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.
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Employers, ERISA, Health Care Reform, Health Plans, Human Resources, Public Policy | Tagged: Employers, Health Care, Health Care Reform, Health Plan |
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Posted by Cynthia Marcotte Stamer
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.
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Disease Management, Employers, Employment Tax, ERISA, Health Care Reform, Health Plans, Public Policy | Tagged: America's Healthy Future Act, Employers, Health Care Reform, Health Plans, Public Policy |
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Posted by Cynthia Marcotte Stamer
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.
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Employee Benefits, Employers, ERISA, Health Care Reform, Public Policy, Risk Management | Tagged: Employer, ERISA, Health Care Reform, Health Plans, Public OPtion, Public Policy |
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Posted by Cynthia Marcotte Stamer
November 5, 2009
Rising business failures, constricting budgets, employment losses and other business and workforce dislocations associated with the recent economic downturn are adding new urgency to efforts by U.S. and international leaders to act to mitigate threats to the security of worker pensions.
In response to these concerns, the U.S. Pension Benefit Guaranty Corp. (PBGC), the United Kingdom’s The Pensions Regulator and Pension Protection Fund recently have reached an information sharing agreement intended to help the agencies in both countries protect retirement benefits earned by workers and retirees on both sides of the Atlantic. Meanwhile, businesses that sponsoring defined benefit pension plans now are required to comply with newly released final Internal Revenue Service regulations that increase minimum contributions required by many sponsors, and impose other new mandates designed to accelerate plan funding and otherwise promote greater security of these benefit programs in an economically challenged business environment.
Under a Memorandum of Understanding, signed on November 4, 2009, the three agencies will share any unrestricted information that advances the security of defined benefit plans sponsored by private sector companies. Confidential financial information from those companies will not be shared. While the agreement facilitates broad access to data, intelligence, and other records, it is not legally binding. Additionally, the agencies are not compelled to lend assistance to each other, especially if legal proceedings are underway, and such assistance would be contrary to the interests of either country. The agreement can be canceled at any time by any party.
The Pensions Regulator oversees private sector defined benefit plans in the UK and is charged with protecting the retirement benefits of plan members. The Regulator is also charged with reducing the risk of claims for compensation from the Pension Protection Fund (PPF). The PPF was created to pay compensation to members of eligible defined benefit pension plans when the plan’s sponsor was unable to pay benefits.
The PBGC is a federal corporation created under the Employee Retirement Income Security Act of 1974. It currently guarantees payment of basic pension benefits earned by 44 million American workers and retirees participating in over 29,000 private-sector defined benefit pension plans. The agency receives no funds from general tax revenues. Operations are financed largely by insurance premiums paid by companies that sponsor pension plans and by investment returns.
The Memorandum of Understanding is one of a variety of actions that the U.S. regulators are taking as part of their efforts to shore up the security of private retirement benefits and funding. On October 15, 2009, the Internal Revenue Service published final regulations regarding the “Measurement of Assets and Liabilities for Pension Funding Purposes; Benefit Restrictions for Underfunded Pension Plans” construing the amended single employer defined benefit plan minimum funding rules in Internal Revenue Code (“Code”) §§ 430(d), 430(f), 430(g), 430(h)(2), 430(i), and 436, added to the Code by the Pension Protection Act of 2006 (PPA ’06), Public Law 109-280 (120 Stat. 780) taking into account subsequent amendments made by the Worker, Retiree, and Employer Recovery Act of 2008 (WRERA ’08), Public Law 110-458 (122 Stat. 5092). These new final regulations implement new federal rules that accelerate the time within which employers are required to fund defined benefit retirement benefit commitments made in single employer defined benefit pension plans and impose other complicated new requirements intended to improve the funding and security of these programs. As implementation of these new rules proceeds, the PBGC is working to respond to the growing wave defined benefit pension plans whose plan sponsors have already gone bankrupt or otherwise have proven unable to meet already existing funding obligations.
If you have questions about or need assistance evaluating or complying these minimum funding rules or other employee benefit, employment, compensation, 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 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 has more than 20 years experience advising and representing employers, plan sponsors and fiduciaries, and others about these and other related workforce, benefits, compensation and compliance matters. 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.
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.
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Defined Benefit Plans, Employee Benefits, Employers, ERISA, Retirement Plans, Tax | Tagged: Corporate Compliance, Defined Benefit Plans, Employee Benefits, Employers, Human Resources, Internal Controls, Minimum Contributions, Retirement Plan Funding, Retirement Plans, Tax |
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Posted by Cynthia Marcotte Stamer
November 5, 2009
Following up on its October expansion of federal requirements that employers and their group health plans provide family leave rights in relation to certain military related absences, Congress now is considering extending and expanding the “COBRA Premium Subsidy” rules for group health plans enacted by Congress on February 17, 2009 as part of the American Recovery and Reinvestment Act of 2009 (ARRA) beyond their currently scheduled December 31, 2009 expiration date and further to restrict the amount that group health plans can charge former employees and their dependents covered by the COBRA Premium Subsidy rules to maintain coverage under the coverage continuation mandates of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (“COBRA”).
COBRA generally allows employee and dependents who otherwise would lose eligibility for group health benefits under union or employer sponsored plans temporarily to continue enrollment in the group health plan by paying up to 102 percent of the full cost of that coverage (the “COBRA premium”) and fulfilling certain other conditions set forth in COBRA. Under ARRA’s COBRA Premium Subsidy Rules, Congress among other things amended COBRA through December 31, 2009 to require that employers “subsidize” 65% of the otherwise applicable COBRA premium for employees or dependents electing COBRA coverage following a loss of eligibility due to the involuntary employment termination between September 15, 2008 and December 31, 2009 who otherwise qualify as “assistance eligible individuals” under ARRA. The COBRA Premium Subsidy rules created a mechanism through which employers providing the required COBRA Premium Subsidy can claim a payroll tax credit for COBRA Premium Subsidy amounts paid with respect to assistance eligible individuals in accordance with ARRA’s mandates.
Senator Sherrod Brown (D-Ohio) and Robert P. Casey (D-PA) now are proposing that Congress extend and expand ARRA COBRA Premium Subsidy requirements applicable to group health plans as proposed by the “COBRA Subsidy Extension and Enhancement Act” (S. 2730). Introduced on November 5, 2009, the Government Printing Office had not published the text of S. 2730 as of the release of this publication. However, It is expected that the official text of S. 2730 will be made available for review soon here. In the meanwhile, the reading of S. 2730 into the record when introduced in the Senate on November 4, 2009 and its sponsors’ news releases, the “COBRA Subsidy Extension and Enhancement Act” (S. 2730) proposes that Congress:
- Extend the COBRA Premium Subsidy requirements an extra six months to 15 months;
- Increase the required subsidy amount during the extended COBRA Premium Subsidy period from 65 percent to 75 percent of the COBRA premium; and
- Clarify that the employees and dependents eligible to qualify as assistance eligible individuals under ARRA includes those losing group health plan eligibility due to an employment loss, whether from an actual employment termination or a decline in hours of employment.
Expanded FMLA Military Leave Related Mandates Added Under Defense Appropriations Laws Already Require Immediate Action
The proposal in S. 2730 to extend the ARRA COBRA Premium Subsidy mandates is the latest in a series of recently enacted and proposed federal laws and implementing regulations imposing an ever-expanding list of federal eligibility mandates on employment based group health plans. These include not only an expanding list of federal mandates that group health plans make available continued coverage to individuals whose eligibility for coverage otherwise would end on account of an employment decline or loss such as those enacted as part of the National Defense Authorization Act for Fiscal Year 2010, Public Law 111-84 (“2010 NDAA”), signed into law by President Obama on October 28, 2009 and the National Defense Authorization Act for Fiscal Year 2008 the (“2008 NDAA”) signed into law by President Bush in January, 2008. These FMLA military leave-related mandates are in addition to separate group health coverage continuation mandates separately imposed upon employers and group health plans under the Uniformed Services Employment and Reemployment Rights Act (USERRA).
For instance, the 2008 NDAA amended the Family and Medical Leave Act (“FMLA”) to add new family military-leave provisions, which were further expanded by the 2010 NDAA. The 2008 NDAA adds two new qualifying circumstances under which eligible employees must be allowed to take FMLA leave and to continue group health plan coverage during that FMLA:
- “Qualifying exigency leave” and
- “Military caregiver leave,” also referred to as “leave to care for a covered servicemember.”
Final regulations implementing the 2008 NDAA FMLA mandates and other FMLA requirements took effect on January 16, 2009. The NDAA for 2010 further amended these family military-leave mandates to expand the circumstances under which the FMLA leave mandates employers and their group health plans extend FMLA leave rights in relation to military members.
Beyond these military-leave related group health plan mandates, group health plans also are required to comply with a host of other recently-expanded federal eligibility and other mandates such as new mandates to offer up to 12-months coverage continuation for dependents whose coverage otherwise would terminate due to a medically required break in school enrollment, expanded group health plan special enrollment and nondiscrimination rules imposed under ARRA, the Genetic Information and Nondiscrimination Act (“GINA”) and the Health Insurance Portability & Accountability Act (“HIPAA”) and various others. Congress is considering further amendments to these and other federal mandates under proposals included in the various health care bills being heavily debated in Congress, as well as others included in legislation proposed separately from these broader health care reform proposals.
Take Prompt Action to Manage Risks
In addition to monitoring and sharing their input with Congress about S. 2730 and other proposed legislation impacting their group health plans, group health plans, their sponsoring employers or unions, insurers, fiduciaries and administrative service providers also should take prompt action to ensure that their group health plan documents, notices and other communications, processes and procedures have been properly updated in response to the statutory regulatory changes to federal group health plan eligibility and other mandates.
If you have questions about or need assistance reviewing or sharing your input with Congress about S. 2730 or other proposed legislation, evaluating and updating, administering or defending your group health plan in light of these or other federal regulations, or with other employee benefit, employment, compensation, 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 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 (ABA) RPTE Employee Benefits & Other Compensation Group and past chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer has more than 20 years experience advising and representing employee benefit plans, employers, plan sponsors and fiduciaries, administrative services providers, insurers and others about these and other related matters. 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.
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.
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COBRA, Employers, ERISA, family leave, FMLA, Health Plans, Human Resources, Insurance, Leave, medical leave | Tagged: ARRA, COBRA, COBRA Subsidy, Employers, FMLA, Group Health plans, Health Plans, Insurers, Military Leave |
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Posted by Cynthia Marcotte Stamer
November 3, 2009
November 15, 2009 is the deadline for group health plans providing prescription drug coverage to send the annually-required notification (the “Part D Notice”) to Medicare-eligible participants whether the plan’s prescription drug coverage is or is not “creditable coverage” (“Creditable Coverage”) for purposes of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (the “MMA”) “Part D” prescription drug coverage program. Before distributing the required Part D Notice, group health plan sponsors and administrators should review and update the Part D Notice as needed in light of 2009 revisions to the Part D Notice requirements issued earlier this year by CMS.
The MMA generally mandates that covered employer-sponsored group health plans send a Part D Notice that complies with the form and content requirements established by the Centers for Medicare & Medicaid Services (“CMS”) to all Medicare Part D-eligible individuals covered under, or who apply for, enrollment in a group health plan providing prescription drug coverage at each of the following times:
- Before the Medicare Part D annual coordinated election period (November 15 – December 31) each year;
- Within the 12 months before an individual’s initial enrollment period for Medicare;
- Before the effective date of coverage for a Medicare-eligible individual beginning participation in the group health plan;
- When the plan’s prescription drug coverage ends or is no longer creditable; and
- Upon a beneficiary’s request.
Because CMS posted revised model notices and updated guidance regarding creditable coverage disclosures earlier this year, plan sponsors and administrators before distributing their Part D Notice generally will need to:
- Determine whether their group health plan does or does not provide creditable coverage for purposes of Medicare Part D regulations;
- Determine which Medicare Part D notification should be provided in light of the existing group health plan design; and
- Review and update, if necessary, the content and form of the Part D Notice to comply with the updated guidance issued earlier this year.
The Annual Part D Notice requirement generally applies to all group health plans not otherwise specifically excluded from coverage even those that do not provide retiree coverage. The MMA generally requires notification to Medicare Part D-eligible employees and dependents, regardless of whether the member is enrolled under active or retired coverage or whether the group health plan coverage is primary or secondary to Medicare.
A group health plan must determine if its prescription drug coverage is “creditable coverage” in accordance with rules contained in the Medicare Part D regulations. These regulations generally specify that prescription drug coverage qualifies as creditable coverage if the actuarial value of the coverage equals or exceeds the actuarial value of the Part D prescription drug coverage, as demonstrated through the use of generally accepted actuarial principles in accordance with CMS actuarial guidelines. This actuarial determination measures whether the expected amount of paid claims under the group health plan’s prescription drug coverage is at least as much as the expected amount of paid claims under the standard Medicare prescription drug benefit. In lieu of an actuarial assessment, the Medicare Part D regulations alternatively allow group health plans to rely upon a safe harbor rule. Under this safe harbor, group health plans offering prescription drug coverage qualify as providing Creditable Coverage without an actuarial assessment if the standards of the safe harbor rule are met.
This determination of creditable coverage for Medicare Part D purposes is separate and distinct from the requirement that group health plans determine and provide notification of “creditable coverage” when group health plan coverage ends pursuant to the group health plan portability requirements imposed by the Health Insurance Portability & Accountability Act of 1996, as amended (“HIPAA”).
When distributing the Part D Notice, group health plan sponsors and administrators also generally will want to make arrangements to ensure that separately required notifications to CMS regarding the creditable coverage status of the group health plan under Medicare Part D will be timely made as well as calendar reminders to prepare and provide the Part D Notice expected to be required in November, 2010. The Medicare Part D regulations also generally require group health plans also to provide a “Disclosure Notice” to CMS informing it whether the applicable group health plan provides Medicare Part D Creditable Coverage on an annual basis during the first 60 days of the plan year, and upon any change that affects whether the group health plan provides prescription drug coverage that is or is not creditable coverage for Medicare Part D purposes..
In addition to the Medicare Part D notice requirements, group health plans also are required to provide various other annual and other notifications by ERISA, the Health Insurance Portability & Accountability Act of 1996, as amended (“HIPAA”), Newborns’ and Mothers’ Health Protection Act, medical coverage e continuation requirements under the Consolidated Omnibus Budget Reconciliation Act, as amended (“COBRA”), the Family & Medical Leave Act and a host of other federal laws, many of require updates in response to statutory and/or regulatory changes in the past year. In addition to updating and providing the required Medicare Part D Notice, many group health plan sponsors and administrators also should review and update their group plan language, notifications and processes in response to amendments affecting these practices as well as a series of other recent changes to federal mandates affecting group health plans. For more information about these and other developments affecting group health plans, checkout some of the writings and recorded presentations of Ms. Stamer available here.
If you need assistance reviewing or updating your group health plan’s implications of the MMA on your group health plans or other health or employee benefit plan requirements, 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 and past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer is nationally recognized for her more than 20 years work, writing and leadership advising employers and other plan sponsors, plan administrators and fiduciaries, insurers, administrative services providers, brokers, and others about the design, documentation, administration and defense of health and other employee benefit, insurance, and other compensation and employment practices. 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.
Comments Off on November 15, 2009 Is Deadline To Send Required Group Health Plan Medicare Part D “Creditable Coverage” Notice |
Employee Benefits, Employers, ERISA, Health Plans, Insurance, Medicare Part D, Prescription Drugs, Reporting & Disclosure | Tagged: Employers, Health Plans, Medicare Part D, Prescription Drug Coverage |
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Posted by Cynthia Marcotte Stamer
October 27, 2009
The Internal Revenue Service (IRS) today published updated procedures governing when certain employers may elect to report social security, Medicare and withheld federal income taxes (employment taxes) annually by filing IRS Form 944, rather than reporting those amounts quarterly for tax years beginning after December 31, 2009.
Beginning in the 2010 tax year, Revenue Procedure 2009-51 will allow qualifying employers to opt out of filing Form 944 social security, Medicare and withheld federal income taxes (“employment taxes”) for any reason if they follow the procedures set forth in Revenue Procedure 2009-51 by the applicable deadline specified in the Revenue Procedure. The procedures set forth in Revenue Procedure 2009-51 generally are available only to employers are those with an estimated annual employment tax liability of $1,000 or less for the entire calendar year, other than employers required to make a return on Form 943, Employer’s Annual Federal Tax Return For Agricultural Employees, or on Schedule H (Form 1040), Household Employment Taxes.
Revenue Procedure 2009-51 outlines the procedures that qualified employers can apply to report employment taxes annually on the Form 944. Employers wishing to take advantage of this option must request to file the Form 944 by contacting the IRS as specified in Revenue Procedure 2009-51 and have received the written approval of their request from the IRS before using the Form 944 by the applicable deadline. Alternatively employers who previously received notification of their qualification to file Form 944 must continue to file Form 944 unless the IRS notifies the employer that the employer no longer qualifies to file Form 944 or the employer opts out consistent with the procedures set forth in Revenue Procedure 2009-51.
Employers electing to report employment taxes annually rather than quarterly should ensure that they continue to timely deposit employment taxes as required by the Internal Revenue Code. Generally, the same deposit rules apply to employers regardless of which form they file to report their employment tax liability; however, the de minimis deposit amount may be different. Employers who file Forms 941 and 944 still must deposit their employment tax liability in accordance with the rules in Treas. Reg. §§ 31.6302-1 and 31.6302-1T or, absent reasonable cause, the employers may be subject to the penalty for failure to deposit under section 6656.
Qualifying employers wishing to make elections under these rules must act in a timely fashion. An employer wishing to request to opt in or out of filing Form 944 for the current tax year via telephone generally must call the IRS at the designated number on or before April 1st of the current tax year (e.g., April 1, 2010 for returns for tax year 2010); written requests generally must be postmarked on or before March 15th of the current tax year (e.g., March 15, 2010 for returns for tax year 2010). Special deadlines apply for businesses that recently received an employer identification number or had an employer identification number but were not previously required to file Forms 941 or Form 944. Consult your tax advisor if you have questions about these deadlines.
If you have questions about or need assistance evaluating, commenting on or responding to these or 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 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 employment, 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 has advised and represented employers on these and other 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. 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.
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Employers | Tagged: Employers, Employment Taxes, FICA, FUTA, Income Tax, IRS, Withholding |
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Posted by Cynthia Marcotte Stamer
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.
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Employee Benefits, Employers, ERISA, Health Care Reform, Health Plans, Public Policy |
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Posted by Cynthia Marcotte Stamer
September 30, 2009
December 29, 2009 is the deadline to submit comments to the Occupational Safety and Health Administration (OSHA) on a proposal to modify its existing Hazard Communication Standard (HCS) published in the Federal Register today (September 30, 2009).
OSHA is proposing to conform with the United Nations’ (UN) Globally Harmonized System of Classification and Labelling of Chemicals (GHS) and make various other changes to the HCS. OSHA says the proposed modifications will improve the quality and consistency of information provided to employers and employees regarding chemical hazards and associated protective measures and will enhance the effectiveness of the HCS in ensuring that employees are apprised of the chemical hazards to which they may be exposed, and in reducing the incidence of chemical-related occupational illnesses and injuries.
The proposed modifications to the HCS standard among other things would:
- Revise criteria for classification of chemical hazards;
- Revise labeling provisions that include requirements for use of standardized signal words, pictograms, hazard statements, and precautionary statements; a specified format for safety data sheets; and
- Revise related revisions to definitions of terms used in the standard, requirements for employee training on labels and safety data sheets.
- Modify provisions of a number of other standards, including standards for flammable and combustible liquids, process safety management, and most substance-specific health standards, to ensure consistency with the modified HCS requirements.
OSHA has proposed to require that employers train employees on the new labels and safety data sheets within two years after publication of the final rule to ensure they are familiar with the new approach and that chemical manufacturers, importers, distributors, and employers be required to comply with all provisions of the modified final rule within three years after its publication. In addition to generally inviting comments on the proposed changes, OSHA has specifically asked for input about the adequacy of these periods.
To review the proposed regulation text, see here.
If you have questions about or need assistance evaluating, commenting on or responding to the Proposed Regulation or other employment, compensation, employee benefit, workplace health and safety, corporate ethics and compliance practices or other related concerns or claims, 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, Ms. Stamer is experienced with assisting employers and others about these and other human resources related concerns. 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 20 years. Ms. Stamer also speaks and writes extensively on these and other related matters. You can learn more about Ms. Stamer and her experience here and access other selected publications and presentations by Ms. Stamer 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:
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.
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Employers, Human Resources, OSHA, Safety |
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Posted by Cynthia Marcotte Stamer
September 29, 2009
The next meeting of the HIT Standards Committee of the Office of the National Coordinator for Health Information Technology (ONC) will be held on October 14, 2009, from 9 a.m. to 3 p.m./Eastern Time at the Omni Shoreham Hotel, 2500 Calvert Street, NW., Washington, DC. The hotel telephone number is 202-234-0700. Interested members of the public are invited to attend.
Created under the American Recovery and Reinvestment Act of 2009 (ARRA), the HIT Standards Committee is charged with making recommendations to the Office of National Coordinator for Health Information Technology (ONC) on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information consistent with the implementation of the Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT Policy Committee. Even as Congress debates further reforms, the activities of the HIT Committee and other components of the ONC are key actors in the continuing efforts of the Obama Administration to promote health care efficiency by reengineering health care technology.
During a previous meeting on August 20, 2009, the HIT Committee finalized certain recommendations concerning meaningful use of electronic medical records, clinical quality, and privacy and security of protected health information, which are available for review here.
According to the ONC announcement regarding the upcoming meeting in today’s (September 29, 2009) Federal Register available here, the Committee plans during the meeting to:
- Discuss reports from its Clinical Operations, Clinical Quality, and Privacy and Security Workgroups
- Take testimony from invited experts in the field of security as it relates to health information technology
Interested persons may present data, information, or views, orally or in writing, on issues pending before the committee. Written submissions may be made to the contact person on or before October 6, 2009. Oral comments from the public will be scheduled between approximately 2:30 p.m. to 3 p.m. Time allotted for each presentation may be limited. If the number of speakers requesting to comment is greater than can be reasonably accommodated during the scheduled open public hearing session, ONC will take written comments after the meeting until close of business.
