Key Affordable Care Act Health Plan Coverage Mandates Guidance Issued June 28; Apply ASAP For Early Retirement Reinsurance Program

June 29, 2010

The Department of Health and Human Services (HHS) Office of Consumer Information and Insurance Oversight (OCIIO) today (June 29, 2010) began accepting applications for the Early Retiree Reinsurance Program (ERRP) established under the Patient Protection and Affordable Care Act (“Affordable Care Act”).  Meanwhile, HHS and the Departments of Treasury and Labor Monday published new interim regulations implementing the Affordable Care Act’s group health plan preexisting condition, lifetime and annual limits, rescissions, and patient protections mandates (the “Rules”).  These two key developments follow the Agencies release of guidance about the Affordable Care Act’s grandfather provisions and other  guidance on the Affordable Care Act’s group health plan rules.

To assist concerned business leaders, plan fiduciaries and plan administrators to understand and cope with these new rules, Solutions Law Press author Cynthia Marcotte Stamer will host a teleconference briefing on these new regulations and other Affordable Care Act health plan guidance on July 9, 2010 from Noon. to 1:30 p.m. Central Time.  To register or for other details, see here.

Early Retiree Reinsurance Program

Created by the Affordable Care Act as a bridge to the new health insurance marketplace established by the Exchanges in 2014, this $5 billion program temporarily will reimburse employers, unions, state and local governments, and nonprofits admitted to the program for a portion of claims paid for early retirees.

The Early Retiree Reinsurance Program will reimburse employers admitted to the program for 80 percent of medical claims costs between $15,000 and $90,000 paid for retirees age 55 and older who are not eligible for Medicare, and their spouses, surviving spouses, and dependents. Employers, including state and local governments and unions, who provide health coverage for early retirees are eligible to apply. Program participants will be able to submit claims for medical care going back to June 1, 2010.

Today is the first day HHS is accepting applications.  Applications for the program, as well as fact sheets and application assistance can be found here.

Key Guidance On Affordable Care Act Health Plan Coverage Mandates Issued Monday

On Monday, June 28, 2010 HHS, Labor and Treasury (the “Agencies”) jointly published interim final rules implementing the Affordable Care Act’s Rules on preexisting conditions, coverage rescissions, lifetime and annual dollar limits for essential benefits, and patient choice/access of providers. See Regulation, Fact Sheet, Patient Protection Model Notice, Lifetime Limits Model Notice and Dependents Model Notice

The Rule implements and interprets the Affordable Care Act’s restrictions on the use by that group health plans and individual and group health insurance coverage (“health plans”) which generally:

  • Prohibit preexisting condition exclusions and limitations for children under age 19;
  • Prohibit arbitrary insurance coverage rescissions;
  • Prohibit lifetime dollar limits on essential benefits;
  • Restrict annual dollar limits on essential benefits;
  • Protect certain choice of physician rights of plan members; and
  • Prohibit certain restrictions on emergency services.

Certain plans qualifying as “grandfathered” for purposes of the Affordable Care Act may qualify as exempt from these requirements.

The Rule is the latest in a series of recently-issued guidance implementing various health coverage requirements of the Affordable Care Act.  It follows closely the publication by the Agencies of regulations about:

  • When group health plans and insurance qualify as “grandfathered plans” for purposes of determining deadlines for complying with certain health care reform requirements imposed under the Patient Protection & Affordable Care Act (Affordable Care Act).  See Fact Sheet, Regulation, FAQs, Table, and Model Notice;
  • Extension of Coverage For Adult Children see Fact Sheet, Regulation, FAQs and IRS Guidance; and IRS Guidance on Tax-Free Employer-Provided Health Coverage Now Available for Children under Age 27,  see here;
  • FAQs on Health Care Reform and COBRA;
  • IRS Issues Regulations on 10-Percent Tax on Tanning Services Effective July 1, see here;
  • IRS Guidance On Special Tax Incentives for Small Businesses to Provide Health Care, Hire New Workers, see here, here, here and here.

 

Register Now For July 9 Teleconference To Catch Up On New Affordable Care Act & Other 2010 Health Plan Changes

Learn more about this and other Affordable Care Act requirements and how it will impact your group health plan by registering to participate in a special Solutions Law Press teleconference briefing on this and other emerging Affordable Care Act group health plan guidance to be conducted by Cynthia Marcotte Stamer on July 9, 2010 from Noon. to 1:30 p.m. Central Time.  To register or for other details, see here.

About Ms. Stamer

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, management attorney and consultant Ms. Stamer is nationally and internationally recognized for more than 23 years of work helping employer and other plan sponsors, insurers, administrators, fiduciaries, governments and others design, administer and defend innovative health and other employee benefit programs and other human resources, compensation and management policies and practices.

As a core focus of her practice, Ms. Stamer works extensively with employer and other health plan sponsors, fiduciaries, administrative and other service providers, insurers, and other clients on health benefit program and product design, documentation, administration, compliance, risk management, and public policy matters.  The publisher of Solutions Law Press, Ms. Stamer also publishes, conducts training and speaks extensively on these and related concerns for the ABA, the Bureau of National Affairs and many other organizations.  Please join us for what promises to be a most interesting discussion.

The Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Committee, a Council Representative on the ABA Joint Committee on Employee Benefits, Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, and the editor and publisher of Solutions Law Press HR & Benefits Update and other Solutions Law Press Publications, Ms. Stamer also is recognized for her publications, industry leadership, workshops and presentations on these and other health industry and human resources concerns. She regularly speaks and conducts training for the ABA, Institute of Internal Auditors, Society for Professional Benefits Administrators, Southwest Benefits Association and many other organizations.  Publishers of her many highly regarded writings on health industry and human resources matters include the Bureau of National Affairs, Aspen Publishers, ABA, AHLA, Aspen Publishers, Schneider Publications, Spencer Publications, World At Work, SHRM, HCCA, State Bar of Texas, Business Insurance, James Publishing and many others.  You can review other highlights of Ms. Stamer’s experience hereHer insights on these and other matters appear in Managed Care Executive, Modern Health Care, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, MDNews, Kentucky Physician, and many other national and local publications. 

If you need help with human resources or other management, concerns, wish to ask about compliance, risk management or training, or need legal representation on other matters please contact Cynthia Marcotte Stamer here or (469)767-8872. 

Other Resources

If you found this information of interest, you also may be interested in reviewing other recent Solutions Law Press updates including:

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to receive our Solutions Law Press distributions here. For important information about this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to here.

©2010 Solutions Law Press. All rights reserved.


Key Guidance Issued About New Affordable Care Act Health Plan Requirements; Teleconference Briefing Planned July 9

June 24, 2010

This week (June 22, 2010), the U.S. Departments of Health and Human Services, Labor and Treasury (the “Agencies”) jointly released an advanced copy of interim final rules (the “Rules”) implementing several key new health coverage mandates enacted as part of the Patient Protection and Affordable Care Act (“Affordable Care Act”).

The Rule scheduled for publication in the Federal Register on June 28, 2010 will implement and interpret the Affordable Care Act’s restrictions on the use by that group health plans and individual and group health insurance coverage (“health plans”) which generally:

  • Prohibit preexisting condition exclusions and limitations for children under age 19
  • Prohibit arbitrary insurance coverage rescissions;
  • Prohibit lifetime dollar limits on essential benefits;
  • Restrict annual dollar limits on essential benefits;
  • Protect certain choice of physician rights of plan members; and
  • Prohibit certain restrictions on emergency services.

Certain plans qualifying as “grandfathered” for purposes of the Affordable Care Act may qualify as exempt from these requirements.

The Rule is the latest in a series of recently-issued guidance implementing various health coverage requirements of the Affordable Care Act.  It follows closely the June 14, 2010 publication by the Agencies of regulations on when group health plans and insurance qualify as “grandfathered plans” for purposes of determining deadlines for complying with certain health care reform requirements imposed under the Patient Protection & Affordable Care Act (Affordable Care Act).

To assist concerned business leaders, plan fiduciaries and plan administrators to understand and cope with these new rules, Solutions Law Press author Cynthia Marcotte Stamer will host a teleconference briefing on these new regulations and other Affordable Care Act health plan guidance on July 9, 2010 from Noon. to 1:30 p.m. Central Time.  To register or for other details, see here.

To review an advanced copy of the Rule see here.  Read the accompanying Fact Sheet here.

About Ms. Stamer

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, management attorney and consultant Ms. Stamer is nationally and internationally recognized for more than 23 years of work helping employer and other plan sponsors, insurers, administrators, fiduciaries, governments and others design, administer and defend innovative health and other employee benefit programs and other human resources, compensation and management policies and practices.

As a core focus of her practice, Ms. Stamer works extensively with employer and other health plan sponsors, fiduciaries, administrative and other service providers, insurers, and other clients on health benefit program and product design, documentation, administration, compliance, risk management, and public policy matters.  The publisher of Solutions Law Press, Ms. Stamer also publishes, conducts training and speaks extensively on these and related concerns for the ABA, the Bureau of National Affairs and many other organizations.  Please join us for what promises to be a most interesting discussion.

The Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Committee, a Council Representative on the ABA Joint Committee on Employee Benefits, Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, and the editor and publisher of Solutions Law Press HR & Benefits Update and other Solutions Law Press Publications, Ms. Stamer also is recognized for her publications, industry leadership, workshops and presentations on these and other health industry and human resources concerns. She regularly speaks and conducts training for the ABA, Institute of Internal Auditors, Society for Professional Benefits Administrators, Southwest Benefits Association and many other organizations.  Publishers of her many highly regarded writings on health industry and human resources matters include the Bureau of National Affairs, Aspen Publishers, ABA, AHLA, Aspen Publishers, Schneider Publications, Spencer Publications, World At Work, SHRM, HCCA, State Bar of Texas, Business Insurance, James Publishing and many others.  You can review other highlights of Ms. Stamer’s experience hereHer insights on these and other matters appear in Managed Care Executive, Modern Health Care, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, MDNews, Kentucky Physician, and many other national and local publications. 

If you need help with human resources or other management, concerns, wish to ask about compliance, risk management or training, or need legal representation on other matters please contact Cynthia Marcotte Stamer here or (469)767-8872. 

Other Resources

If you found this information of interest, you also may be interested in reviewing other updates and publications by Ms. Stamer including:

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to receive our Solutions Law Press distributions here. For important information about this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to here.

©2010 Solutions Law Press. All rights reserved.


Registration Open For July 9 In “Affordable Care Act & Other Federal Health Plan Guidance Update”

June 23, 2010

Solutions Law Press Invites You To Learn What You Must Do Now To Meet Key Affordable Care Act Health Plan Deadlines

 Affordable Care Act & Other Federal Health Plan Guidance Update

July 9, 2010 Teleconference – Noon to 1:30 P.M. Central Time

Solutions Law Press invites you to catch up on the latest guidance on new requirements that group health plans must meet under the Affordable Care Act and other emerging federal health plan regulations by participating in the Affordable Care Act & Other Federal Health Plan Guidance Update” teleconference to be conducted by attorney Cynthia Marcotte Stamer on Friday, July 9, 2010 from Noon to 1:30 P.M. Central Time for a registration fee of $50.00. To register for this program, see here,

Affordable Care Act Requires Prompt Action By Group Health Plans & Employers

The combined package of comprehensive health care reform legislation enacted by Congress this Spring through the Patient Protection and Affordable Care Act (Public Law 111-148) as amended by the Health Care and Education Reconciliation Act (Public Law 111-152) (collectively referred to as the “Affordable Care Act”) will require most employers, employment-based group health plans, plan sponsors, plan fiduciaries, plan administrators and other service providers and insurers take prompt action to meet compliance deadlines and preserve other options over the next several months. Employer and other group health plan sponsors, fiduciaries, insurers and administrators must act quickly to update their health plan documents, communications and practices to comply with new federal requirements that become effective under the Affordable Care Act on the first day of the plan year beginning after September 22, 2010 and various other changes in federal health plan rules effective or scheduled to take effect during 2010 or 2011 plan years. Quick action also may be needed to claim small employer tax credits, retiree medical subsidies or other benefits. 

July 9 Briefing Provides Key Information

The July 9, 2010 Affordable Care Act & Other Federal Health Plan Guidance Update” teleconference will include an update on the latest regulatory guidance about impending Affordable Care Act group health plan rules and other key information to help employers, group health plans, plan administrators and fiduciaries and others working with these plans to understand and respond to these new requirements.

The briefing will cover:

  • Key elements of Affordable Care Act reforms impacting employment-based health plans
  • Impending Affordable Care Act deadlines for employment-based group health plans and their sponsors during 2010 or 2011
  • Update on guidance on grandfathered plan status meaning, qualification and disqualification
  • Update on guidance on new dependent child coverage extension rules
  • Update on guidance on early retiree medical reinsurance program
  • Update on guidance on new small employer health coverage tax credit
  • Update on other recent and pending Affordable Care Act group health plan rule guidance
  • Tips to coordinate Affordable Care Act and other federal group health plan mandate compliance
  • Practical strategies for responding to new requirements and changing rules
  • Participant questions

About The Presenter

The program will be presented by attorney Cynthia Marcotte Stamer. With more than 23 years of experience advising employers, group health plans, plan fiduciaries, plan administrators and vendors, insurers and others about health plan and managed care matters, Ms. Stamer is nationally known for her work, publications and presentations on health plan and other employee benefit, health care and insurance matters.  Current Chair of the American Bar Association (ABA) RPTE Employee Benefit & Other Compensation Committee, a Council Member of the ABA Joint Committee on Employee Benefits and Past Chair of the ABA Health Law Section Managed Care & Insurance  Interest Group, Ms. Stamer continuously advises employers, health plans, plan sponsors, fiduciaries, plan administrators, plan vendors, insurers and others about health program related legal, operational, documentation, public policy, enforcement, privacy, technology, litigation and risk management and other concerns. Ms. Stamer also publishes and speaks extensively on these and other health and managed care program concerns and practices.  Her insights on these and related topics have appeared in Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, Managed Healthcare, Health Leaders, various ABA publications and a many other national and local publications.  To contact Ms. Stamer or for additional information about Ms. Stamer, her experience, involvements, programs or publications, contact Ms. Stamer at (469) 767-8872 or via e-mail here, or see here.

Other Helpful Resources & Other Information

 If you find this of interest, you also be interested reviewing some of our other Solutions Law Press resources available for review here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here. You can access other recent updates and other informative publications and resources of Ms. Stamer here.   For important information concerning this communication click here.  If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2010 Solutions Law Press.   All rights reserved.


Stamer Speaks June 9 On “Health Care Reform’s Implications For Employers, Health Plans & Employee Benefits Practitioners” In Houston

May 19, 2010

Cynthia Marcotte Stamer will discuss “Health Care Reform’s Implications for Employers, Health Plans and Employee Benefits Practitioners” at the June 9, 2010 meeting of Houston WEB. The program is scheduled for Wednesday, June 9, 2010 at the DoubleTree Guest Suites, 5353 Westheimer, Houston, Texas from 11:30 a.m. to 1:30 pm.

Narrowly passed by Congress in March after a year of contentious debate, the comprehensive health care reform legislation imposes a complex array of reforms impacting employment based health plans, employers, and the insurers and other vendors and administrators of these programs.  Ms. Stamer will explore key elements of these reforms impacting employers and employment based health coverage and their implications for employers, employment based health plans, and employee benefits and other attorneys providing advice about these arrangements.

 To register or for more information about this event, see here.  If you need assistance reviewing or responding to these or other employee benefit, compensation or labor and employment concerns, contact the author of this update, Cynthia Marcotte Stamer, for assistance at (469) 767-8872 or here.

About Ms. Stamer

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, management attorney and consultant Ms. Stamer is nationally and internationally recognized for more than 23 years of work helping businesses manage labor and employment, employee benefits, performance management and discipline, compliance and internal controls, risk management, and public policy matters including significant, cutting edge experience advising employer and other health plan sponsors, fiduciaries, insurers, administrators and others design, administer, and defend defensible, cost-effective health and other employee benefit programs.

