TRANSACTION OR MATTER ADDRESSED HEREIN. 

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

Employers and other self-insured group health plan sponsors and health insurers, adjust your budgets and prepare to open up your wallets to pay additional fees mandated by the Patient Protection and Affordable Care Act (“PPACA”).  

Self-insured employers and health insurers generally must begin paying a new fee imposed as part of PPACA.  PPACA generally requires that health insurance policy issuers and plan sponsors of self-insured health plans pay the new fee for policy and plan years ending on or after October 1, 2012, and before October 1, 2019 or policy and plan years ending on or after October 1, 2012, and before October 1, 2019.  July 31, 2013 is the deadline for reporting and payment of the first fee payment required by these provisions.

The Internal Revenue Service (IRS) and Department of Treasury published final regulations (“Regulations”) implementing these new rules on December 6, 2012.   These Regulations include many provisions that are likely to come as a surprise to many employer and other health plan sponsors. Health insurers, employers and other sponsors of self-insured health plans and others responsible for their funding and administration need to review these regulations and make other arrangements to budget for and timely report and pay this required fee.

New Fees Help Fund New Patient-Centered Outcomes Research Institute

PPACA amended the Internal Revenue Code (“Code”) to require the new fee to help fund the establishment and operation of the new Patient-Centered Outcomes Research Institute (the ‘‘Institute’’) to be created by PPACA.  Congress intends that the Institute will be a private, nonprofit corporation charged with conducting research to help assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence-based medicine through the synthesis and dissemination of comparative clinical effectiveness research findings.

PPACA added new Sections 4375, 4376, and 4377 to the Code to provide a funding source for the Trust Fund.  These new Code Sections impose require issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans to pay the new fee by July 31, 2012 for each plan year beginning after September 30, 2012 and before October 1, 2019 to fund the Patient-Centered Outcomes Research Trust Fund (the “Trust Fund”), which in turn will help pay the costs of the Institute.

Code Section 4377(c) provides that the fees imposed by sections 4375 and 4376 are treated as taxes for purposes of subtitle F of the Code (sections 6001 through 7874 that set forth the rules of federal tax procedure and administration).

Fee Amount Calculation & Payment

As amended by PPACA, the Code requires that employers sponsoring self-insured group health plans and most health insurers file a return and pay a fee equal to $1 multiplied by the average number of lives covered under the plan or policy by July 31, 2012.  The amount of this fee will increase to $2 multiplied by the average number of lives for post-September 30, 2013 plan years.  For post-September 30, 2014 plan years, the Code provides for further adjustments in the fee based on increases in the projected per capita amount of National Health Expenditures.

To meet this requirement, health insurers and plan sponsors must file a Form 720, Quarterly Federal Excise Tax Return along with the required payment once a year on or before July 31 of the calendar year following the last day of the policy year or plan year for which the fee is required to report and pay the fee.

Overview of ACA Rules Requiring Payment of Fee

The Code now separately assesses a fee on issuers of health insurance policies and on plan sponsors of self-insured health plans for each policy year ending on or after October 1, 2012 and before October 1, 2019. Code Section 4375 requires payment of a fee by “issuers” of “specified health insurance policies.”  Code Section 4376 requires “sponsors” of self-insured health plans to pay a fee. 

Each of these Code Sections basically uses the same formula to calculate the required fee owing by a health insurance issuer or a self-insured plan sponsor. The amount of the required fee due on July 31, 2013 for plan years beginning on or before October 1, 2013 will be one dollar multiplied by the average number of lives covered by the policy or plan. The fee due on July 31, 2014 for plan years beginning between October 2, 2013 and October 1, 2014 is set to increase to two dollars multiplied by the average number of lives covered under the policy. For policy or plan years ending on or after October 1, 2014, PPACA provides for additional increases in the required fee based on increases in the projected per capita amount of National Health Expenditures. See Treas. Reg. §§ 46.4375–1;  Rejecting arguments that Congress only intended to require that either the insurer or the plan sponsor pay a fee annually, the Regulations construe these requirements as obligating both a self-insured health plans sponsor and an insurer to pay a separate fee annually, even if the fee is assessed upon the same lives.

The Preamble to the Regulations states that a self-insured plan sponsor must pay the fee with respect to arrangements where the plan design layers a self-insured portion of the plan with an insured portion, even though the insurer also must pay the fee with respect to the insured portion.