ONC hopes to make background material available to the public at least two (2) business days prior to the meeting. However, if ONC is unable to post the background material on its Web site before the meeting, it will make that material publicly available at the location of the advisory committee meeting, and post the background material on ONC’s web site after the meeting here.
The designated person to contact for additional information is Jonathan Ishee, Office of the National Coordinator, HHS, 200 Independence Ave, SW., Room 729-G, Washington, DC 20201, 202-205-8493, Fax: 202-690-6079, e-mail: jonathan.ishee@hhs.gov.
If you need assistance preparing or presenting comments to the HIT Standards Committee or with monitoring or responding to other health care IT, privacy and data security, regulatory, operational, public policy or other health or other employee benefit or human resources concerns, please contact the author of this update, Curran Tomko Tarski LLP Partner Cynthia Marcotte Stamer at (214) 270-2402 or via e-mail at CStamer@CTTLegal.com.
Other Recent Developments
If you found this information of interest, you also may be interested in reviewing some of the following recent Solution Law Press Updates available online by clicking on the applicable article title below:
For More Information
We hope that this information is useful to you. If you need assistance with auditing or defending these or other health care compliance, risk management, transaction or operation concerns, please contact the author of this update, Curran Tomko Tarski LLP Labor, Employment & Employee Benefit Practice Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com, Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health and other employee benefit, human resources and related matters.
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, registering to receive updates in blog form here or e-mailing this information to support@solutionslawyer.net.
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 here. To unsubscribe, e-mail here.
©2009 Cynthia Marcotte Stamer. All rights reserved.
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Uncategorized | Tagged: EHR, Electronic Medical Records, EMI, Employee Benefits, ERISA, Health Care Reform, Health Insurance, Health IT, Human Resources, Meaningful Use |
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Posted by Cynthia Marcotte Stamer
September 21, 2009
November 20, 2009 is the deadline to submit comments to the Internal Revenue Service Joint Board For The Enrollment Of Actuaries on proposed amendments to its rules for relating to the enrollment of actuaries under section 3042 of the Employee Retirement Income Security Act of 1974 (ERISA) published here in today’s Federal Register. The Proposed Regulations would update the eligibility requirements for performing actuarial services for ERISA-covered employee pension benefit plans set forth in to 20 C.F.R. part 901, including the continuing education requirements and the standards for performing such actuarial services. The proposed amendments would affect employee pension benefit plans and the actuaries providing actuarial services to those plans.
If you have questions about or need assistance evaluating, commenting on or responding to the Proposed Regulations, or 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 Practice Group Chair Cynthia Marcotte Stamer. Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Group and an ABA Joint Committee on Employee Benefits Representative, Ms. Stamer is experienced with assisting employee benefit plan sponsors, fiduciaries, advisors and consultants and others about a diverse range of employee benefits, compensation and other related matters. With more than 20 years experience in these and other employee benefit, compensation and other matters, 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.
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Employee Benefits, ERISA, Human Resources, Retirement Plans |
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Posted by Cynthia Marcotte Stamer
September 18, 2009
Proposed regulations modifying existing Equal Employment Opportunity Commission (EEOC) rules concerning the conditions that an individual must meet to qualify as having a “disability” for purposes of claiming protection under the Americans with Disabilities Act (ADA) are expected to be published in the Federal Register the week of September 21, 2009.
On September 16, 2009, the EEOC announced that Commissioners had approved a Notice of Proposed Rulemaking (Proposed Regulation) which would make several significant changes to the its current regulatory definition of the term “disability” for purposes of the ADA. The EEOC announced this week that the Proposed Regulation is expected to be published in the Federal Register the week of September 21, 2009. Interested persons will have 60 days from the publication date of the Proposed Rule to submit comments to the EEOC concerning the Proposed Regulation.
Why The Change?
The proposed changes are intended to respond to amendments enacted under the ADA Amendments Act (ADAAA), which took effect January 1, 2009. Enacted on September 25, 2008, the ADAAA made a number of significant changes to the definition of “disability” in the ADA as well as directed EEOC to amend its existing ADA regulation to reflect the changes made by the ADAAA.
The ADAAA amendments to the ADA definition of “disability” make it easier for certain individuals alleging employment discrimination based on disability to establish disability status under the ADA’s definition of “disability” by overruling various Supreme Court holdings and portions of EEOC’s existing ADA regulations considered by many members of Congress as too narrowly applying the definition of “disability.”
While the ADAAA retains the ADA’s basic definition of “disability” as an impairment that substantially limits one or more major life activities, a record of such an impairment, or being regarded as having such an impairment, provisions of the ADAAA that took effect on January 1, 2009 change the required interpretation of these terms. Under the ADAAA, “major life activities” now include both many activities that the EEOC has recognized (e.g., walking) as well as activities that EEOC has not specifically recognized (e.g., reading, bending, and communicating), as well as major bodily functions (e.g., “functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions”).
In addition to these clarifications, the ADAAA also broadens the reach of the ADA’s definition of “disability” in various other respects. For instance, the ADAAA:
- Asserts that mitigating measures other than “ordinary eyeglasses or contact lenses” shall not be considered in assessing whether an individual has a disability;
Clarifies that an impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active;
- Changes the definition of “regarded as” so that it no longer requires a showing that the employer perceived the individual to be substantially limited in a major life activity, and instead says that an applicant or employee is “regarded as” disabled if he or she is subject to an action prohibited by the ADA (e.g., failure to hire or termination) based on an impairment that is not transitory and minor; and
- Provides that individuals covered only under the “regarded as” prong are not entitled to reasonable accommodation.
As part of the required implementation of its provisions, the ADAAA also mandates that the EEOC revise that portion of its existing regulations defining the term “substantially limits” and “major life activities” to comport to the changes enacted by the ADAAA. In response to this statutory direction, the Proposed Regulation to be published next week proposes changes both to the ADA regulation itself and to the Interpretive Guidance (also known as the Appendix) that was published at the same time as the original ADA regulation. See 29 C.F.R. section 1630. The Appendix provides further explanation from the EEOC on how its ADA regulations should be interpreted.
About The New Guidance and Proposed Regulations
In anticipation of the publication of the Proposed Regulation, the EEOC on September 16, 2009 sought to provided a peek into its new post-ADAAA construction of the ADA definition of disability by releasing its “Questions and Answers on the Notice of Proposed Rulemaking for the ADA Amendments Act of 2008” Questions and answers on the Notice of Proposed Rulingmaking for the ADA Amendments Act of 2008 (the “Q&As”).
The Q&As and other EEOC statements released this week indicate that the Proposed Regulation will emphasize that the definition of disability — an impairment that poses a substantial limitation in a major life activity — must be construed broadly. It will provide that that major life activities include “major bodily functions;” that mitigating measures, such as medications and devices that people use to reduce or eliminate the effects of an impairment, are not to be considered when determining whether someone has a disability; and that impairments that are episodic or in remission, such as epilepsy, cancer, and many kinds of psychiatric impairments, are disabilities if they would “substantially limit” major life activities when active. The regulation also will provides a streamlined means through which persons claiming disability may demonstrate a substantial limitation in the major life activity of working, and implements the ADAAA’s new standard for determining whether someone is “regarded as” having a disability.
Required Response
Employers face increasing exposure to disability claims as a result of the ADAAA amendments, new genetic information nondiscrimination rules enacted under the Genetic Information Nondiscrimination Act (GINA), and a heightened emphasis on disabilities discrimination law enforcement by the Obama Administration. In light of this rising exposure, employers and others covered by the ADA should evaluate their existing practices in light of the Q&As and make adjustments, submit comments regarding the Proposed Regulations or both as part of their efforts to manage their organization’s ADA liability exposure. Because the ADAAA already is in effect, employers already face the possibility of being called upon to defend their hiring and employment practices under the amended ADAAA definition of disability, even though the EEOC has not issued final guidance. For this reason, it is important that employers take timely action both to update relevant written policies and procedures, as well as to change hiring and other operational processes, conduct training, implement appropriate oversight and monitoring and take other steps to mitigate these exposures.
If you have questions about or need assistance evaluating, commenting on or responding to the Proposed Regulations, the Q&As, or 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 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 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 has advised and represented employers on these and other 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. 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.
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ADA, Disease Management, EEOC, Employee Benefits, Employers, GINA, Human Resources, Internal Controls, Internal Investigations, OFCCP, Retaliation, Retirement Plans | Tagged: ADA, Disability Discrimination, Employee Benefits, Employer, Employers, Employment, Employment Agreements, GINA, Human Resources, Internal Controls, Internal Investigations, Light Duty, Risk Management |
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Posted by Cynthia Marcotte Stamer
September 15, 2009
December 14, 2009 is the deadline to comment on proposed regulations relating to the exclusion from gross income for amounts received on account of personal physical injuries or physical sickness published by the Internal Revenue Service (IRS) in light of amendments enacted by the Small Business Job Protection Act of 1996.
The Small Business Job Protection Act of 1996 (SBJPA) amended Internal Revenue Code § 104 to delete the requirement that to qualify for exclusion from gross income, damages received from a legal suit, action, or settlement agreement must be based upon “tort or tort type rights” (the “tort test”). As amended by the SBJPA, Code § 104(a)(2) excludes from gross income the amount of any damages (other than punitive damages) received (whether by suit or agreement and whether as lump sums or as periodic payments) on account of personal physical injuries or physical sickness.
In keeping with this amendment, the proposed regulations published today (9/15/09) would amend the regulations to eliminate the tort test as a requirement for personal injury damages generally to qualify for exclusion under Code § 104. Under the proposed regulations, the current requirement that “personal injuries or sickness” awards be “based upon tort or tort type rights” to qualify for exclusion under Code § 104(a)(2) also would be removed in light of recent judicial and statutory developments. As a consequence, physical injuries could qualify for the Code § 104(a)(2) exclusion even though the injury giving rise to the damages is not defined as a tort under state or common law. Furthermore, the Code § 104(a)(2) exclusion also would not depend on the scope of remedies available under state or common law. As a consequence, the proposed rule would allow the exclusion for damages awarded under no-fault statutes.
According to the proposed regulations, however, the tort test would not be eliminated as a requirement for punitive damage awards to qualify for income exclusion under Code § 104. The preamble to the proposed regulations explains the IRS does not construe the SBJPA amendment as removing the tort test or otherwise extend Code § 104 to such awards. Rather, the proposed regulations would provide that punitive damage awards do not qualify for income exclusion under Code § 104.
If adopted as proposed, the IRS has indicated that it intends to treat the proposed rules as effective for personal injury awards received after August 20, 1996, except for any amount received under a written binding agreement, court decree, or mediation award in effect on (or issued on or before) September 13, 1995. For amounts paid pursuant to a written binding agreement, court decree, or mediation award entered into or issued after September 13, 1995 and received after August 20, 1996, a taxpayer would be permitted to file a claim for refund of any tax overpayments paid within the period of limitations under section 6511.
If you have questions about or need assistance commenting on or responding to the proposed regulations or other employment, compensation, employee benefit, workplace health and safety, corporate ethics and compliance practices other related matters, 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 compensation and employee benefit, workplace safety, equal employment opportunity and other labor and employment, as well as advising ad defending employers 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 has advised and represented employers on these and other 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. 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.
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Employers, Employment Tax, ERISA, Human Resources, Tax |
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Posted by Cynthia Marcotte Stamer
September 9, 2009
The U.S. Department of Labor Occupational Safety and Health Administration (OSHA) today (September 9, 2009) published a final rule revising the personal protective equipment (PPE) sections of its general industry, shipyard employment, longshoring, and marine terminals standards regarding requirements for eye- and face-protective devices, head protection, and foot protection.
The Final Rule published in today’s Federal Register:
- Updates OSHA regulatory references to recognize more recent editions of the applicable national consensus standards
- Deletes references to obsolete prior editions of the national consensus standards
- Amends provisions requiring safety shoes to comply with a specific American National Standards Institute (ANSI) standard
- Amends a provision that requires filter lenses and plates in eye- protective equipment to meet a test for transmission of radiant energy specified by another ANSI standard.
Instead of the amended standards, OSHA will require this safety equipment to comply with the applicable PPE design provisions.
The changes implemented under the Final Rule will become effective on October 9, 2009. Interested persons can review a copy of the Final Regulation here.
If your business needs assistance with auditing, updating or defending its workplace health and safety, human resources, corporate ethics, and compliance practices, or responding to employment related or other charges or suits, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402; another Curran Tomko Tarski, LLP attorney of your choice.
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 workplace safety, 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. 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.
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Corporate Compliance, Employers, Human Resources, OSHA, Safety |
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Posted by Cynthia Marcotte Stamer
September 4, 2009
The Department of Labor (DOL) is proposing changes to its rules governing the certification of temporary employment of nonimmigrant workers in temporary or seasonal agricultural employment and the enforcement of the contractual obligations applicable to employers of such nonimmigrant workers.
The proposed changes appear in a Notice of Proposed Rulemaking (Proposed Rule) in today’s (September 4, 2009) Federal Register here. The Proposed Rule reexamines the process by which employers obtain a temporary labor certification from DOL for use in petitioning the Department of Homeland Security (DHS) to employ a nonimmigrant worker in H-2A status. DOL also proposes to amend the regulations at 29 CFR part 501 to provide for sufficient enforcement under the H-2A program so that workers are appropriately protected when employers fail to meet the requirements of the H-2A program.
About The Author
Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, Ms. Stamer has more than 20 years experience representing and advising businesses and government on labor and employment, internal controls, employee benefits, safety and other related matters. An ABA Joint Committee on Employee Benefits Council Member and Chair of the ABA RPTE Employee Benefits & Other Compensation Group, Ms. Stamer also is a highly popular speaker and widely published author. Her insights on human resources, employee benefits and internal controls matters appear in the Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, and a many other national and local publications. For additional information about Ms. Stamer, her experience, involvements, programs or publications, see here
We hope that this information is useful to you. If you need assistance responding to these or other compliance, risk management, transaction or operation concerns, please contact the author of this update, Cynthia Marcotte Stamer, at (214) 270-2402, cstamer@cttlegal.com.
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 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 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.
©2009 Solutions Law Press. All rights reserved.
Comments Off on DOL Proposes Changes To H-2A Temporary & Seasonal Agricultural Nonimmigrant Worker Certification Procedures & Related Rules |
E-Verify, Employers, Human Resources, I-9 |
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Posted by Cynthia Marcotte Stamer
September 2, 2009
September 10, 2009 – Noon to 1:30 P.M. Central Time Participate In Person or Via Remote!
Health care providers, health plans, health clearinghouses and their business associates (Covered Entities) must comply with the new “Breach Notification For Unsecured Protected Health Information” regulation (Breach Regulation) by September 23, 2009.
Catch up on what the Breach Rule means for your organization and how it must respond by participating in the “HITECH Act Health Data Security & Breach Update” on Thursday, September 10, 2009 from Noon to 1:30 P.M. Central Time for a registration fee of $45.00. Registrants will have the option to participate via teleconference or in person at the offices of Curran Tomko Tarski LLP, 2001 Bryan Street, Suite 2050, Dallas Texas 75201. For information about registering for this program or other questions here,
The Breach Rule requires Covered Entities to notify affected individuals following a “breach” of “unsecured” protected health information. Just published August 24th, the Breach Regulation is part of a series of guidance that HHS is issuing to implement new and stricter personal health information privacy and data security requirements for Covered Entities added to HIPAA under the Health Information Technology for Economic and Clinical Health (HITECH) Act signed into law on February 17, 2009 as part of American Recovery and Reinvestment Act of 2009 (ARRA). The briefing will cover:
- Who must comply, health plans, employers, others?
- What your organization must do
- How to qualify protected health information as exempt from the breach regulations as “secure” protected health information
- What is considered a breach of unsecured protected health information
- What steps must a covered entity take if a breach of unsecured protected information happens
- What liabilities do covered entities face for non-compliance
- What new contractual requirements, policies and procedures Covered Entities and Business Associates will need
- How the Breach Regulation, the Privacy Regulation, impending FTC red flag rules and state data breach and privacy rules interrelate
- Other recent developments
- Practical tips for assessing, planning, moving to and defending compliance
- Participant questions
- More
About The Presenter
The program will be presented by Curran Tomko and Tarski LLP Health Care & Employee Benefits Practice Leader and Partner Cynthia Marcotte Stamer. Ms. Stamer is nationally known for her work, publications and presentations on privacy and security of health and other sensitive information in health and managed care, employment, employee benefits, financial services, education and other contexts. Chair of the ABA RPTE Employee Benefits & Other Compensation Committee, a ABA Joint Committee on Employee Benefits Council Representative, Vice President of the North Texas Health Care Compliance Professionals Association, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has more than 20 years experience advising clients about health and other privacy and security matters. A popular lecturer and widely published author on privacy and data security and other related health care and health plan matters, Ms. Stamer is the Editor in Chief of the forthcoming 2010 edition of the Information Security Guide to be published by the American Bar Association Information Security Committee in 2010, as well as the author of “Protecting & Using Patient Data In Disease Management: Opportunities, Liabilities And Prescriptions,” “Privacy Invasions of Medical Care-An Emerging Perspective,” “Cybercrime and Identity Theft: Health Information Security Beyond HIPAA,” and a host of other highly regarded publications. She has continuously advises employers, health care providers, health insurers and administrators, health plan sponsors, employee benefit plan fiduciaries, schools, financial services providers, governments and others about privacy and data security, health care, insurance, human resources, technology, and other legal and operational concerns. Ms. Stamer also publishes and speaks extensively on health and managed care industry privacy, data security and other technology, regulatory and operational risk management matters. 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.
We hope that this information is useful to you. If you need assistance monitoring, evaluating or responding to these or other compliance, risk management, transaction or operation concerns, please contact the author of this update, Cynthia Marcotte Stamer, at (214) 270-2402, cstamer@cttlegal.com or another Curran Tomko Tarski LLP Partner of your choice.
Other Helpful Resources & Other Information
If you find this 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 Solutions Law Press. All rights reserved.
Comments Off on Register Now For HITECH Act Health Data Security & Breach Update: Learn What You Must Do This Month To Comply With New Health Data Breach Regulations |
Corporate Compliance, Data Security, Disease Management, Employers, GINA, Health Plans, HIPAA, Human Resources, Insurance, Internal Controls, Privacy, Protected Health Information | Tagged: Corporate Compliance, Employee Benefits, Employer, Employers, Employment, ERISA, GINA, Health Care Reform, Health Insurance, Health Plans, Human Resources, Insurance, Insurer, Internal Controls, Managed Care, Medical Coverage, Privacy |
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Posted by Cynthia Marcotte Stamer
August 25, 2009
Provisions of the ADA Amendments Act (ADAAA) that expand the definition of “disability” under the Americans with Disabilities Act (ADA) “in favor of broad coverage of individuals” do not apply to actions taken before effective date of the ADAAA, January 1, 2009, according to a recent decision of the U.S. Circuit Court of Appeals for the District of Columbia. While the holding provides some comfort for employers in relation to pre-January 1, 2009 actions, employers need to take appropriate steps to mitigate disability claim risks for actions on or after the January 1, 2009 effective date of the ADAAA.
As signed into law on September 25, 2008, the ADAAA amended the definition of “disability” for purposes of the disability discrimination prohibitions of the ADA to make it easier for an individual seeking protection under the ADA to establish that that has a disability within the meaning of the ADA. The ADAAA retains the ADA’s basic definition of “disability” as an impairment that substantially limits one or more major life activities, a record of such an impairment, or being regarded as having such an impairment. However, provisions of the ADAAA that took effect January 1, 2009 change the way that these statutory terms should be interpreted in several ways. Most significantly, the Act:
- Directs EEOC to revise that portion of its regulations defining the term “substantially limits;”
- Expands the definition of “major life activities” by including two non-exhaustive lists: (1) The first list includes many activities that the EEOC has recognized (e.g., walking) as well as activities that EEOC has not specifically recognized (e.g., reading, bending, and communicating); and (2) The second list includes major bodily functions (e.g., “functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions”);
- States that mitigating measures other than “ordinary eyeglasses or contact lenses” shall not be considered in assessing whether an individual has a disability;
- Clarifies that an impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active;
- Changes the definition of “regarded as” so that it no longer requires a showing that the employer perceived the individual to be substantially limited in a major life activity, and instead says that an applicant or employee is “regarded as” disabled if he or she is subject to an action prohibited by the ADA (e.g., failure to hire or termination) based on an impairment that is not transitory and minor; and
- Provides that individuals covered only under the “regarded as” prong are not entitled to reasonable accommodation.
The ADAAA also emphasizes that the definition of disability should be construed in favor of broad coverage of individuals to the maximum extent permitted by the terms of the ADA and generally shall not require extensive analysis.
In Lytes v. DC Water and Sewer Authority, D.C. Cir. No. 08-7002 (July 21, 2009), the D.C. Court of Appeals considered and rejected the retroactivity argument made by Lytes in his appeal from a trial court’s finding that he was not disabled under the ADA. As the ADAAA took effect while his action was pending, Lytes sought to convince the Appeals Court to apply the ADAAA amended definition retroactively. Contending that the ADAAA amendment merely clarified the existing law under the ADA, Lytes argued that the Court should apply the broader definition of disability when considering the legality of his termination from employment in 2004.
Rejecting Lytes’ retroactivity argument, the Court of Appeals ruled that the ADAAA amendment of the definition of “disability” under the ADA applies only on a prospective basis based on its finding that Congress had clearly provided that the ADAAA amendments only would apply to post-December 31, 2008 actions. Accordingly, the Court of Appeals affirmed the District Court’s finding that Lytes termination in 2004 did not violate the ADA as then effective as his lack of disabled status under the then-applicable definition of disability meant he was not entitled to accommodation.
In adopting these changes, Congress expressly sought to overrule existing employer-friendly judicial precedent construing the current provisions of the ADA and to require the Equal Employment Opportunity Commission (EEOC) to update its existing guidance to confirm with the ADAAA Amendments.