As a core focus of her practice, Ms. Stamer works extensively with employer and other health plan sponsors, fiduciaries, administrative and other service providers, insurers, and other clients on health benefit program and product design, documentation, administration, compliance, risk management, and public policy matters.  The publisher of Solutions Law Press, Ms. Stamer also publishes, conducts training and speaks extensively on these and related concerns for the ABA, the Bureau of National Affairs and many other organizations.  Please join us for what promises to be a most interesting discussion

The Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Committee, a Council Representative on the ABA Joint Committee on Employee Benefits, Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, and the editor and publisher of Solutions Law Press HR & Benefits Update and other Solutions Law Press Publications, Ms. Stamer also is recognized for her publications, industry leadership, workshops and presentations on these and other health industry and human resources concerns. She regularly speaks and conducts training for the ABA, Institute of Internal Auditors, Society for Professional Benefits Administrators, Southwest Benefits Association and many other organizations.  Publishers of her many highly regarded writings on health industry and human resources matters include the Bureau of National Affairs, Aspen Publishers, ABA, AHLA, Aspen Publishers, Schneider Publications, Spencer Publications, World At Work, SHRM, HCCA, State Bar of Texas, Business Insurance, James Publishing and many others.  You can review other highlights of Ms. Stamer’s experience hereHer insights on these and other matters appear in Managed Care Executive, Modern Health Care, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, MDNews, Kentucky Physician, and many other national and local publications. 

If you need help with human resources or other management, concerns, wish to ask about compliance, risk management or training, or need legal representation on other matters please contact Cynthia Marcotte Stamer here or (469)767-8872. 

Other Resources

If you found this information of interest, you also may be interested in reviewing other updates and publications by Ms. Stamer including:

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to receive our Solutions Law Press distributions here. For important information about this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to here.

©2010 Solutions Law Press. All rights reserved.


CBO Raises Estimated Cost of Health Care Reforms As Employers, Health Plans Brace Costs Of Newly Effective & Impending Mandates

May 15, 2010

By Cynthia Marcotte Stamer 

New analysis  released Tuesday, May 11 by the non-partisan Congressional Budget Office shows H.R. 3590, the Patient Protection and Affordable Care Act, Public Law 111-148 (Health Care Reform Law) passed in March will cost $115 Billion more than originally estimated in the CBO’s March 15, 2010 discretionary spending analysis. News of the cost estimate increase comes as U.S. employer and other health plan sponsors, insurers and others are bracing for the first wave of new federal health plan mandates enacted as part of the Health Care Reform Law to take effect in September and a host of other federal mandates previously enacted that take effect in the 2009 and 2010 plan years. 

Projected Cost of Health Care Reform Increased 

According to CBO, additional information about the potential effects of the Health Care Reform Law on spending funded through the annual appropriation process (discretionary spending). By their nature all such potential effects on discretionary spending are subject to future appropriation actions, which could result in greater or smaller costs than the sums authorized by the legislation. While still limited in certain respects, the updated CBO analysis provides information on the major components of such costs in three general categories: 

  • The costs that will be incurred by federal agencies to implement the new policies established by the Health Care Reform Law, such as administrative expenses for the Department of Health and Human Services and the Internal Revenue Service for carrying out key requirements of the legislation.
  • Explicit authorizations for future appropriations for a variety of grant and other program spending for which the act identifies the specific funding levels it envisions for one or more years. (Such cases include provisions where a specified funding level is authorized for an initial year along with the authorization of such sums as may be necessary for continued funding in subsequent years.)
  • Explicit authorizations for future appropriations for a variety of grant and other program spending for which no specific funding levels are identified in the legislation. That type of provision generally includes legislative language that authorizes the appropriation of “such sums as may be necessary,” often for a particular period of time.

According to the updated analysis, CBO estimates that total authorized costs in the first two categories probably exceed $115 billion over the 2010-2019 period. CBO still does not have an estimate of the potential costs of authorizations in the third category. 

CBO previously issued an estimate of the Health Care Reform Law’s direct spending and revenue effects  in combination with the Reconciliation Act of 2010 (Public Law 111-152), which amended it.  (Direct spending effects are those that do not require subsequent appropriation action.)  CBO estimated that those two laws, in combination, would produce a net reduction in federal deficits of $143 billion over the 2010-2019 period as a result of changes in direct spending and revenues. 

Impending Federal Health Plan Mandate Changes Bring New Costs, Risks Now 

CBO’s adjustment to its cost projections comes as U.S. employers and insurers already are bracing to cope with a host of new federally imposed health plan mandates and accompanying costs that already have or will in the next 12-months impact their existing health benefit programs. Examples of these new mandates include: 

  • COBRA Stimulus Bill Premium Subsidy and Other Mandates
  • New FMLA and USERRA Coverage Continuation Mandates
  • Dependent Care Coverage Extension Mandates For Students Requiring Medical Leave Effective
  • Genetic and Other Disability Discrimination Mandates under GINA, ADA Amendments Act of 2008, HIPAA Portability and Other Federal Mandates
  • Expanded Mental Health Parity Mandates
  • HIPAA Data Breach and Other Protected Health Information Privacy and Data Security Mandates
  • New IRS Excise Tax Self-Assessment & Reporting Mandates For Plans Violating COBRA, Mental Health Parity and Wide Range of Other Federal Mandates
  • Changes To Retiree Medical Subsidy Rules
  • Early Retiree Medical Reinsurance Program For Employers Providing Qualifying Retiree Coverage
  • New Small Employer Tax Credit Rules
  • Mandated extension of dependent coverage to age 26
  • Prohibition of Pre-Existing Condition Limits on Dependent Coverage
  • New restrictions on annual and lifetime benefit limitations
  • Mandate to cover 100% of preventative care
  • Prohibition against coverage rescissions
  • Primary Care Physician choice mandates
  • Restrictions on coverage limitations for emergency and obstetrical care
  • Extension of Internal Revenue Code Section 105(h) nondiscrimination mandates to certain insured health plans
  • Many others

Employer and other health plan sponsors, their insurers, administrators and others responsible for updating and administering group and other health plans must move immediately to meet these evolving mandates while bracing for anticipated increased costs and other obligations expected to result as the Health Care Reform Law takes effect over the next few years.  Employers, administrators and insurers needing additional information about these changes can review the resources and training materials available here and/or contact the author of this update, attorney and consultant Cynthia Marcotte Stamer, for assistance at (469) 767-8872 or here 

Responsible & Prompt Action Needed 

Employer and other health plan sponsors, administrators, fiduciaries and insurers both should act quickly to update their programs, plan documents, communications and practices to comply with federal mandates that have and are scheduled to take effect and stay involved with regulators and Congress as the regulatory rules and processes to implement the Health Care Reform Law are developing.  Ultimately, the cost and other implications of the Health Care Reform Law will depend largely upon how its provisions are construed and implemented by federal and state regulators, along with any subsequent adjustments, if any that Congress may elect to enact.  With federal officials hard at work preparing implementing regulations and other guidance and procedures, health industry leaders and other concerned Americans should stay informed and continue to share their input on these critical issues as these decisions are shaped.  Join the discussion by participating in the Coalition For Responsible Health Care Policy linked in group and/or its subgroup,  Project COPE: Coalition for Patient Empowerment and/or register to receive updates Coalition for Responsible Heath Care Policy by RSS Feed.Coalition for Responsible Health Care PolicyCoalition for Responsible Health Care PolicyCoalition for Responsible Health Care Policy 

The author of this update, Cynthia Marcotte Stamer, recently has conducted briefings on the implications of the Affordable Care Act and other regulatory changes impacting health plans and their employer and other sponsors, insurers, administrators and others for the Society of Professional Benefits Administrators, the Dallas Bar Association and others.  Several other presentations and update are scheduled in the upcoming months.  For information about these programs or to register to receive information about these programs, see here.   

About Ms. Stamer 

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, management attorney and consultant Ms. Stamer is nationally and internationally recognized for more than 22 years of work helping businesses manage labor and employment, employee benefits, performance management and discipline, compliance and internal controls, risk management, and public policy matters including significant, cutting edge experience advising employer and other health plan sponsors, fiduciaries, insurers, administrators and others design, administer, and defend defensible, cost-effective health and other employee benefit programs.   

The Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Committee, a Council Representative on the ABA Joint Committee on Employee Benefits, Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Vice President of the North Texas Health Care Compliance Professionals Association, past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, and the editor and publisher of Solutions Law Press HR & Benefits Update and other Solutions Law Press Publications Ms. Stamer also is recognized for her publications, industry leadership, workshops and presentations on these and other health industry and human resources concerns. She regularly speaks and conducts training for the ABA, American Health Lawyers Association (AHLA), Health Care Compliance Association, Institute of Internal Auditors, Harris County Medical Society, the Medical Group Management Association, Society for Professional Benefits Administrators, Southwest Benefits Association, Harris County Medical Society, Medical Group Management Association, Society of Human Resources Management, and many other organizations.  Publishers of her many highly regarded writings on health industry and human resources matters include the Bureau of National Affairs, Aspen Publishers, ABA, AHLA, Aspen Publishers, Schneider Publications, Spencer Publications, World At Work, SHRM, HCCA, State Bar of Texas, Business Insurance, James Publishing and many others.  You can review other highlights of Ms. Stamer’s experience hereHer insights on these and other matters appear in Managed Care Executive, Modern Health Care, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, MDNews, Kentucky Physician, and many other national and local publications.  

If you need help with human resources or other management, concerns, wish to ask about compliance, risk management or training, or need legal representation on other matters please contact Cynthia Marcotte Stamer here or (469)767-8872.  

Other Resources 

If you found this information of interest, you also may be interested in reviewing other updates and publications by Ms. Stamer including: 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to receive our Solutions Law Press distributions here. For important information about this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to here. 

©2010 Solutions Law Press. All rights reserved.


Join Project COPE: Help Develop Real Tools To Meaningfully Empower Patients & Improve Health Care Access, Affordability & Quality

May 15, 2010

With all the recent debate about health care policy reforms, it is important to keep the focus on the practical needs of patients and their families in dealing with an illness or disability, and simple steps that health care providers, employers, insurers and other payers, churches and other community organizations, and regular people can do to meaningfully help patients and their families effectively access and pay for care and meet other related challenges attendant to illness and disabilities.

No easy, one-size fits all cure exists to help patients and their families deal with illness or disability.  Paying for care is only a small part of the health care challenge for any patient and his or her family.  The good news is that health treatment and disease management advances increasingly are converting once deadly illnesses and disabilities into chronic conditions.  The challenge is that patients living with these conditions often survive with ongoing (often expensive) medical treatments, work-life adjustments and other continuous partial but imperfect fixes that come at great financial, productivity and personal costs to themselves, their families and society.  The government and its public policies can’t change this anymore than the patients, families, employers, friends and communities that live and deal with these patients.  Indeed, the process of reform and the confusion it will foster is likely to create new complications in the upcoming years.

Consequently, to make any real and meaningful difference in the empowerment of  patients and the mitigation of the financial and other challenges that patients and their families, health care providers, employer and other business and community leaders, health plans, insurers and others experience in dealing with ill or disabled person starts with recognition of basic realities of illness and disabilities and pursuing the many small practical opportunities to mitigate these challenges, including the following:  

No One Easy Fix; Just Many Small Ones

Being old or being sick (or having a loved one who is) stinks. Not everyone was born with a BMW for a body and even some BMW’s are lemons. Even for a car, there isn’t always a clear “evidence based” answer to the unavoidable “why me/us” questions every patient and their family must face.  However, the answers to these and other tough questions often are must less clear and more intractable for patients and their families:

  • What’s wrong with this body?
  • Can it be fixed and if so, how do I fix it?
  • If it can’t be fixed, what do I do?
  • How do I pay for the fix? How do I find the money and other resources?
  • How do we keep working and keep pursuing the cure at the same time?
  • I am scared, lonely, confused, tired, hurting, alone, uneducated, unemployed, etc.

Money only can do so much to fix or mitigate the experience of being ill, old or disabled and there isn’t enough money to pay for all the fixes that exist for those people with broken or aging body parts.  While dollars play a critical role in a patient’s ability to access certain resources, it can only partially answer these questions.  All patients and their families still struggle to deal with these intractable questions.

Communication & Understanding Key Tools

The best way to get Americans to make better choices about the health care they choose is to provide better communications and other tools to empower them with improved understanding needed to make better choices and better cope.  Misunderstanding and miscommunications in the system fuel much pain and inefficiency.

  • When families and patients get good information that indicates that the $20,000 spent for a procedure will only cause a lot of suffering and expense to extend a life already suffering for another 48 hours, they usually chose quality of life over length of life.
  • Studies show that physicians and the RNs working with them agree in less than 70 percent of the times about the care ordered and how to administer it. Communication elsewhere among health care providers further erodes cost effectiveness and quality.
  • Government regulation and the tension that results from regulation and practices that break up health care teams makes this worse contributes to this problem. 

Better communication and understanding between health care providers and the patients and their families and friends that help the patients will improve quality and efficiency of care.

  • All Americans need to be taught basic communication and coping skills to be better and more responsible health care patients, and effective health care buddies for their family and friends.
  • Providers need to communicate effectively with patients, family members, payers and each other. Patients and families need to learn to take responsibility to insist on answers to the questions they have that are necessary to meet their care needs.
  • Health plans, insurers and other payers need to communicate effectively with patients and their families, as well as health care providers about what coverage is being purchased, what is and is not covered, what must be done to qualify for coverage, care choices affecting coverage, and the availability of other alternatives when coverage is limited or not available.

Demographic Realities Ensure Inadequacy Of Funding

The aging population means that the gap between patients that need money for care and the available dollars to pay for care will continue to grow unless care is rationed in some way that limits or denies certain care to some ill, disabled or aging people.  Decisions about rationing by necessity require individual specific, personal decision-making. Just because the most health care dollars are spent in the last months of life doesn’t mean that these dollars are necessarily wasted. The question should be what quality of life was realized for the dollars spent.  This is a qualitative decision that is of necessity highly personal for each patient and his or her family.  It cannot be fully accounted for or decided based on actuarial and accounting curves. Many old and sick people are extraordinary functional, valuable and important to someone.

Personal Responsibility For Self & Neighbor Best Investment

The most overlooked opportunities for quality and cost improvements rest with the people in health care:

  • The patients, their families and friends
  • Health care providers
  • Employers, churches, social organizations and other community organizations and resources that deal with patients and their families;
  • Health plans, insurers, and others that administer care; and
  • Others that encounter patients and their families.
  • 

Caring for ourselves, our families, our friends and others in our community is our right, our privilege and our job. The best opportunity to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care for ourselves, our loved ones, our friends and Americans generally by stop waiting for someone else to do it. Noone is better qualified to care about your loved ones than you.  Do what you can and celebrate what you can do.  Speak up, step up and help bridge the gap when you or your organization can do so by extending yourself a little bit.  Speak up to help communicate and facilitate when you can.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   You can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources

For important information concerning this communication click here.  If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to here.


House Could Vote On Obama Health Care Reform Sunday

March 18, 2010

By Cynthia Marcotte Stamer

Time is running out for Americans to make their health care reform views known to key Congressional decision-makers. The stage now appears to be set for the House of Representatives to vote as early as Sunday on the Reconciliation Act of 2010 (H.R. 4872), the latest version of health care reform backed by President Obama, Speaker Nancy Pelosi and other key Congressional Democrats.   The impending deadline means that Americans concerned about the potential outcome of the impending vote need to act quickly if they wish to attempt to influence the decision. For tips about sharing your input with Congress effectively, see Getting Your Health Care Reform Message Heard By Key Congressional Leaders.

Developments Today Start Clock Running For Vote

On Thursday, March 18, 2010, two key developments set the stage for a vote on H.R. 4871 as early as Sunday:

  • The House Rules Committee posted the text of H.R. 4872 on its website; and
  • The Congressional Budget Office (CBO) delivered its scoring of H.R 4872 to House Speaker Nancy Pelosi.

The delivery of CBO scoring started the clock running on the 72 hour mandatory period between the release of the CBO scoring and any final vote on the bill. This means the House could vote on H.R. 4872 as early as Sunday, March 21. 

If passed by the House, H.R. 4872 would make sweeping changes to the U.S. health care system impacting virtually every American patient, health care provider, employer and taxpayer.  To learn the facts about these proposed changes, read the full text of H.R. 4872 here.  

According to the CBO, H.R. 4872 will cost $940 billion over 10 years to extend coverage to 32 million uninsured people.  To learn more specifics about these CBO cost and other determinations, review the CBO scoring here.