The fee calculation differs slightly for purposes of determining the fee a self-insured plan sponsor owes versus the fee owed by an insurer.  Regardless, however, the Regulations state that for purposes of calculating these numbers, retirees and beneficiaries continuing coverage under the group medical coverage continuation rules generally count. The Preamble to the Regulations states that the IRS views retiree-only plans and COBRA coverage subject to the tax imposed under Code § 4375 and plan sponsors may be required to pay the tax under Code § 4376.  Concerning retiree-only coverage, the Preamble states:

• Although group health plans that have fewer than two participants who are current employees (such as retiree-only plans) are excluded from the requirements of Code chapter 100 (setting forth requirements applicable to group health plans such as portability, nondiscrimination, and market reform requirements), this exclusion does not apply to Code §§ 4375 and 4376 because these sections are in chapter 34; and
• For self-insured arrangements, Code § 4376(c)(2)(A) states explicitly that an applicable self-insured health plan includes a plan established or maintained by one or more employers for the benefit of their employees or former employees.

Section 4376 Fee For Self-Insured Plan Sponsors

Applicability of Code Section 4376 Fee To Self-Insured Health Plans.  The fee under Code Section 4376 applies to the plan sponsor of an applicable self-insured health plan.

Section 4376(c) defines an applicable self-insured health plan as any plan for providing accident or health coverage if any portion of the coverage is provided other than through an insurance policy, and the plan is established or maintained by either:

• One or more employers for the benefit of their employees or former employees;
• One or more employee organizations for the benefit of their members or former members;
• Jointly by one or more employers and one or more employee organizations for the benefit of employees or former employees;
• By a voluntary employees’ beneficiary association described in Code Section 501(c)(9); or
• By any organization described in section 501(c)(6), or (6) if not previously described, by a multiple employer welfare arrangement (as defined in section 3(40) of the Employee Retirement Income Security Act (“ERISA”), a rural electric cooperative under ERISA Section 3(40)(B)(iv), or a rural telephone cooperative association under ERISA Section 3(40)(B)(v).  See Code § 4376; Regulation §46.4376–1(a), (b)(1).

Code Section 4376(b)(1) requires that the plan sponsor of a self-insured health plan pay the required fee for self-insured health plans imposed by Section 4376(a).  For this purpose, Code Section 4376(b)(2) defines a plan sponsor as:

• The employer in the case of a plan established or maintained by a single employer;
• The employee organization in the case of a plan established or maintained by an employee organization;
• The association, committee, joint board of trustees, or other similar group of representatives of the parties who establish or maintain the plan in the case of: (1) a plan established or maintained by two or more employers or jointly by one or more employers and one or more employee organizations; (2) a multiple employer welfare arrangement; or (3)  a voluntary employees’ beneficiary association described in Code Section 501(c)(9); or
• The cooperative or association that establishes the plan in the case of a plan established or maintained by a rural electric cooperative or rural telephone cooperative association within the meaning of ERISA.

Regulation § 46.4376-2(b)(2) defines plan sponsor to mean the following:

• The employer for a self-insured health plan established or maintained by a single employer;
• The employee organization for a self-insured health plan established or maintained by an employee organization;
• The joint board of trustees for a multiemployer plan within the meaning of Code  §414(f));
• The committee, in the case of a multiple employer welfare arrangement within the meaning of Section 3(40) of the Employee Retirement Income Security Act (“ERISA”);
• The cooperative or association that establishes or maintains an applicable self-insured health plan established or maintained by a rural electric cooperative under ERISA § 3(40)(B)(iv) or rural cooperative association under ERISA 3(40)(B)(v);
• The trustee, in the case of an applicable self-insured health plan established or maintained by a voluntary employees’ beneficiary association under Code § 501(c)(9) not merely serving as a funding vehicle for a plan that is established or maintained by an employer or other person;
• In the case of an applicable self-insured health plan the plan sponsor of which is not previously described, the person identified by the terms of the document under which the plan is operated as the plan sponsor, or the person designated by the terms of the document under which the plan is operated as the plan sponsor for Code § 4376 purposes, provided that designation is made in writing, and that person has consented to the designation in writing, by no later than the date by which the return paying the fee under section 4376 for that plan year is required to be filed, after which date that designation for that plan year may not be changed or revoked, and provided further that a person may be designated as the plan sponsor only if the person is one of the persons establishing or maintaining the plan (for example, one of the employers that establishes or maintains the plan with one or more other employers or employee organizations); or
• Where an applicable self-insured health plan sponsor is not previously  and for which no identification or designation of a plan sponsor has been made under the prior paragraph the plan sponsor means, each employer that establishes or maintains the plan with respect to employees of that employer, each employee organization that establishes or maintains the plan with respect to members of that employee organization, and each board of trustees, cooperative, or association that establishes or maintains the plan.