Violations of the ADA can expose businesses to substantial liability. Violations of the ADA may be prosecuted by the EEOC or by private lawsuits. Employees or applicants that can prove they were subjected to prohibited disability discrimination under the ADA generally can recover actual damages, attorneys’ fees, and up to $300,000 of exemplary damages (depending on the size of the employer).
While the Lytes decision indicates that businesses will not be required to defend pre-2009 actions under the amended disability standards enacted by the ADAAA, businesses should prepare to meet new challenges in defending ADA claims arising from actions taken after December 31, 2008. The ADAAA amendments make it likely that businesses generally will face more disability claims from a broader range of employees and will possess fewer legal shields to defend themselves against these claims. These changes will make it easier for certain employees to qualify as disabled under the ADA. Consequently, businesses should act strategically to mitigate their ADA exposures in anticipation of these changes.
To help mitigate the expanded employment liability risks created by the ADAAA amendments, businesses generally should act cautiously when dealing with applicants or employees with actual, perceived, or claimed physical or mental impairments to minimize exposures under the ADA. Management should exercise caution to carefully and appropriate the potential legal significance of physical or mental impairments or conditions that might be less significant in severity or scope, correctable through the use of eyeglasses, hearing aids, daily medications or other adaptive devices, or that otherwise have been assumed by management to fall outside the ADA’s scope. Employers should no longer assume, for instance, that a visually impaired employee won’t qualify as disabled because eyeglasses can substantially correct the employee’s visual impairment.
Likewise, businesses should be prepared for the EEOC and the courts to treat a broader range of disabilities, including those much more limited in severity and life activity restriction, to qualify as disabling for purposes of the Act. Businesses should assume that a greater number of employees with such conditions are likely to seek to use the ADA as a basis for challenging hiring, promotion and other employment decisions. For this reason, businesses generally should tighten job performance and other employment recordkeeping to enhance their ability to demonstrate nondiscriminatory business justifications for the employment decisions made by the businesses.
Businesses also should consider tightening their documentation regarding their procedures and processes governing the collection and handling records and communications that may contain information regarding an applicant’s physical or mental impairment, such as medical absences, worker’s compensation claims, emergency information, or other records containing health status or condition related information. The ADA generally requires that these records be maintained in separate confidential files and disclosed only to individuals with a need to know under circumstances allowed by the ADA.
As part of this process, businesses also should carefully review their employment records, group health plan, family leave, disability accommodation, and other existing policies and practices to comply with, and manage exposure under the new genetic information nondiscrimination and privacy rules enacted as part of the Genetic Information and Nondiscrimination Act (GINA) signed into law by President Bush on May 21, 2008. Effective November 21, 2009, Title VII of GINA amends the Civil Rights Act to prohibit employment discrimination based on genetic information and restricts the ability of employers and their health plans to require, collect or retain certain genetic information. Under GINA, employers, employment agencies, labor organizations and joint labor-management committees face significant liability for violating the sweeping nondiscrimination and confidentiality requirements of GINA concerning their use, maintenance and disclosure of genetic information. Employees can sue for damages and other relief like currently available under Title VII of the Civil Rights Act of 1964 and other nondiscrimination laws. For instance, GINA’s employment related provisions include rules that will:
- Prohibit employers and employment agencies from discriminating based on genetic information in hiring, termination or referral decisions or in other decisions regarding compensation, terms, conditions or privileges of employment;
- Prohibit employers and employment agencies from limiting, segregating or classifying employees so as to deny employment opportunities to an employee based on genetic information;
- Bar labor organizations from excluding, expelling or otherwise discriminating against individuals based on genetic information;
- Prohibit employers, employment agencies and labor organizations from requesting, requiring or purchasing genetic information of an employee or an employee’s family member except as allowed by GINA to satisfy certification requirements of family and medical leave laws, to monitor the biological effects of toxic substances in the workplace or other conditions specifically allowed by GINA;
- Prohibit employers, labor organizations and joint labor-management committees from discriminating in any decisions related to admission or employment in training or retraining programs, including apprenticeships based on genetic information;
- Mandate that in the narrow situations where limited cases where genetic information is obtained by a covered entity, it maintain the information on separate forms in separate medical files, treat the information as a confidential medical record, and not disclosure the genetic information except in those situations specifically allowed by GINA;
- Prohibit any person from retaliating against an individual for opposing an act or practice made unlawful by GINA; and
- Regulate the collection, use, access and disclosure of genetic information by employer sponsored and certain other health plans.
These employment provisions of GINA are in addition to amendments to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, the Internal Revenue Code of 1986, and Title XVIII (Medicare) of the Social Security Act that are effective for group health plan for plan years beginning after May 20, 2009.
If you have any questions or need help reviewing and updating your organization’s employment and/or employee practices in response to the ADAAA, GINA or other applicable laws, or if we may be of assistance with regard to any other workforce management, employee benefits or compensation matters, please do not hesitate to contact the author of this update, Curran Tomko Tarksi LLP Labor & Employment Practice Chair Cynthia Marcotte Stamer at 214.270.2402.
About The Author
Management attorney and consultant Cynthia Marcotte Stamer helps businesses, governments and associations solve problems, develop and implement strategies to manage people, processes, and regulatory exposures to achieve their business and operational objectives and manage legal, operational and other risks. Board certified in labor and employment law by the Texas Board of Legal Specialization, with more than 20 years human resource and employee benefits experience, Ms. Stamer helps businesses manage their people-related risks and the performance of their internal and external workforce though appropriate human resources, employee benefit, worker’s compensation, insurance, outsourcing and risk management strategies domestically and internationally. Recognized in the International Who’s Who of Professionals and bearing the Martindale Hubble AV-Rating, Ms. Stamer also is a highly regarded author and speaker, who regularly conducts management and other training on a wide range of labor and employment, employee benefit, human resources, internal controls and other related risk management matters. Her writings frequently are published by the American Bar Association (ABA), Aspen Publishers, Bureau of National Affairs, the American Health Lawyers Association, SHRM, World At Work, Government Institutes, Inc., Atlantic Information Services, Employee Benefit News, and many others. For a listing of some of these publications and programs, see here. Her insights on human resources risk management matters also have been quoted in The Wall Street Journal, various publications of The Bureau of National Affairs and Aspen Publishing, the Dallas Morning News, Spencer Publications, Health Leaders, Business Insurance, the Dallas and Houston Business Journals and a host of other publications. Chair of the ABA RPTE Employee Benefit and Other Compensation Committee, a council member of the ABA Joint Committee on Employee Benefits, and the Legislative Chair of the Dallas Human Resources Management Association Government Affairs Committee, she also serves in leadership positions in numerous human resources, corporate compliance, and other professional and civic organizations. For more details about Ms. Stamer’s experience and other credentials, contact Ms. Stamer, information about workshops and other training, selected publications and other human resources related information, see here or contact Ms. Stamer via telephone at 214.270.2402 or via e-mail 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 in this electronic Solutions Law publication 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.
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.
Comments Off on ADAAA Amendment Broader ADA “Disability” Definition Not Retroactive, Employer Action Needed To Manage Post 1/1/2009 Risks |
ADA, Corporate Compliance, EEOC, Employers, GINA, Human Resources, OFCCP, Retaliation | Tagged: ADA, Corporate Compliance, Disability Discrimination, Employee Benefits, Employers, Employment, Health Insurance, Health Plans, Human Resources |
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Posted by Cynthia Marcotte Stamer
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.
Comments Off on New Study Shares Data On Migrant Health Care Challenges Along The Border |
Disease Management, Employers, ERISA, Health Care Reform, Human Resources, I-9, Immigration, Pandemic, Public Policy |
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Posted by Cynthia Marcotte Stamer
August 24, 2009
Employer and other health plans, health care providers, health clearinghouses and their business associates must start complying with new federal data breach notification rules on September 23, 2009.
The new “Breach Notification For Unsecured Protected Health Information” regulation (Breach Regulation) published here in today’s Federal Register requires health plans, health care providers, health care clearinghouses and their business associates (Covered Entities) covered under the personal health information privacy and security rules of the Health Insurance Portability & Accountability Act (HIPAA) to notify affected individuals following a “breach” of “unsecured” protected health information.The Breach Regulation is part of a series of guidance that HHS is issuing to implement new and stricter personal health information privacy and data security requirements for Covered Entities added to HIPAA under the Health Information Technology for Economic and Clinical Health (HITECH) Act signed into law on February 17, 2009 as part of American Recovery and Reinvestment Act of 2009 (ARRA).
You are invited to catch up on what these new rules mean for your organization and how it must respond by participating in the “HITECH Act Health Data Security & Breach Update” on Wednesday, September 9 2009 from Noon to 1:30 P.M. Central Time.
HITECH Act Data Breach and Unsecured PHI Rules
Published in the August 24, 2009 Federal Register, the new Breach Regulation implements the HITECH Act requirement that Covered Entities and their business associates notify affected individuals, the Secretary of HHS, and in some cases, the media, when a breach of “unsecured protected health information” happens and the form, manner, and timing of that notification. Covered Entities must begin complying with the new Breach Regulation on September 23, 2009.
Part of a series of new HHS rules implementing recent changes to HIPAA enacted under the HITECH Act to strengthen existing federally mandates requiring Covered Entities to safeguard protected health information, the Breach Regulation will obligate Covered Entities and business associates to provide certain notifications following a breach of “protected health information” that not secured at the time of the breach through the use of a technology or methodology meeting minimum standards issued by HHS pursuant to other provisions of the HITECH Act.
Under the HITECH Act, the breach notification obligations contained in the Breach Notification only apply to a breach of “unsecured protected health information.” The Breach Regulation exempts breaches of protected health information that qualify as “secured” under separately issued HHS and Federal Trade Commission (FTC) standards for encryption and destruction of protected health information from its breach notification requirements.
For purposes of the HITECH Act, electronic protected health information is considered “unsecured” unless the Covered Entity has satisfied certain minimum standards for the protection of that data established pursuant to the HITECH Act. Earlier this year, HHS and the FTC issued interim rules defining the minimum encryption and destruction technologies and methodologies that Covered Entities must use to render protected health information unusable, unreadable, or indecipherable to unauthorized individuals for purposes of determining when protected health information is “unsecured” for purposes of the HITECH Act. Concurrent with its publication of the Breach Regulation, HHS also released guidance updating and clarifying this previously issued guidance.
Read the Breach Regulation here . To review the HITECH Act Breach Notification Guidance and Request for Information, see here .
Register For September 9, 2009 “HITECH Act Health Data Security & Breach Update”
Interested persons are invited to register here now to learn what these new rules mean for your organization and how it must respond by participating in the “HITECH Act Health Data Security & Breach Update” on Wednesday, September 9, 2009 from Noon to 1:30 P.M. Central Time. For a registration fee of $45.00, registrants will have the option to participate via teleconference or in person at the offices of Curran Tomko Tarski LLP, 2001 Bryan Street, Suite 2050, Dallas Texas 75201. For questions or other information about this program, e-mail here.
Conducted by Curran Tomko and Tarski LLP Partner Cynthia Marcotte Stamer, the briefing will cover:
- Who must comply
- What your organization must do
- How to qualify protected health information as exempt from the breach regulations as “secure” protected health information
- What is considered a breach of unsecured protected health information
- What steps must a covered entity take if a breach of unsecured protected information happens
- What liabilities do covered entities face for non-compliance
- What new contractual requirements, policies and procedures Covered Entities and Business Associates will need
- How the Breach Regulation, the Privacy Regulation, impending FTC red flag rules and state data breach and privacy rules interrelate
- Other recent developments
- Practical tips for assessing, planning, moving to and defending compliance
- Participant questions
- More
About The Presenter
The program will be presented by Curran Tomko Tarski LLP Partner Cynthia Marcotte Stamer. Ms. Stamer is nationally known for her work, publications and presentations on privacy and security of health and other sensitive information in health and managed care, employment, employee benefits, financial services, education and other contexts.
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 clients about health and other privacy and security matters. A popular lecturer and widely published author on privacy and data security and other related health care and health plan matters, Ms. Stamer is the Editor in Chief of the forthcoming 2010 edition of the Information Security Guide to be published by the American Bar Association Information Security Committee in 2010, as well as the author of “Protecting & Using Patient Data In Disease Management: Opportunities, Liabilities And Prescriptions,” “Privacy Invasions of Medical Care-An Emerging Perspective,” “Cybercrime and Identity Theft: Health Information Security Beyond HIPAA,” and a host of other highly regarded publications. She has continuously advises employers, health care providers, health insurers and administrators, health plan sponsors, employee benefit plan fiduciaries, schools, financial services providers, governments and others about privacy and data security, health care, insurance, human resources, technology, and other legal and operational concerns. Ms. Stamer also publishes and speaks extensively on health and managed care industry privacy, data security and other technology, regulatory and operational risk management matters. 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.
We hope that this information is useful to you. If you need assistance monitoring, evaluating or responding to these or other compliance, risk management, transaction or operation concerns, please contact the author of this update, Cynthia Marcotte Stamer, at (214) 270-2402, cstamer@cttlegal.com or another Curran Tomko Tarski LLP Partner of your choice.
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.com.
©2009 Cynthia Marcotte Stamer. All rights reserved.
Comments Off on Employer & Other Health Plans & Other HIPAA-Covered Entities & Their Business Associates Must Comply With New HHS Health Information Data Breach Rules By September 23 |
ARRA, Corporate Compliance, Data Security, Employee Benefits, Employers, ERISA, GINA, Health Plans, HIPAA, Human Resources, Insurance, Internal Controls, Preemption, Privacy, Protected Health Information, Risk Management, Stimulus Bill, Tax | Tagged: Corporate Compliance, Data Security, Employee Benefits, Employer, Employers, Employment, ERISA, GINA, Health Care Reform, Health Insurance, Health Plans, HealthP Plans, Human Resources, Insurance, Insurer, Internal Controls, Internal Investigations, Labor, Managed Care, Medical Coverage, Privacy, Risk Management, Subsidy Bill, Tax |
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Posted by Cynthia Marcotte Stamer
August 20, 2009
Employers and other health plan sponsors, fiduciaries, insurers and service providers need to move quickly to prepare to comply with “breach notification” regulations issued by the U.S. Department of Health and Human Services (HHS) yesterday (August 19, 2009). The new data breach regulations will require health plans, as well as health care providers, business associates and other covered entities (Covered Entities) under the personal health information privacy and security rules of the Health Insurance Portability & Accountability (HIPAA) to notify affected individuals following a “breach” of “unsecured” protected health information. Scheduled for publication in the Federal Register on August 24, 2009, the new breach notification regulations are part of a series of new rules that implement new electronic personal health information data security and data breach notification requirements for Covered Entities added to HIPAA under the Health Information Technology for Economic and Clinical Health (HITECH) Act signed into law on February 17, 2009 as part of American Recovery and Reinvestment Act of 2009 (ARRA). Covered entities must begin complying with the new rules no later than September 24, 2009.
Curran Tomko Tarski, LLP Health Practice leader Cynthia Marcotte Stamer will conduct a briefing on these new protected health information data security and data breach rules on Thursday, September 10, 2009 from Noon to 1:30 P.M. Central Time. For a registration fee of $45.00, registrants will have the option to participate via teleconference or in person at the offices of Curran Tomko Tarski LLP, 2001 Bryan Street, Suite 2050, Dallas Texas 75201. For more information, e-mail here.
HITECH Act Data Breach and Unsecured PHI Rules
The new data breach notification rules are part of a series of recent HIPAA enacted under the HITECH Act to strengthen the federal rules requiring HIPAA covered entities to safeguard electronic and certain other protected health information. Enhanced data security and data breach rules added as part of these HITECH Act amendments obligate covered entities and business associates to provide certain notifications following a breach of “unsecured” “protected health information” within the meaning of HIPAA, as amended. “Unsecured protected health information” is defined as protected health information that is not secured through the use of a technology or methodology specified by the HHS Secretary.
The new data breach regulations implement the HITECH Act requirement that Covered Entities and their business associates notify affected individuals, the Secretary of HHS, and in some cases, the media, of a breach and the form, manner, and timing of that notification. For purposes of the HITECH Act, electronic protected health information is considered “unsecured” unless the covered entity has satisfied certain minimum standards for the protection of that data established pursuant to the HITECH Act. HHS and the Federal Trade Commission previously issued certain initial guidance concerning the HITECH Act standards for determining when electronic personal health information qualifies as secure. To help further define when electronic health information is treated as “unsecured” and therefore subject to the breach notification requirements, the data breach rules also update and clarify the previously issued existing HHS guidance specifying encryption and destruction as the technologies and methodologies that render protected health information unusable, unreadable, or indecipherable to unauthorized individuals published earlier this year by HHS to for purposes of determining when protected health information will be considered “unsecured” for purposes of the HITECH Act data breach rules. Entities subject to the HHS and FTC regulations that secure health information as specified by the guidance through encryption or destruction are relieved from having to notify in the event of a breach of such information.
The HHS interim final regulations are effective September 24, 2009, which is the date 30 days after the date they will be published on the Federal Register and include a 60-day public comment period. To review the interim final data breach regulations, see here. To review the HITECH Act Breach Notification Guidance and Request for Information, see here.
For More Information
The author of this article, Curran Tomko and Tarski LLP Labor and Employment and Health Care Practice Chair Cynthia Marcotte Stamer has extensive experience advising and assisting employer and other health plan sponsors, insurers, managed care providers and other health and insurance industry clients about HIPAA and other privacy and data security matters, as well as a diverse range of health care, employment, and emplyee benefit policy, regulatory, compliance, risk management and operational concerns.
Current Chair of the American Bar Association (ABA) Real Property, Trusts & Estates Employee Benefit & Other Compensation Committee, an ABA Joint Committee on Employee Benefits Council member, past chair of the American Bar Association Health Law Section Managed Care & Insurance Section, Martindale Hubble AV-rated and recognized in International Who’s Who of Professionals, Ms. Stamer continuously advises health care providers, health care payers and administrators, employers, governments and others about health care, insurance, human resources, privacy and data security, technology, and other legal and operational concerns. A popular lecturer and widely published author on privacy and data security and other related health care and health plan matters, Ms. Stamer also writes and speaks extensively on health and managed care industry privacy, data security and other technology, regulatory and operational risk management matters. She currently serves as the Editor in Chief of the forthcoming 2010 edition of the Information Security Guide to be published by the American Bar Association Information Security Committee in 2010. Examples of her other works include “Protecting & Using Patient Data In Disease Management: Opportunities, Liabilities And Prescriptions,” “Privacy Invasions of Medical Care-An Emerging Perspective,” “Cybercrime and Identity Theft: Health Information Security Beyond HIPAA,” and a host of others. Her insights on health care, health insurance, human resources and related matters appear in the Atlantic Information Service Privacy Report, The Wall Street Journal, Business Insurance, the Dallas Morning News, Managed Healthcare, Health Leaders, and a various other national and local publications. For additional information about Ms. Stamer, her experience, involvements, programs or publications, see here.
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.
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.
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Corporate Compliance, ERISA, GINA, Health Plans, HIPAA, Human Resources, Insurance, Internal Controls, Internal Investigations | Tagged: Corporate Compliance, Data Breach, Data Security, Date Security, Employee Benefits, Employers, ERISA, GINA, Health Plans, HIPAA, Human Resources, Insurance, Insurer, Internal Controls, Managed Care, PHI, Privacy, Privacy Rule, Protected Health Information, Security Rule |
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Posted by Cynthia Marcotte Stamer
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.
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Disease Management, Employee Benefits, Employers, ERISA, Health Care Reform, Health Plans, Insurance, Malpractice, Preemption, Privacy, Public Policy, Tax, Wellness | Tagged: Employee Benefits, Employer, Employers, Employment, ERISA, Health Care Reform, Health Insurance, Health Plans, Human Resources, Insurance, Insurer, Managed Care, Medical Coverage, Tax |
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Posted by Cynthia Marcotte Stamer
August 3, 2009
The Department of Health & Human Services (HHS) today (August 3, 2009) transferred authority for the administration and enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule to the Office for Civil Rights (OCR). Prior to this announcement, responsibility for interpretation and enforcement of the Security Rule rested with the Centers for Medicare & Medicaid Services (CMS). The change reflects the growing seriousness of HHS and others about enforcing federal privacy and data security mandates for health information. HHS anticipates the transfer of authority will eliminate duplication and increase efficiencies in how the department ensures that Americans’ health information privacy is protected.
HHS has the authority for administration and enforcement of the federal standards for health information privacy called for in HIPAA. The Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. OCR has been responsible for enforcement of the Privacy Rule since 2003. The Security Rule specifies a series of administrative, technical, and physical security procedures for covered entities to use to assure the confidentiality of electronic protected health information. The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA), mandated improved enforcement of the Privacy Rule and the Security Rule.
Through a separate delegation, CMS continues to have authority for administration and enforcement of the HIPAA Administrative Simplification regulations, other than privacy and security of health information.
The transfer of Security Rule enforcement authority comes as guidance about new data breach rules for electronic protected health information is impending. This impending guidance relates to the implementation of new breach notification rules for covered entities and their business associates concerning their obligation to use of technologies and methodologies that render protected health information unusable, unreadable, or indecipherable to unauthorized individuals, as required by amendments to HIPAA enacted under the Health Information Technology for Economic and Clinical Health (HITECH) Act passed as part of the American Recovery and Reinvestment Act of 2009 (ARRA) last February. OCR officials have stated that they are working to publish the next set of regulations regarding these new breach notifications before the end of August, 2009.
In addition to adding the breach notification requirements, the HITECH Act also tightened the HIPAA mandates in several other respects. Among other things, it amended HIPAA to:
- Broaden the applicability of the HIPAA’s Privacy Rules and penalties to include business associates;
- Clarify that HIPAA’s criminal sanctions apply to employees or other individuals that wrongfully use or access PHI held by a covered entity;
- Increase criminal and civil penalties for HIPAA Privacy Rules violators;
- Allow State Attorneys General to bring civil damages actions on behalf of certain state citizens who are victims of HIPAA Privacy and Security Rule violations;
- Modify certain HIPAA use and disclosure and accounting requirements and risks;
- Prohibits sales of PHI without prior consent;
- Tighten certain other HIPAA restrictions on uses or disclosures;
- Tighten certain HIPAA accounting for disclosure requirements;
- Clarify the definition of health care operations to excludes certain promotional communications; and
- Expand the Business Associates Agreement Requirements.