This Is Only The Beginning: Stay Involved

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the President’s proposal or some other version of health care reform passes this week, Congress already has and will continue to consider other legislation impacting health care reform.  This reality is demonstrated by Congressional actions recently taken on the COBRA premium subsidy extension, Medical reimbursement for physicians, continuing federal efforts to develop and implement federal health care quality and technology standards, and other legislative, regulatory and enforcement actions taken while public attention has been focused largely only on the broader health care reform debate.

Upcoming mid-term elections will significantly impact the nature and scope of these upcoming efforts.  Perhaps even more significantly, the enactment of legislation is only a beginning point.  The real meaning of these or other health care reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Monitoring and staying active in these ongoing processes provides a critical opportunity to continue to monitor your issues and provide input to shape how they are addressed.

To help stay informed about health industry and other developments and  join the discussion about these and other health care reform proposals, concerned Americans are invited to join the Coalition for Responsible Health Care Reform Group on Linkedin and registering to receive these updates here.   

If you need assistance evaluating or formulating comments on the proposed reforms contained in the House Bill or on other health industry matters please contact Cynthia Marcotte Stamer at cstamer@cttlegal.com or 214.270.2402.

Ms. Stamer has extensive experience advising and assisting employers, health industry, and health insurance clients and others about a diverse range of health care, employee benefit, and employment policy, regulatory, compliance, risk management and operational concerns.  You can get more information about her health industry experience here.  

Former Chair of the American Bar Association Health Law Section Managed Care & Insurance Interest Group and currently Chair of the American Bar Association RPTE Employee Benefits & Compensation Committee, a Council Representative to the ABA Joint Committee on Employee Benefits and Vice President of the North Texas Health Care Compliance Association, Ms. Stamer is nationally recognized for more than 22 years work with health care providers, managed care and other payers, employers, governments and other clients on health care, employee benefit, and other concerns.  From her extensive involvement with federal and state legislative and regulatory health, pension and other reforms in the U.S. to her involvement as a lead advisor to the Government of Bolivia on its pension privatization legislation, Ms. Stamer’s experience includes significant experience working with clients domestically on key health care and other public policy matters.  The publisher of Solutions Law Press, Ms. Stamer also publishes, conducts training and speaks extensively on these and related concerns.  For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

If you found this information of interest, you also may be interested in reviewing other updates and publications by Ms. Stamer including:

You can review other publications and resources and additional information about the experience of Ms. Stamer here and learn more about  other Curran Tomko Tarski LLP attorneys here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information to Cstamer@CTTLegal.com or registering to participate in the distribution of these and other updates on our Solutions Law Press distributions here. For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to here.

©2010 Cynthia Marcotte Stamer. All rights reserved.


Health Plan Liability Heats Up As Plans & Businesses Face New Obligations, Costs & Exposures under New HIPAA Privacy Rules Effective 2/17 & Other Expanding Federal Health Plan Mandates

February 17, 2010

Today (February 17, 2010), employer and other health plans and health insurers (“covered entities”) and service providers performing functions on behalf of these entities (“business associates”) must begin complying with tighter federal requirements for the use, access, protection and disclosure of protected health information under Privacy & Security Standards of the Health Insurance Portability & Accountability Act (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Coming as U.S. employers continue to struggle to provide health benefits in the face of skyrocketing health benefit costs, these and other new federal regulations impacting employment-based health plans and their sponsoring businesses, fiduciaries and administrators are forcing U.S. business leaders to make appropriate health plan cost and compliance management a key management priority.

2/17/10 & Other HIPAA Privacy Rule Changes Require Prompt Attention

The HIPAA Privacy Rule changes scheduled to take effect February 17, 2010 are likely to require that health plans and their business associates update their written policies, operational procedures, privacy notices and business associate agreements in several respects.

While the HITECH Act gave covered entities and business associates a year to complete the necessary arrangements to comply with these impending HITECH Act changes, many health plans and business associates have not completed the necessary arrangements despite expanding liability exposures that can result from noncompliance. To mitigate these exposures, covered entities and their business associates should act quickly both to update their services agreements, plans and policies, practices, and procedures, and to implement the training, oversight, and other management procedures necessary to comply with the HITECH Act changes and to mitigate other HIPAA risks.

The risks of noncompliance for health plans, business associates and others mishandling protected health information are real and growing. Wrongful use, access or disclosure of protected health information in violation of HIPAA subjects participating health plans, health care providers, health care clearinghouses, their business associates and other workforce members and others to civil penalties,  criminal prosecution and, since February 17, 2009, civil lawsuits brought by state attorneys general on behalf of citizens of their states whose HIPAA rights were violated.  Since September 23, 2009, health plans and other HIPAA covered entities as well as their  business associates also became obligated to provide breach notification under new mandates imposed by the HITECH Act. 

In addition to these HIPAA-specific exposures, wrongful use, access or disclosure of medical information also can give rise to liability for health plans and other covered entities, business associates, employees and other members of their workforce and others improperly using, accessing or disclosing protected health information.  Federal and state prosecutions may and increasingly do criminally prosecute individuals for improperly accessing or using medical or other personal information under a variety of other federal or state laws .  See e.g., Cybercrime & Identity Theft:Health Information Security Beyond HIPAA; NY AG Cuomo Annoucment of 1st Settlement For Violation of NY Security Breach Notification Law; Woman Who Revealed AIDs Info Gets A Year.  Additionally, State courts also increasingly are permitting individuals harmed by HIPAA violations to use HIPAA as the foundation of state law duties used to maintain state negligence, invasion of privacy, retaliation or other claims for damages. Read more here

To manage these and other HIPAA-related risks, sponsoring employers, fiduciaries, administrators, insurers and their vendors should begin with carefully and timely reviewing and updating existing plan documents, vendor agreements, privacy notices and other communications and associated practices and policies.  The focus of these efforts definitely should seek both to adopt the specific technical changes necessary to make the health plans and their contracts technically comply on paper with these and other HIPAA mandates, and to tailor these documents, communications and practices promote operational compliance and minimize exposure to associated risks.  In relation to these efforts, sponsoring employers, insurers, fiduciaries and administrators also should ensure that required certifications from employers and other plan sponsors, representations from business associates, training and other compliance conditions are properly in place.  In this respect, employers sponsoring health plans should not overlook the potential need to adopt appropriate policies and implement needed training and safeguards to enable the health plan and the employer demonstrate, if necessary that HIPAA’s requirements for sharing protected health information with members of the employer’s workforce for plan administration, underwriting or certain other purposes have been satisfied.

Other Health Plan Updates Also Required

The HIPAA Privacy Rule changes effective today are only part of the ever-growing list of federal mandates that group health plan sponsors, fiduciaries, insurers, administrators and service providers need to be concerned about.  In addition to the new HIPAA Privacy Rule requirements taking effect today, health plans, their sponsors, administrators, fiduciaries, insurers, business associates and other service providers face a host of other new federal health plan and privacy mandates that have taken effect over the past year, and will become subject to additional mandates in upcoming months.  Consequently, while focusing on HIPAA compliance, health plans, their employer or other sponsors, insurers, fiduciaries, administrators and service providers also should not overlook the need to review and update their health plans in response to a host of other changes in federal health plan mandates.

In addition to otherwise applicable civil damage awards and civil penalty exposures that can result from violations of these requirements, new Internal Revenue Service regulations that took effect January 1, 2010 also require that employers, health plans or others self-report violations of certain of these requirements and self assess and pay resulting excise taxes arising under the Internal Revenue Code.  See, e.g., COBRA, HIPAA, GINA, Mental Health Parity or Other Group Health Plan Rule Violations Trigger New Excise Tax Self-Assessment & Reporting Obligations

The highly volatile health plan regulatory environment makes it likely that many health plans are not appropriately updated to comply with these and other federal requirements. In recent months, health plans, their employer or other sponsors, administrators and others also have become obligated to comply with a host of other expanded federal health plan rules and requirements. See e.g., New Mental Health Parity Regulations Require Health Plan Review & Updates; New Labor Department Rule Allows Employers 7 Days To Deliver Employee Contributions To Employee Benefit Plans; Newly Extended COBRA Subsidy Rules Require Employers, Administrators Send Required Notices & Update Health Plan Documents & Procedures Quickly;  Employer & Other Health Plans & Other HIPAA-Covered Entities & Their Business Associates Must Comply With New HHS Health Information Data Breach Rules By September 23.

These and other developments make it imperative that health plans, their employer or other  sponsors, administrators, insurers, fiduciaries and service providers get serious about complying with these and other federal health plan mandates and managing health plan related liabilities and costs. Sponsors, insurers, fiduciaries and administrators should ensure that health plan documents, insurance and other vendor contracts, policies, procedures and communications are timely updated to comply with these and other emerging mandates.  When implementing these updates, parties concerned about costs or liabilities also should exercise care to ensure that plan documents, communications, contracts, administrative forms and procedures are optimally designed and drafted not only to be technically compliant, but also to support the enforceability of plan design and cost expectations, minimize administrative and other avoidable costs, and minimize liability exposures.  In furtherance of these efforts, employer and other plan sponsors also should consider tightening their practices and requirements for credentialing, selection, oversight and contracting with administrators and vendors, and take other prudent steps to manage health plan related risks.

Curran Tomko Tarski LLP Can Help

If your organization need advice or assistance in reviewing, updating, administering or defending its HIPAA or other privacy policies, practices, business associate or other agreements, notices or other related activities, consider contacting Curran Tomko Tarski LLP Partner Cynthia Marcotte Stamer.

A widely published author and speaker on HIPAA and other employee benefit and human resources related matters, Ms. Stamer has extensive experience advising health plans, their employer and other sponsors, health insurers, TPAs and other business associates and others about HIPAA and other health plan and privacy matters. Currently serving as both Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Group and as an ABA Joint Committee on Employee Benefits Council representative and Former Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer has more than 23 years experience assisting employers, insurers, plan administrators and fiduciaries and others to design, implement, draft and administer health and other employee benefit plans and to defend audits, litigation or other disputes by private parties, the IRS, Department of Labor, Office of Civil Rights, Medicare, state insurance regulators and other federal and state regulators. A nationally recognized author and lecturer, Ms. Stamer also speaks and writes extensively on these and other related matters. For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Examples of other recent updates that may be of interest include:

For important information concerning this communication click here.   

 ©2010 Cynthia Marcotte Stamer. All rights reserved.


President Signs Law Extending & Expanding Temporary AARA COBRA Subsidy Requirements For Group Health Plans

December 22, 2009

By Cynthia Marcotte Stamer

Employer and union sponsored group health plans, their sponsors and administrators must act quickly to comply with the extension and expansion of temporary “COBRA Subsidy Rules” for “assistance eligible individuals” originally added to the group health plan medical coverage continuation requirements of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (“COBRA”) by the American Recovery and Reinvestment Act of 2009 (“AARA”) last February.

The Department of Defense Appropriations Act (H.R. 3326) signed into law by President Obama on December 19, 2009 extended the period that employer and union-sponsored group health plans must allow employees and members of their family that lose group health plan coverage due to an involuntary employment loss to continue their group medical coverage under the reduced premium and other temporary ARRA COBRA Subsidy Rules and lengthened the period during which an involuntary employment loss can qualify an otherwise COBRA-eligible employee or dependent as an assistance eligible individual.

Original COBRA Subsidy Rules

As originally enacted, the ARRA COBRA Subsidy Rules limited the COBRA premium that a COBRA-covered group health plan could charge a COBRA-eligible employee or dependent whose group health plan eligibility ended due to an involuntary employment loss between September 1, 2008 and December 31, 2009 (“assistance eligible individual”) to 35% of the otherwise applicable COBRA premium (the “Reduced ARRA Premium”) for a period of up to 9 months (the “Subsidy Period”).  ARRA dictated that employers sponsoring these group health plans must pay the remaining 65% of the COBRA premium (the “COBRA Subsidy”) for the assistance eligible individual during the Subsidy Period, but allowed employers to seek reimbursement by claiming a payroll tax credit for these COBRA Subsidy payments by complying with applicable IRS procedures.  AARA also mandated that group health plans offering a choice of coverage options offer assistance eligible individuals the option to switch coverage options and required group health plans to notify assistance eligible individuals of the special COBRA Subsidy Rules.

H.R. 3326 COBRA Subsidy Rules Extension

As signed into law on December 19, 2009, H.R. 3326:

  • Extends the period during which an involuntary employment loss can qualify an otherwise COBRA-eligible employee or dependent as an assistance eligible individual for an additional two months (from December 31, 2009 to February 28, 2010);
  • Adds an additional six months (from 9 to 15 months) the Subsidy Period during which an assistance eligible individual experiencing an involuntary loss of employment between September 1, 2008 and February 28, 2010 is entitled to pay the Reduced AARA Premium;
  • Requires group health plans to notify assistance eligible individuals of the extension; and
  • Requires group health plans to allow additional time for assistance eligible individuals who had exhausted their original 9-month Subsidy Period before H.R. 3326 extended the Subsidy Period to 15 months to pay the Reduced AARA Premium related to the extension.

Group health plans, their employer or union sponsors, administrators, insurers and service providers will need to act quickly to prepare and provider required updated notifications to assistance eligible individuals of these extended eligibility periods and their resulting rights,  and otherwise update their plan documents, procedures, and COBRA notifications in light of these new rules. 

If you have questions about or need assistance evaluating, commenting on or responding to these or other employment, health or other employee benefit, workplace health and safety, corporate ethics and compliance or other concerns or claims, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer.  The author of the “Health Plan Eligibility Toolkit,” Ms. Stamer is experienced with assisting employers, insurers, administrators, and others to design and administer group health plans cost-effectively in accordance with COBRA and other applicable federal regulations as well as advising and defending employers and others against tax, employment discrimination and other labor and employment, and other related audits, investigations and litigation, charges, audits, claims and investigations by the IRS, Department of Labor and other federal and state regulators.. Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group, a representative to the ABA Joint Committee on Employee Benefits Council, past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group and Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, Ms. Stamer has advised and represented employers on these and other labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 22 years. Ms. Stamer also speaks and writes extensively on these and other related matters.  For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Some other recent updates that may be of interested include the following, which you can access by clicking on the article title:

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2009 Cynthia Marcotte Stamer. All rights reserved. 


DOL Shares 2010 Regulatory Plans Monday, December 7; Get A Sneak Peek on Its Plans

December 5, 2009

Get a peek at the U.S. Department of Labor’s (DOL’s) regulatory plans for 2010 on Monday, December 10, 2009.

On Monday, Dec. 7, the DOL will release its annual regulatory agenda for the upcoming year.  The same day, it also will video cast remarks by Secretary Hilda L. Solis outlining the department’s regulatory agenda beginning at 10 a.m. EST.  From 2 to 3 p.m. EST Ssecretary Solis alsowill host a live Web chat open to the public to discuss the contents of the agenda. Questions may be submitted in advance of the chat following the video presentation. Register to join the chat on Monday here.

If your organization needs assistance with assessing, managing or defending labor and employment, compensation or benefit practices, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer or another Curran Tomko Tarski LLP attorney of your choice.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group and a nationally recognized author and speaker, Ms. Stamer is experienced with advising and assisting employers with these and other labor and employment, employee benefit, compensation, risk management  and internal controls matters. Ms. Stamer is experienced with assisting employers and others about compliance with federal and state equal employment opportunity, compensation, health and other employee benefit, workplace safety, and other labor and employment laws, as well as advising and defending employers and others against tax, employment discrimination and other labor and employment, and other related audits, investigations and litigation, charges, audits, claims and investigations by the IRS, Department of Labor and other federal and state regulators. She has counseled and represented employers on these and other workforce matters for more than 22 years. Ms. Stamer also speaks and writes extensively on these and other related matters. For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Examples of other recent updates you may have missed include:

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2009 Cynthia Marcotte Stamer. All rights reserved.


Senate Finance Chairman Baucus Introduces New Health Care Reform Bill

November 19, 2009

S.1796, America’s Healthy Future Act of 2009 Reflects Chairman’s Response To House’s Passage of HR 3962 & Other Feedback

Senate Finance Committee Chairman Max Baucus (D-MT) today (November 19, 2009) introduced his latest health care reform proposal, the America’s Healthy Future Act of 2009 (S.1796).  Chairman Baucus’ introduction of S. 1796 follows the November 7, 2009 passage by the U.S. House of Representatives of the massive health care reform proposal sponsored by Representative John Dingell (D-MI) and supported by Speaker Nancy Pelosi, the Affordable Health Care for America Act (HR. 3962).