While the fee will impact most health insurance policies and self-insured plans, the Code does exempt a few arrangements.  See Code § 4376.  Regulation § 46.4376-1(b)(2) construes these exemptions to include the following categories of programs:

• A plan that provides benefits substantially all of which are excepted benefits for purposes of the HIPAA Portability Rules under Code § 9832(c).  Pursuant to this provision, for instance, the Regulations state that a health flexible spending arrangement (health FSA) under Code § 106(c)(2)) that satisfies the requirements to be treated as an excepted benefit under Code § 9832(c) and Regulation § 54.9831–1(c)(3)(v) is not an applicable self-insured health plan. However, a health FSA that is not treated as an excepted benefit under Code § 9832(c) and Regulation § 54.9831–1(c)(3)(v) is an applicable self-insured health plan.
• An employee assistance program, disease management program, or wellness program if the program does not provide significant benefits in the nature of medical care or treatment.
• A plan that, as demonstrated by the facts and circumstances surrounding the adoption and operation of the plan, was designed specifically to cover primarily employees who are working and residing outside the United States (as defined in § 46.4377–1(a)(3)).  See Regulation § 46.4376–1(b)(ii).

Where the same plan sponsor maintains multiple self-insured arrangements Regulation § 46.4376(b)(iii) specifies that the employer may treat two or more arrangements established or maintained by the same plan sponsor that provide accident and health coverage other than through an insurance policy and that have the same plan year as a single applicable self-insured health plan for purposes of reporting and calculating the Code § 4376 fee.

Calculation Of Self-Insured Plan Fee Under Code § 4376

Regulation § 46.4376-1 requires that a self-insured plan sponsor determine the number of covered lives for purposes of calculating the fee using on of the following methods:

• The actual count method where the plan sponsor adds the totals of lives covered for each day of the plan year and divides that total by the number of days in the plan year;
• The snapshot method, the plan sponsor adds the totals of lives covered on a date during the first, second, or third month of each quarter of the plan year (or more dates in each quarter if an equal number of dates is used in each quarter), and divides that total by the number of dates on which a count was made in accordance with rules set forth in the Regulations.  For instance, Each date used for the second, third and fourth quarter must be within three days of the date in that quarter that corresponds to the date used for the first quarter, and all dates used must fall within the same plan year. If a plan sponsor uses multiple dates for the first quarter, the plan sponsor must use dates in the second, third, and fourth quarters that correspond to each of the dates used for the first quarter or are within three days of such corresponding dates, and all dates used must fall within the same plan year. The 30th and 31st day of a month are treated as the last day of the month for purposes of determining the corresponding date for any month that has fewer than 31 days. The number of lives covered on a designated date using this method may be determined using either the snapshot factor method or the snapshot count method set forth in the Regulations.  In the snapshot factor method, the number of lives covered on a date is equal to the sum of: (1) the number of participants with self-only coverage on that date; plus (2) the number of participants with coverage other than self-only coverage on the date multiplied by 2.35.    In the snapshot count method, the number of lives covered on a date equals the actual number of lives covered on the designated date.  The plan sponsor must use the same method of calculating the average number of lives covered under the plan consistently for the duration of the plan year. However, a plan sponsor may use a different method from one plan year to the next.
• The Form 5500 method, where the plan sponsor determines the average number of lives covered under a plan for a plan year as the result of the sum of the total participants covered at the beginning and the end of the plan year, as reported on the Form 5500 or Form 5500–SF for the applicable self-insured health plan, divided by 2. This method is only available if the Form 5500 is filed by the due date for payment of the fee.  This means where a plan administrator extends filing beyond July 31, the plan sponsor cannot use this method.

The Regulations establish a special rule for lives covered solely by the fully-insured options under an applicable self-insured health plan.  Under this special rule, when an applicable self-insured health plan provides accident and health coverage through fully insured options and self-insured options, the plan sponsor is permitted to disregard the lives that are covered solely under the fully-insured options in determining the lives covered taken into account for the actual count method, the snapshot method, and the Form 5500 method.