These and other developments make it imperative HIPAA covered entities and their business associates take prompt action to immediately review and update their data security and privacy practices to guard against growing liability exposures under HIPAA and other federal and state laws. Covered entities must update policies and practices to avoid these growing liabilities. Business associates that have not already done so also must appoint privacy officers and adopt and implement privacy and data security policies and procedures fully compliant with HIPAA and other applicable federal and state rules, including amendments enacted as part of the American Recovery and Reinvestment Act of 2009 signed into law on February 17, 2009.
For more information about today’s announcement, see here. See here for the initial guidance and request for comments issued by HHS regarding these new security standards.
Chair Elect of the American Bar Association RPTE Employee Benefits & Compensation Committee, an ABA Joint Committee on Employee Benefits Council member, and Chair of the Curran Tomko Tarski Labor, Employment & Employee Benefits Practice, Cynthia Marcotte Stamer is nationally and internationally recognized for her work assisting businesses, employee benefit plan fiduciaries and vendors, governments, and other entities to develop administer and defend cost-effective employee benefit other human resources programs, policies and procedures to meet their budgetary, risk management and compliance and other objectives. Board certified in Labor & Employment law, Ms. Stamer applies her extensive experience regarding employment, employee benefit, tax, privacy and data security and other related laws to assists clients in a wide range of business and litigation contexts. The co-founder of the Solutions Law Consortium, Ms. Stamer also makes extensive use of cloud computing and other technology in her own practice and provides input to human resources and other clients others about the use of these and other technology tools to manage employee benefit, human resources, internal controls and other operations. In connection with this work, Ms. Stamer has works, writes and consults extensively with a diverse range of clients about the development, use technology and other processes to streamline health and other benefit, payroll and other human resources, employee benefits, tax, compliance and other business processes and the management and protection of sensitive personal and other information and data.
If your organization or employee benefit plan needs assistance managing or evaluating options or responsibilities associated with the use of technology and data in connection with its health care, employee benefits, tax or other operation or other human resources, employee benefits or and compliance concerns, 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.
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.
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Employee Benefits, HIPAA, Human Resources, Insurance, Internal Controls, Privacy | Tagged: Employee Benefits, Employer, Employers, ERISA, GINA, Health Care Reform, Health Insurance, Health Plans, HIPAA, Human Resources, Insurance, Insurer, Internal Controls, Managed Care, Medical Coverage, Privacy, Risk Management |
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Posted by Cynthia Marcotte Stamer
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.
Comments Off on Speak Up America: Where & How To Read & Share Your Feedback About The Health Care Reform Legislation |
Employee Benefits, Employers, Employment Tax, ERISA, Health Care Reform, Health Plans, Human Resources, Immigration, Income Tax, Insurance, Malpractice, Preemption, Professional Liability, Tax, Uncategorized | Tagged: Corporate Compliance, Employee Benefits, Employer, Employers, ERISA, Health Care Reform, Health Insurance, Health Plans, Human Resources, Insurance, Insurer, Labor, Managed Care, Medical Coverage |
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Posted by Cynthia Marcotte Stamer
July 29, 2009
Cynthia Marcotte Stamer will speak about “Technology Issues for Tax Attorneys and their Clients” on September 26, 2009 at the American Bar Association 2009 Fall Joint Tax Meeting in Chicago.
The September 26 program will feature a panel discussion of:
- Research tools, anti-virus, encryption and other technology practice aids, tools and tricks tax practitioners;
- IRS, DOL and other rules impacting opportunities for employers and employee benefit plan administrators to use electronic communications to reduce employment and employee benefit plan communication expenses;
- Electronic communications with government agencies and the need to be prepared to provide electronic records for tax audits;
- Expanding personal information privacy and data security considerations; and
- More.
Moderated by Frank Palmieri of Palmieri & Eisenberg, Alexandria, VA, the confirmed panelists include:
- Catherine Sanders Reach of the American Bar Association, Chicago, IL;
- Cynthia Marcotte Stamer of Curran Tomko Tarksi LLP, Dallas, TX;
- Joy M. Mercer of Joy M. Mercer, PC, Florham Park, NJ; and
- Danny A. Martin, Jr. of Shell Oil Company, Houston, TX.
The session is scheduled to take place from 2:30 p.m. – 4:00 p.m. on Saturday, September 26, 2009. To register for the meeting or other details, see here.
Chair Elect of the American Bar Association RPTE Employee Benefits & Compensation Committee, an ABA Joint Committee on Employee Benefits Council member, and Chair of the Curran Tomko Tarski Labor, Employment & Employee Benefits Practice, Cynthia Marcotte Stamer is nationally and internationally recognized for her work assisting businesses, employee benefit plan fiduciaries and vendors, governments, and other entities to develop administer and defend cost-effective employee benefit other human resources programs, policies and procedures to meet their budgetary, risk management and compliance and other objectives. Board certified in Labor & Employment law, Ms. Stamer applies her extensive experience regarding employment, employee benefit, tax, privacy and data security and other related laws to assists clients in a wide range of business and litigation contexts. The co-founder of the Solutions Law Consortium, Ms. Stamer also makes extensive use of cloud computing and other technology in her own practice and provides input to human resources and other clients others about the use of these and other technology tools to manage employee benefit, human resources, internal controls and other operations. In connection with this work, Ms. Stamer has works, writes and consults extensively with a diverse range of clients about the development, use technology and other processes to streamline health and other benefit, payroll and other human resources, employee benefits, tax, compliance and other business processes and the management and protection of sensitive personal and other information and data.
If your organization or employee benefit plan needs assistance managing or evaluating options or responsibilities associated with the use of technology and data in connection with its health care, employee benefits, tax or other operation or other human resources, employee benefits or and compliance concerns, 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.
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.
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Employee Benefits, Employers, Employment Tax, ERISA, Health Plans, Income Tax, Internal Controls, Privacy, Professional Liability, Risk Management, Tax, Wage & Hour | Tagged: Data Security, Employee Benefit Communications, Employee Benefits, Health Care, Health Plans, Privacy, Retirement Plans, Tax, Technology |
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Posted by Cynthia Marcotte Stamer
July 22, 2009
Businesses that fire or discipline employees increasingly face retaliation claims by disgruntled workers claiming the protection of nondiscrimination and other federal and state whistleblower and anti-retaliation laws.
The U.S. Supreme Court’s recent decision in Crawford v. Metropolitan Gov’t of Nashville and Davidson County, No. 06-1595, highlights the need for employers to exercise constant vigilance to potential retaliation claims and the need to act to avoid retaliating, or appearing to retaliate against employees when conducting internal investigations, terminations, promotions or other workforce management activities. While the decision specifically addressed retaliation under Title VII, the use of similar language in other federal laws regulating business conducting – including those covered by the Federal Sentencing Guidelines – makes it likely that the decision has much broader implications.
Technically, the Crawford decision specifically applied to retaliation under Title VII of the Civil Rights Act of 1964 (Title VII) in the context of a sexual harassment complaint investigation. However, business should anticipate that creative plaintiffs and their legal counsel soon will ask courts to apply the Crawford holding beyond sexual harassment to reach to claims brought by employees claiming injury in retaliation for statements made in relation to investigation of other federal statutes prohibiting retaliation. A host of federal and state employment and other laws prohibit businesses from retaliating against employees for reporting possible prohibited conduct or seeking to exercise certain rights legally protected rights. Because many of these statutes use the same or similar language to the anti-retaliation provisions of Title VI, share the same or similar purpose, or both, businesses should anticipate that certain courts will be inclined to view the Crawford rationale, if not its holding, as applicable to retaliation claims under certain of these other federal statutory prohibitions. Accordingly, pending further guidance, most businesses interested in minimizing exposures to retaliation claims will want to design and administer investigations to avoid the impression of illegal retaliation against witnesses in sexual harassment investigations as other investigations where similar anti-retaliation provisions may apply. Accordingly, most U.S. businesses will treat Crawford as having potential implications both in relation to sexual harassment and other investigations under Title VII as well as investigations conducted other federal laws containing similar anti-retaliation provisions.
The Crawford Decision
In its February 2, 2009 unanimous Crawford decision, the Supreme Court ruled that the anti-retaliation provisions of Title VII protect employees against retaliation for giving a “disapproving account” of unlawful behavior when responding to questions asked during the employer’s investigation of a sexual harassment discrimination, even if the employee took no further overt action to complain about, seek to remedy or stop the misconduct.
Vicky Crawford sued the employer under Title VII’s anti-retaliation provision, which prohibits an employer from terminating a worker because she “has opposed any practice made an unlawful employment practice” under Title VII. The Crawford case arose from statements Ms. Crawford made in response questions addressed to her as part of her employer’s investigation of sexual harassment rumors. Asked if she’d witnessed any inappropriate behavior by a supervisor, Ms. Crawford answered told the employer about a series of harassing acts by the supervisor toward herself. Besides reporting her experience in reply to employer questions during the investigation, however, Ms. Crawford did not file a sexual harassment complaint or otherwise report her alleged sexual harassment experience to the employer. Following the interview, the employer did not discipline the supervisor. However, the employer subsequently fired Ms. Crawford and two other employees who also reported being harassed by the supervisor. As part of its defense, the employer argued that Ms. Crawford’s report during the course of the investigation did not qualify as “opposition” prohibited under Title VII.
The question before the Supreme Court was whether simply disclosing an act of harassment in answer to a question constitutes “oppos[ing]” an unlawful practice, or whether – as the court of appeals had held – opposition within the meaning of the provisions requires something more assertive.
Applying the ordinary meaning of “oppose,” the Supreme Court unanimously found that “When an employee communicates to her employer a belief that the employer has engaged in . . . employment discrimination, that communication virtually always constitutes the employee’s opposition to the activity.” Accordingly, the Supreme Court ruled that protected opposition under Title VII includes giving a “disapproving account” of unlawful behavior, even if the employee takes no further action on her own to seek to stop or remedy the conduct.
Explaining its conclusions, the Supreme Court stated that a contrary rule that would require a worker to engage in “active, consistent” behavior in order to engage in protected opposition would be inconsistent with common usage. For example, the Court explained, one can “oppose capital punishment” without doing anything active to end it. The Supreme Court rejected as “freakish” an interpretation of “opposition” that would protect an employee who reports discrimination on her own initiative but not one who reports the same discrimination in the same words when her boss asks a question.”
While concurring in the unanimous opinion, Justices Alito and Thomas cautioned against reading that opinion too broadly. Their opinion clarifies that in their view, covered opposition must be “active and purposive” to qualify as protected. Consequently, they warned that the Court’s opinion should not be read to suggest that Title VII protects merely opposing a practice in principle (like opposing capital punishment) without taking any action at all to express that opposition.
Other Broader Potential Implications & Lessons From Crawford
Although the report by Ms. Crawford involved her notification to the employer that she too may have been sexually harassed, the implications of the Crawford decision reach more broadly.
Crawford specifically construed the anti-retaliation provisions of 42 U. S. C. §2000e–3(a), which makes it unlawful “for an employer to discriminate against any . . . employe[e]” who (1) “has opposed any practice made an unlawful employment practice by this subchapter”, or (2) “has made a charge, testified, assisted, or participated in any manner in an investigation, proceeding, or hearing under this subchapter”. This provision of Title VII and other equal employment opportunity laws, as well as the Family & Medical Leave Act and various other employment laws commonly contain similar prohibitions against an employer or business discriminating against protected persons for opposing unlawful practices or making charges, testifying, assisting or participating in investigation of practices prohibited under the applicable employment law. Consequently, there exists a significant probability that courts will apply the Crawford holding to retaliation claims brought by employees for testimony or other participation in investigation in other equal employment opportunity charges under Title VII and other employment laws.
It also is possible that employees ask the courts to extend the holding of Crawford to retaliation claims brought by employees claiming to have been retaliated against for participating in the investigation of or expressing opposition to illegal practices under a wide range of other statutes. Beyond the employment context, many other federal laws incorporate similar prohibits against employer discrimination against employees for opposing practices made unlawful under their provisions or providing testimony or participating in investigations of potential violations of their provisions. For example, in connection with its criminal prohibition of major fraud against the United States, paragraph (h) of 18 U.S.C § 1031 creates a right for individuals discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment by an employer because of lawful acts done by the employee on behalf of the employee or others “in furtherance of a prosecution under this section (including investigation for, initiation of, testimony for, or assistance in such prosecution)” to recover for job and seniority reinstatement, 2 times the amount of back pay, interest, litigation costs and reasonable attorneys fees and other special damages.
Given these similarities, pending further guidance, U.S. businesses generally will want to exercise sensitivity when dealing with employees who express opposition, testify or otherwise participate in investigations or prosecutions of potential violations under Title VII and other federal laws that contain the same or similar anti-retaliation provisions.
Read from this perspective, the Crawford decision highlights the advisability for businesses not to overlook the potential significance of the statements and conduct by employees involved in any internal investigation, performance, or other activity that might later form the basis of a retaliation complaint.
Businesses generally should listen carefully when conducting investigations, employee counseling and discipline meetings, and exit interviews with an eye out for the need to investigate potential legal violations, defend against retaliation charges, or both.
Although businesses should continue to require employees to report known or suspected discrimination or other prohibited conduct in accordance with a specified formal procedure, the Crawford decision reminds businesses not to overestimate the protection afforded by the establishment of formal reporting procedures.
Crawford also highlights the need for businesses to be careful to investigate and properly respond to new charges of discrimination or other potential legal or policy violations that may be uncovered in the course of an investigation, disciplinary meeting or exist interview.
Additionally, businesses also should seek to evaluate the potential implications of their dealings with employees who previously have made charges, participated in investigations, or claimed other protected rights such as taking a protected leave or the like.
Likewise, as in the defense of other employment claims, Crawford also reflects the value and importance of businesses appropriately documenting performance concerns relating to a specific employee and legitimate business challenges motivating employment actions as they arise, in the event that it subsequently becomes necessary to present evidence of a valid performance or business justification to defend against allegations by an employee claiming to have been discharged or otherwise discriminated against in retaliation for engaging in protected conduct under Title VII or other similar federal anti-retaliation laws.
Finally, businesses should keep in mind the potential value of strong documentation. When seeking to defend against claims of discrimination or retaliation, the strength of the employer’s documentation often can play a significant role in the cost and ease of defense of the claim or charge. Businesses should work to prepare and retain documentation not only of allegations, investigations and determinations regarding both employee performance and discipline, as well as the handling of alleged violations of equal employment opportunity or other laws. Documentation should be prepared and retained on a systematic basis with an eye to strengthening the organization’s ability to prevent and defend against charges that the organization violated the core obligations under the applicable law as well as to defend employment decisions involving employees who may be in a position to assert retaliation claims.
The importance of good investigation and documentation practices takes on particular importance in the current tough economic environment. While retaliation claims have been rising for many years, the recent economic downturn is fueling an increase in the number of employees seeking to claim protection in the tightening economy based on retaliation or other employment law protections. Workforce dissention and changes in personnel also can complicate further the ability to defend these claims just as the Department of Labor and other federal regulators are turning up the enforcement heat. As a result, appropriate investigation and documentation procedures are particularly important in the current environment.
Curran Tomko Tarski LLP Can Help
If your business needs assistance auditing, updating or defending its human resources, corporate ethics, and compliance practices, or responding to employment related or other 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 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.
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.
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Corporate Compliance, EEOC, family leave, Human Resources, I-9, Internal Controls, Internal Investigations, medical leave, Risk Management, Sexual Harassment, Tax | Tagged: ADA, Corporate Compliance, Disability Discrimination, Discrimination, Employee Benefits, Employment, Equal Employment Opportunity, ERISA, GINA, Health Insurance, Human Resources, Insurance, Internal Controls, Internal Investigations, Labor, Minimum Wage, Overtime, Retaliation, Risk Management, Sexual Harassment, Whistleblower |
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Posted by Cynthia Marcotte Stamer
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.
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Affirmative Action, Corporate Compliance, EEOC, Employers, Government Contractors, Human Resources, OFCCP, Public Policy, Stimulus Bill |
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Posted by Cynthia Marcotte Stamer
July 20, 2009
The federal minimum wage for non-exempt employees increases to $7.25 per hour this Friday, June 24, 2009. This means that by Friday, every employer of employees subject to the minimum wage provisions of the Fair Labor Standard Act (FLSA) will be required to:
- Ensure non-exempt employee pay equals or exceeds the increased federal minimum wage of $7.25 per hour; and
- Update the federal minimum wage and hour notice postings that the FLSA requires employers post in a conspicuous place in all of their establishments to notify employees about the FLSA minimum wage and overtime rules. A revised Federal minimum wage poster, reflecting the minimum wage increase to $7.25 per hour is now available free of charge on the Department of Labor’s Web site here in multiple languages.
While implementing these required updates, U.S. employers also generally should audit existing wage and hour practices and documentation and take other steps to defend against the heightened emphasis on enforcement of federal wage overtime, minimum wage, child labor and other wage and hour laws announced by the U.S. Department of Labor Wage & Hour Division (WHD). In March, 2009 Secretary of Labor Hilda Solis announced that the Labor Department was adding 250 new field investigators and taking other steps to strengthen its enforcement of these federal wage and hour laws. See WHD Press Release. Consistent with this promise to emphasize wage and hour enforcement, the Labor Department has announced a series of wage and hour enforcement actions since President Obama took office in January affecting various industries in all regions of the nation. These include the following:
- U.S. Labor Department recovers more than $200,000 in back wages and interest from New York City staffing company and president (April 16, 2009);
- Fredericksburg, Va., military contractor pays nearly $180,000 in back wages following U.S. Labor Department investigation (April 15, 2009);
- Dairy Queen in East Grand Forks, Minn., cited for federal child labor violations (April 15, 2009);
- U.S. Labor Department recovers nearly $270,000 for low-wage workers in Mountain View and Sunnyvale, Calif. (April 2, 2009);
- Teaneck, N.J., information technology company agrees to pay more than $509,000 in back wages following U.S. Labor Department investigation (March 30, 2009);
- U.S. Labor Department secures nearly $517,000 in back wages for 60 employees of Merrill Lynch & Co. Inc. in New York City (March 24, 2009);
U.S. Labor Department cites Smith’s Restaurant, Bolivar, Mo., for overtime, minimum wage and child labor violations (March 17, 2009);
- U.S. Department of Labor obtains more than $370,000 in back wages for employees of Carrollton, Ky., company (March 6, 2009);
- Willow Lake Mine in Galatia, Ill., agrees to pay more than $510,000 in back wages to workers to settle U.S. Department (March 2, 2009);
- U.S. Labor Department fines Southland plasterer for repeat pay violations (February 26, 2009);
- New York City car washes, corporate officer agree to pay more than $228,000 in back wages, interest and penalties to resolve U.S. Labor Department suit (January 29, 2009);
- Former owner of Queens, N.Y., restaurant agrees to pay more than $85,000 in back wages, damages and penalties to settle U.S. Labor Department lawsuit (January 28, 2009);
- U.S. Labor Department recovers nearly $192,000 in overtime back wages for employees of New York City parking garage chain (January 27, 2009);
Labor Department officials are promising continued strong enforcement of federal wage and hour and other labor and employment laws in the months ahead.
The continuing emphasis of the DOL upon FLSA enforcement, coupled with the growth in FLSA enforcement actions by private plaintiffs, provides an important warning to employers of low wage workers specifically, as well as employers generally, of the importance of being prepared to defend their worker classification and overtime practices against DOL and/or private litigant investigations. When it updated its regulations governing the classification of workers as exempt versus non-exempt under the FLSA in 2004, the DOL urged employers to review and update their worker classification and overtime practices to comply with the updated regulations. At the same time, the DOL announced its intention to vigorously enforce its FLSA regulations against employers failing to adhere to these updated rules. Despite these widely publicized compliance efforts, DOL studies of employer compliance with overtime rules continue to reflect that 50 percent of employers are not in compliance with these mandates.
Therefore, in addition to adjusting existing rates of pay to comply with the increased minimum wage, employers also should:
- Audit overtime pay practices to verify they comply with applicable federal and state requirements,
- Review workers classified as exempt employees and/or non-employee contractors in light of the FLSA and applicable state wage and hour laws to assess the sustainability of these characterizations against a legal challenge; and
- Audit the adequacy of current practices for tracking and documenting time worked by non-exempt workers in light of the FLSA and applicable state wage and hour laws.
Employers are cautioned to keep in mind that employers generally bear the burden of proving that their existing worker classification, wage and overtime practices meet or exceed the minimum standards imposed by the FLSA and any applicable state wage and hour law. In addition to specifically targeting wage and hour enforcement generally, the Obama Administration also has directed the Department of Labor and other agencies to carefully scrutinize the appropriateness of situations where businesses classify persons performing services as working in a non-employee capacity.
The minimum wage increase that takes effect this Friday is the last of three provided by the enactment of the Fair Minimum Wage Act of 2007, which amended the FLSA to increase the federal minimum wage in three steps: to $5.85 per hour effective July 24, 2007; to $6.55 per hour effective July 24, 2008; and now to $7.25 per hour effective July 24, 2009. The latest change will directly benefit workers in 30 states (Alabama, Alaska, Arkansas, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming) where the state minimum wage is currently at or below the federal minimum wage, or there is no state minimum wage. It will also benefit workers in the District of Columbia, where the minimum wage is required to be $1 more than the federal minimum wage. A family with a full-time minimum wage earner will see its monthly income increase by about $120.
Every employer of workers subject to the FLSA’s minimum wage provisions must post, and keep posted in each of its establishments, a notice explaining this act. The notice must be posted in conspicuous places to permit employees to readily read them. Posters and other compliance assistance materials concerning the minimum wage increase are available free of charge from the Labor Department’s Wage and Hour Division and may also be obtained from the agency’s Web site at http://www.wagehour.dol.gov.