Totaling 1504 pages in length, S.1796 proposes a lengthy and complex array of reforms to the U.S. health care coverage and delivery system, which would affect virtually each U.S. employer, health care provider, payer, and resident. As with the provisions of HR. 3962 and other versions of health care reform, the reforms outlined in the provisions of S.1796 include complexities and nuances which may not be apparent in partisan or non-partisan discussions or summaries of its goals or purposes. Consequently, individuals or businesses concerned about the proposed reforms are encouraged to begin and base their review and analysis on the actual text of S.1796, a copy of which as introduced is available for review here.  

The continuing emphasis of President Obama and other members of the Democratic Party Leadership in Congress on the passage of health care reform means that Senator Baucus and other Democratic Leaders in Congress are likely to continue to make passage of health care reform a priority.  U.S. businesses and individuals concerned about the proposed reforms should carefully review both the Senate and House bills and act quickly to provide their input on any matters of special interest and concern.

Selected Health Coverage Reform Highlights

Among other things, S.1796, as introduced, would enact sweeping health insurance coverage reforms that would create new obligations for employers, insurers, and individual workers.  In this respect, S.1796, among other things would:

  • Amend the Social Security Act (SSA) to add a new title XXII (Health Insurance Coverage) to ensure that all Americans have access to affordable and essential health benefits coverage.
  • Require all health benefits plans offered to individuals and employers in the individual and small group market to be qualified health benefits plans (QHBPs).
  • Amend the Internal Revenue Code to: (1) allow tax credits related to the purchase of health insurance through the state exchanges; and (2) impose an excise tax on individuals without essential health benefits coverage and on employers who fail to meet health insurance coverage requirements with respect to their full-time employees.
  • Prohibit QHBP from excluding coverage for preexisting conditions, or otherwise limiting or conditioning coverage based on any health status-related factors.
  • Require QHBPs to offer coverage in the individual and small group markets on a guaranteed issue and guaranteed renewal basis.
  • Amend the cafeteria plan rules of Internal Revenue Code § 125 to, among other things, require that in order for a health flexible spending arrangement (HFSA) to qualify as a qualified benefit eligible to be offered under a cafeteria plan, the cafeteria plan must limit the maximum salary reduction contribution per employee per taxable year to $2,500 beginning in 2011.
  • Increase the threshold for the itemized income tax deduction for medical expenses.
  • Require states to: (1) establish rating areas; (2) adopt a specified risk adjustment model; and (3) establish transitional reinsurance programs for individual markets.
  • Require QHBP offerors in the individual and small group markets to consider all enrollees in a plan to be members of a single risk pool.
  • Require the Secretary of Health and Human Services (HHS) to establish: (1) risk corridors for certain plan years; (2) high risk pools for individuals with preexisting conditions; (3) a temporary reinsurance program for retirees covered by employer-based plans; and (4) a program under which a state establishes one or more QHBPs to provide at least an essential benefits package to eligible individuals in lieu of offering coverage through an exchange.
  • Entitle a qualified individual to the choice to enroll or not to enroll in a QHBP offered through an exchange covering the individual’s state as well as QHBPs in the individual market while at the same time requiring that such individuals to be U.S. citizens or lawful residents.
  • Require each state to establish: (1) an exchange designed to facilitate enrollment in QHBPs in the individual market; and (2) a Small Business Health Options Program (SHOP) exchange designed to assist qualified small employers in facilitating the enrollment of their employees in QHBPs in either the individual or the small group market.
  • Direct the Secretary to: (1) establish a system allowing state residents to participate in state health subsidy programs; and (2) study methods exchange QHBPs can employ to encourage health care providers to make increased meaningful use of electronic health records.
  • Dictate the mandated contents of an essential health benefit benefits package, including little or no cost-sharing, no annual or lifetime limits on coverage, and preventive services.
  • Amend the Internal Revenue Code to codify and revise the Health Insurance Portability and Accountability Act of 1996 (HIPAA) wellness program regulations.
  • Amend the Internal Revenue Code to codify and revise the Health Insurance Portability and Accountability Act of 1996 (HIPAA) wellness program regulations.
  • With regard to abortions: (1) declare that the Act does not require health care benefits plans to provide coverage for abortions; prohibit QHBPs from discriminating against any individual health care provider or health care facility because of its willingness or unwillingness to provide, pay for, provide coverage of, or refer for abortions; (3) continues application of state and federal laws regarding abortion; (4) prohibit the use of premium credits and cost-sharing subsidies for QHBPs covering abortion services for which federal funding is prohibited; (5) require the plan offeror to determine whether or not the plan provides coverage of abortion services for which federal funding is prohibited or is allowed; and  (6) require the Secretary to assure that at least one QHBP covers abortion services for which federal funding is prohibited or allowed; and at least one QHBP that does not cover abortion services for which federal funding is allowed.

Other Selected Health Care System, Reimbursement & Other Reform Highlights

S.1796 also would expand and modify existing Medicare, Medicaid, CHIP and other federal health care programs and enact a host of other new rules and requirements affecting health care providers, drug companies and other participants in the U.S. health care system.  Other proposed reforms include provisions that would:

  • Require the President to: (1) certify annually in the President’s Budget whether or not the provisions in this Act will increase the budget deficit in the coming fiscal year; and (2) instruct the HHS Secretary and the Secretary of the Treasury to make required reductions in exchange credits and subsidies.
  • Establish a new mandatory eligibility category under SSA title XIX (Medicaid) for all non-elderly, nonpregnant individuals who are otherwise ineligible for Medicaid.
  • Revise Medicaid benefits.
  • Rescind funds available in the Medicaid Improvement Fund for FY2014-2018.
  • Make appropriations for Aging and Disability Resource Center initiatives.
  • Increase the federal medical assistance percentage (FMAP) for states to offer home and community-based services as a long-term care (LTC) alternative to nursing homes.
  • Create a Community First Choice Option.
  • Add a new optional categorically needy eligibility group to Medicaid for individuals: (1) with income that exceeds 133% of the poverty line; and (2) certain other individuals, but only for benefits limited to family planning services and supplies.
  • Direct the Secretary to establish a grants program to support school-based health centers.
  • Remove smoking cessation drugs, barbiturates, and benzodiazepines from Medicaid’s excluded drug list.
  • Revise requirements for Medicaid disproportionate share hospital (DSH) payments.
  • Direct the Secretary to establish a Federal Coordinated Health Care Office within the Centers for Medicare & Medicaid Services (CMMS).
  • Direct the Secretary to establish a Medicaid Quality Measurement Program.
  • Revise requirements for the Medicaid and CHIP Payment and Access Commission (MACPAC) under SSA title XXI, Children’s Health Insurance Program.
  • Set forth special rules relating to American Indians and Alaska Indians.
  • Require the Secretary to establish procedures for sharing data collected under a federal health care program on race, ethnicity, sex, primary language, type of disability, and related measures and data analyses.
  • Amend SSA title V with respect to the Maternal and Child Health (MCH) block grant program.
  • Provide funding for abstinence education.
  • Incorporate reforms originally proposed under the Elder Justice Act of 2009 pursuant to which amendments would be made to the provisions of SSA title XX relating to Block Grants to States for Social Services with respect to elder abuse, neglect, and exploitation and their prevention.
  • Establish within the Office of the Secretary an Elder Justice Coordinating Council.
  • Direct the Secretary to establish a hospital value-based purchasing program under Medicare.
  • Extend the Medicare Physician Quality Reporting Initiative program (PQRI) incentive payments beyond 2010.
  • Modify the Physician Feedback Program.
  • Require the Secretary to develop a plan to implement a Medicare value-based purchasing program for home health agencies and skilled nursing facilities (SNFs).
  • Amend SSA title XVIII (Medicare) to direct the Secretary to establish a national strategy to improve the delivery of health care services, patient health outcomes, and population health.
  • Direct the President to convene an Interagency Working Group on Health Care Quality.
  • Amend the General Provisions of SSA title XI to provide for the establishment of a Center for Medicare and Medicaid Innovation within CMMS.
  • Amend SSA title XVIII to direct the Secretary to establish a shared savings program that promotes accountability for a patient population and coordinates items and services under Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance).
  • Create a Hospital Readmissions Reduction Program.
  • Direct the Secretary to establish a Community-Based Care Transitions Program.
  • Revise requirements with respect to residents in teaching hospitals.
  • Increase the Medicare physician payment update.
  • Direct the Secretary to establish a Working Group on Access to Emergency Medical Care.
  • Extend the Medicare-Dependent Hospital Program.
  • Amend the Tax Relief and Health Care Act of 2006 with respect to the hospital wage index.
  • Establish a Medicare prescription drug discount program for brand-name drugs for beneficiaries who enroll in Medicare part D (Voluntary Prescription Drug Benefit Program) and have drug spending that falls into the coverage gap.
  • Establish an independent Medicare Commission to reduce the per capita rate of growth in Medicare spending.
  • Amend SSA title XI to add a new part D, Comparative Effectiveness Research, under which would be established a Patient-Centered Outcomes Research Institute.
  • Establish in the Department of Treasury the Patient-Centered Outcomes Research Trust Fund.
  • Establish a nationwide program for national and state background checks on direct patient access employees of long term care facilities and providers.
  • Direct the Secretary to establish new procedures for screening providers of medical or other items or services and suppliers under the Medicare, Medicaid, and CHIP programs.
  • Direct the Secretary to establish a self-referral disclosure protocol to enable health care service providers and suppliers to disclose violations.
  • Requires the Secretary to expand the number of areas included in Round Two of the durable medical equipment (DME) competitive bidding program.
  • Extend the period for collection of overpayments due to fraud.
  • Amend the Internal Revenue Code with respect to: (1) an excise tax on the excess benefit of high cost employer-sponsored health coverage; (2) distributions from health savings accounts for drugs and insulin that are prescribed drugs and insulin only; (3) a limitation on salary reduction contributions by employers to a health flexible spending arrangement; (4) expanded information reporting requirements; (5) additional qualifying requirements for charitable hospital organizations; and (6) a qualifying therapeutic discovery project tax credit.
  • Impose annual fees on: (1) manufacturers and importers of branded prescription pharmaceuticals or of medical devices; and (2) health insurance providers.
  • Prescribe a special rule to limit excessive remuneration by certain health insurance providers.
  • Exclude from an individual’s gross income the value of any qualified Indian health care benefit.

Monitoring & Responding To Health Care Reform Proposals

As was the case with HR. 3962, members of the Senate are likely to debate and weigh a variety of amendments and refinements to the provisions of S.1796 as it deliberates its enactment.  If you or someone else you know would like to receive updates about health care reform proposals and other related legislative, regulatory, and enforcement developments, please:

  • Register for this resource at the link above;
  • Join the Coalition for Responsible Health Policy group at linkedin.com to share information and input and join in other dialogue with others concerned about health care reform;
  • Share your input by communicating with key members of Congress on committees responsible for this legislation and your elected officials directly and by actively participating in and contributing to other like-minded groups; and
  • Be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here

If you have questions about or need assistance evaluating, commenting on or responding to health care or other legislative or regulatory reforms, or any other employment, compensation, employee benefit, workplace health and safety, corporate ethics and compliance practices, concerns or claims, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment/Employee Benefits  Practice Chair Cynthia Marcotte Stamer. 

Ms. Stamer has more than 22 years of experience advising and assisting business, government and other clients to evaluate and respond to health care, pension reform, workforce and other proposed or adopted changes in federal or state health care, employee benefit, employment, tax and other federal and state laws.  A member of the leadership council of the American Bar Association Joint Committee on Employee Benefits, Chair of the ABA Real Property, Probate & Trust Section and Employee Benefits & Compensation Group and past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group Ms. Stamer is highly regarded legal advisor, policy advocate, author and speaker recognized both nationally and internationally for her more than 20 years of work assisting U.S. public and private employers, health care providers, health insurers, and a broad range of other clients to respond to these and other health care, employee benefit and workforce public policy, regulatory and compliance and risk management concerns within the U.S. as well as internationally.  Her work includes extensive involvement providing input and assistance about health care, workforce, pensions and social security and other reforms domestically and internationally.  In addition to her continuous involvement in U.S. health care, pensions and savings, and workforce policy matters, Ms. Stamer has served as an advisor on these matters internationally.  As part of this work, she served as a lead advisor to the Government of Bolivia on its social security reform as well as has provided input on ethics, medical tourism, workforce and other reforms internationally.

In addition to her extensive work on health and other employee benefit matters, Ms. Stamer also is Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and has continuously has advised and represented employers and others on labor and employment, compensation, employee benefit and other personnel and staffing matters throughout her career. Ms. Stamer is experienced with assisting employers and others about compliance with federal and state equal employment opportunity, compensation and employee benefit, workplace safety, and other labor and employment, as well as advising and defending employers and others against tax, employment discrimination and other labor and employment, and other related audits, investigations and litigation, charges, audits, claims and investigations by the IRS, Department of Labor and other federal and state regulators. Ms. Stamer is a widely published author and popular speaker on health plan and other human resources, employee benefits and internal controls issues.   Her work has been featured and published by the American Bar Association, BNA, SHRM, World At Work, Employee Benefit News and the American Health Lawyers Association.  Her insights on human resources risk management matters have been quoted in The Wall Street Journal, the Dallas Business Journal, Managed Care Executive, HealthLeaders, Business Insurance, Employee Benefit News and the Dallas Morning News.

If your organization needs assistance with monitoring, assessing, or responding to these or other health care, employee benefit or human resources reforms,  please contact Ms. Stamer via e-mail here, or by calling (214) 270-2402.  For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here. For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Some other recent updates that may be of interested include the following, which you can access by clicking on the article title:

Proposed Chemical Facility Anti-Terrorism Bill Would Obligate Chemical Facilities To New Background Check, HR & Other Safety & Security Safeguards

IRS Rules For Employer Reporting Of Wages Paid to Nonresident Alien Employees Performing Services In U.S. Change

House Passes Affordable Health Care For America, Health Care Reform Debate Focus Now Moves To The Senate

SHRM Tells Members Say “NO!” To Pelosi-Backed Health Care Reform

IRS Updates Procedures Qualifying Small Employers Can Use To Qualify To Report Employment Taxes Annually Rather Than Quarterly

OSHA Proposes To Change Hazard Communication Standard

IRS Proposes Changes In Actuarial Enrollment Standards For Performance of Actuarial Services Under the Employee Retirement

EEOC Prepares To Broaden “Disability” Definition Under ADA Regulations

IRS Proposes To Update Regulations On Exclusion of Damages Received on Account of Personal Physical Injuries or Physical Sickness To Eliminate Tort Test

OSHA Final Rule Updates OSHA Personal Protective Equipment Standards

DOL Proposes Changes To H-2A Temporary & Seasonal Agricultural Nonimmigrant Worker Certification Procedures & Related Rules

ADAAA Amendment Broader ADA “Disability” Definition Not Retroactive, Employer Action Needed To Manage Post 1/1/2009 Risks

New Study Shares Data On Migrant Health Care Challenges Along The Border

Employer & Other Health Plans & Other HIPAA-Covered Entities & Their Business Associates Must Comply With New HHS Health Information Data Breach Rules By September 23

HHS Reassignment Of HIPAA Enforcement Duties Signals Rising Seriousness of Enforcement Commitment

Speak Up America: Where & How To Read & Share Your Feedback About The Health Care Reform Legislation

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2009 Cynthia Marcotte Stamer. All rights reserved. 


House Passes Affordable Health Care For America, Health Care Reform Debate Focus Now Moves To The Senate

November 9, 2009

The U.S. House of Representatives passed the massive health care reform bill introduced by Representative John Dingle and backed by House Speaker Nancy Pelosi, H.R. 3962, the Affordable Health Care for America Act (HR 3962) by a recorded vote of 220 – 215 late Saturday, November 7, 2009 after a day of debate which lead to the adoption of an amendment prohibiting the use of federal funds for abortion services in the public option.  The health care reform debate now moves to the Senate. 

As of this morning (November 9, 2009), the U.S. Government Printing Office had not released an official copy of the text of H.R. 3962 revised to reflect the amendments adopted by the House on Saturday prior to its passage of H.R. 3962.  However, a record of the amendments approved by House members before passage of H.R. 3962 along with text of the bill prior as originally introduced on October 29, 2009 are available for review online here.