As for insured plans, the Regulations also provide special rules for determining the fee the first year the fee is in effect.  Under this rule, for a plan year beginning before July 11, 2012, and ending on or after October 1, 2012, a plan sponsor may determine the average number of lives covered under the plan for the plan year using any reasonable method.

Section 4375 Fee For Insurers

The fee under Code Section 4375 generally applies to issuers of a “specified health insurance policy.” Code Section 4375(c) generally defines a specified health insurance policy as any accident or health insurance policy (including a policy under a group health plan) issued with respect to individuals residing in the United States. Code Section 4377(a)(1) defines accident and health coverage as any coverage that, if provided by an insurance policy, would cause the policy to be a specified health insurance policy under Code Section 4375.  See Treas. Reg. § 46.4375–1.

Policies Subject To Fee.  Regulation § 46.4377–1(a) defines a “specified health insurance policy” as “any accident and health insurance policy (including a policy under a group health plan) issued with respect to individuals residing in the United States” other than those recognized as exempt by the Regulation.  The Regulation makes clear that this includes any policy that provides accident and health coverage to an active employee, former employee, or qualifying beneficiary, as continuation coverage required under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) or similar continuation coverage under other Federal law or state law.

However Regulation § 46.4377-1(a)(ii) exempts the following arrangements from the definition of a specified health insurance policy.

• Any insurance policy if substantially all of its coverage is of excepted benefits described in Code Section 9832(c);
• Any group policy issued to an employer where the facts and circumstances show that the group policy was designed and issued specifically to cover primarily employees who are working and residing outside of the United States for purposes of Regulation § 46.4377–1(a)(3);
• Any stop loss or indemnity reinsurance policy; or
• Any insurance policy to the extent it provides an employee assistance program, disease management program, or wellness program if the program does not provide significant benefits in the nature of medical care or treatment.

Fee Calculation.  The amount of the fee an insurer must pay for a policy for a policy year under Code § 4375 is equal to the product of the average number of lives covered under the policy for the policy year, multiplied by the applicable dollar amount for that policy year.

The applicable dollar amount multiplier is $1 for the fee due on October 1, 2013;  $2 for the fee due on October 1, 2014, and the adjusted amount for fees due after October 1, 2014.

Determination Of The Average Number Of Lives Covered. To determine the average number of lives covered under a specified health insurance policy during a policy year, the Regulation requires an issuer to use one of the following methods:

• The actual count method, where the issuer determines the average number of lives covered under a policy for a policy year under the actual count method by adding the total number of lives covered for each day of the policy year and dividing that total by the number of days in the policy year;
• The snapshot method, where the issuer determines the average number of lives covered under a policy for a policy year by adding the totals of lives covered on a date during the first, second, or third month of each quarter (or more dates in each quarter if an equal number of dates is used for each quarter), and dividing that total by the number of dates on which a count is made. Each date used for the second, third and fourth quarters must be within three days of the date in that quarter that corresponds to the date used for the first quarter, and all dates used must be within the same policy year. If an issuer uses multiple dates for the first quarter, the issuer must use dates in the second, third, and fourth quarters that correspond to each of the dates used for the first quarter or are within three days of such corresponding dates, and all dates used must be within the same policy year. The 30th and 31st day of a month are treated as the last day of the month for purposes of determining the corresponding date for any month that has fewer than 31 days (for example, if either March 30 or March 31 is used as a counting date for a calendar year policy, June 30 is the corresponding date for the second quarter);
• The member months method, where the issuer determines the average number of lives covered under all policies in effect for a calendar year based on the member months (an amount that equals the sum of the totals of lives covered on prespecified days in each month of the reporting period) reported on the National Association of Insurance Commissioners (“NAIC”) Supplemental Health Care Exhibit filed for that calendar year. Under this method, the average number of lives covered under the policies in effect for the calendar year equals the member months divided by 12; or
• The state form method, where an insurer not required to file NAIC annual financial statements may determine the number of lives covered under all policies in effect for the calendar year using a form filed with the issuer’s state of domicile and a method similar to the member months method if the form reports the number of lives covered in the same manner as member months are reported on the NAIC Supplemental Health Care Exhibit.  See Regulation § 46.4375–1(c)(2)(i).