Many states have minimum wage laws with provisions that differ from the federal law. When an employer is subject to both, the employer must pay the higher of the two rates.
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 wage and hour and other employment and compensation compliance and risk management concerns, as well as defending employers against federal and state Department of Labor and private plaintiff wage and hour and other labor and employment, compensation and employee benefit charges, 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.
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Employers, Internal Controls, Internal Investigations, Wage & Hour |
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Posted by Cynthia Marcotte Stamer
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.
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Employers, Health Care Reform, Health Plans, Income Tax, Public Policy, Tax | Tagged: Employer, Employers, Health Care Reform, Health Insurance, Health Plans, Medical Coverage, Tax |
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Posted by Cynthia Marcotte Stamer
July 16, 2009
Three Dallas organizations take flight to assist others
Job Fair In Plano This Weekend
Dallas area jobseekers still can make plans to participate in a free Jobseeker’s Networking Fair to be held in Dallas July 18, 2009
No Cost – No pre-registration
8:00am-1:00pm
St. Andrew United Methodist Church – Wesley Hall
5801 W. Plano Parkway Plano, Texas 75093
(Park in North lots on Mira Vista St.)
8:00am Registration begins, Speed Networking, One-On-One Coaching; Resume Review, Career Direction etc.
9:00am Keynote Address: Bryan Dodge – “How to Build a Better You”
Highlighting his new book “The Good Life Rules” subtitle “8 Keys to Being Your Best at Work and Play”
Educational Sessions following keynote to include:
Linkedin, Tweeter/Facebook, 30 Second Commercial, Attitude, How to Jump Start Your Job Search, Interview Skills, Resume Writing, Negotiating the Offer…and more. Speed Networking continues.
Contact: Bill Brewer – 214-291-8082 – bbrewer@standrewumc.org or
Terry Stallcup – 972-720-8844 – tstallcup@ultimateconsulting.net or
Cathy Henesey – 214-725-0710 – cathysphr@verizon.net
Talk about event on twitter enter #NETFAIR. Don’t know what this means, come to one of the Twitter sessions to learn more.
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Employers |
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Posted by Cynthia Marcotte Stamer
July 16, 2009
On Friday (July 10, 2009), the U.S. Senate 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 to her position an extensive resume of employee benefit experience including extensive governmental and private practice experience. 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 has also 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 Attorneys Can Help
Curran Tomko Tarski LLP Labor & Employment Practice Group Chair, Cynthia Marcotte Stamer, and other members of Curran Tomko 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 or at (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 Helpful Resources & Information
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@cttlegal.com.
©2009 Curran Tomko Tarski LLP. All rights reserved.
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Posted by Cynthia Marcotte Stamer
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.
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Employee Benefits, Employers, ERISA, Health Care Reform, Health Plans, Human Resources, Insurance, Public Policy | Tagged: Employee Benefits, Employer, Employment, Health Care Reform, Health Insurance, Health Plans, Human Resources, Insurance, Insurer, Managed Care, Medical Coverage, Premium Subsidy, Tax |
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Posted by Cynthia Marcotte Stamer
July 14, 2009
CMS Hospital Compare Website Seeks To Help Consumers Evaluate Hospital Quality & Make More Informed Healthcare Choices
Employers, health plans and other patient empowerment advocates should review and communicate to employees and others within the patient community newly expanded health care quality outcome data recently included on the Hospital Compare Website, a Centers for Medicare & Medicaid Services (CMS) internet resource providing various hospital quality data on more than 4000 U.S. hospitals.
By sharing data through Hospital Compare, CMS joints the efforts of many employers, health plans and others in seeking to empower conumers with hospital and other quality data. The initiative is one of many government and private efforts to promote quality and reduce costs by tapping the power of health care consumers.
According to CMS, Hospital Compare now provides “better” data on the previously posted mortality rates for individual hospitals, as well as new data on 30-day readmissions for heart attack, heart failure, and pneumonia. Previously, Hospital Compare had provided only mortality rates for these three conditions.
The Hospital Compare Web site will show a hospital’s mortality or readmissions rate is “Better than,” “No different from,” or “Worse than” the U.S. national rate. This data information includes each hospital’s risk-standardized mortality rate (RSMR), an estimate of the rate’s certainty (also known as the interval estimate), and the number of eligible cases for each hospital. By posting hospital RSMRs, interval estimates, and the number of eligible cases, CMS is giving consumers and communities additional insight into the performance of their local hospitals in hopes that this will prompt all hospitals to work toward achieving the level of the top-performing hospitals in the country.
Reducing the rate of hospital readmissions to improve quality and achieve savings are key components of President Obama’s health care reform agenda. Administration officials indicate that hospital readmissions are reducing the quality of health care while increasing hospital costs. CMS officials hope posting of this expanded health care outcome data will help consumers make more informed health care choices.
According to CMS data, on average 1 in 5 Medicare beneficiaries who are discharged from a hospital today will re-enter the hospital within a month. Hospital Compare data show that for patients admitted to a hospital for heart attack treatment, 19.9 percent of them will return to the hospital within 30 days, 24.5 percent of patients admitted for heart failure will return to the hospital within 30 days, and 18.2 percent of patients admitted for pneumonia will return to the hospital within 30 days. Both the mortality and the readmissions measures have been endorsed by the National Quality Forum (NQF) and are supported by the Hospital Quality Alliance (HQA). CMS says both sets of measures are risk-adjusted and take into account previous health problems to “level the playing field” among hospitals and to help ensure accuracy in performance reporting.
“Providing readmission rates by hospital will give consumers even better information with which to compare local providers,” said Charlene Frizzera, CMS Acting Administrator. “Readmission rates will help consumers identify those providers in the community who are furnishing high-value healthcare with the best results.”
CMS has been tracking selected hospital outcomes data since 2007, when Hospital Compare debuted 30-day mortality rates for heart attack and heart failure. Thirty-day mortality rates for pneumonia were added to the Website in 2008. Hospital Compare also includes 10 measures that capture patient satisfaction with hospital care, 25 process of care measures, and two children’s asthma care measures. The site also features information about the number of selected elective hospital procedures provided to patients and what Medicare pays for those services.
According to CMS, public reporting of these and other measures is intended to empower patients and their families with information they need to engage their local hospitals and physicians in active discussions about quality of care. CMS officials assert that all hospitals, regardless of their readmission and mortality rates, should use the data available in these free, detailed reports to find ways to continually improve the care they deliver.”
This year, CMS has changed the way it calculates the mortality data to provide even better information to consumers. In 2007 and 2008, Medicare used only one year of claims data to compute mortality, while the rates added to the Web site today encompass three full years of claims data (from July 1, 2005 – June 30, 2008). Although this means that consumers cannot compare data from last year’s rate with this year’s rate, CMS officials believe the expanded data set should provide a clearer picture of how well hospitals are performing.
Using the three-year data method, CMS estimates that the national 30-day mortality rate for patients originally admitted for heart attack care is 16.6 percent. For heart failure patients, the national 30-day mortality rate is 11.1 percent, and for pneumonia patients the national rate is 11.5 percent.
According to CMS, Hospital Compare readmissions and mortality measures are risk-adjusted measures and were developed by a team of clinical and statistical experts from Yale and Harvard Universities under the direction of CMS and are endorsed by the NQF. The model CMS uses to assess hospital readmissions and mortality rates is based on claims data and has been validated by models based on clinical data. It takes into account medical care received during the year prior to each patient’s hospital admission, as well as the number of admissions at each hospital. The model uses this information to adjust for differences in each hospital’s patient mix, so that hospitals that care for older, sicker patients are on a “level playing field” with those whose patients would be expected to be at less risk of dying within 30 days of admission.
The author of this article, Curran Tomko and Tarski LLP Health Care Practice Chair Cynthia Marcotte Stamer has extensive experience advising and assisting health care providers and payers establish, administer health care quality assurance and other programs. Former Chair of the American Bar Association Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer advises and represents health care payers and providers with a diverse array of quality assurance and other legal and operational risk management initiatives and writes and speaks extensively on these issues. Her many publications and presentations on managed care and other health plan and health care quality matters include “Practical Solutions for Achieving Clinical Quality & Financial Efficiency in an Evolving Health Care Arena,” “Building Your Patient Empowerment Toolkit,” “Selected Thoughts About Medical Judgment-Based Coverage Decisions Under ERISA-Covered Health Plans After Davila” and numerous other quality improvement and patient empowerment workshops for employee and patient groups, health plans, health care providers, medical societies, government officials, community organizations others. You can get more information about her experience here.
If you need assistance with patient empowerment and consumer directed health care, health care quality and utilization and other health benefit and health education concerns, wish to inquire about arranging for patient empowerment, HIPAA or other compliance audit or training, or need legal representation on other 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
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 reviewing one or more of the following other recent articles published on our electronic Solutions Law Press HR & Benefits Update publication available here, registering to receive those updates , or both. 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 HR & Benefits 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 Ms. Stamer, her 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.
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Posted by Cynthia Marcotte Stamer
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.
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COBRA, Employee Benefits, Employers, ERISA, Health Care Reform, Health Plans, Human Resources, Public Policy, Retirement Plans |
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Posted by Cynthia Marcotte Stamer
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.
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Employers, Public Policy |
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Posted by Cynthia Marcotte Stamer
June 24, 2009
With the September 8, 2009 deadline for federal government contractors to begin using E-Verify to confirm the employment eligibility of new employees, the U.S. Citizenship and Immigration Services (USCIS) now is inviting comments or suggestions for improving the E-Verify Program Designated Agent Process.
August 24, 2009 is the deadline for employers and other interested parties to submit to USCIS comments or suggestions for improving the E-Verify Program Designated Agent Process under which a participating employer may choose to outsource submission of employment eligibility verification queries for newly hired employees to a Designated Agent. USCIS invited the comments in a Request For Public Comment On E-Verify Program Designated Agent Process published in the June 23, 2009 Federal Register.
Federal government contractors and subcontractors will be required to begin using the E-Verify system to verify the eligibility of employees to work in the United States on September 8. 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. This new federal government contractor mandate to use E-Verify is fueling heightened interest and concern by these and other businesses in the existence and particulars of the E-Verify program.
The E-Verify Program is a free employment eligibility confirmation system operated jointly by USCIS and the Social Security Administration (SSA). Under impending regulations, government contractors Recently re-extended by Congress, it is designed to determine the employment eligibility of new hires. The E-Verify Program allows participating employers to electronically confirm the employment eligibility of newly hired employees to help maintain a stable and legal workforce.
An E-Verify Designated Agent is a liaison between E-Verify and employers who choose to outsource submission of employment eligibility verification queries for newly hired employees. E-Verify Designated Agents conduct the verification process for other employers or clients. An E-Verify Designated Agent must register online and sign a Memorandum of Understanding (MOU) with SSA and DHS. Once the MOU is approved, the E-Verify Designated Agent can then begin registering employers and clients who have designated it to perform their verification services.
Since the program design for Designated Agents has changed very little over the past several years, USCIS plans to review the Designated Agent process to assess how Designated Agents provide this service to their clients. According to the Notice, the purpose of this notice is to request that Designated Agents, their clients, or others with Designated Agent experience provide their comments or suggestions for improving the Designated Agent process.
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.
Comments Off on With September 8 Deadline For Government Contractors To Use E-Verify, USCIS Invites Comments On E-Verify Program Designated Agent Process |
Corporate Compliance, E-Verify, Employers, Government Contractors, Human Resources, I-9 |
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Posted by Cynthia Marcotte Stamer
June 19, 2009
Domestic partners of federal government workers now qualify for enrollment in dependent benefits under certain federal employee benefit plans but not federal health and pension benefits under a presidential memorandum signed by President Obama June 17, 2009. The memorandum also signals that President Obama anticipates extending other federal benefits to same-sex domestic partners later this year.
The presidential memorandum calls for allowing the domestic partners of federal employees to be added to the long-term care insurance program and permitting employees to use their sick leave to take care of domestic partners and non-biological, non-adopted children. However, the presidential memorandum did not extend federal health and pension benefits to same-sex domestic partners. Instead, the presidential memorandum:
- Orders all federal agencies and departments within the next 90 days to assess their other existing benefits to determine their authority to extend other existing benefits to same-sex domestic partners of their Federal employees and
- Directs the Office of Personnel Management to issue guidance within 90 days to all executive departments and agencies regarding compliance with, and implementation of, the civil service laws, rules, and regulations, including 5 U.S.C. 2302(b)(10), which make it unlawful to discriminate against Federal employees or applicants for Federal employment on the basis of factors not related to job performance.
You can read the presidential memorandum here.
Over the past decade, public and private employers increasingly have extended the availability of domestic partner benefits. This trend is picking up more speed as various states have begun recognizing same-sex marriages or other official domestic partnership relationships and/or prohibiting discrimination in employment and other business transactions on the basis of sexual relationship. The provision of these benefits continues to raise many tax and other operational issues, however. Accordingly, businesses should seek the advice of competent legal counsel concerning these obligations.
Additional Resources & Information
We hope that this information is useful to you. 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, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here.
©2009 Cynthia Marcotte Stamer. All rights reserved.
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Uncategorized |
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Posted by Cynthia Marcotte Stamer
June 11, 2009
Coalition For Responsible Health Care Reform Founded To Help Concerned Americans Respond
Americans concerned about plans of President Obama and Congressional Democrats to enact comprehensive health care reform this year must speak up now.
Senator Edward M. Kennedy yesterday (June 9, 2009) circulated a 625 page proposal to radically reform the U.S. health care system. The latest draft of the “Affordable Health Choices Act” (the “Act”) details the comprehensive health care reforms that President Obama and Democrats in Congress propose to enact before year end.
President Obama and key Congressional Democrats are moving quickly to enact their vision for “comprehensive health reform” this year. The Act circulated yesterday by Senator Kennedy would radically change the U.S. health care system in enacted as currently proposed.
Consistent with announced plans by President Obama and key Congressional Democrats to enact “comprehensive health care reform” this year, Democratic leaders in Congress are rushing to enact this legislation well before year end. In furtherance of plans to fast track enactment of the Act, the Senate Committee on Health, Education, Labor and Pensions (HELP) chaired by Senator Kennedy will hold a hearing on the Act this week in anticipation of meetings to mark up of the Act on Tuesday, June 16 at 2:30 p.m. in Russell 325.
The Act, as proposed, would make sweeping changes to the U.S. health care system and radically expand the involvement of government in the delivery and financing of health care. Among other things, the Act as proposed would:
- Establish government provided “Gateway” health care coverage programs to provide coverage for Americans not insured under qualifying employer or other privately run “qualified health plan” to be financed in part through surcharges on private health plans and health insurers and other taxes and assessments and in part through premiums on enrolled individuals
- Require that Americans participating in the Gateway health care coverage programs be offered the opportunity to enroll in at least one “public health insurance option”
- Require Americans to chose either to enroll in a government run Gateway health program or enroll in qualifying coverage under a privately run qualified health plan
- Impose sweeping new mandates on employer and union-sponsored group health plans and insurers
- Impose newly created taxes on individuals that fail to maintain enrollment in health coverage under either a Gateway health program or a private qualified health plan
- Tax and/or eliminate the deductibility of health coverage premiums and certain other amounts paid by certain employers and employees
- Impose new federal mandates for health care providers, health plans and health insurers relating to the quality standards, the use of health care technology and other matters
- Grant federal regulators sweeping authority to define what qualifies as appropriate health care and health care coverage, the health care services that qualify for health care coverage and the payment and delivery of health care services.
You can review a copy of currently proposed provisions of the 615 page Act here.
Individuals concerned about these and other proposed health care reforms must act immediately to become familiar and share their input on the proposals.
Assistance Monitoring & Responding To Health Care Reform Proposals
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;
- 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.
You can register to receive future updates on legislative and regulatory health care reform proposals and other related information by registering for this resource or access other publications by Ms. Stamer and access other helpful resources here.
Long-time health policy advocate and advisor Cynthia Marcotte Stamer has more than 22 years of experience advising and assisting clients to evaluate and respond to health care reform proposals and other proposed or adopted changes in federal or state health care, employee benefit, employment, tax and other federal and state laws. Former Chair of the American Bar Association’s Managed Care & Insurance Section, 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.
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.
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.
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.
Additional Resources & Information
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.
©2009 Cynthia Marcotte Stamer. All rights reserved.
Comments Off on Democrats Introduce Health Care Reform Legislation, Work To Fast Track Enactment |
Uncategorized | Tagged: Affordable Health Choices Act, CHIP, COBRA, Employee Benefits, Employers, Employment, ERISA, health benefit mandates, health care finance, health care IT, health care quality, Health Care Reform, Health Insurance, Health Plans, health premiums, Human Resources, Insurance, Insurer, Labor, Managed Care, Medicaid, Medicaid Advantage, Medical Coverage, Medicare, Medicare Advantage, Occupational Injury, Premium Subsidy, uninsured |
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Posted by Cynthia Marcotte Stamer
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.
Comments Off on September 8, 2009 New Deadline For Government Contractors, Subcontractors Deadline To Use E-Verify |
Corporate Compliance, E-Verify, Employee Benefits, Employment Agreement, Government Contractors, Human Resources, I-9, Immigration, Internal Controls, Public Policy, Risk Management | Tagged: Corporate Compliance, E-Verify, Employers, Employment, Employment Agreements, Government Contractors, Human Resources, I-9, Internal Controls, Labor |
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Posted by Cynthia Marcotte Stamer
June 9, 2009
Cynthia Marcotte Stamer will moderate a June 25, 2009 teleconference on “Can Benefits Lawyers and Other Service Providers Be Sued for Malpractice for Services to ERISA Plans?”
The telephone conference hosted by the American Bar Association (ABA) Joint Committee on Employee Benefits (JCEB) is scheduled for Thursday, June 25, 2009 from 1:00-2:00 pm Eastern Time, 12:00-1:00 pm Central Time, 11:00 am-12:00 pm Mountain Time, and 10:00 am-11:00 am Pacific Time.
The teleconference will feature a discussion by Hogan & Hartson LLP attorney Kurt Lawson and AARP Foundation Litigation attorney Mary Ellen Signorille about how the federal precedent governing when and how ERISA preemption affects state malpractice and misfeasance claims against accountants, lawyers, health care providers, actuaries and others has evolved during the five year period since the United State’s Aetna v. Davila decision reframed when ERISA preempts state law malpractice claims and the implications of this precedent on the viability and litigation of these state law malpractice claims.
To register or for additional information, go to here.
About Cynthia Marcotte Stamer
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.
Comments Off on Stamer Moderates June 25 ABA Teleconference On When Benefits Lawyers and Other Service Providers Be Sued for Malpractice for Services to ERISA Plans |
Employee Benefits, Employers, ERISA, Health Plans, Human Resources, Insurance, Internal Controls, Malpractice, Preemption, Professional Liability, Retirement Plans, Risk Management | Tagged: Employee Benefits, Employer, Employers, Employment, ERISA, ERISA Preemption, Health Plans, Human Resources, Insurance, Insurer, Internal Controls, Labor, Malpractice, Managed Care, Medical Coverage, Vendor Contracting |
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Posted by Cynthia Marcotte Stamer
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.
Comments Off on Registration Open For June 23 Dallas HR 2009 Health Plan Eligibility Update Program |
Absenteeism, ADA, COBRA, Disease Management, Employee Benefits, Employers, Employment Tax, ERISA, family leave, GINA, Health Care Reform, Health Plans, Human Resources, Income Tax, Insurance, Internal Controls, medical leave, Military Leave, Privacy, Risk Management, Stimulus Bill, Tax | Tagged: ADA, COBRA, Corporate Compliance, Disability Discrimination, Employee Benefits, Employer, Employers, Employment, Employment Agreements, ERISA, Health Insurance, HealthP Plans, Human Resources, Insurance, Insurer, Internal Controls, Labor, Managed Care, Medical Coverage, Military Leave, Occupational Injury, Premium Subsidy, Risk Management, Stimulus Bill, Subsidy Bill, Tax |
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Posted by Cynthia Marcotte Stamer
June 9, 2009
Virtually all employers will be require to allow employees provide up to 56 hours of paid if Congress passes the “Healthy Families Act” (H.R. 2460) introduced by Representative Rosa DeLauro with the support of 101 co-sponsors on May 18, 2009. Given the significant number of co-sponsors already on record as supporting the legislation, employers concerned about the proposed legislation need to act quickly to communicate their concerns to Congress.
If enacted as currently introduced, H.R. 2460 both would significantly expand the number of employers required by federal law to provide sick leave and overlay a mandate to provide paid sick leave in addition to the existing unpaid leave mandates currently applicable under the Family and Medical Leave Act to employers of more than 50 employees.
As proposed, H.R. 2460 would require all employers of 15 or more employees:
- To accrue at least 1 hour of paid sick time (up to a maximum of 56 hours per calendar year) for every 30 hours worked by each employee from beginning with the first day of employment of the employee. Exempt employees generally would be assumed to work 40 hours in each workweek for purposes of calculating accrued sick leave;
- Guarantee employees the right to begin using accrued paid sick time for one of the purposes qualifying for sick leave under H.R. 2460 beginning with the 60th calendar day following commencement of the employee’s employment and thereafter as he accrues additional paid sick time;
- To allow employees to carry over earned but unused paid sick time from one calendar year to the next except under certain limited conditions; and
- To reinstate accrued but unused leave for any employee rehired within 12 months after separating from employment and continue to recognize additional paid sick time accruals beginning with the recommencement of employment with the employer.