We also encourage you and others to join the discussion about these and other health care reform proposals and concerns by joining the Coalition for Responsible Health Care Reform Group on Linkedin, registering to receive these updates here

If you have questions about or need assistance monitoring, evaluating, commenting on or responding to this or any other health care reform proposal or other federal or state health care, workforce or other legislative, regulatory or other developments or concerns, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group, Ms. Stamer is experienced with assisting employers and others about compliance with federal and state health care, employee benefit, workforce and other legislation and regulation. Ms. Stamer has advised and represented clients about these and other health care labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 20 years. Ms. Stamer also speaks and writes extensively on these and other related matters. Her public policy experience includes ongoing involvement in these concerns within the U.S. for 30 years, as well as serving as a policy advisor on Social Security Reform to the Government of Bolivia and providing input or other representation to various other clients on workforce, health care and other policies in various other regions of the world. 

For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2009 Cynthia Marcotte Stamer. All rights reserved. 


SHRM Tells Members Say “NO!” To Pelosi-Backed Health Care Reform

November 6, 2009

In a rare weekend meeting, the House of Representatives is scheduled to  consider H.R. 3962, the Affordable Health Care for America Act and, if Speaker Nancy Pelosi has her way, vote to pass it as early as this weekend. 

In anticipation of this action, the Society For Human Resources (SHRM) is voicing strong opposition to H.R. 3962 and  urging U.S. citizens and businesses to express their strong opposition to it as well to members of Congress immediately.

According to communications circulated this week, SHRM “strongly supports comprehensive health care reform that strengthens the employer-based system, promotes wellness programs and health promotion initiatives, strengthens the Employee Retirement Income Security Act (ERISA), increases purchaser and consumer access to cost and quality information and increases access to affordable health coverage.  SHRM says the House bill fails to achieve these goals.  Accordingly, SHRM is urging American’s to contact their Representative today to urge a NO VOTE on H.R. 3962.

 SHRM’s concerns about the proposal include that H.R. 3962:

  • Does not include provisions to facilitate greater availability of wellness programs among employers and employees. 
  • Does not include meaningful cost, quality, or transparency provisions to ensure that both employers and employees have better access to health-related information.
  • Requires employers to provide and pay for “qualified” health care coverage or face an 8 percent payroll tax.  Employers must pay 72.5 percent of the premium for individuals and 65 percent of the premium for families.  In addition, even if an employer provides and pays for health insurance coverage for their workforce, that employer could still be subject to an 8 percent payroll tax if employees decline employer coverage because it is unaffordable – defined as more than 12 percent of the employee’s income.
  • Would erode the Employee Retirement Income Security Act (ERISA) by applying state law remedies to employer purchased coverage  in a health insurance exchange; prohibiting post-retirement reductions of retiree health benefits by group health plans, unless reductions are also made to active employees’ health benefits; and requiring employer-sponsored plans to meet detailed federal requirements that will increase costs.
  • Includes a public insurance plan option that raises serious concerns about cost-shifting to private plans. SHRM objects because inadequate reimbursement practices under Medicare and Medicaid has resulted in significant cost-shifting to private plans, increasing costs for both employers and employees. 

In light of these concerns, SHRM is asking all members and other concerned Americans to write mMembers of Congress TODAY and urge them to oppose the Affordable Health Care for America Act. It invites members to use SHRM’s HRVoice to share thes econcernings by:

  • Log ging onto HR Voice
  • Under the heading “Take Immediate Action on these Hot Issues,” click on:   “VOTE NO on the Affordable Health Care for America Act (H.R. 3962)” and
  • Personalizing and sending individualized letters by including specific information about the organization you work for, your experiences in the workplace, and why this legislation would negatively impact your organization. 

If you have questions about or need assistance monitoring, evaluating, commenting on or responding to this or any other health care reform proposal or other federal or state health care, workforce or other legislative, regulatory or other developments or concerns, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group, Ms. Stamer is experienced with assisting employers and others about compliance with federal and state health care, employee benefit, workforce and other legislation and regulation. Ms. Stamer has advised and represented clients about these and other health care labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 20 years. Ms. Stamer also speaks and writes extensively on these and other related matters. Her public policy experience includes ongoing involvement in these concerns within the U.S. for 30 years, as well as serving as a policy advisor on Social Security Reform to the Government of Bolivia and providing input or other representation to various other clients on workforce, health care and other policies in various other regions of the world. 

For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.


SHRM Urges American’s To Oppose HR 3962, The Affordable Health Care For America Act

November 6, 2009

In a rare weekend meeting, the House of Representatives is scheduled to  consider H.R. 3962, the Affordable Health Care for America Act and, if Speaker Nancy Pelosi has her way, vote to pass it as early as this weekend. 

In anticipation of this action, the Society For Human Resources (SHRM) is voicing strong opposition to H.R. 3962 and  urging U.S. citizens and businesses to express their strong opposition to it as well to members of Congress immediately.

According to communications circulated this week, SHRM “strongly supports comprehensive health care reform that strengthens the employer-based system, promotes wellness programs and health promotion initiatives, strengthens the Employee Retirement Income Security Act (ERISA), increases purchaser and consumer access to cost and quality information and increases access to affordable health coverage.  SHRM says the House bill fails to achieve these goals.  Accordingly, SHRM is urging American’s to contact their Representative today to urge a NO VOTE on H.R. 3962.

 SHRM’s concerns about the proposal include that H.R. 3962:

  • Does not include provisions to facilitate greater availability of wellness programs among employers and employees. 
  • Does not include meaningful cost, quality, or transparency provisions to ensure that both employers and employees have better access to health-related information.
  • Requires employers to provide and pay for “qualified” health care coverage or face an 8 percent payroll tax.  Employers must pay 72.5 percent of the premium for individuals and 65 percent of the premium for families.  In addition, even if an employer provides and pays for health insurance coverage for their workforce, that employer could still be subject to an 8 percent payroll tax if employees decline employer coverage because it is unaffordable – defined as more than 12 percent of the employee’s income.
  • Would erode the Employee Retirement Income Security Act (ERISA) by applying state law remedies to employer purchased coverage  in a health insurance exchange; prohibiting post-retirement reductions of retiree health benefits by group health plans, unless reductions are also made to active employees’ health benefits; and requiring employer-sponsored plans to meet detailed federal requirements that will increase costs.
  • Includes a public insurance plan option that raises serious concerns about cost-shifting to private plans. SHRM objects because inadequate reimbursement practices under Medicare and Medicaid has resulted in significant cost-shifting to private plans, increasing costs for both employers and employees. 

In light of these concerns, SHRM is asking all members and other concerned Americans to write mMembers of Congress TODAY and urge them to oppose the Affordable Health Care for America Act. It invites members to use SHRM’s HRVoice to share thes econcernings by:

  • Log ging onto HR Voice
  • Under the heading “Take Immediate Action on these Hot Issues,” click on:   “VOTE NO on the Affordable Health Care for America Act (H.R. 3962)” and
  • Personalizing and sending individualized letters by including specific information about the organization you work for, your experiences in the workplace, and why this legislation would negatively impact your organization. 

If you have questions about or need assistance monitoring, evaluating, commenting on or responding to this or any other health care reform proposal or other federal or state health care, workforce or other legislative, regulatory or other developments or concerns, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group, Ms. Stamer is experienced with assisting employers and others about compliance with federal and state health care, employee benefit, workforce and other legislation and regulation. Ms. Stamer has advised and represented clients about these and other health care labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 20 years. Ms. Stamer also speaks and writes extensively on these and other related matters. Her public policy experience includes ongoing involvement in these concerns within the U.S. for 30 years, as well as serving as a policy advisor on Social Security Reform to the Government of Bolivia and providing input or other representation to various other clients on workforce, health care and other policies in various other regions of the world. 

For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.


Senate Finance Bill Finishes Drafting & Releases For Review the America’s Healthy Future Act Bill Language

October 22, 2009

Americans finally have a chance to read the actual statutory language of the painfully negotiated package of proposed health care reforms that the Senate Finance Committee proposes for adoption.  The Senate Finance Committee leadership finally finished drafting has posted the 1506 page long text of the proposed statutory language of the health care reform provisions of the “America’s Healthy Future Act” on its website here.

When the Senate Finance Committee vote passing the America’s Health Future Act, members of the Senate Finance Committee had not yet had the opportunity to review the actual statutory language to be proposed to implement the package of heatlh care reforms painfully hashed out in their committee.  As the actual statutory language had not been completed at the time a majority of the Democrats and one Republican Senator serving on the Senate Finance Committee voted to send the legislation to the the full Senate, the vote actually was taken based on a narative description of the intended reforms set forth in a revised draft of the “Chairman’s Mark” of the legislation.  Since that time Senate Finance Committee Chairman Max Baucus and other key Democrat Senators on the Senate Finance Committee have worked behind closed doors to prepare the actual statutory language to be presented to the full Senate.

As proposed, the America’s Healthy Future Act would require sweeping changes to the U.S. health care systems that would radically impact the roles and responsibilities of every patient, health care provider, health care payor, employer and other American.  Because of the potential implications on the way health care is financed, delivered and administered and the projections that the legislation will cost approximately $1 Trillion, all parties are urged to carefully review the complex and lengthy legislation to gain an understanding of the legislation and to act quickly to make any concerns known to elected leaders in Congress. 

If you need help evaluating or responding to this health care reform legislation or with other employee benefit, compensation, employee benefit or insurance matters, please contact the author of this update, Cynthia Marcotte Stamer.  Current Chair of the American Bar Association (ABA) RPTE Section Employee Benefits & Other Compensation Group and the former Chair of the ABA Health Law Section Managed Care & Insurance Group, Ms. Stamer has more than 20 years experience advising employers, private and public health plans and their sponsors, insurers and administrators and others about health care policy, regulatory compliance, risk management and operational issues,

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Some other recent updates that may be of interested include the following, which you can access by clicking on the article title:

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2009 Cynthia Marcotte Stamer. All rights reserved. 


New Study Shares Data On Migrant Health Care Challenges Along The Border

August 24, 2009

Health care costs, care concerns and other health care utilization and risk patterns are a common issue of discussion in the continuing health care reform discussion. Meanwhile, employers, health care providers and policy leaders in Border States or elsewhere who employ a significant number of migrant workers frequently express interest in more information about the health care and disability care and benefit needs, understanding and utilization patterns of migrant families for purposes of planning benefit and human resources practices. A new report published by the Texas Department of State Health Services may shed some light on these issues. The Texas Department of State Health Services 2007 Health Risk Factors in the Texas-Mexico Border report presents a summary of health-related risk factors and trends among residents of fifteen Texas counties along the US-Mexico border. Its findings are based on data collected through the 2007 Behavioral Risk Factor Surveillance System (BRFSS), a nation-wide telephone-based survey of randomly-selected adults that gathers information on many conditions and behaviors known to influence personal health. Data from the fifteen counties were clustered into five areas: the Lower Rio Grande Valley – commonly known as ‘The Valley’ – (Hidalgo, Starr, and Cameron Counties), Webb and Zapata Counties, Val Verde and Maverick Counties, the Big Bend area (Brewster, Culberson, Hudspeth, Jeff Davis, Pecos, Presidio, and Terrell Counties), and El Paso County. For the purposes of this analysis, “the border” refers to these five areas. Interested persons can review this report here.

About The Author

Past Chair of the ABA Health Law Section Managed Care & Insurance Section and currently the Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Section and a Council Representative of the ABA Joint Committee On Employee Benefits, Ms. Stamer has more than 20 years experience advising health industry and other clients about labor and employment, health and other employee benefits, public policy and other health care and workforce matters. A primary drafter of the Bolivian Social Security Privatization law, Ms. Stamer also frequently provides input domestically and internationally on workforce, health care, migration and other policies. A popular lecturer and widely published author on these and other matters, she frequently writes and speaks about health and workforce issues of special populations including migrant workers, ex pats, and others.  Her insights on health care, health insurance, human resources and related matters appear in the Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Managed Healthcare, Health Leaders, and a many other national and local publications.  For additional information about Ms. Stamer, her experience, involvements, programs or publications, see here.  

Other Helpful Resources & Other Information

If you found these updates of interest, you also be interested in one or more of the following other recent articles published on our electronic Curran Tomko Tarski LLP publications available for review here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here. You can access other recent updates and other informative publications and resources provided by Curran Tomko Tarski LLP attorneys and get information about its attorneys’ experience, briefings, speeches and other credentials here. For important information concerning this communication click here. If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@cttlegal.net.

©2009 Cynthia Marcotte Stamer. All rights reserved.


House Democratic Majority Hopes To Iron Out Differences In Key Health Care Reform Legislation During August Recess

August 4, 2009

Democratic Leaders in the House of Representatives plan to hammer out differences three versions of the America’s Affordable Health Choices Act (H.R. 3200) as separately passed by three key House Committees in July before House members return from their August recess in hopes of bringing the agreed to version of H.R. 3200 to the full house in September.   Each version of H.R. 3200 would impose significant new obligations, regulations and costs on employers, health insurers and health plans, and employees.

After negotiating a last minute pre-August recess deal with certain Blue Dog Democrat Committee members, the House Energy and Commerce Committee on July 31, 2009 passed its version of H.R. 3200, the America’s Affordable Health Choices Act (H.R. 3200). The version of H.R. 3200 passed by the House Energy and Commerce Committee incorporates a series of amendments to the language of H.R. 3200 as originally introduced.  For instance, this version of H.R. 3200 provides incentives for states to adopt certain tort reforms, provides for a public plan option that would reimburse physicians based on negotiated rates rather Medicare rates, and would allow states to offer both state-based heath insurance exchanges and health insurance co-ops. To review H.R. 3200 as amended by the House Energy and Commerce Committee, see here.

The approval by the Energy and Commerce Committee of its version of H.R. 3200 follows the July 17, 2009 approval by the House Ways and Means Committee and Education and Labor Committee of their own versions of H.R. 3200.  For details on the version of H.R. 3200 approved by the House Ways and Means Committee, see here.  For details on the version of H.R. 3200 approved by the House Education and Labor Committee, see here

Leading House Democrats have announced their intention to work to resolve differences between these three versions of H.R. 3200 as passed by these Committees during August recess in hopes of  bringing the agreed to version of H.R. 3200 to a vote  of the full House of Representatives in September.

Meanwhile, House members from both parties also generally are using the August recess as an opportunity to reconnect with local constituents on health care reform and other core issues.

For More Information

The author of this article, Curran Tomko and Tarski LLP Partner  Cynthia Marcotte Stamer has extensive experience advising and assisting employers and other health plan sponsors, insurers and others about health benefit and other benefits, human resources and health care matters.  The current Chair of the American Bar Association Real Propoerty, Probate & Trust Section Employee Benefit Plans and Other Compensation Committee and former Chair of the ABA Health Law Section Managed Care & Insurance Group, she regularly advises these and other clients about the design, administration, defense  and regulation of health benefit, wellness and disease management, managed care, onsight wellness, and other benefit and insurance regulations, legislative and regulatory reforms impacting these and other arrangements, and related matters.  

We hope that this information is useful to you.  If you need assistance monitoring, evaluating or responding to these or other proposed health care or other regulatory reforms or with other health care compliance, risk management, transaction or operation concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270-2402, cstamer@cttlegal.com or your other favorite Curran Tomko Tarski LLP Partner.

We also encourage you and others to join the discussion about these and other health care reform proposals and concerns by joining the Coalition for Responsible Health Care Reform Group on Linkedin, registering to receive these updates here.

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information to cstamer@cttlegal.com.  If you prefer not to receive these updates via e-mail in the future, e-mail your request with “remove” in the subject to support@solutionslawyer.net.


Speak Up America: Where & How To Read & Share Your Feedback About The Health Care Reform Legislation

August 1, 2009

As the health care reform policy debate continues, Americans increasingly are asking where to read the text of the health care reform legislation that members of Congress are debating and how to share their input. 

 While numerous alternatives presently are pending before Congress, much of recent discussion and debate has focused around one of the following bills:

  • H.R. 3200: America’s Affordable Health Choices Act of 2009,  introduced in the House by Rep Dingell, John D. on July 14, 2009  the text of which as originally introduced may be reviewed  here.  It has been the focus of significant mark up negotiation through out July before the following House Energy and Commerce, House Ways & Means, and House Education & Labor Committees; and
  • S. __, the Affordable Health Choices Act approved by the Senate Committee on Health, Education, Labor and Pensions, the text of which as approved may be reviewed here.

When reviewing these bills, Americans should keep in mind that members of Congress are engaged in ongoing negotiations about the specific provisions and language of these bills, as well as other legislation.  Official developments generally may be monitored here.