Issuers must use the same method of calculating the average number of lives covered under a policy consistently for the duration of the year and must use the same method of computing lives for all policies for which a liability is reported on a Form 720, “Quarterly Federal Excise Tax Return,” for a particular year. Regulation § 46.4375–1(c)(2)(ii). However, the Regulation allows an issuer that determines the average number of lives covered by using the actual count method or the snapshot method to change its method of computing the average lives covered to the snapshot method or actual count method, respectively, provided that the issuer uses the same method for computing the average lives covered for all policies for which a liability is reported on the Form 720 for that year. Regulation § 46.4375–1(c)(2). 

The Regulations also impose various other special rules.  For instance, the Regulations state that if the issuer elects to determine the average number of lives covered for all policies in effect during a calendar year using the member months method or the state form method, the applicable dollar amount with respect to such issuer’s policies for such calendar year is the applicable dollar amount for policy years ending on December 31 of such calendar year, except that the applicable dollar amount with respect to such an issuer’s policies for calendar year 2019 is the applicable dollar amount for policy years ending on September 30, 2019. The Regulations provide various examples of these calculations to illustrate the rules.

The Regulations also provide special rules for the first year and the last year the fee is in effect for an insurer.  See Regulation § § 46.4375–1(c).

Plans, Insurers Should Evaluate Options, Plan To Pay Required Fees

The impending obligation provides yet another reason that employers and other self-insured plan sponsors, administrators, insurers, and vendors should re-evaluate their existing health plan designs and costs.  Most health insurers and self-insured health plan sponsors will want not only to budget for the impending additional costs associated with these fees, but also evaluate options for mitigating their impact, as well as the costs and administrative burden of tracking and making the required filings.  For instance, insurers and plan sponsors of programs subject to these new fees generally will want to evaluate which of the options for collecting the data and calculating the fees will most benefit them.  Also, where plan designs used by particular employer or other plan sponsors include both insured and self-insured features, the insurer, plan sponsor and their advisors may want to consider the advisability of restructuring or redesigning plans to mitigate fees or administrative or other expenses.  In all cases, parties should audit their programs to ensure that each program and its element is identified and properly taken into account to avoid inadvertent oversights resulting in penalties or other avoidable costs.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help with these or other health benefit or other human resources, employee benefit, insurance, compensation or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, and Past Chair of the ABA Health Law Section Managed Care & Insurance Section, Ms. Stamer is nationally and internationally recognized for her experience and skill aiding clients with a diverse range of employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of leading edge experience helping employers; health and other employee benefit plans and their sponsors, administrators, fiduciaries; TPAs, insurers, governments, employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Her experience includes extensive work representing advising these and other clients, governmental bodies, insurance and financial services organizations, third party administrators and others to develop, design, defend and administer creative health, disability, severance and other employee benefit and compensation arrangements, products and services.  She also helps these and other clients monitor, address and respond to federal, state, and international health care and insurance and other regulatory, legislative, audit and enforcement developments. Ms. Stamer  has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. Ms. Stamer regularly works with agencies, publishes and speaks extensively on human resources and employee benefits,  medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.    You can get more information about her HIPAA and other experience here.

If you need help with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

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©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.

$50K Settlement Shows Small Breach Reports Carry Enforcement Risk

Properly encrypt and protected electronic protected health information (ePHI) on laptops and in other mediums!  That’s the clear message of the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) in its announcement of its first settlement under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule involving a breach of ePHI of fewer than 500 individuals by a HIPAA-covered entity, Hospice of North Idaho (HONI). 

In announcing the settlement against HONI, OCR sent a clear message that OCR stands ready to penalize these health care providers, health plans, healthcare clearinghouses and their businesses associates (covered entities) when their failure to properly secure and protect ePHI on laptops or in other systems results in a breach of ePHI even when the breach affects fewer than 500 individuals.

OCR Director Leon Rodriguez reiterated OCR’s expectation that covered entities will properly encrypt ePHI on mobile or other devices in OCR’s announcement of the HONI settlement.  “This action sends a strong message to the health care industry that, regardless of size, covered entities must take action and will be held accountable for safeguarding their patients’ health information.” said OCR Director Leon Rodriguez. “Encryption is an easy method for making lost information unusable, unreadable and undecipherable.”

In light of this latest clear warning, health plans and their fiduciaries, sponsors and administrators, health care providers, health care clearinghouses and their business associates should review plans, practices and data security as affecting ePHI and other protected health information on mobile and other devices.