The purposes that H.R. 2460 would require employers to allow employees to use accrued sick leave also would be broader than those currently protected under the medical leave provisions of the FMLA. Under H.R. 2460, employees could use sick leave for any of the following absences:
- An absence resulting from a physical or mental illness, injury, or medical condition of the employee;
- An absence resulting from obtaining professional medical diagnosis or care, or preventive medical care, for the employee
- In absence for the purpose of caring for a child, a parent, a spouse, or any other individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship (a “family member”), who has any of the conditions or needs for diagnosis or care of a physical or mental illness, injury, or medical condition or in the case of someone who is not a child, is otherwise in need of care; and
- An absence resulting from domestic violence, sexual assault, or stalking, if the time is to seek medical attention for the employee or a family member to recover from physical or psychological injury or disability caused by domestic violence, sexual assault, or stalking or obtain or assist a family member in obtaining services from a victim services organization, psychological or other counseling; to seek relocation; or to take legal action, including preparing for or participating in any civil or criminal legal proceeding related to or resulting from domestic violence, sexual assault, or stalking.
In addition, H.R. 2460 also would require covered employers:
- To notify employees about their sick leave rights as dictated by H.R. 2460; and
- Not to discharge or discriminating against (including retaliating against) any individual, including a job applicant, for exercising, or attempting to exercise, any right provided or for opposing any practice made unlawful by H.R. 2460;
- Not to use the taking of paid sick time under H.R. 2460 as a negative factor in an employment action, such as hiring, promotion, or a disciplinary action;
- Not to count the paid sick time under a no-fault attendance policy or any other absence control policy;
- Not otherwise to interfere with, restrain, or deny the exercise of, or the attempt to exercise, any right provided under H.R. 2460; and
- Not to discharge or in any other manner discriminate against (including retaliating against) any individual, including a job applicant, because such individual has filed an action, or has instituted or caused to be instituted any proceeding, under or related to H.R. 2450; has given, or is about to give, any information in connection with any inquiry or proceeding relating to any right provided under H.R. 2450; or has testified, or is about to testify, in any inquiry or proceeding relating to any right provided under H.R. 2450.
Even before the current economic downturn, many employers already viewed the unpaid leave mandates imposed by the FMLA and other laws as burdensome. The added costs and complexities of providing more paid time off under another federally imposed mandate couldn’t come at a worse time for many employers. Given the number of co-sponsors, many commentators view the proposed mandates in H.R. 2450 as likely to pass the House unless businesses act quickly to educate members of Congress about their concerns.
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,
If you need help responding to these proposals or with other questions relating to compliance or risk management under other federal or state employment, employee benefits, compensation, or internal controls laws or regulations, please contact Curran Tomko Tarski LLP Labor & Employment Practice Group Chair, Cynthia Marcotte Stamer at (214) 270.2402 or via e-mail here. Board Certified in Labor and Employment Law by the Texas Board of Legal Specialization, “Cindy” works with businesses, speaks and publishes extensively on these and other labor and employment, employee benefit, internal controls and compensation matters.
Other Information & Resources
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.
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Absenteeism, ADA, Corporate Compliance, Employers, family leave, Health Plans, Human Resources, Internal Controls, Internal Investigations, Leave, medical leave | Tagged: ADA, Corporate Compliance, Disability Discrimination, Employer, Employers, Employment, Human Resources, Internal Controls, Labor, Light Duty |
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Posted by Cynthia Marcotte Stamer
June 4, 2009
Employers will face more changes to their responsibilities to employees serving or returning from military service and their families if Congress adopts certain proposed legislation scheduled for hearings by members of the House Committee on Veterans Affairs this week. Concerned businesses should communicate any concerns to members of these committees and other Congressional contacts as soon as possible.
As Congress continues to consider additional expansions to existing federal veteran re-employment rights and retraining programs, the House Committee on Veterans Affairs is holding hearings on several pending proposals. On Thursday, June 4, 2009, for instance:
- The Subcommittee on Health of the House Committee on Veterans Affairs plans to mark up H.R. 1211, Women Veterans Health Care Improvement Act and then hold a hearing on “Meeting the Needs of Family Caregivers of Veterans” beginning at 10:30 a.m. Eastern in Room 334 Cannon House Office Building; and
- The Subcommittee on Economic Opportunity of the House Committee on Veterans Affairs plans to hear testimony about a proposal to extend existing military employment leave and reemployment rights to individuals called to full-time National Guard duty set forth in H.R. 1879, the National Guard Employment Protection Act of 2009, at a hearing to consider several pieces of legislation scheduled to begin at 1 p.m. on Thursday, June 4, 2009 See Hearing Schedule.
The June 4 hearings are the latest in a series of Congressional activities hearings focusing on promoting employment and health care rights for individuals serving or returning from service in the military and their families. In addition to H.R. 1879, other legislation scheduled for mark up during the Thursday afternoon hearing includes:
- H.R. 1037, Pilot College Work Study Programs for Veterans Act of 2009 would direct the Secretary of Veterans Affairs to conduct a five-year pilot project to test the feasibility and advisability of expanding the scope of certain qualifying work-study activities under title 38, United States Code;
- H.R. 1098, Veterans’ Worker Retraining Act of 2009 would increase the amount of educational assistance payments made by the Secretary of Veterans Affairs to individuals pursuing an apprenticeship or on-job training under: (1) the Montgomery GI Bill educational assistance program; (2) the Post-Vietnam Era Veterans educational assistance program; (3) the Survivors and Dependents educational assistance program; and (4) the Selected Reserve Montgomery GI Bill educational assistance program.
- H.R. 1172, Pat Tillman Veterans’ Scholarship Initiative would direct the Secretary of Veterans Affairs to include on the Internet website of the Department of Veterans Affairs a list of organizations that provide scholarships to veterans and their survivors;
- H.R. 1821, Equity for Injured Veterans Act of 2009 would increase vocational rehabilitation and employment benefits for certain veterans and provide child care reimbursement for certain rehabilitating single veterans; and
- H.R. 2180, would amend title 38, United States Code, to waive housing loan fees for certain veterans with service-connected disabilities called to active service.
If you need help responding to these proposals or with other questions relating to compliance or risk management under other federal and state military leave and veterans rights laws or regulations, please contact Curran Tomko Tarski LLP Labor & Employment Practice Group Chair, Cynthia Marcotte Stamer at (214) 270.2402 or cstamer@cttlegal.com. Board Certified In Labor and Employment Law by the Texas Board of Legal Specialization, “Cindy” works with businesses, speaks and publishes extensively on these and other labor and employment, employee benefit, internal controls and compensation matters.
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ERISA, Health Plans, Human Resources, Internal Controls, Internal Investigations, Military Leave, Retirement Plans, Risk Management, Uncategorized, USERRA | Tagged: Corporate Compliance, Employee Benefits, Employment, Health Insurance, Health Plans, Human Resources, Internal Controls, Labor, Military Leave |
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Posted by Cynthia Marcotte Stamer
June 3, 2009
June 3, 2009
Domestic partner benefits provided under employer or union sponsored health plans no longer would be taxable to enrolling employees if Congress adopts legislation recently proposed in the House and Senate.
HR 2625, the Tax Equity for Health Plan Beneficiaries Act and a companion bill, S 1153 S 1153 would amend the Internal Revenue Code of 1986 to extend the exclusion from gross income for employer-provided health coverage for employees’ spouses and dependent children to coverage provided to other eligible designated beneficiaries of employees, including domestic partners. According to a press release from Rep. McDermott, the bill would eliminate federal income and payroll taxes on health benefits provided to domestic partners.
Currently, the value of health benefits provided to domestic partners of employees under an employer’s group health plan typically are taxable income to the employee for purpose of the Internal Revenue Code. Valuing and reporting taxable payments on domestic partner benefits can be a headache for employers that provide those benefits.
If you need help responding to these proposals or with other questions relating to compliance or risk management under other federal or state employment, employee benefits, compensation, or internal controls laws or regulations, please contact Curran Tomko Tarski LLP Labor & Employment Practice Group Chair, Cynthia Marcotte Stamer at (214) 270.2402 or via e-mail here. Board Certified in Labor and Employment Law by the Texas Board of Legal Specialization, “Cindy” works with businesses, speaks and publishes extensively on these and other labor and employment, employee benefit, internal controls and compensation matters. For additional information about Curran Tomko Tarski LLP see the Curran Tomko Tarski Website.
Other Information & Resources
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 here. 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 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.
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COBRA, Employee Benefits, Employers, ERISA, Health Plans, Human Resources, Income Tax, Insurance, Tax | Tagged: Disease Management, Employee Benefits, Employers, ERISA, Health Insurance, Health Plans, Human Resources, Insurance, Insurer, Managed Care, Medical Coverage, Tax, Wellness, Withholding |
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Posted by Cynthia Marcotte Stamer
June 3, 2009
The Pension Benefit Guaranty Corporation (PBGC) announced June 1, 2009 that General Motors Corp. plans to continue its two defined benefit pension plans even though it has filed for Chapter 11 bankruptcy protection. Termination of defined benefit pension plans is a common action when companies sponsoring those plans file for Chapter 11 bankruptcy.
GM’s defined benefit plans cover more than 670,000 pension plan participants.
According to the PBGC, stakeholders in the bankruptcy, including GM, the United Auto Workers and the U.S. government, have stated their intent to maintain the plans under the sponsorship of a new corporate entity to be formed from the sale of GM’s productive assets. The PBGC announced its commitment to work with all parties to achieve that outcome.
The PBGC is a federal corporation created under the Employee Retirement Income Security Act of 1974. It currently guarantees payment of basic pension benefits earned by 44 million American workers and retirees participating in over 29,000 private-sector defined benefit pension plans. The agency receives no funds from general tax revenues. Operations are financed largely by insurance premiums paid by companies that sponsor pension plans and by investment returns.
Individuals with questions about the PBGC and its benefit guarantees should consult the agency’s auto-sector Web page at PBGC.gov. GM workers and retirees with specific questions about their GM pension benefit should call the GM Benefits & Services Center at 1-800-489-4646.
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Posted by Cynthia Marcotte Stamer
May 29, 2009
Pressure is mounting for group health plans and their employer and other sponsors and administrators to complete the details required to comply with special medical coverage continuation rules (COBRA Subsidy Rules) added to the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (COBRA) by the American Recovery and Reinvestment Act of 2009 (Stimulus Bill).
The U.S. Department of Labor Employee Benefits Security Administration (EBSA) recently (May 21, 2009) announced its appeal process for assistance eligible individuals to use to complain to the EBSA when they believe they wrongfully have been denied a premium subsidy for their group health plan continuation coverage in violation of the temporary modifications (COBRA Subsidy Rules) to the group health plan medical coverage continuation requirements of the COBRA Stimulus Rules. These are the expedited complaint and appeals procedures mandated under the Stimulus Bill.
The COBRA Subsidy Rules, new 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. Get details or register here.
The Stimulus Bill allows individuals denied the premium subsidy to get expedited review by the EBSA. Under the appeals procedures announced May 21, individuals begin this review process by completing an appeals application available on line at http://www.dol.gov/ebsa/COBRA/main.
Employers and group health plans and their plan administrators and plan insurers have been required to provide notifications and COBRA premium subsidies for certain former employees and their dependents that qualify as assistance eligible individuals and take other actions to comply with the COBRA Subsidy Rules since the COBRA Subsidy Rules took effective on February 17, 2009. While many employers and plan administrators undertaken some efforts to comply with these new COBRA mandates, many still have not fully completed all of the compliance arrangements.
With procedures to receive and administer appeals, the EBSA now is prepared to investigate possible violations of the Stimulus Bill COBRA rules. Accordingly, employers, plan administrators and insurers sponsoring or administering group health plan should prepare to respond to investigations that may be initiated by the filing of a request for EBSA review.
You can read details about the COBRA Subsidy Rules here.
Stimulus COBRA Rules In A Nutshell
Congress enacted the COBRA Subsidy Rules that took effect February 17, 2009 to help certain involuntarily terminated former employees and their dependents maintain COBRA coverage by requiring COBRA-covered group health plans temporarily to extend certain special COBRA treatment for “assistance eligible individuals.”
The Stimulus Bill temporarily limits the COBRA premium that a COBRA-covered group health plan can require an “assistance eligible individual” to pay for COBRA Coverage to 35% of the otherwise applicable COBRA premium (the “Reduced Premium”) for a period of up to 9 months (the “Subsidy Period”) beginning with the individual’s first period of COBRA Coverage beginning after February 17, 2009. The employer or insurer that collects this Reduced Premium must pay the remaining 65% of the COBRA premium (the “COBRA Subsidy”) for the assistance eligible individual during the Subsidy Period. However, the Stimulus Bill provides for that employer or insurer to claim a payroll tax credit equal to the amount of these COBRA Subsidy payments by complying with applicable IRS procedures.
The Stimulus COBRA Rules also requires group health plans to offer a second COBRA enrollment period to each assistance eligible individual not enrolled in COBRA Coverage on February 17, 2009. These second electors must be allowed to elect prospectively to enroll in COBRA coverage until the date that their COBRA Coverage eligibility otherwise would have ended if they had maintained COBRA Coverage since their termination.
Additionally, COBRA-covered group health plans that offer employees different plan options allow assistance eligible individuals the option to change their coverage choice from a higher cost option to a lesser cost option. Group health plan administrators also must provide certain notifications to assistance eligible individuals concerning these changes.
“Assistance Eligible Individuals”
The Stimulus COBRA Rules only apply to qualified beneficiaries whose loss of coverage resulted from the “involuntary termination of employment” of a covered employee. The Stimulus Bill definition of “assistance eligible individual” generally includes any COBRA “qualified beneficiary” who meets all of the following requirements:
ü Has a loss of coverage within the meaning of COBRA (“qualifying event”) as a result of the “involuntary termination of employment” of a covered employee from September 1, 2008 to December 31, 2009;
ü Is eligible for COBRA Coverage at any time during the period beginning September 1, 2008 and ending December 31, 2009; and
ü Elects COBRA coverage when first offered or as during the additional second election period required for assistance eligible individuals not enrolled in COBRA Coverage on February 17, 2009.
IRS Notice 2009-27 defines an “involuntary termination” as “a severance from employment due to the independent exercise of the unilateral authority of the employer to terminate the employment, other than due to the employee’s implicit or explicit request, where the employee was willing and able to continue performing services” based on all the facts and circumstances.
For COBRA Premium Assistance purposes, the facts and circumstances determine whether a termination is involuntary. Thus, IRS Notice 2009-27 states that a termination designated as voluntary or as a resignation nevertheless will be considered involuntary where the facts and circumstances indicate that the employer would have terminated the employee’s services, and that the employee had knowledge that the employee would be terminated.
Notice 2009-27 identifies as examples of terminations that fall within this definition of “involuntary termination” as including the following facts and circumstances:
ü The employer’s failure to renew a contract at the time the contract expires, if the employee was willing and able to execute a new contract providing terms and conditions similar to those in the expiring contract and to continue providing the services;
ü An employee-initiated termination from employment if the termination from employment constitutes a termination for good reason due to employer action that causes a material negative change in the employment relationship for the employee;
ü An involuntary reduction of hours of employment to zero hours, such as a lay-off, furlough, or other suspension of employment, resulting in a loss of health coverage;
ü An employee’s voluntary termination of employment in response to an employer imposed reduction of hours of employment where the reduction in hours is a material negative change in the employment relationship for the employee;
ü An employer’s action to end an individual’s employment while the individual is absent from work due to illness or disability (but not mere absence from work due to illness or disability before the employer has taken action to end the individual’s employment);
ü A termination designated on account of “retirement” if the facts and circumstances indicate that, absent retirement, the employer would have terminated the employee’s services, and the employee had knowledge that the employee would be terminated;
ü The covered employee resigned as the result of a material change in the geographic location of employment for the employee;
ü A lockout initiated by an employer but not a work stoppage as the result of a strike initiated by employees or their representatives; and
ü A termination elected by the employee in return for a severance package (a “buy-out”) where the employer indicates that after the offer period for the severance package, a certain number of remaining employees in the employee’s group will be terminated
Notice 2009-27 also clarifies that the termination of employment giving rise to the loss of group health plan coverage and the loss of the group health plan coverage both must occur between September 1, 2008 and December 31, 2009 in order for an individual to qualify as an assistance eligible individual. Consequently, if the involuntary termination occurs before September 1, 2008, but the loss of coverage resulting in eligibility for COBRA Coverage occurs after September 1, 2008 (but no later than December 31, 2009), Notice 2009-28 states that the individual will not qualify as an assistance eligible individual. Likewise, where an individual’s involuntary termination occurs by December 31, 2009, but the loss of coverage resulting in eligibility for COBRA Coverage occurs after December 31, 2009, the qualified beneficiary will not qualify as an assistance eligible individual for purposes of the Subsidy COBRA Rules. According to Notice 2009-27, where the involuntary termination of employment and loss of coverage as a covered employee or dependent occur between September 1, 2008 and December 31, 2009, the election of COBRA Coverage need not occur by December 31, 2009.
Many group health plans are drafted to provide that the date that employee or dependent coverage ends or changes as a result of an employment loss is the last day of the month or some other date after the actual date of the employment termination. Under group health plans where the loss of coverage due to the qualifying event is delayed, Notice 2009-27 also reminds employers and plan administrators of the need to focus on how group health plan provisions, separation agreements and other related documents define when the loss of coverage occurs under a group health plan when applying these rules.
For purposes of COBRA, Notice 2009-27 states that when a loss of coverage under a group health plan occurs under these circumstances depends on how the group health plan treats the provision of health coverage between the date of the employment loss and the date of the resulting loss of employee and/or dependent coverage. If the plan treats the provision of health coverage as deferring the loss of coverage, Notice 2009-27 indicates the loss of coverage generally occurs when the individual ceases to be entitled to employee or dependent coverage on the same terms and conditions as would have applied had he not experienced the qualifying event. However, if the plan treats the continued provision of health coverage from the termination date until employee or dependent coverage later ends as a result as reducing the period of required COBRA Coverage, then the loss of coverage occurs on the termination date or other later date. Appropriate drafting is important to support the desired characterization.
Calculation of 35% of COBRA Premium
Based on the guidance in Notice 2009-27, many employers will want to terminate severance or other arrangements under which former employees are allowed to pay less than the maximum COBRA premium for some period of time. According to Notice 2009-29,.the premium used to determine the 35% share that must be paid by (or on behalf of) an assistance eligible individual is the cost that would be charged to the assistance eligible individual for COBRA Coverage if the individual were not an assistance eligible individual. If absent the Stimulus COBRA Rules, the group health plan would require the assistance eligible individual to pay 102% of the “applicable premium” for continuation coverage, i.e., generally the maximum permitted, the Reduced Premium equals 35% of the 102% of the applicable premium. As no good deed goes unpunished, however, if the premium the group health plan would charge the assistance eligible individual is less than the maximum allowable COBRA premium, the Reduced Premium will be 35% of that lesser amount. In determining whether an assistance eligible individual has paid 35% of the premium, payments on behalf of the individual by another person (other than the employer with respect to which the involuntary termination occurred) are taken into account.
Coverage Eligible For Premium Reduction
Notice 2009-27 also provides guidance about what types of group health plan coverage qualifies for premium reduction. According to the Notice, the premium reduction is available for COBRA Coverage of any group health plan, except a health flexible spending arrangement (FSA) under section 106(c) offered under a section 125 cafeteria plan. This includes vision-only or dental-only plans, “mini-med plans” and certain health reimbursement accounts (HRAs).
The Notice 2009-27 distinguishes exempted FSAs from covered health reimbursement arrangements (HRAs) for purposes of these rules. According to Notice 2009-27, while an HRA may qualify as an FSA under section 106(c), the exclusion of FSAs from the premium reduction is limited to FSAs provided through a section 125 cafeteria plan, which would not include an HRA.
Notice 2009-27 also indicates that retiree coverage can qualify for the premium reduction where the retiree coverage does not differ from the coverage made available to similarly situated active employees.
Premium Reduction Period Duration
Notice 2009-27 also provides guidance about when periods of coverage and the Premium Reduction Period begin and end. Under the Stimulus COBRA Rules, the premium reduction applies as of the first period of coverage beginning on or after February 17, 2009 (February 17, 2009) for which the assistance eligible individual is eligible to pay only 35% of the premium and be treated as having made full payment. For this purpose, a period of coverage is a monthly or shorter period with respect to which premiums are charged by the plan with respect to such coverage.
According to Notice 2009-27, when the Premium Reduction Period begins for an assistance eligible individual depends on the period the plan charges COBRA premiums. Where a group health plan requires an individual who loses coverage other than on the last day of the month who wishes to enroll in COBRA Coverage to pay a pro-rata portion of the monthly premium, Notice 2009-27 states the first period of coverage to which the premium reduction applies for an assistance eligible individual who loses coverage after February 17, 2009 generally is the individual’s first partial month of coverage. A different rule applies when the assistance eligible individual elects COBRA Coverage under the second election period required by the Stimulus Bill Rules, however. Whether a plan requires COBRA Coverage be paid for based on a calendar month or pro rata basis, March 1, 2009 is the beginning of the first period of coverage within the Premium Reduction Period for any assistance eligible individual enrolling during the second enrollment period and the Reduced Premium only applies to that individual for COBRA Coverage from March 1, 2009 through the end of his otherwise applicable Premium Reduction Period.
End Of Premium Reduction Period
An assistance eligible individual ceases to qualify for the premium reduction on the earliest of:
ü The first date the assistance eligible individual becomes eligible for other group health plan coverage (with certain exceptions) or Medicare coverage,
ü The date that is nine months after the first day of the first month for which the Stimulus Bill premium reduction provisions apply to the individual, or
ü The date the individual ceases to be eligible for COBRA Coverage.
Notice 2009-27 confirms that the Premium Reduction Period of an assistance eligible individual ends on the first date he becomes eligible for other group health plan coverage or Medicare effect even if the assistance eligible individual does not enroll in the other group health plan coverage.
According to Notice 2009-27, whether an offer of retiree coverage that is not COBRA Coverage simultaneously with the offering of COBRA Coverage ends the Premium Reduction Period depends on whether the retiree coverage is offered under the same group health plan as the COBRA Coverage or under a different group health plan. If offered under the same group health plan, the offer of the retiree coverage has no effect on the Premium Reduction Period. If offered under a different group health plan, the offer of retiree coverage that is not COBRA coverage ends the Premium Reduction Period. However Notice 2009-27, however, If offered to someone whose eligibility for COBRA coverage arose between September 1, 2008 and February 17, 2009, the offer render the individual ineligible for the premium reduction only if the period the individual is given for enrolling in the retiree coverage extends to at least February 17, 2009.