Many American businesses and individuals also are asking about how and where to share their views, how to organize others to do the same and other questions about getting the word out. Here a some quick ideas. We encourage others to share. 

  • The Coalition For Patient Empowerment and the Coalition for Responsible Health Care Reform linkedin group are two one of many resources where individuals are sharing information about these matters. 
  • Concerned individuals should share their views both by faxing, e-mailing or telephoning key decisionmakers in Congress, as well as joining and participating in activities of other individuals and groups that share their concerns.  Contact and get involved with this and other groups that share your concerns.
  • Contact the offices of your Congressional representatives in the House and Senate as well as other members of Congress that support your views and ask them about other groups and ways that you can share your views. They will welcome your input and involvement.
  •  If you are aware of or involved in a group that shares your views, we encourage you to share it on the Coalition for Responsible Health Care Reform linkedin group.  If you or others are planning a town hall or other health care reform meeting, use this or other linked in groups to spread the word.
  • If you are interested in volunteering to plan events in your region, let us know.   

We also encourage you and others to join the discussion about these and other health care reform proposals and concerns by joining the Coalition for Responsible Health Care Reform Group on Linkedin, and registering to receive these updates here.

When communicating, consider targeting your messages to members of Congress whose votes are likely to be impacted by your communications. 

For instance, with both the House and Senate in the majority in Congress, Democrats generally have greater control over what legislation moves forward.  The Democratic Leadership of the House and Sentate generally can get legislation passed by their members as long as they can maintain consensus among the members of their parties.  In connection with the health care reform proposals, however, cost and other considerations have made maintaining a consensus more difficult than on other legislation.  Certain fiscally moderate members of the Democratic Party have expressed concern about the expense and other aspects of their Leadership proposed health care reform proposals.  These Democrats in Congress generally the members of Congress whose votes are most likely to be impacted by public input and feedback generally and from voters in their districts and contributors specifically. 

In the House of Representatives, these members likely are the “Blue Dog Democrats.”  Read about Blue Dog Democrats here.    

The fiscal conservatism of Blue Dog Democrats makes them more likely to listen to concerns about the cost and other concerns relating to the health care reform bills touted by the Democrat Leadership in the House and Senate.  In fact, many Blue Dog Democrats already are speaking out about their concerns about the cost and other aspects of the Bill. 

Contact from voters and contributors in their districts and others could make a major difference in the ability that the House Democrat Leadership needs to pass their Bill.  Immediately contacting these members and getting others – particularly voters and contributors in the districts that elect these members – is one of the most important steps that concerned Americans can do to position their concerns to be heard.   

For most concerned voters, telephone or fax contact is the best means to convey these messages.  To minimize spam, most members only accept e-mail submitted through their website links.  Security concerns can delay receipt of written correspondence for weeks.

For persons interested in making their voices heard and sharing information with others who wish to do the same, the following contact information may be of interest:

The number of the Capital Switchboard is 202-224-3121.

The Blue Dog Leadership Team and there telephone and fax numbers are:

Rep. Stephanie Herseth Sandlin (SD), Blue Dog Co-Chair for Administration, Telephone: 202.225.2801 , Fax: 202.225.5823

Rep. Baron Hill (IN-09), Blue Dog Co-Chair for Policy,Telephone: 202-225-4031, Fax: (202) 226-6866

Rep. Charlie Melancon (LA-03), Blue Dog Co-Chair for Communications, Telephone: 202-225-4031, Fax: (202) 226-3944

Rep. Heath Shuler (NC-11), Blue Dog Whip, Telephone:  202-225-6401, Fax: (202) 226-6422

The Blue Dog Members and their telephone numbers are :

  • Altmire, Jason (PA-04),(202)225-2565
  • Arcuri, Mike (NY-24), (202)225-3665
  • Baca, Joe (CA-43),(202)225-6161
  • Barrow, John (GA-12), (202) 225-2823
  • Berry, Marion (AR-01), (202) 225-4076
  • Bishop, Sanford (GA-02), (202) 225-3631
  • Boren, Dan (OK-02), (202) 225-2701
  • Boswell, Leonard (IA-03), (202) 225-3806
  • Boyd, Allen (FL-02), (202) 225-5235
  • Bright, Bobby (AL-02), (202) 225-2901
  • Cardoza, Dennis (CA-18), (202) 225-6131
  • Carney, Christopher (PA-10), (202) 225-3731
  • Chandler, Ben (KY-06), (202) 225-4706
  • Childers, Travis (MS-01), (202) 225-4306
  • Cooper, Jim  (TN 5th), (202) 225-4311
  • Costa, Jim  (CA 20th), (202) 225-3341
  • Cuellar, Henry  (TX 28th), (202)  225-1640
  • Dahlkemper, Kathleen A. (PA 3rd), (202) 225-5406
  • Davis, Lincoln (TN 4th),(202) 225-6831
  • Donnelly, Joe  (IN 2nd), (202) 225-3915
  • Ellsworth, Brad  (IN 8th), (202) 225-4636
  • Giffords, Gabrielle  (AZ 8th), (202) 225-2542
  • Gordon, Bart  (TN 6th), (202) 225-4231
  • Griffith, Parker  (AL 5th), (202) 225-4801
  • Harman, Jane  (CA 36th), (202) 225-8220
  • Herseth Sandlin, Stephanie  (SD At Large), (202) 225-2801
  • Hill, Baron P.  (IN 9th), (202) 225-5315
  • Holden, Tim  (PA 17th), (202) 225-5546
  • Kratovil, Frank Jr. (MD 1st), (202) 225-5311
  • McIntyre, Mike  (NC 7th), (202) 225-2731
  • Marshall, Jim  (GA 8th), (202) 225-6531
  • Matheson, Jim  (UT 2nd), (202) 225-3011
  • Melancon, Charlie  (LA 3rd), (202) 225-4031
  • Michaud, Michael H. (ME 2nd), (202) 225-6306
  • Minnick, Walt  (ID 1st), (202) 225-6611
  • Mitchell, Harry E.  (AZ 5th), (202) 225-2190
  • Moore, Dennis  (KS 3rd), (202) 225-2865
  • Murphy, Patrick J.  (PA 8th), (202) 225-4276
  • Nye, Glenn C.  (VA 2nd), (202) 225-4215
  • Peterson, Collin C.  (MN 7th), (202) 225-2165
  • Pomeroy, Earl  (ND At Large), (202) 225-2611
  • Ross, Mike  (AR 4th), (202)  225-3772
  • Salazar, John T.  (CO 3rd), (202) 225-4761
  • Sanchez, Loretta  (CA 47th), (202) 225-2965
  • Schiff, Adam B.  (CA 29th), (202) 225-4176
  • Scott, David  (GA 13th), (202) 225-2939
  • Shuler, Heath  (NC 11th), (202) 225-6401
  • Space, Zachary T. (OH 18th), (202) 225-6265
  • Tanner, John S.  (TN 8th), (202) 225-4714
  • Taylor, Gene  (MS 4th), (202) 225-5772
  • Thompson, Mike  (CA 1st), (202) 225-3311
  • Wilson, Charles (OH-06), (202) 225-5705

You and others also are invited to join the discussion about these and other health care reform proposals and concerns by:

  • Joining the Coalition for Responsible Health Care Reform Group on Linkedin and registering to receive these updates here; and
  • E-mailing Cstamer@cttlegal.com to participate in the Coalition for Patient Empowerment.

Curran Tomko Tarski LLP Can Help

If your business needs assistance monitoring or providing input on health care reform or other human resources, employee benefit or compensation legislation or regulations, or auditing, updating or defending its health or other employee benefit, human resources, or compensation arrangements, or responding to employee benefits, employment or compensation related charges or suits, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402; or your favorite Curran Tomko Tarski, LLP attorney.  For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi, LLP team, see here.

The author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer and other members of Curran Tomko and Tarski LLP are experienced with assisting employer and employee benefit plan sponsors, administrators and others about labor and employment, compensation and employee benefit compliance and risk management concerns, as well as advising and defending these and other clients in labor and employment, compensation, and employee benefit related audits, investigations and litigation, charges, audits, claims and investigations.  

Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, Chair of the ABA RPTE Employee Benefit Plans and Other Compensation Group, a member of the ABA Joint Committee on Employee Benefits, and past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer has extensive experience with health and retirement, work force and other employee benefit and employment matters.  She is nationally and internationally known for her innovative work with employers, associations, churches, insurers and others to develop health benefit, onsight medical, wellness and other employee benefit and employment arrangements, as well as her involvement in health care, pension and other public policy advocacy.

More Information & Resources

You can review other recent human resources, employee benefits and internal controls publications and resources and additional information about the employment, employee benefits and other experience of Ms. Stamer here /the Curran Tomko Tarski LLP attorneys here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information to Cstamer@CTTLegal.com or registering to participate in the distribution of these and other updates on our Solutions Law Press HR & Benefits Update distributions here. For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net.

©2009 Cynthia Marcotte Stamer. All rights reserved.


OFCCP To Apply Special Procedures, Heightened Scrutiny To Equal Employment Practices of Government Contractors, Subcontractors On ARRA Funded Projects

July 20, 2009

U.S. businesses engaged to provide services on projects funded from the $787 billion of stimulus funding provided under the American Recovery and Reinvestment Act of 2009 (“ARRA”) signed into law by President Barack Obama in February, 2009 will face heightened equal employment opportunity scrutiny and be subject to special procedures by the Office of Federal Contract Compliance Programs (“OFCCP”) according to “Procedures for Scheduling and Conducting Compliance Evaluations of American Recovery and Reinvestment Act of 2009 (ARRA) Funded Contractors” issued July 7, 2009.  See OFCCP Order No. ADM 0901/SEL the “ARRA Procedures”). 

Businesses providing services or supplies on ARRA funded projects directly or as subcontractors be considered government contractors, required to comply with the equal employment opportunity requirements of  Executive Order 11246, as amended (EO 11246); Section 503 of the Rehabilitation Act of 1973,as amended (Section 503); and the Vietnam Veterans’ Readjustment Assistance Act of 1974, as amended, 38 U.S.C. 4212 (VEVRAA).   OFCCP has made clear that it will conduct compliance evaluations and host compliance assistance events to ensure that federal contractors comply and are aware of their responsibilities under EO 11246, Section 503 and VEVRAA. 

A review of the ARRA Procedures makes clear that ARRA funded contractors can expect to face much more rigorous scrutiny during their compliance audits that normally applies in non-ARRA contract compliance reviews.

OFCCP has established separate scheduling procedures to provide for compliance evaluations of ARRA funded contractors separate from those usually applicable to government contractors because ARRA obligates OFCCP separately to track its ARRA-related and non-ARRA-related enforcement activities.

The ARRA Procedures require that Regional, District and Area offices conduct a full compliance evaluation, including a full desk audit and onsite review, of every ARRA funded contractor establishment scheduled, even in the absence of systemic discrimination indicators. Normally applied by OFCCP to non-ARRA government contract reviews, Active Case Management (ACM) procedures normally allow OFCCP to conduct only an abbreviated desk audit in the absence of systematic discrimination indicators in non-ARRA compliance evaluations.  These ACM procedures will not be used in ARRA compliance evaluations. 

Due to the special nature of ARRA, OFCCP also has indicated that the ARRA compliance evaluations will not apply the following scheduling exceptions typically applicable in non-ARRA contract compliance reviews:

  • No more than 25 establishments per contractor exception: Presently, for contractors with multiple establishments, the Federal Contractor Scheduling System (FCSS) limits the number of compliance evaluations scheduled to 25 new evaluations during a scheduling cycle. The 25-establishment limit does not apply to ARRA compliance evaluations.
  • Two year exception: Presently, contractor establishments that have been reviewed by OFCCP are excepted from further review for a 24-month period. Under ARRA scheduling procedures, ARRA funded contractor establishments may be eligible for an ARRA compliance evaluation even if they have been reviewed within the previous 24 months. However, pre-award clearance is not required for contractor establishments reviewed by OFCCP within the past 24 months.

However, ARRA scheduling procedures will apply the following scheduling exceptions:

  • ARRA funded contractor establishments that have undergone an FCSS compliance evaluation will be excepted from scheduling and review under ARRA procedures for six months from the date of the FCSS case closure.
  • ARRA funded contractor establishments that have undergone an ARRA compliance evaluation will not be subject to another ARRA evaluation.
  • ARRA funded contractor establishments that have undergone an ARRA evaluation will also be excepted from scheduling for a standard OFCCP compliance evaluation, pursuant to FCSS, for 24 months from the date of closure of the ARRA compliance evaluation.

ARRA funded contractors also are subject to other special pre-award clearance, pre-award intake, pre-award classification and other special procedures.  The ARRA Procedures also set for special requirements particularly applicable to construction contracts funded by ARRA.

The special procedures and heightened compliance review procedures provided for under the ARRA Procedures indicate that government contractors or subcontractors providing services or supplies on projects funded with ARRA funds will want to place special attention on compliance with OFCCP and other federal equal employment opportunity and other employment regulation compliance.

The author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer and other members of Curran Tomko and Tarski LLP are experienced with assisting employers and others about compliance with federal and state equal employment opportunity and other labor and employment, compensation and employee benefit compliance and risk management concerns, as well as advising ad defending employers against federal and state employment discrimination and other labor and employment, compensation, and employee benefit related audits, investigations and litigation, charges, audits, claims and investigations.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, Ms. Stamer has advised and represented employers on wage and hour and a diverse range of other labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 20 years.  If your business needs assistance auditing or updating its wage and hour or other human resources compliance practices, or responding to wage and hour or other employment related charges or suits, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402; or your favorite Curran Tomko Tarski, LLP attorney.  For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi, LLP team, see here.

Other Information & Resources

You can review other recent human resources, employee benefits and internal controls publications and resources and additional information about the employment, employee benefits and other experience of Ms. Stamer here /the Curran Tomko Tarski LLP attorneys here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information to Cstamer@CTTLegal.com or registering to participate in the distribution of these and other updates on our Solutions Law Press HR & Benefits Update distributions here. For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net.

©2009 Cynthia Marcotte Stamer. All rights reserved.


Contact House Blue Dog Democrats About Health Care Reform Bill Concerns

July 18, 2009

Individuals concerned about the  “American’s Affordable Health Care Choices Act of 2009” health care reform proposal introduced by the House Democratic Leadership earlier this week should target their input on the Democrats in Congress most likely to listen to those concerns. In the House of Representatives, these members likely are the “Blue Dog Democrats” in the House.  Read about Blue Dog Democrats here.    

The fiscal conservatism of Blue Dog Democrats makes them more likely to listen to concerns about the cost and other concerns relating to the health care reform bills touted by the Democrat Leadership in the House and Senate.  In fact, many Blue Dog Democrats already are speaking out about their concerns about the cost and other aspects of the Bill. 

Contact from voters and contributors in their districts and others could make a major difference in the ability that the House Democrat Leadership needs to pass their Bill.  Immediately contacting these members and getting others – particularly voters and contributors in the districts that elect these members – is one of the most important steps that concerned Americans can do to position their concerns to be heard.   

For most concerned voters, telephone or fax contact is the best means to convey these messages.  To minimize spam, most members only accept e-mail submitted through their website links.  Security concerns can delay receipt of written correspondence for weeks.

For persons interested in making their voices heard and sharing information with others who wish to do the same, the following contact information may be of interest:

The number of the Capital Switchboard is 202-224-3121.