HONI Settlement For Small Breach Notification

On January 2, 2013, OCR announced HONI will pay OCR $50,000 to settle potential HIPAA violations that occurred in connection with the theft of an unencrypted laptop computer containing ePHI. The HONI settlement is the first settlement involving a breach of ePHI affecting fewer than 500 individuals.  Read the full HONI Resolution Agreement here.

OCR opened an investigation after HONI reported to HHS that an unencrypted laptop computer containing ePHI of 441 patients had been stolen in June 2010.  HONI team members regularly use Laptops containing ePHI their field work.  Over the course of the investigation, OCR discovered that HONI had not conducted a risk analysis to safeguard ePHI or have in place policies or procedures to address mobile device security as required by the HIPAA Security Rule.  Since the June 2010 theft, HONI has taken extensive additional steps to improve their HIPAA Privacy and Security compliance program.

HIPAA Security & Breach Notification For ePHI

The HONI settlement is notable because it marks the first time OCR has sanctioned a covered entity as a result of an OCR investigation stemming from the covered entity’s report of a breach of unsecured protected health information involving fewer than 500 individuals under new breach notification rules added to HIPAA in 2009.

Under the originally enacted requirements of HIPAA, covered entities and their business associates are required to restrict the use, access and disclosure of protected health information and establish and administer various other policies and safeguards in relation to protected health information.  Additionally, the Security Rules require specific encryption and other safeguards when covered entities collect, create, use, access, retain or disclose ePHI.   

The Health Information Technology for Economic and Clinical Health (HITECH) Act amended HIPAA, among other things to tighten certain HIPAA requirements, expand its provisions to directly apply to business associates, as well as covered entities and to impose specific breach notification requirements.  The HITECH Act Breach Notification Rule requires covered entities to report an impermissible use or disclosure of protected health information, or a “breach,” of 500 individuals or more (Large Breach) to the Secretary of HHS and the media within 60 days after the discovery of the breach.  Smaller breaches affecting less than 500 individuals (Small Breach) must be reported to the Secretary on an annual basis. Since the Breach Notification Rule took effect, OCR’s announced policy has been to investigate all Large Breaches and such investigations have resulted in settlements or other corrective action in relation to various Large Breaches.  Until now, however, OCR has not made public any resolution agreements requiring settlement payments involving any Small Breaches.

Enforcement Actions Highlight Growing HIPAA Exposures For Covered Entities

While the HONI settlement marks the first settlement on a small breach, this is not the first time OCR has sought sanctions against a covered entity for data breaches involving the loss or theft of unencrypted data on a Laptop, storage device or other computer device. In fact, OCR’s first resolution agreement – reached before Congress added the HIPAA Breach Notification Rules to HIPAA – stemmed from such a breach.  Providence To Pay $100000 & Implement Other Safeguards.   Breaches resulting from the loss or theft of unencrypted ePHI on mobile or other computer devices or systems has been a common basis of investigation and sanctions since that time, particularly since the Breach Notification rules took effect including breaches of ePHI involving compromised health plan information.  See, e.g., OCR Hits Alaska Medicaid For $1.7M+ For HIPAA Security Breach.  Coupled with statements by OCR about its intolerance, the HONI and other settlements provide a strong warning to covered entities to properly encrypt ePHI on mobile and other devices.

Furthermore, the HONI settlement also adds to growing evidence of the growing exposures that health care providers, health plans, health care clearinghouses and their business associates need to carefully and appropriately manage their HIPAA encryption and other Privacy and Security responsibilities. See OCR Audit Program Kickoff Further Heats HIPAA Privacy Risks; $1.5 Million HIPAA Settlement Reached To Resolve 1st OCR Enforcement Action Prompted By HITECH Act Breach Report; HIPAA Heats Up: HITECH Act Changes Take Effect & OCR Begins Posting Names, Other Details Of Unsecured PHI Breach Reports On Website.  Covered entities are urged to heed these warning by strengthening their HIPAA compliance and adopting other suitable safeguards to minimize HIPAA exposures. 

In the face of rising enforcement and fines, OCR’s initiation of HIPAA audits and other recent developments, covered entities and their business associates should tighten privacy policies, breach and other monitoring, training and other practices to reduce potential HIPAA exposures in light of recently tightened requirements and new enforcement risks. 

In response to these expanding exposures, all covered entities and their business associates should review critically and carefully the adequacy of their current HIPAA Privacy and Security compliance policies, monitoring, training, breach notification and other practices taking into consideration OCR’s investigation and enforcement actions, emerging litigation and other enforcement data; their own and reports of other security and privacy breaches and near misses, and other developments to decide if additional steps are necessary or advisable. 