Notice 2009-27 also addresses when eligibility for coverage under an HRA ends eligibility for the premium reduction. It states that becoming eligible for HRA coverage ends the Premium Reduction Period unless the HRA qualifies as an FSA under section 106(c). Under section 106(c), an FSA is health coverage under which the maximum amount of reimbursement which is reasonably available to a participant of the coverage is less than 500% of the value of the coverage. For this purpose, the maximum amount of reimbursement which is reasonably available is generally the balance of the HRA and the value of the HRA coverage would generally be the applicable premium for COBRA continuation of the HRA coverage.
Notice 2009-27 also clarifies that the Premium Reduction Period of an eligible individual may extend beyond December 31, 2009 for individuals who qualify as assistance eligible individuals on or before December 31, 2009. For example, the Premium Reduction Period of an assistance eligible individual whose Premium Reduction Period begins on December 1, 2009 could extent until August 31, 2010, assuming the individual does not become eligible for other group health plan coverage or Medicare or lose eligibility for COBRA Coverage before that date.
With regard to the effect of Medicare eligibility on an assistance eligible individual’s Premium reduction Period, Notice 2009-27 indicates that an individual currently enrolled in Medicare when the involuntary termination of employment occurs is ineligible for premium reduction, even though they may be eligible to elect COBRA continuation coverage by paying the otherwise applicable unreduced COBRA premium.
Dealing With Assistance Eligible Individuals Not Eligible For Premium Subsidy Based On Eligibility For Other Group Coverage
Under the Stimulus Bill, assistance eligible individuals are required to provide notification and resume paying the unreduced usual COBRA premium when they become eligible for Medicare or other group health coverage. Where an assistance eligible individual fails to provide the required notice and continues to take advantage of the premium reduction after his Premium Reduction Period terminates due to his becoming eligible for other coverage or Medicare, Notice 2009-27 states the employer is not responsible for recovering the additional premium or otherwise recouping the COBRA premium.
Dealing With Assistance Eligible Individuals Subject to Phase Out of Premium Subsidy Eligibility Based On Income
The Stimulus COBRA Rules include tax provisions designed phase out the COBRA Subsidy for certain highly compensated employees by taxing a portion of those amounts. Notice 2009-7 discusses the mechanics through which highly compensated employees can avoid this tax liability by electing to waive the Premium Reduction and Premium Subsidy.
An assistance eligible individual who wants to make a permanent election to waive the right to the premium reduction makes the election by providing a signed and dated notification (including a reference to “permanent waiver”) to the employer or other person who is reimbursed for the premium reduction under the COBRA Premium Subsidy provisions of Code § 6432. No separate additional notification to any government agency. If an assistance eligible individual makes the permanent election to waive the right to the premium reduction, the individual may not later reverse the election and may not receive the premium reduction for any future period of COBRA Coverage in 2009 or 2010, regardless of modified adjusted gross income in those years.
Notice 2009-27 makes clear that these rules don’t allow employers to deny the Reduced Premium to these assistance eligible individuals. According to Notice 2009-27, “Even if an assistance eligible individual’s income is high enough that the recapture of the premium reduction would apply, COBRA Coverage must be provided upon payment of 35% of the premium unless the individual has notified the plan that the individual has elected the permanent waiver of the premium reduction (or the period for the premium reduction has ended).
Second COBRA Election Period
The Stimulus Bill also requires group health plans to offer a second election period to assistance eligible individuals not enrolled in COBRA Coverage on February 17, 2009 whose employment terminated between September 1, 2008 and February 16, 2009. Notice 2009-27 confirms that any individual (including a dependent) who did not have an election of COBRA Coverage in effect on February 17, 2009, but who would have been an assistance eligible individual if the election were in effect must be offered this second election period. For those electing COBRA Coverage during this second election period, the resulting coverage begins with the first period of COBRA continuation coverage beginning on or after February 17, 2009. Notice 2009-27 confirms that this extended election period is available for all individuals who are qualified beneficiaries as the result of an involuntary termination during the period from September 1, 2008, through February 17, 2009, even if they still have an open COBRA election period as of February 17, 2009. If these individuals elect COBRA under their original COBRA election period, COBRA coverage is retroactive to their loss of coverage and the premium reduction does not apply to the periods of coverage prior to the first period of coverage beginning on or after February 17, 2009 (generally, periods of coverage before March 2009 for plans with monthly coverage periods).
If, as a result of the extended election period, an assistance eligible individual becomes eligible for COBRA Coverage under a group health plan that requires payment of COBRA premiums on a calendar month basis, the individual’s first period of coverage will begin on March 1 and the Reduced Premium only applies prospectively from that date. According to Notice 2009-27, this does not change even if the plan otherwise requires individuals who lose coverage before the last day of the month and who wish to enroll in COBRA continuation coverage to pay a pro-rata portion of the monthly premium for the first partial month of coverage.
In contrast, where a group health plan determines the required COBRA premiums based on the loss of coverage, Notice 2009-27 states that the first period of coverage begins on the first day after the loss of coverage and ends on the day of the following month corresponding to the day of the loss of coverage. For example, if the last day of coverage was October 3, 2008, the period of coverage runs from the fourth of the month to the third of the following month, and thus the first period of coverage on or after February 17, 2009, is the period March 4, 2009, through April 3, 2009.
Notice 2009-27 also discusses the operation of these rules as applied to certain HRAs
Who Pays The Premium Subsidy & Claims The Payroll Tax Credit
In previously issued guidance, the IRS indicated that between the sponsoring employer or union and a group insurer, the party that collects the Reduced Premium bears responsibility to pay the 65% Premium Subsidy then claiming the payroll tax credit under the Stimulus COBRA Rules. According to Notice 2009-27, if the insurer and the employer of insured, single employer group health plan have agreed that the insurer will collect the premiums directly from the qualified beneficiaries, the insurer must treat an assistance eligible individual paying 35 of the premium as having paid the full premium, even before the employer pays the insurer the remaining 65%. If the insurer fails to treat a 35% payment by an assistance eligible individual as a payment of the full premium, the insurer may be liable for the excise tax under Code § 4980B(e)(1)(B), which applies to persons responsible for administering or providing benefits under the plan and whose act or failure to act caused (in whole or in part) the failure, if the person assumed responsibility for the performance of the act to which the failure relates.
For More Information or Assistance
If your organization needs help responding to the COBRA Subsidy Rules or other group health plan or other employee benefit or human resources matters, please contact Cynthia Marcotte Stamer. Ms. 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.
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COBRA, Employee Benefits, Employers, ERISA, Health Plans, Human Resources, Internal Controls | Tagged: COBRA, Corporate Compliance, Employee Benefits, Employer, Employers, Employment, Employment Agreements, ERISA, Health Insurance, Human Resources, Insurance, Insurer, Internal Controls, Internal Investigations, Labor, Managed Care, Medical Coverage, Premium Subsidy, Risk Management, Stimulus Bill, Subsidy Bill, Tax |
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Posted by Cynthia Marcotte Stamer
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.
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Disease Management, Employee Benefits, Employers, Employment Tax, ERISA, Health Care Reform, Health Plans, Human Resources, Income Tax, Insurance, Public Policy, Risk Management, Tax | Tagged: Employer, Employers, Health Care Reform, Health Insurance, Health Plans, Human Resources, Insurance, Insurer, Labor, Managed Care, Medical Coverage, Risk Management, Tax |
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Posted by Cynthia Marcotte Stamer
May 21, 2009
New restrictions on the collection, use and disclosure of genetic information applicable to employer and union-sponsored group health plans enacted under Title I of the Genetic Information Nondiscrimination Act of 2008, Public Law No. 110-233 (GINA) for group health plan years that begin on or after today (May 21, 2009). For non-calendar year plans with plan years beginning between June 1 and December 1, the effective date occurs on first day of their 2009 plan year. For example, the effective date will be June 1, 2009 for a plan with a 2009 plan year that begins June 1. For calendar year plans, the compliance deadline is January 1, 2010. All employer-sponsored group health plans are required to comply with GINA. There are no small group exceptions.
GINA In A Nutshell
GINA amended federal law to include specific prohibitions against certain discrimination based on genetic information by group health plans and health insurers (Title I) and to prohibit discrimination based on genetic information by employers of 15 or more employees (Title II).
Effective for all group health plan years beginning on or after May 21, 2009, GINA’s new restrictions on the collection and use of genetic information by group health plans added under Title I of GINA are accomplished through the expansion of a series of already existing group health plan nondiscrimination and privacy rules. GINA’s group health plan provisions amend and expand the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Employee Retirement Income Security Act of 1974 (ERISA), Title VII of the Civil Rights Act, the Public Health Service Act, the Internal Revenue Code of 1986, and Title XVIII (Medicare) of the Social Security Act to implement sweeping new federal restrictions on the collection, use, and disclosure of information that falls within its broad definition of “genetic information” by group health plans. For individual health insurers, GINA’s restrictions take effect May 22, 2009. The broad definition of the term “genetic information” in GINA will require group health plan sponsors and insurers to carefully review and update their group health plan documents, communications, policies and practices to comply with forthcoming implementing regulations to avoid liability under new GINA’s rules governing genetic information collection, use, protection and disclosure in a series of areas.
Meanwhile, employers, unions and others face their own new prohibitions against genetic information based employment discrimination added by Title II of GINA, which take effect November 21, 2009. The Equal Employment Opportunity Commission (EEOC) published proposed regulations interpreting Title II of GINA in March, 2009.
Broad Definition of “Genetic Information”
The broad range of information included within GINA’s broad definition of “genetic information” means its new restrictions have a sweeping reach when applied to most group health plans. GINA defines “genetic information to include with respect to any individual, information about:
- Such individual’s genetic tests;
- The genetic tests of family members of such individual; and
- The manifestation of a disease or disorder in family members of such individual.
GINA also specifies that any reference to genetic information concerning an individual or family member includes genetic information of a fetus carried by a pregnant woman and an embryo legally held by an individual or family member utilizing an assisted reproductive technology.
Pending issuance of regulatory guidance, GINA’s inclusion of information about the “manifestation of a disease or disorder in family members” raises potential challenges for a broad range of group health plan health assessment and other wellness and disease management programs which provide financial incentives or condition eligibility on the provision of family health histories or other information that could be construed as genetic information.
Group Health Plan Genetic Testing Collection and Nondiscrimination Rules
Under GINA’s nondiscrimination rules, group health plans and health insurers may not:
- Request, require or purchase genetic information for underwriting purposes or in advance of an individual’s enrollment;
- Adjust premiums or contribution amounts of the group based on genetic information;
- Request or require an individual or family member to undergo a genetic test except in limited situations specifically allowed by GINA;
- Impose a preexisting condition exclusion based solely on genetic information, in the absence of a diagnosis of a condition;
- Discriminate against individuals in eligibility and continued eligibility for benefits based on genetic information; or
- Discriminate against individuals in premium or contribution rates under the plan or coverage based on genetic information, although such a plan or issuer may adjust premium rates for an employer based on the manifestation of a disease or disorder of an individual enrolled in the plan.
GINA also prohibits insurers providing individual health insurance from establishing rules for eligibility, adjusting premiums or contribution amounts for an individual, imposing preexisting condition exclusions based on, requesting or requiring individuals or family members to undergo genetic testing.
Of particular concern to many plan sponsors and fiduciaries are the potential implications of these new rules on existing wellness and disease management features group health plans. Of particular concern is how regulators will treat the collection of family medical history and certain other information as part of health risk assessments used in connection with these programs. Although official guidance is still pending, many are concerned that regulators will construe certain commonly used practices of requiring covered persons to provide family medical histories or other genetic information through health risk assessments (HRAs) to qualify for certain financial incentives as a prohibited underwriting practice under GINA. Even where health risk assessments are not used, however, most group health plan sponsors should anticipate that GINA will require specific amendments to their plan documents, communications and processes.
Taking timely action to comply with these nondiscrimination and collection prohibitions is important. Under amendments to ERISA made by GINA, group health plan noncompliance can create significant liability for both the plan and its sponsor. Participants or beneficiaries will be able to sue noncompliant group health plans for damages and equitable relief. If the participant or beneficiary can show an alleged violation would result in irreparable harm to the individual’s health, the participant or beneficiary may not have to exhaust certain otherwise applicable Department of Labor administrative remedies before bringing suit. In addition to these private remedies, GINA also authorizes the imposition of penalties against employers and other sponsors of group health plans that violate applicable requirements of GINA of up to $500,000. The minimum penalties generally are set at the greater of $100 per day or a minimum penalty amount ranging from $2,500 for de minimus violations corrected before the health plan received notice of noncompliance to $15,000 in cases in which the violations are more than de minimus. GINA also includes language allowing the Secretary of Labor to reduce otherwise applicable penalties for violations that could not have been identified through the exercise of due diligence or when the plan corrects the violation quickly.
GINA Amendments To Health Plan Privacy Rules Under HIPAA
In addition to its nondiscrimination rules, GINA also amends HIPAA to make clear that “genetic information” as defined by HIPAA is protected health information protected by HIPAA’s Privacy & Security Standards of HIPAA. This means that it will require that all genetic information be treated as protected health information subject to the Privacy and Security Standards applicable to group health plans covered by HIPAA. Although the statutory provisions that accomplish these changes are deceptively simple, compliance with these requirements likely will require group health plans and their business associates to amend existing privacy policies, notices and practices to appropriately restrict disclosures for underwriting, operations and certain other uses to withstand scrutiny under the GINA privacy rule amendments.
The HITECH Act amended and increased civil penalties for HIPAA privacy violations in many circumstances effective February 17, 2009.
Regulatory Guidance Status
As the the deadline for compliance for post May 20, 2009 plan years is rapidly approaching, however, many group health plans and their sponsors will need forward with their compliance arrangements in the absence of regulatory guidance interpreting these requirements.
GINA’s fractured assignment of responsibility and authority to develop, implement and enforce regulatory guidance of its genetic information rules can create confusion for parties involved in compliance efforts. Because the group health plan requirements of Title I of GINA are refinements to the group health plan privacy and nondiscrimination rules previously enacted as part of HIPAA, GINA specifically assigned authority to construe and enforce its group health plan requirements to the agencies responsible for the interpretation and enforcement of those original rules:
- The Department of Labor Employee Benefit Security Administration (EBSA);
- The Internal Revenue Services (IRS), and
- The Department of Health & Human Services.
While these three agencies previously published a request for public comments about issues under Title I’s provisions, see http://edocket.access.gpo.gov/2008/pdf/E8-24194.pdf, none of these three agencies as of May 20, 2009 has published interim or other regulations interpreting the GINA provisions within their scope of responsibility since the formal comments period ended December 9, 2009. Although the EBSA Spring 2009 regulatory agenda reflected it intended to publish interim regulations by today and agency officials continue to indicate they intend to publish guidance “soon,” no guidance had been published as of May 20, 2009.
Even if the agencies issue guidance by the end of May plan sponsors and administrators of group health plans with new plan years beginning in the next 60 to 90 days are expressing concern that they will have inadequate time to complete compliance arrangements. As a result, in addition to guidance about GINA’s requirements generally, some are hopeful that the guidance with include transition rules or other relief to allow more time to comply with the regulations when finally issued. Regulators as of May 20, 2009 had not given any indication that they plan or perceive that they are authorized to provide such relief.
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 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.
©Cynthia Marcotte Stamer. All rights reserved.
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Corporate Compliance, EEOC, Employee Benefits, Employers, GINA, Health Plans, Privacy, Risk Management, Wellness | Tagged: Corporate Compliance, Disability Discrimination, Disease Management, Employee Benefits, Employer, Employers, Employment, ERISA, GINA, Health Insurance, Health Plans, Human Resources, Insurance, Insurer, Managed Care, Medical Coverage, Risk Management, Tax |
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Posted by Cynthia Marcotte Stamer
May 14, 2009
Many employers have used the Model Notices posted March 19, 2009 by the Department of Labor (DOL) to meet the April 17, 2009 deadline to provide initial notification to employees and dependents whose group health coverage terminated as a result of an involuntary termination of employment between September 1, 2008 and February 17, 2009 under the temporary rules 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 (“Stimulus Bill”). However, most employers including many distressed and reorganizing companies and their group health plan administrators, fiduciaries and insurers have additional work to do to complete the arrangements to comply with these new Stimulus Bill COBRA rules
Although many employers and group health plans have taken preliminary action to comply, most employers and group health plan insurers, administrators and fiduciaries have not fully completed the steps needed to complete compliance arrangements. Among the companies sponsoring group health plans most likely to be behind in their compliance efforts are those in bankruptcy and distressed companies, where internal human resources and employee benefit staff and outside vendor relationships are likely to be reduced, overextended, or otherwise distracted.
In some instances, parties responsible for sending notifications and making other compliance arrangements have not begun to comply. More typically, however, employers sponsoring group health plans, their administrators, insurers or fiduciaries may mistakenly believe that preliminary compliance efforts fulfilled their compliance responsibilities. As a result, many have failed to complete all of the steps necessary to comply. For instance:
- Many employers, health plan fiduciaries and administrators have not formally amended their group health plans, updated their COBRA initital notifications and summary plan descriptions, implemented required procedures and finished other arrangements necessary to bring their group health plans into compliance with the Stimulus Bill COBRA requirements.
- Many employers, insurers, administrators and fiduciaries who used the Model Notices initially to provide required notices are finding additional refinements to their notices and procedures to reduce questions and confusion by recipients attributable to poor tailoring of the information to their particular plan design.
- Many employers who outsource the collection of COBRA premiums or other aspects of COBRA administration will want to revise Model Notice language to avoid unnecessarily undermining previously negotiated allocations of fiduciary responsibility to those third parties for responsibilities outsourced.
Employers, health plan administrators, and health insurers involved in the sponsorship or administration of COBRA-covered group health plans should consult with counsel about the suitability of using the Model Notices to provide required notifications of the new Stimulus Bill COBRA rules and other steps necessary to comply with the new requirements. Compliance with the Stimulus Bill COBRA rules is mandatory for all COBRA-covered group health plans and certain other arrangements including group health plans sponsored by businesses in bankruptcy where the entity or a commonly controlled or affiliated entity continues to maintain a group health plan.
Stimulus Bill COBRA Rule Basics
The Stimulus Bill provisions that took effect on February 17, 2009 require special COBRA treatment for “assistance eligible individuals.” See “Stimulus Bill COBRA Amendments Require Immediate Group Health Plan Action” for more information. The Stimulus Bill COBRA amendments are intended to help certain involuntarily terminated former employees and their dependents maintain COBRA coverage. Employers must amend their plans to comply with these mandates and, if they wish to seek reimbursement for COBRA Subsidies, must comply with IRS requirements. Meanwhile, group health plan administrators and insurers must take immediate action to provide required notifications and implement other administrative changes necessary to comply with the new rules.
The Stimulus Bill definition of “assistance eligible individual” generally includes any COBRA “qualified beneficiary” who meets all of the following requirements:
- Is eligible for COBRA continuation coverage at any time during the period beginning September 1, 2008 and ending December 31, 2009;
- Elects COBRA coverage (when first offered or during the additional election period): and
- Has a qualifying event for COBRA coverage that is the employee’s involuntary termination during the period beginning September 1, 2008 and ending December 31, 2009.
This definition includes both involuntarily terminated employees and their dependents who lost coverage under a group health plan due to the involuntary termination.
As part of their COBRA amendments, the Stimulus Bill limits the COBRA premium that a COBRA-covered group health plan can charge an “assistance eligible individual” to 35% of the otherwise applicable COBRA premium for a period of up to 9 months (the “Subsidy Period”) beginning March 1, 2009. 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. However, the Stimulus Bill allows an employer to seek reimbursement by claiming a payroll tax credit for these COBRA Subsidy payments by complying with applicable IRS procedures.
The Stimulus Bill also requires certain assistance eligible individuals whose employment terminated between September 1, 2008 and February 16, 2009 and did not elect COBRA coverage when previously offered or who allowed COBRA coverage to lapse after electing that coverage be offered a second COBRA enrollment period in which to elect prospectively to enroll in COBRA coverage. It also requires that group health plans that offer employees different plan options allow assistance eligible individuals the option to change their coverage choice. Also Group health plan administrators must provide certain notifications to assistance eligible individuals concerning these changes.
March 19, 2009 & Other Piecemeal Guidance
The March 19, 2009 DOL Guidance containing the Model Notices is part of a series of interim and evolving guidance separately issued by the IRS and DOL between February and April. The March 19, 2009 DOL Guidance includes:
- Various Model Notices
- New FAQs for Employers on the COBRA Premium Reduction
- Expanded FAQs for Employees on the COBRA Premium Reduction
- Updated FAQs for Employees on General COBRA Provisions
In addition to the March 19, 2009 Guidance, the DOL and IRS previous also had issued a series of other guidance relating to the implementation and application of the Stimulus Bill COBRA rules on a piecemeal basis. These include separately issued IRS guidance detailing the documentation and procedures that the IRS has indicated that employers or others who collect discounted COBRA premiums from Stimulus Bill assistance eligible individuals must meet in order to comply with the COBRA Stimulus Bill mandates and to recover additional amounts that the employer pays as a COBRA premium subsidy on behalf of assistance eligible individuals through the payroll tax credit provisions of the Stimulus Bill COBRA rules. You can review:
While the Model Notices and other guidance provides helpful insights about the new requirements, many group health plan sponsors, administrators and fiduciaries are likely to find it necessary or desirable to specifically tailor the notifications and other procedures they provide to more clearly communicate the workings of the new requirements as they relate to their specific plans so as to minimize administrative burdens of compliance and fiduciary risks.