The Blue Dog Leadership Team and there telephone and fax numbers are:

Rep. Stephanie Herseth Sandlin (SD), Blue Dog Co-Chair for Administration, Telephone: 202.225.2801 , Fax: 202.225.5823

Rep. Baron Hill (IN-09), Blue Dog Co-Chair for Policy,Telephone: 202-225-4031, Fax: (202) 226-6866

Rep. Charlie Melancon (LA-03), Blue Dog Co-Chair for Communications, Telephone: 202-225-4031, Fax: (202) 226-3944

Rep. Heath Shuler (NC-11), Blue Dog Whip, Telephone:  202-225-6401, Fax: (202) 226-6422

The Blue Dog Members and their telephone numbers are :

Altmire, Jason (PA-04),(202)225-2565

Arcuri, Mike (NY-24), (202)225-3665

Baca, Joe (CA-43),(202)225-6161

Barrow, John (GA-12), (202) 225-2823

Berry, Marion (AR-01), (202) 225-4076

Bishop, Sanford (GA-02), (202) 225-3631

Boren, Dan (OK-02), (202) 225-2701

Boswell, Leonard (IA-03), (202) 225-3806

Boyd, Allen (FL-02), (202) 225-5235

Bright, Bobby (AL-02), (202) 225-2901

Cardoza, Dennis (CA-18), (202) 225-6131

Carney, Christopher (PA-10), (202) 225-3731

Chandler, Ben (KY-06), (202) 225-4706

Childers, Travis (MS-01), (202) 225-4306

Cooper, Jim  (TN 5th), (202) 225-4311

Costa, Jim  (CA 20th), (202) 225-3341

Cuellar, Henry  (TX 28th), (202)  225-1640

Dahlkemper, Kathleen A. (PA 3rd), (202) 225-5406

Davis, Lincoln (TN 4th),(202) 225-6831

Donnelly, Joe  (IN 2nd), (202) 225-3915

Ellsworth, Brad  (IN 8th), (202) 225-4636

Giffords, Gabrielle  (AZ 8th), (202) 225-2542

Gordon, Bart  (TN 6th), (202) 225-4231

Griffith, Parker  (AL 5th), (202) 225-4801

Harman, Jane  (CA 36th), (202) 225-8220

Herseth Sandlin, Stephanie  (SD At Large), (202) 225-2801

Hill, Baron P.  (IN 9th), (202) 225-5315

Holden, Tim  (PA 17th), (202) 225-5546

Kratovil, Frank Jr. (MD 1st), (202) 225-5311

McIntyre, Mike  (NC 7th), (202) 225-2731

Marshall, Jim  (GA 8th), (202) 225-6531

Matheson, Jim  (UT 2nd), (202) 225-3011

Melancon, Charlie  (LA 3rd), (202) 225-4031

Michaud, Michael H. (ME 2nd), (202) 225-6306

Minnick, Walt  (ID 1st), (202) 225-6611

Mitchell, Harry E.  (AZ 5th), (202) 225-2190

Moore, Dennis  (KS 3rd), (202) 225-2865

Murphy, Patrick J.  (PA 8th), (202) 225-4276

Nye, Glenn C.  (VA 2nd), (202) 225-4215

Peterson, Collin C.  (MN 7th), (202) 225-2165

Pomeroy, Earl  (ND At Large), (202) 225-2611

Ross, Mike  (AR 4th), (202)  225-3772

Salazar, John T.  (CO 3rd), (202) 225-4761
Sanchez, Loretta  (CA 47th), (202) 225-2965

Schiff, Adam B.  (CA 29th), (202) 225-4176
Scott, David  (GA 13th), (202) 225-2939

Shuler, Heath  (NC 11th), (202) 225-6401

Space, Zachary T. (OH 18th), (202) 225-6265

Tanner, John S.  (TN 8th), (202) 225-4714

Taylor, Gene  (MS 4th), (202) 225-5772

Thompson, Mike  (CA 1st), (202) 225-3311

Wilson, Charles (OH-06), (202) 225-5705

We also encourage you and others to join the discussion about these and other health care reform proposals and concerns by joining the Coalition for Responsible Health Care Reform Group on Linkedin, registering to receive these updates here The author of this article, Curran Tomko and Tarski LLP Health Care Practice Chair Cynthia Marcotte Stamer has extensive experience advising and assisting health industry clients and others about a diverse range of health care policy, regulatory, compliance, risk management and operational concerns.  You can get more information about her health industry experience here.  

If you need assistance evaluating or formulating comments on the proposed reforms contained in the House Bill or on other health industry matters please contact Cynthia Marcotte Stamer, CTT Health Care Practice Group Chair, at cstamer@cttlegal.com, 214.270.2402 or your other favorite Curran Tomko Tarski LLP attorney. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on our electronic Solutions Law Press Health Care Update publication available here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please register to receive this Solutions Law Press Health Care Update here and be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here. You can access other recent updates and other informative publications and resources provided by Curran Tomko Tarski LLP attorneys and get information about its attorneys’ experience, briefings, speeches and other credentials here.

For important information concerning this communication click here.  If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net.

©2009 Cynthia Marcotte Stamer.  All rights reserved.


House Democrats Introduce Their Version of Health Care Reform, the “America’s Affordable Health Choices Act of 2009”

July 15, 2009

House Democrats introduced their proposal for health care reform this afternoon (July 14, 2009), the “America’s Affordable Health Choices Act of 2009 (the “House Bill”).  Introduced under the sponsorship of three key House committees -Energy and Commerce, Ways and Means, and Education and Labor — the 1018 page House Bill details the sweeping and comprehensive health care reforms that Democrat Leaders in the House are touting.  A copy of the House Bill as introduced may be reviewed here.

The House Bill proposes sweeping reforms built around the establishment of a public plan option while technically continuing to permit private plans to operate but in a federally regulated form allowing for little meaningful plan design control to private payers, health care providers or the individuals choosing among the plan options.   The Congressional Budget Office estimates that the coverage side of the bill will cost $1 trillion and cover 97 percent of the legal population within 10 years.

The following is a brief overview of certain key provisions of the House Bill drawn mostly from a series of high level summaries released by House Democrats along with the House Bill.  Long on politically comforting phrasing and short on details, you can read these summaries here.

Public Plan Option.  The House Bill proposes the establishment of a public health insurance option that would compete with allowable private plans, both of which would be subject to sweeping federal controls.  Democrat House co-sponsors represent the House Bill:

  • Provides a public health insurance option that would compete with private insurers within the Health Insurance Exchange.
  • The public health insurance option would be made available in the new Health Insurance Exchange (Exchange) along with private health insurance plans that comply with the design dictates established in the House Bill.
  • The public health insurance option and private plan options meet the same benefit requirements and comply with the same insurance market reforms
  • The public option’s premiums would be established for the local market areas designated by the Exchange.
  • Individuals with affordability credits could choose among the private carriers and the public option.
  • Require that the public health plan and private health plan options and private options each must be financially self-sustaining
  • Promote primary care, encourage coordinated care and shared accountability, and improve quality.
  • Institute new payment structures and incentives to promote these critical reforms.
  • Specify health care provider participation in the plans will be voluntary; Medicare providers are presumed to be participating unless they opt out.
  • Provides for provider reimbursements for services from the plans initially will be established using “rates similar to those used in Medicare with greater flexibility to vary payments.
  • Speaker of the House Nancy Pelosi has announced plans to proceed immediately on mark up on the House Bill with the intention to of scheduling a vote on the House Bill by the end of July. Assuming that House leaders adhere to this schedule, the planned timetable leaves little opportunity for critical evaluation and input by members of Congress or the public who may have questions or concerns about the proposed legislation. Prompt and coordinated action is required for individuals with concerns about any of the proposed reforms.

Federal Mandates Health Plan Benefits.  In order to achieve affordable, quality health care for all, the House Bill would impose federal standards regulating the benefits that the public health plan and private health plans would be required and permitted to offer.  Under these provisions, the House Bill would:

  • Establish a standardized benefit package that covers essential health services.
  • Vest the power in the Secretary of Health & Human Services to decide the coverage that would be included in this mandated standardize benefit package.
  • Eliminate cost-sharing for preventive care (including well baby and well child care)
  • Impose caps annual out-of-pocket spending for individuals and families.
  • Create a new independent Benefits Advisory to recommend to the Secretary and update the core package of benefits.
  • Provide for the public health plan option to offer four tiers of benefit packages from which consumers can choose to best meet their health care needs. Each allowable plan would be required to provide the dictated core benefits.
    • The Basic Plan would include the federally mandated core set of covered benefits and cost sharing protections;
    • The Enhanced Plan would include the federally mandated core set of covered benefits with more generous cost sharing protections than the Basic plan;
    • The Premium Plan would include the federally mandated core set of covered benefits with more generous cost sharing protections than the Enhanced plan; and
    • The Premium Plus Plan would include the federally mandated core set of covered benefits, the more generous cost sharing protections of the Premium plan, and additional covered benefits (e.g., oral health coverage for adults, gym membership, etc.) that will vary per plan. In this category, insurers must disclose the separate cost of the additional benefits so consumers know what they’re paying for and can choose among plans accordingly.

The House Bill empowers the Secretary of Health & Human Services to decide the federally dictated, required core set of benefits provides coverage with input from a newly created Benefits Advisory Commission.  These core benefits are intended to include inpatient hospital services, outpatient hospital services, physician services, equipment and supplies incident to physician services, preventive services, maternity services, prescription drugs, rehabilitative and habilitative services, well baby and well child visits and oral health, vision, and hearing services for children and mental health and substance abuse services.  However, the particular, terms and scope of these benefits is left to HHS to define.

Health Insurance Exchange.  The House Bill also calls for the establishment of a “Health Insurance Exchange” meeting federal mandates through which low income individuals initially, and certain small businesses would be offered the option to purchase health care coverage through federally mandated purchasing groups.  In the first year, the House Bill provides for the Health Insurance Exchange to accept those without health insurance, those who are buying health insurance on their own, and small businesses with fewer than 10 people. In the second year, the Health Insurance Exchange could accept small businesses with fewer than 20 people. After that, “larger employers as permitted by the Commissioner.” In other words, expansion is discretionary, not mandated.

Affordability & Subsidies.  The House Bill provides sliding-scale affordability credits for individuals and families with incomes above the Medicaid thresholds but below 400% of poverty and imposes a cap on total out-of-pocket spending for individuals and families covered under the plans regardless of income.  In addition, the House Bill would broaden Medicaid coverage to include individuals and families with incomes below 133% of poverty.

Effective 2013, sliding scale affordability credits would be provided provided to individuals and families between 133% to 400% of poverty. That means the credits phase out completely for an individual with $43,320 in income and a family of four with $88,200 in income (2009).

The sliding scale credits limit individual family spending on premiums for the essential benefit package to no more than 1.5% of income for those with the lowest income and phasing up to no more than 11% of income for those at 400% of poverty.

The affordability credits also subsidize cost sharing on a sliding scale basis, phasing out at 400% of poverty, ensuring that covered benefits are accessible.

The Health Insurance Exchange would administer the affordability credits in relationship with other federal and state entities, such as local Social Security offices and Medicaid agencies.

The essential benefit package, and all other benefit options, limit exposure to catastrophic costs with a cap on total out of pocket spending for covered benefits. Special provisions would apply to Medicaid. 

Effective 2013, individuals with family income at or below 133% of poverty ($14,400 for an individual in 2009) are eligible for Medicaid. State Medicaid programs would continue to cover those individuals with incomes above 133% of poverty, using the eligibility rules states now have in place.

Paying The Tab.  House Democrats propose to finance approximately half of the estimated $1 trillion bill for their proposed reforms through projected $500 billion or so in savings from Medicare and Medicaid achieved by a variety of reimbursement and benefit cutbacks and other reforms. The rest of the financing would come from a combination of revenue expections from employer and individual mandates (an estimated $200 billion over 10 years) and a surtax on the richest 1.5 percent of Americans. The surtax is 1 percent on income between $350,000 and $500,000; 1.5 percent on income between $500,000 and $1,000,000; and 5.4 percent in income above $1,000,000. The House Bill permits the amount of this surtax to vary if the bill is less or more expensive than initially anticipated.

The author of this article, Curran Tomko and Tarski LLP Health Care Practice Chair Cynthia Marcotte Stamer has extensive experience advising and assisting health industry clients and others about a diverse range of health care policy, regulatory, compliance, risk management and operational concerns.  You can get more information about her health industry experience here.  

If you need assistance evaluating or formulating comments on the proposed reforms contained in the House Bill or on other health industry matters please contact Cynthia Marcotte Stamer, CTT Health Care Practice Group Chair, at cstamer@cttlegal.com, 214.270.2402 or your other favorite Curran Tomko Tarski LLP attorney. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on our electronic Solutions Law Press Health Care Update publication available here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please register to receive this Solutions Law Press Health Care Update here and be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here. You can access other recent updates and other informative publications and resources provided by Curran Tomko Tarski LLP attorneys and get information about its attorneys’ experience, briefings, speeches and other credentials here.

For important information concerning this communication click here.  If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net.

©2009 Cynthia Marcotte Stamer.  All rights reserved.


Washington Attorney Phyllis Borzi Unanimously Confirmed as Assistant Secretary of Labor for the Employee Benefits Security Administration

July 11, 2009

The U.S. Senate today (July 10, 2009) unanimously confirmed the nomination of attorney Phyllis Borzi as Assistant Secretary of Labor for the Employee Benefits Security Administration

Highly respected by both union and non-union employee benefit plan practitioners and leaders, Ms. Borzi brings key policy and regulatory knowledge, practical industry and political experience and strong leadership and administrative skills to her post. 

Ms.  Borzi comes to her new role with an extensive resume of employee benefit experience including extensive governmental and private practice experience as well as employee benefit leadership in the American Bar Association and numerous other professional organizations.   Her private practice employee benefit experience has encompassed extensive representation of union and other employee benefit plans, their sponsors, fiduciaries and others. 

In addition to her extensive private sector experience, Ms. Borzi also has extensive Congressional and other governmental experience.  Until January 1995, Ms. Borzi served as pension and employee benefit counsel for the U.S. House of Representatives, Subcommittee on Labor-Management Relations of the Committee on Education and Labor.  She was on the Committee staff for 16 years. 

In 1993, in connection with the Presidential Task Force on Health Care Reform, chaired by former First Lady Hillary Rodham Clinton, Ms. Borzi served on working groups dealing with insurance reform, workers’ compensation and employer coverage.  She holds a Master of Arts degree in English from Syracuse University and received her law degree from Catholic University Law School, where she was editor-in-chief of the law review.  

Ms. Borzi is a charter member and a former President of the American College of Employee Benefit Counsel; she served as a member of its Board of Governors from 2000-2008.  Ms. Borzi has served as a member of the Advisory Board of the BNA Pension & Benefits Reporter (and a former co-chair of the Board) and a former member of the Advisory Committee of the Pension Benefit Guaranty Corporation. 

Ms. Borzi also has served on the Advisory Board of the Pension Research Council, The Wharton School, The University of Pennsylvania and a member of the Board of the Women’s Institute for a Secure Retirement (WISER). 

In 2008, Ms. Borzi was appointed by the U.S. District Court for the Northern District of Ohio to serve as a public member of the Administrative Committee for the Goodyear VEBA, an entity that was judicially established pursuant to a negotiated settlement agreement between the company, the Steelworkers and class representatives for the Steelworkers retirees.

Ms. Borzi has published numerous articles on ERISA, health care law and policy and retirement security issues and is a frequent speaker on programs sponsored by legal, professional, business, consumer and state and local governmental organizations. 

An active member of the American Bar Association throughout her career, Ms. Borzi surrenders her post as chair of the ABA’s Joint Committee on Employee Benefits (representing the Health Law Section).

Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer and other members of Curran Tomko and Tarski LLP has extensive experience advising employer and other plan sponsors, benefit plans and their fiduciaries about a diverse range of domestic and international health and managed care, pension, deferred compensation and other ERISA and employee benefit and employment compliance, administration, operational and public policy matters.  A member of the Joint Committee on Employee Benefits (representing the Real Property, Trusts and Estates Section), Ms. Stamer is the current Vice-Chair and 2009-2010 Chair Elect of the RPTE Employee Benefits and Compensation Committee. 

If your organization needs assistance with employee benefits and ERISA, compensation, managed care or other labor and employment, compensation or benefit concerns or regulations, please contact Ms. Stamer here, (214) 270-2402; or your favorite Curran Tomko Tarski, LLP attorney.  For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi, LLP team, see here.

Other Information & Resources

You can review other recent human resources, employee benefits and internal controls publications and resources and additional information about the employment, employee benefits and other experience of the Curran Tomko Tarski LLP attorneys here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information to Cstamer@CTTLegal.com or registering to participate in the distribution of these and other updates on our HR & Employee Benefits Update distributions here. Also stay abreast of emerging internal controls and compliance challenges by registering for our Corporate Compliance, Risk Management & Internal Controls distributions. For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net.

©2009 Cynthia Marcotte Stamer. All rights reserved.