New OCR HIPAA Mobile Device Educational Tool

While OCR enforcement of HIPAA has significantly increased, compliance and enforcement of the encryption and other Security Rule requirements of HIPAA are a special focus of OCR. 

To further promote compliance with the Breach Notification Rule as it relates to ePHI on mobile devices, OCR and the HHS Office of the National Coordinator for Health Information Technology (ONC) recently kicked off a new educational initiative, Mobile Devices: Know the RISKS. Take the STEPS. PROTECT and SECURE Health Information.  The program offers health care providers and organizations practical tips on ways to protect their patients’ health information when using mobile devices such as laptops, tablets, and smartphones.  For more information, see here.  For more information on HIPAA compliance and risk management tips, see here.

For Help With Compliance, Risk Management, Investigations, Policy Updates Or Other Needs

If you need help monitoring HIPAA and other health and health plan related regulatory policy or enforcement developments, or to review or respond to these or other human resources, employee benefit, or other compliance, risk management, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Nationally recognized for her extensive work, publications and leadership on HIPAA and other privacy and data security concerns, Ms. Stamer has extensive experience representing, advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical and other privacy and data security, employment, employee benefits, and to handle other compliance and risk management policies and practices; to investigate and respond to OCR and other enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

A Fellow in the American College of Employee Benefit Counsel, State Bar of Texas and American Bar Association, Vice President of the North Texas Health Care Compliance Professionals Association, the Former Chair of the ABA RPTE Employee Benefit & Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice Chair of the ABA TIPS Employee Benefit Committee, an ABA Joint Committee on Employee Benefits Council Representative, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer serves as the scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR. Ms. Stamer also regularly works with OCR and other agencies, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns.  Her publications and insights  on HIPAA and other data privacy and security concerns appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.   For instance, Ms. Stamer for the third year will serve in 2013 as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR.  Her insights on HIPAA risk management and compliance often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

In addition to this extensive HIPAA specific experience, Ms. Stamer also is recognized for her experience and skill aiding clients with a diverse range of other employment, employee benefits, health and safety, public policy, and other compliance and risk management concerns. 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, a member of the Editorial Advisory Board and expert panels of HR.com, Employee Benefit News, InsuranceThoughtLeadership.com, and Solutions Law Press, Inc., management attorney and consultant Ms. Stamer has 25 years of experience helping employers; employee benefit plans and their sponsors, administrators, fiduciaries; employee leasing, recruiting, staffing and other professional employment organizations; and others design, administer and defend innovative workforce, compensation, employee benefit  and management policies and practices.   Ms. Stamer often has worked, extensively on these and other workforce and performance related matters.  In addition to her continuous day-to-day involvement helping businesses to manage employment and employee benefit plan concerns, she also has extensive public policy and regulatory experience with these and other matters domestically and internationally.  A former member of the Executive Committee of the Texas Association of Business and past Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Ms. Stamer served as a primary advisor to the Government of Bolivia on its pension privatization law, and has been intimately involved in federal, state, and international workforce, health care, pension and social security, tax, education, immigration, education and other legislative and regulatory reform in the US and abroad.  She also is recognized for her publications, industry leadership, workshops and presentations on these and other human resources concerns and regularly speaks and conducts training on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, and many other national and local publications. For more information about Ms. Stamer and her experience or to get access to other publications by Ms. Stamer see here or contact Ms. Stamer directly. 

If you need help with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested in exploring other Solutions Law Press, Inc. ™ tools, products, training and other resources here and reading some of our other Solutions Law Press, Inc.™ human resources news here including the following:

• Learn Latest On OCR New HIPAA De-Identification Guidance
• Company President, Officer Can’t Use Bankruptcy To Avoid Liability For Using Plan Money For Company Operations
• Peter Madoff 10 Sentence For Defrauding ERISA Plans Reminder Manage Plan Investment Responsibilities
• IRS Plans To Issue 2013 Withholding Guidance By 12/31
• ESOP, Other Employee Plan Investments In Company Stock Land Plans, Fiduciaries, Sponsors & Others In Hot Water
• Confirm Qualified Plans Updated By Reviewing Against 2012 Required Plan Qualification Requirements Change List
• Catch Up On Health Reform & Other Key Employee Benefits & Insurance Issues Emerging Issues and Litigation Relating to Life, Health, Disability and ERISA Symposium In Ft. Lauderdale
• 2013 Standard Mileage Rates Announced
• IRS Shares Rules Allowing Government Plans To Switch Remedial Amendment Cycles
• Reminder To Amend Health FSA Plan Terms To Include ACA $2500 Contribution Before 2013 Plan Year Begins
• Bank’ $1Million Plus Overtime Settlement Shows Risks of Misapplying FLSA’s Administrative Exemption
• Labor Department Serves The Christmas Light Co. & Its Owner With Holiday Season FLSA Lawsuit
• Boston Hides and Furs Ltd. Sued For $1 Million For Alleged Willful FLSA Wage & Hour Law Violations
• 2013 Maximum Yearly PBGC Guaranteed Pension Benefit Amount To Increase Slightly In 2013
• Rare Court Order Telling Union To Stop Filing Grievances Example Of Employer Risks When Caught Between Competing Unions
• IRS OKs Retirement Plans Allowing Plan Loans & Hardship Withdrawals To Hurricane Sandy Victims
• Agencies Release ACA Wellness, Adult Pre-Existing Condition, Essential Health Benefits Guidance; Briefing Planned
• New Employee Smart Phone App New Tool In Labor Department’s Aggressive Wage & Hour Law Enforcement Campaign Against Restaurant & Other Employers
• 12 Steps Every Employer With A Health Plan Should Do Now No Matter Who Wins the Election
• Boost Employee Recognition of Value Of Employer & Other Retirement Savings Tools & Plans
• Texas Landscaper’s $106,000 In Minimum Wage & Overtime Settlement Reminds Employers To Prepare For FLSA Enforcement
• NLRB’s Nailing of Bel Air Hotel Reminder RIFs, Other Reengineering & Transactions Impacting Workforce Requirement Proper Risk Management
• Tighten Disability Discrimination Defenses As National Disability Employment Awareness Month Promises To Whip Up New Claims & Awareness
• Settlement of OFCCP Employment Discrimination Charge Reminder To ARRA, Other Government Contractors Of Heightened Enforcement Risks
• $1.25M NLRB Backpay Order Highlights Risks of Mismanaging Union Risks In Health Care & Others M&A Deals
• As EEOC Steps Up ADA Accommodation Enforcement, New DOD Apple App, Other Resources Released
• $1.5 M HIPAA Security Breach Resolution Agreement Shows Looming HIPAA Risks
• Labor Risks Rising For Employers Despite NLRB Loss Of Arizona Secret Ballot Challenge
• USI Advisors Will Pay $1.27 Million To Settle Charges It Violated ERISA Fee Disclosure Requirements

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides business and management information, tools and solutions, training and education, services and support to help organizations and their leaders promote effective management of legal and operational performance, regulatory compliance and risk management, data and information protection and risk management and other key management objectives.  Solutions Law Press, Inc.™ also conducts and assists businesses and associations to design, present and conduct customized programs and training targeted to their specific audiences and needs.  For additional information about upcoming programs, to explore becoming a presenting sponsor for an upcoming event, e-mail your request to info@Solutionslawpress.com   These programs, publications and other resources are provided only for general informational and educational purposes. Neither the distribution or presentation of these programs and materials to any party nor any statement or information provided in or in connection with this communication, the program or associated materials are intended to or shall be construed as establishing an attorney-client relationship, to constitute legal advice or provide any assurance or expectation from Solutions Law Press, Inc., the presenter or any related parties. If you or someone else you know would like to receive future Alerts or other information about developments, publications or programs or other updates, send your request to info@solutionslawpress.com.  CIRCULAR 230 NOTICE: The following disclaimer is included to comply with and in response to U.S. Treasury Department Circular 230 Regulations.  ANY STATEMENTS CONTAINED HEREIN ARE NOT INTENDED OR WRITTEN BY THE WRITER TO BE USED, AND NOTHING CONTAINED HEREIN CAN BE USED BY YOU OR ANY OTHER PERSON, FOR THE PURPOSE OF (1) AVOIDING PENALTIES THAT MAY BE IMPOSED UNDER FEDERAL TAX LAW, OR (2) PROMOTING, MARKETING OR RECOMMENDING TO ANOTHER PARTY ANY TAX-RELATED TRANSACTION OR MATTER ADDRESSED HEREIN. 

©2013 Cynthia Marcotte Stamer, P.C.  Non-exclusive license to republish granted to Solutions Law Press, Inc.™  All other rights reserved.