Grants To Promote Youth Employment, Retraining For Employment In Renewable

July 1, 2009

U.S. Department of Labor Employment and Training Administration recently has announced a series of opportunities to apply for grants to provide training to promote youth employment, prepare workers for careers in energy efficiency and renewable energy, and to promote other employment opportunities.  The application deadline for most of these grants are rapidly approaching.  Some of these opportunities include the following:

  • Green Capacity Building Grants.   DOL has announced the availability of $500 million for projects that prepare workers for careers in the energy efficiency and renewable energy industries described in Section 171(e)(1)(B) of the Workforce Investment Act.  The grants are designed to teach workers the skills required in emerging energy efficiency and renewable energy industries.  Eligible applicants are limited to organizations that are current DOL grantees.  The Department expects to award between 50 and 100 grants, ranging from $50,000 to $100,000.  To view press release, visit: here.  For more information and to obtain an application, visit here.  Deadline:  August 5, 2009
  • Pathways Out of Poverty Grants.  DOL has announced the availability of approximately $150 million for projects that provide training and placement services to provide pathways out of poverty and into employment within industries described in the Supplementary Information, Part B of this Solicitation for Grant Application.  National nonprofit and local entities are eligible to apply.  Grants will range from approximately $3 to $8 million for national grantees and $2 to $4 million for local grantees.  For more information and application instructions, visit:  To obtain additional information, visit here.  Deadline:  September 29.
  • Energy Training Partnership Grants.  The U.S. Department of Labor’s Employment and Training Administration announced the availability of approximately $100 million for 20-30 projects that provide training and placement services in the energy efficiency and renewable energy industries for workers impacted by national energy and environmental policy, individuals in need of updated training related to the energy efficiency and renewable energy industries, and unemployed workers.  National, nonprofit labor management organizations and Statewide or local nonprofit entities are eligible to apply.  To obtain additional information, visit here.  Deadline:  October 20.
  • New Safety and Health Training Grants.  The Occupational Safety and Health Administration (OSHA) is accepting applications for nearly $7 million in Susan Harwood Training Grants available to nonprofit, community and faith-based organizations.  OSHA awards funds to provide training and education programs on safety and health topics for workers and their employers.  For fiscal year 2009, the program offers 24 targeted topic areas including crane safety, combustible dust, emergency preparedness and response, and the OSHA recordkeeping process.  To view the press release and obtain additional information, visit here.  Deadline:  July 24.
  • Department of Health and Human Services Support Systems for Rural Homeless Youth:  Collaborative State and Local Demonstration Grants.  The U.S. Department of Health and Human Services’ Family and Youth Services Bureau is accepting applications from States for this collaborative demonstration project, to work with local community-based organizations.  The grants are intended to influence policies, programs and practices that affect the design and delivery of services to runaway and homeless youth in Transitional Living Programs, as well as to homeless youth aging out of State child welfare systems and into Independent Living Programs.  For more information and to obtain an application, visit here.  Deadline:  August 3.
  • Early-Career Researchers Invited to Apply for William T. Grant Scholars Program.  The William T. Grant Foundation’s Scholars Program supports promising early career researchers whose research contributes to understanding and improving the lives of young people in the United States between the ages of 8 and 25.  Every year, four to six William T. Grant Scholars are selected to receive a five-year $350,000 grant.  Candidates are nominated by a supporting institution and must submit five-year research plans that demonstrate creativity, intellectual rigor, and a commitment to continued professional development.  For more information and to obtain an application, visit here.  Deadline:  July 8.
  • BJ’s Charitable Foundation Invites Applications for Community Programs.  BJ’s Charitable Foundation is accepting applications from non-profit organizations to enhance and enrich community programs that primarily benefit children and families.  Non profit organizations with 501 (c)(3) tax-exempt status that positively impact communities where BJ’s Clubs are located may apply.  For additional information, visit here.  Application Deadlines: July 10, and November 6.
  • Youth Service America Invites Applications for 2010 Global Youth Service Day (GYSD).  Youth Service America is accepting applications for its 2010 Global Youth Service Day (April 23-25, 2010).  The grants are designed to assist organizations to be a “Lead Agency” in increasing participation in their programs while connecting with the larger youth service movement.  Lead Agencies will receive a $2,000 GYSD planning grant sponsored by State Farm Companies Foundation, travel support to attend the Youth Service Institute in Washington, D.C., and direct assistance from Youth Service America to ensure a successful Global Youth Service Day.  To obtain additional information and an application, visit  here.  Deadline: July 17.
  • The Ruddie Memorial Youth Foundation Accepting Applications from First-Time Applicants.  The Ruddie Memorial Youth Foundation aims to identify and disseminate innovative and effective programs for helping underprivileged youth reach their full potential.  The foundation supports programs that provide youth (birth to 25 years of age) with new opportunities for health, personal growth, and success in the United States. Applications will be accepted from nonprofit 501(c)(3) organizations based in the greater metropolitan areas of Baltimore, Boston, Chicago, Los Angeles, Madison, Milwaukee, New York City, Philadelphia (new this year), San Francisco, Seattle, and Washington, D.C.  To obtain additional information and application, visit here.  Deadline:  July 31.

Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer and other members of Curran Tomko and Tarski LLP are experienced with advising and assisting employers and others to respond to proposed legislation and regulations and addressing other leave and other labor and employment, employee benefit, compensation, and internal controls concerns.

If your organization needs assistance with investigating youth employment or other workforce redevelopment grant program participation and compliance or other labor and employment, compensation or benefit concerns or regulations, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402; or your favorite Curran Tomko Tarski, LLP attorney.  For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi, LLP team, see here.

Other Information & Resources

You can review other recent human resources, employee benefits and internal controls publications and resources and additional information about the employment, employee benefits and other experience of the Curran Tomko Tarski LLP attorneys here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information to Cstamer@CTTLegal.com or registering to participate in the distribution of these and other updates on our HR & Employee Benefits Update distributions here. Also stay abreast of emerging internal controls and compliance challenges by registering for our Corporate Compliance, Risk Management & Internal Controls distributions. For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net.

©2009 Cynthia Marcotte Stamer. All rights reserved.


September 8, 2009 New Deadline For Government Contractors, Subcontractors Deadline To Use E-Verify

June 9, 2009

September 8 now is the deadline for federal government contractors and subcontractors to begin using U.S. Citizenship and Immigration Services’ (USCIS) E-Verify system to verify the eligibility of employees to work in the United States. 

The Obama Administration recently delayed implementation of the final rule requiring federal contractors and subcontractors to use E-Verify to confirm the eligibility of employees to work in the U.S. The Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (collectively known as the Federal Acquisitions Regulatory Councils) published an amendment in the Federal Register on June 5, 2009, postponing the applicability of the final rule until Sept. 8, 2009. 

As originally published November 14, 2008, the final rule requiring that federal government contractors and subcontractors agree to electronically verify the employment eligibility of their employees went into effect January 19, 2009.  However, the compliance deadline was delayed in January and again in April, 2009 by the Obama Administration.  Prior to the delay granted this month, the deadline to begin using U.S. Citizenship and Immigration Services’ (USCIS) E-Verify system was delayed to June 30, 2009.

Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer and other members of Curran Tomko and Tarski LLP are experienced with advising and assisting employers and others to respond to proposed legislation and regulations and addressing other leave and other labor and employment, employee benefit, compensation, and internal controls concerns. If your organization needs assistance with assessing or responding to H.R. 2450 or assistance with leave and absence management or other labor and employment, compensation or benefit concerns or regulations, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402; or your favorite Curran Tomko Tarski, LLP attorney.  For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi, LLP team, see here.

Other Information & Resources

You can review other recent human resources, employee benefits and internal controls publications and resources and additional information about the employment, employee benefits and other experience of the Curran Tomko Tarski LLP attorneys at here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information to Cstamer@CTTLegal.com or registering to participate in the distribution of these and other updates on our HR & Employee Benefits Update distributions here. Also stay abreast of emerging internal controls and compliance challenges by registering for our Corporate Compliance, Risk Management & Internal Controls distributions. For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net. 

©2009 Cynthia Marcotte Stamer. All rights reserved.


Registration Open For June 23 Dallas HR 2009 Health Plan Eligibility Update Program

June 9, 2009

Amid soaring health care costs and tightening corporate budgets, employers and other group health plan sponsors, fiduciaries and administrations now also must update their group health plan eligibility and enrollment practices to comply with the American Recovery and Reinvestment Act of 2009 (the “Stimulus Bill”), COBRA subsidy mandates, HIPAA special enrollment rule amendments and a host of other changes to federal eligibility mandates that already have or will take effect this year.  Meanwhile, employers must keep a careful watch on Congress as it considers enacting sweeping health care reforms that are likely to place more obligations on employers.

Health plan eligibility design and administration plays a critical role in controlling health benefit costs and is a leading and growing source of health plan legal risk for employers, fiduciaries and administrators.  Understanding and properly managing these concerns is imperative for employers and others sponsoring or administering these programs.

Stamer Discusses Health Plan Eligibility Rules June 23

Cynthia Marcotte Stamer will explain newly effective COBRA Subsidy Rules, genetic information nondiscrimination rules and other recent and impending changes to federal health plan eligibility mandates will be explained on June 23, 2009 during a 2009 Health Plan Eligibility Update briefing hosted by the Dallas Human Resources Management Association including:

Cynthia Stamer will explain to attendees what they need to know and do about:

  • New Stimulus Bill COBRA Subsidy Rules and other special COBRA rules that took effect on February 17
  • New GINA group health plan information scheduled to take place in 2009
  • Changes to HIPAA special enrollment and nondiscrimination rules
  • Implications for group health plans based on recent changes to FMLA and USERRA regulations
  • Medicare, Medicaid and CHIP nondiscrimination rules
  • Impending college student continuation mandates
  • And more….

Get  details or register on line here or by telephoning Dallas Human Resources Management Association at 214-631-8775.

Stamer’s Health Plan Experience Extensive

The immediate past Chair of the American Bar Association’s Managed Care & Insurance Section, Cynthia Marcotte Stamer is a highly regarded legal advisor, author and speaker recognized both nationally and internationally for her expertise in the areas of health benefits and other human resource compliance matters. Board Certified in Labor and Employment Law by the Texas Board of Legal Specialization, “Cindy” recently joined Curran Tomko Tarski, LLP as the Chair of its Labor & Employment and Health Care Practices April 1, 2009.

The Managing Editor of Solutions Law Press and an Editorial Advisory Board Member and author for Employee Benefit News and other publications, Ms. Stamer is a widely published author and popular speaker. In addition to hundreds of publications on health plan and other human resources, employee benefit and internal controls issues, Ms. Stamer is the author of the “Health Plan Eligibility Toolkit.” Her work has been featured and published by the American Bar Association, BNA, SHRM, World At Work, Employee Benefit News and the American Health Lawyers Association. Her insights on human resources risk management matters have been quoted in The Wall Street Journal, the Dallas Business Journal, Managed Care Executive, HealthLeaders, Business Insurance, Employee Benefit News and the Dallas Morning News.

Ms. Stamer also serves in a number of professional leadership roles including the leadership council of the ABA Joint Committee on Employee Benefits, Vice Chair of the ABA Real Property, Probate & Trust Section and Employee Benefits & Compensation Group.

Cynthia Marcotte Stamer and other members of Curran Tomko and Tarski LLP are experienced with advising and assisting employers with these and other health plan and other employee benefit,  labor and employment, compensation, and internal controls matters. If your organization needs assistance with assessing, managing or defending its wage and hour or other labor and employment, compensation or benefit practices, please contact Ms. Stamer via e-mail here, or by calling (214) 270-2402.  For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here,   For more information and other members of the Curran Tomko Tarksi, LLP team, see the Curran Tomko Tarski Website.

We hope that this information is useful to you. For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here,   For more information and other members of the Curran Tomko Tarksi, LLP team, see the Curran Tomko Tarski Website.

You can register to receive future updates and information about upcoming programs, access other publications by Ms. Stamer and access other helpful resources here.  If you or someone else you know would like to receive updates about developments on these and other human resources and employee benefits concerns, please be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here.  If you would prefer not to receive these updates, please send a reply e-mail with “Remove” in the subject line to support@SolutionsLawyer.net. You also can register to participate in the distribution of these updates by registering to participate in the Solutions Law Press HR & Benefits Update Blog here.

 ©2009 Cynthia Marcotte Stamer. All rights reserved.


Tell Senate Committee Today Not To Mess Up Health Benefits

May 27, 2009

Today is the last day that individuals and businesses concerned about health care can provide feedback to Congress on health care reform proposals on the fast track for adoption by Congress and have their opinion included in the official hearing record of the  May 12, 2009 Senate Finance Committee Hearing on  “Financing Comprehensive Health Care Reform.”  Start speaking up today and keep speaking out until you are heard.

Senate health care reform leaders have announced their intention to have the Senate vote and pass health care reform legislation that would drastically change the U.S. health care and health insurance system during June. Individuals and businesses concerned about Congressional proposals to private health benefits with federal government benefits, to tax individuals and businesses on health benefits, and to make other radical changes in our health care programs should e-mail their concerns to Congress today.  Recent statements by Congressional leaders and President Obama indicate that the intend to act quickly to pass major health care reforms within the next few months, beginning with action by the Senate in June.

The Senate Finance Committee discussed the proposed changes during a “Roundtable Discussion” hearing on May 12, 2009.  Among the changes that this hearing reflects to be under serious consideration by Congress are proposals:

  • To tax individuals on health benefits and/or coverage
  • Reduce or eliminate employer tax benefits for providing health coverage
  • Mandate individuals and/or employees pay government mandated health insurance premiums
  • Replace existing employer and private health insurance programs with government run or mandated benefit programs
  • Involve the federal government  in deciding who and when Americans get care
  • Establish other burdensome federal requirements and regulations on health benefits and health care providers.

 You can review or listen to the testimony and learn more about what Congress plans to do to your and your employees’ health benefits here.

If you or others that you know are concerned about all or any of these proposals, we urge you to share your feedback TODAY as follows and staying involved as Congress moves to act: 

  • E-mail the Health Care Reform Leadership of the Senate Finance Committee at Health_reform@finance_dem.senate.gov
  • E-mail each member of the Senate Finance Committee at http://finance.senate.gov/sitepages/committee.htm
  • Call (202) 224-4515 and share your views with Congressional Staffers Erin Shields (Baucus) and Jill Gerber (Grassley), Committee on Finance, 219 Dirksen Senate Office Building, Washington, D.C. 20510-6200
  • Tell your Senators and Representatives you oppose Congressional plans to fast track health care reform the way Congress enacted the Stimulus Bill
  • Tell your Senators and Representatives you will support members of Congress who vote responsibly on health care reform
  • Tell your Senators and Representatives in Congress and political party leaders you will work to defeat members and candidates that advocate these and other irresponsible health care reform legisltation
  • Carry through on your promises
  • Keep speaking out until you are heard and Congress gets the message.    

Cynthia Marcotte Stamer is an attorney, author and health care advocate known for her work and writings nationally and internationally on health care and coverage policy and legal matters . If your organization needs assistance with assessing, managing or communicating its concerns about this legislation or other health care and insurance, employment or employee benefit practices, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402; or your favorite Curran Tomko Tarski, LLP attorney.  For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi, LLP team, see the http://www.cttlegal.com.

Other Information & Resources

Cynthia Marcotte Stamer and other members of Curran Tomko and Tarski LLP are experienced with advising and assisting employers with these and other labor and employment, employee benefit, compensation, and internal controls matters. If your organization needs assistance with assessing, managing or defending its wage and hour or other labor and employment, compensation or benefit practices, please contact Ms. Stamer at e-mail, (214) 270-2402; or your favorite Curran Tomko Tarski, LLP attorney.  For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi, LLP team, see the Curran Tomko Tarski Website or Cynthia Marcotte Stamer, P.C. Website.

We hope that this information is useful to you. You can register to receive future updates and information about upcoming programs, access other publications by Ms. Stamer and access other helpful resources at CynthiaStamer.com For additional information about Ms. Stamer and her experience, see here or contact Ms. Stamer directly. If you or someone else you know would like to receive updates about developments on these and other human resources and employee benefits concerns, please be sure that we have your Currant contact information – including your preferred e-mail- by creating or updating your profile at CynthiaStamer.com.  If you would prefer not to receive these updates, please send a reply e-mail with “Remove” in the subject line to support@SolutionsLawyer.net. You also can register to participate in the distribution of these updates by registering to participate in the Solutions Law Press HR & Benefits Update Blog here.  For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to support@SolutionsLawyer.net.

 

©2009 Cynthia Marcotte Stamer.  Permission to forward with attribution granted to concerned parties.  All other rights reserved.