More Resources, Information & Assistance
Curran Tomko Tarski LLP Partner Cynthia Marcotte Stamer consults with clients and writes and speaks extensively about COBRA and other group health plan matters. Author of the “Health Care Eligibility Toolkit” and nationally known for her experience on COBRA matters, her Solutions Law Press article discussing the highlights of these IRS requirements and other previous guidance at http://www.cynthiastamer.com/documents/alerts/20090303_NEW%20IRS%20&%20DOL%20Guidance%20On%20Stimulus%20Bill%20COBRA%20Relief.pdf is just one of many helpful publications she has written on the Stimulus Bill COBRA Rules and other related matters. The Stimulus Bill COBRA rules were among the updates discussed by Cynthia Marcotte Stamer during a March 11, 2009 Health Plan Update Teleconference she presented for Solutions Law Press.
If you are an employer or other group health plan sponsor, administrator, insurer or fiduciary and need assistance in preparing required notifications or with other matters relating to the Stimulus Bill COBRA Rules or any other health or other employee benefits matter, contact Cynthia Marcotte Stamer at CStamer@SolutionsLawyer.net or via telephone at 972.419.7188. For information about how to purchase a recording of this teleconference or to review other breaking news updates about these Stimulus Bill COBRA Rules, e-mail CStamer@cttlegal.com.
You also can register to receive these and other updates by registering for this blog or by registering to receive other helpful Curran Tomko Tarski LLP publications at CTTLegal.com.
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COBRA, Employee Benefits, Employers, ERISA, Health Plans, Human Resources, Income Tax, Stimulus Bill | Tagged: COBRA, Corporate Compliance, Employee Benefits, Employers, Employment, Health Insurance, Health Plans, Human Resources |
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Posted by Cynthia Marcotte Stamer
May 13, 2009
Recent concerns over the H1N1 Swine Flu (swine flu) pandemic and warnings of a possible resurgence of the swine flu pandemic or some other pandemic in the future is forcing many employers to question when concerns that an employee suffers from a contagious disease can justify the employer making inquires about the health of an employee or the exclusion of the employee from the workplace. New guidance set forth in the “U.S. Equal Employment Opportunity Commission ADA-Compliant Employer Preparedness For the H1N1 Flu Virus” (Guidance) published by the U.S. Department of Labor Equal Employment Opportunity Commission (EEOC) on May 4, 2009 provides some insights for employers about the EEOC’s perspective on these questions.
The Guidance details the EEOC’s answers to certain basic questions about when the EEOC views certain workplace preparation strategies for responding to the 2009 flu virus as compliant with the Americans with Disabilities Act (ADA). Employers considering updates to their current pandemic and infectious disease response plans are cautioned that in addition to potential ADA exposures, practices for periods after November 21, 2009 also generally must be tailored to comply with new restrictions on employer’s collection of and discrimination based on genetic information based on the Genetic Information Nondiscrimination Act of 2008 (GINA). Proposed regulations interpreting the employment provisions of GINA published by the EEOC in March 2009 do not specifically address the implications of GINA on employer planning or response to pandemic concerns.
ADA Concerns Apply To Employers Planning For & Applying Swine Flu Response
Title I of the Americans with Disabilities Act (ADA) protects applicants and employees from disability discrimination. Among other things, the ADA regulates when and how employers may require a medical examination or request disability-related information from applicants and employees, regardless of whether the individual has a disability. The Guidance confirms that the EEOC views this requirement as affecting when and how employers may request health information from applicants and employees regarding H1N1 flu virus.
Effective January 1, 2009, Congress amended the Americans with Disabilities Act pursuant to the Americans with Disabilities Act Amendments Act of 2008 (ADAAA) to change the way that the ADA’s statutory definition of the term “disability” historically has been interpreted by certain courts. The ADAAA amendments generally are intended and expected to make it easier for certain individuals to qualify as disabled under the ADA. While the Guidance announces that the EEOC intends to revise its ADA regulations to reflect the broader group of persons protected as disabled under the ADAAA amendments, it also indicates that the EEOC does not perceive that the ADAAA changes the actions prohibited by the ADA as they relate to common pandemic planning and response activities. Consequently, the Guidance states that the EEOC views the guidance in “Disability-Related Inquiries & Medical Examinations of Employees Under the ADA” published by the EEOC in 2000 and its “Enforcement Guidance: Preemployment Disability-Related Questions & Medical Examinations” published in 1995 as setting forth the governing rules for medical testing, inquires and other pandemic response planning under the ADA.
Under the ADA, an employer’s ability to make disability-related inquiries or require medical examinations is analyzed in three stages: pre-offer, post-offer, and employment.
- At the first stage (prior to an offer of employment), the ADA prohibits all disability-related inquiries and medical examinations, even if they are related to the job.
- At the second stage (after an applicant is given a conditional job offer, but before s/he starts work), an employer may make disability-related inquiries and conduct medical examinations, regardless of whether they are related to the job, as long as it does so for all entering employees in the same job category.
- At the third stage (after employment begins), an employer may make disability-related inquiries and require medical examinations only if they are job-related and consistent with business necessity.
- The ADA requires employers to treat any medical information obtained from a disability-related inquiry or medical examination (including medical information from voluntary health or wellness programs), as well as any medical information voluntarily disclosed by an employee, as a confidential medical record. Employers may share such information only in limited circumstances with supervisors, managers, first aid and safety personnel, and government officials investigating compliance with the ADA.
Employers deviating from these requirements when administering their pandemic planning or response risk disability discrimination liability under the ADA unless they otherwise can defend their action under one of the exceptions to the ADA’s disability discrimination prohibitions. When making post-offer inquiries or requiring post offer examinations or imposing other conditions for safety reasons, the Guidance and EEOC in unofficial discussions have emphasized the importance of the employer’s ability to demonstrate the job or safety relevance of the medical inquiry or examination based on credible scientific evidence such as the latest scientific evidence available from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).
Other than emphasizing the importance of acting appropriately in response to credible scientific evidence and pointing to preexisting guidance, the Guidance does not extensively address with specificity the circumstances under which the EEOC will view any particular action taken by an employer as defensible under the safety or other exceptions of the ADA. Likewise, the Guidance does not discuss in any details the conditions, if any, under which the EEOC would view suffering, a history of suffering or association with or exposure to swine flu as qualifying an individual as disabled or perceived to be disabled for purposes of the ADA. Consequently, employer must rely on other less specifically tailored guidance for purposes of assessing the defensibility of a proposed action on these grounds.
Planning for Absenteeism Under ADA
When planning for a possible pandemic, employers must be careful about when and how they ask employees about factors, including chronic medical conditions that may cause them to miss work in the event of a pandemic. According to the Guidance, an employer may survey its workforce to gather personal information needed for pandemic preparation if the employer asks broad questions that are not limited to disability-related inquiries. An inquiry would not be disability-related if it identified non-medical reasons for absence during a pandemic (e.g., mandatory school closures or curtailed public transportation) on an equal footing with medical reasons (e.g., chronic illnesses that weaken immunity). The Guidance includes a sample of what the EEOC views as ADA-compliant survey that could be given to all employees before a pandemic.
The Guidance also indicates that where appropriate safeguards are applied to comply with the ADA, it also may be appropriate for an employer under certain limited circumstances, to require entering employees to have a medical test post-offer to determine their exposure to the influenza virus. According to the EEOC, the ADA permits an employer to require entering employees to undergo a job relevant medical examination after making a conditional offer of employment but before the individual starts work, if all entering employees in the same job category must undergo such an examination. Thus, the Guidance reflects that the requirement by an employer as part of its pandemic influenza preparedness plan that all entering employees in the same job categories undergo the same post offer medical testing for the virus in accordance with recommendations by the WHO and the CDC in response to a new influenza virus may be ADA-compliant.
Infection Control in the Workplace Under the ADA
The Guidance also discusses the EEOC’s perceptions about the ADA implications of employer use of certain infection control practices in the workplace during a pandemic provided that the requirements are applied in a nondiscriminatory fashion consistent with the ADA. For instance, the Guidance states that employers generally may apply with following infection control practices without implicating the ADA:
- Require all employees to comply with certain infection control practices, such as regular hand washing, coughing and sneezing etiquette, and tissue usage and disposal without implicating the ADA;
- May require employees to wear personal protective equipment provided that where an employee with a disability needs a related reasonable accommodation under the ADA (e.g., non-latex gloves, or gowns designed for individuals who use wheelchairs), employer provides these accommodations absent undue hardship;
- Encourage or require employees to telework as an infection-control strategy, based on timely information from public health authorities about pandemic conditions or offer telework as a possible reasonable accommodation.
In all cases, of course, the Guidance cautions that employers must not single out employees either to telework or to continue reporting to the workplace on a basis prohibited by the ADA or any of the other federal Equal Employment Opportunity laws.
Impending GINA Rules
As signed into law, GINA amends Title VII of the Civil Rights Act, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, the Internal Revenue Code of 1986, and Title XVIII (Medicare) of the Social Security Act to implement sweeping new federal restrictions on the collection, use, and disclosure of “genetic information” by employers, employment agencies, labor organizations, joint labor-management committees, group health plans and insurers and their agents. GINA’s group health plan restrictions are scheduled to take effect May 21, 2009. The employment related genetic testing rules of GINA take affect November 21, 2009. Employers and other covered entities will need to carefully review and timely update their pandemic and other infectious disease response practices as well as their group health plan, family leave, disability accommodation, and other existing policies in light of these new federal rules.
Although EEOC has not finalized its implementing regulations for GINA yet, employers should anticipate that GINA will impact their pandemic and other related practices. The implications of GINA for employers and other entities covered by its provisions because of its broad definition of genetic information.
Under GINA, “genetic information” is defined to mean with respect to any individual, information about:
- Such individual’s genetic tests;
- The genetic tests of family members of such individual; and
- The manifestation of a disease or disorder in family members of such individual.
GINA also specifies that any reference to genetic information concerning an individual or family member includes genetic information of a fetus carried by a pregnant woman and an embryo legally held by an individual or family member utilizing an assisted reproductive technology.
Pending issuance of final regulatory guidance, Gina’s inclusion of information about the “manifestation of a disease or disorder in family members” raises potential challenges for a broad range of wellness and safety, leave, and other employment and benefit practices, particularly as apparently will reach a broader range of conditions than those currently protected under the disability discrimination prohibitions of the Americans With Disabilities Act (“ADA”).
Depending on the contemplated inquiry or practice, certain inquiries or actions intended for use as part of an employer’s pandemic preparedness or response activities could fall within the scope of GINA’s protections. For this reason, employers also should consider the potential treatment of a proposed pandemic preparation or response activity intended to be applied after GINA takes effect in light of GINA. Additionally, employers also should consider the risk that information collected under existing or previously applied pandemic or other infectious disease prevention and response activities might qualify for additional protection when GINA takes effect in November, 2009.
Other Resources
Businesses, health care providers, schools, government agencies and others concerned about preparing to cope with pandemic or other infectious disease challenges also may want to review the following resources authored by Curran Tomko Tarski LLP partner Cynthia Marcotte Stamer:
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 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 www.cttlegal.com.
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Absenteeism, ADA, Disease Management, EEOC, Employee Benefits, GINA, Health Plans, Human Resources, Internal Controls, Pandemic, Privacy, Risk Management, Swine Flu, Telecommuting | Tagged: ADA, Corporate Compliance, Disability Discrimination, Disease Management, Employee Benefits, Employers, Employment, ERISA, genetic testing, GINA, Health Insurance, Health Plans, Human Resources, Internal Controls, Labor, Light Duty, Medical Coverage, Pandemic, Risk Management, Swine Flu, Wellness |
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Posted by Cynthia Marcotte Stamer
May 12, 2009
The recent sentencing of a West Texas man on a child pornography conviction serves as an important reminder to employers of the need to consider the potential criminal exposures and responsibilities of their organization and its management under the Federal Sentencing Guidelines when an investigation of sexual harassment policy violations uncovers evidence that an employee may have engaged in the transmission or receipt of pornography on company computers or systems.
On May 8, 2009, U.S. District Judge Sam R. Cummings sentenced Rory Dale Worthan, of Big Spring, Texas, to 78 months in prison followed by a 30-year term of supervised release illegal possession of child pornography. Worthan pled guilty in January to one count of possession of child pornography. He admitted that on February 8, 2007, he had an image of child pornography on his computer’s hard drive that he had downloaded from the Internet. His conviction was part of a series of convictions resulting from a West Texas child pornography sting operation.
Although Worthan’s conviction related to his use of his personal computer system, statistics show that workplace access of child and other pornography during company hours is common. In fact, some studies report that 70 percent of all Web traffic to Internet pornography sites occurs between the traditional work hours of 9 a.m. and 5 p.m. See “Workplace Web Use: Give ‘em an inch …,” Douglas Schweitzer, SearchSecurity.com (Sept. 27, 2004).
While most employers already are aware of the substantial employment discrimination and sexual harassment liability exposures that employee access, possession and transmission of pornography and other sexually explicit or suggestive content can create under Title VII and other federal and state employment discrimination laws, many are unaware that the use by employees of their computers to access, store, transmit or engage in other activities involving child pornography or other sexually explicit materials also may have criminal implications for their organization under certain circumstances.
As part of broader prohibitions against activities involving the sexual exploitation of minors, for instance under the U.S. Criminal Code, Title XVIII makes the creation, receipt, transmission possession, retention, transmission and certain other activities involving child pornography or certain other visual depictions involving the use or depiction of a minor engaging in sexually explicit conduct under certain circumstances a felony under federal law.
Under the organizational provisions of the Federal Sentencing Guidelines, a business that employs an employee or agent who engages in these activities during working hours or using company systems or equipment may face vicarious liability for the wrongful criminal actions by its employee in violation of these or other federal laws where the criminal action engaged in by the employee is a Felony or Class A misdemeanor. Under such circumstances, the liability exposure of the employer generally depends upon its ability to demonstrate that it had suitable policies and procedures in place to prohibit and prevent the activity, whether it timely investigated and took appropriate measures to report the violation to federal law enforcement officials and cooperate with them in their investigation and prosecution of the offending employee and other factors.
In addition to these criminal liability risks, employers also may face exposure to civil judgments in lawsuits brought by families of children victimized by employees using employer computers or operating systems. In Doe v. XYC Corp., 887 A.2d 1156 (N.J. Super. Ct. App. Div. 2005), for example, a New Jersey appellate court ruled that an employer could be held liable in a negligence action to a victim of child pornography based on the actions of one of its employees. In Doe, the wife of an employee who used his workstation computer at work to view and circulate nude photographs of his 10-year old stepdaughter sued the employer for negligence claim. The mother claimed the employer acted negligently by failing to detect and stop her husband from using his work computer to interact with child pornography Web sites, thereby allowing him to “continue clandestinely photographing and molesting” his 10-year-old stepdaughter.
For this reason, employers who uncover evidence that an employee or agent during working hours or using company equipment or systems may have created, received, transmitted, or stored child pornography or other sexually explicit materials must take prompt action to mitigate both their civil and criminal liability exposure. In addition to taking prompt action to prevent, investigate and discipline employees and agents that violate employer policies against using or possessing sexually inappropriate materials, businesses also should promptly seek the assistance of competent legal counsel to evaluate whether the prohibited conduct violated federal child pornography or other criminal laws. Where an investigation uncovers evidence of a potential violation of such laws, employers should seek assistance of counsel experienced with both employment and white collar criminal laws about the advisability of notifying federal law enforcement officials about that evidence and the best procedures to use to make those disclosures. In addition, employers should implement reasonable procedures to prevent and minor activities that may suggest employees or others granted access to company systems may be engaging in prohibited actions and take well documented action to investigate and redress this suspected misconduct.
As the monitoring and investigation of these concerns typically will require that an employer search or monitor employee e-mail or other files, employers also should ensure that they have in place appropriate privacy disclaimer, system use and background check and investigations that empower the employer to minimize potential exposures to privacy or other employment claims by employees or others whose e-mail or other files or activities are scrutinized in connection with these activities.
Chair of the Curran Tomko LLP Labor and Employment Practice and Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization, Cynthia Marcotte Stamer regularly assists U.S. businesses to investigate and redress sexual harassment and other employment and internal controls matters. If your organization needs assistance with investigating or responding to a suspected sex discrimination or sexual harassment matter involving pornography or other suspected employee misconduct under company policies or applicable federal or state law, 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 Tarski, LLP team, see the www.cttlegal.com.
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Corporate Compliance, EEOC, Employers, Internal Controls, Internal Investigations, Privacy | Tagged: Computer Use, Corporate Compliance, Corporate Ethics, Federal Sentencing Guidelines, Internal Investigations, Pornography, Risk Management, Sex Discrimination, Sex Disriminaioin, Sexual Harassment |
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Posted by Cynthia Marcotte Stamer
May 5, 2009
As the U.S. rushes to try to contain the spread of the swine influenza A (H1N1) virus infection (swine flu), businesses increasingly are facing employee leave requests and other employment and operational disruptions plans caused by school, day care or other closures and other business disruptions resulting from efforts to contain the disease while also working to take appropriate steps to prevent the spread of the disease within their own organizations.
Regardless of how deadly it ultimately proves to be, the pandemic proportion of the swine flu outbreak now ensures that most U.S. businesses will experience some disruption in operations as a result of the epidemic and efforts to contain it.
According to officials from the Centers for Disease Control and Prevention (CDC), as of 11:00 a.m. Eastern Time, 36 states had reported a total of 236 confirmed cases of swine flu and more cases are expected. That number includes the first U.S. swine flu fatality: a 22-month-old child from Mexico who died of the illness at a Houston, Texas hospital while visiting the United States last week. States currently hardest hit include New York (73 cases), Texas (41 cases), California (30 cases), Delaware (20 cases) and Arizona (17 cases). In the near future, however, CDC officials anticipate confirmed cases in all 50 states.
CDC officials and other experts continue to emphasize that the success of efforts to prevent the unnecessary spread of the disease depends largely on good health habits, limiting exposure to the virus and prompt diagnosis and treatment of afflicted persons. Employers can help reduce the risk that members of their workforce and their families will catch the virus by promoting good health habits and encouraging workers and their families to stay home and seek prompt treatment in the event of an illness. Simultaneously planning for and dealing with absences and other staffing challenges result from school, day care and other closings prevents a greater challenge for many employers, however.
Easy Preventive Safeguards
While the CDC says getting employees and their families to get a flu shot remains the best defense against a flu outbreak, it also says getting employees and family members to consistently practice good health habits like covering a cough and washing hands also is another important key to prevent the spread of germs and prevent the spread of respiratory illnesses like the flu. To help promote health habits within their workforce, many businesses may want to download and circulate to employees and families the free resources published by the CDC at http://www.cdc.gov/flu/protect/habits.htm. These and other resources make clear that Employers should encourage employees and their families to practice good health habits by telling employees and their families to take the following steps:
- Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
- Stay home when you are sick to help prevent others from catching your illness. Cover your mouth and nose.
- Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
- Clean your hands to protect yourself from germs.
- Avoid touching your eyes, nose or mouth.
- Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
- Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
Many businesses are promoting these and other conducts that help prevent the spread of disease by sharing educational materials such as the growing range of free materials provided by the CDC and others available at the government sponsored website, http://www.pandemicflu.gov. For instance, business can access and download free copies of the following publications at http://www.cdc.gov/flu/protect/habits.htm:
- Cover Your Cough
- Be a Germ Stopper: Healthy Habits Keep You Well
- Flu Prevention Toolkit: Real People. Real Solutions
- Stopping the Spread of Germs at Home, Work & School
Dealing With Lost Time & Productivity Challenges
Businesses also should begin preparing backup staffing and production strategies to prepare for disruptions likely to result if a significant outbreak occurs. Whether or not the disease afflicts any of its workers, businesses can anticipate the swine flu outbreak will impact their operations -either as a result of occurrences affecting their own or other businesses or from workflow disruptions resulting from safeguards that the business or other businesses implement to minimize swine flu risks for its workforce or its customers.
For many employers, however, planning for and dealing with requests for time off or other workplace disruptions resulting from pandemic containment efforts presents special challenges. While most employers have well established policies and procedures for providing medical leave to employees during periods of their own or a family member’s illness under the Family & Medical Leave Act (FMLA) or otherwise, many employers are experiencing difficulty in responding to leave requests of healthy employees necessitated by school or day care closings, suspected exposures, or other pandemic response disruptions.
Certainly, whether or not legally mandated, the CDC and other official advisories make clear that sick employees should not be in the workplace. Employers of course must provide medical leave as required by the FMLA or other similar state laws as well as any contractually agreed to leave. To better insulate their workforce against potential exposure to the virus, however, many employers also may wish consider temporarily modifying existing leave or other work policies with an eye to better defending their workforce against a major outbreak. In this respect, employers need to consider both how to respond to the present wave of the virus and to plan for the possible need to respond to another potentially stronger outbreak of the swine flu virus that the CDC and other experts caution likely may arise in the Fall or Winter.
As part of their efforts to insulate their workplaces against exposure to the virus, employers generally should discourage workers from coming to work if they or a family member are experiencing symptoms or have been exposed to the virus. For this reason, businesses generally evaluate workplace policies or practices that may pressure or encourage employees with swine flu or any other contagious disease to report to work. Employers should consider whether the potential risks make advisable adjustments to their current attendance, telecommuting, leave and paid time off and other policies.
In light of the current situation, many businesses may want to consider temporarily adjust their leave, telecommuting and other policies in light of the impending health risk. For instance, recognizing that the decision to close a school or child care facility in response to a known or suspected infection seeks to minimize the spread of the disease through exposure to other then undiagnosed cases, businesses generally should think twice about allowing employees to bring these potentially exposed children into the workplace. Instead, employers may wish to consider being more flexible in allowing employees to work from home or take leave to care for children whose schools or child care facilities are closed due to concerns about possible exposure to reduce the risk of creating unnecessary exposure in their workplace.
To help minimize financial pressures on workers to report to work when they may be ill or exposed to the virus, many employers also may want to consider providing or offering short-term disability insurance, expanding the availability of paid or unpaid leave or both.
Regardless of the specific choices a particular business makes, businesses need to take appropriate steps to document, implement, and communicate their decisions. If considering allowing or requiring employees to work from home, employers need to implement appropriate safeguards to monitor and manage employee performance, and to protect the employer’s ability to comply with applicable wage and hour, worker’s compensation, safety, privacy and other legal and operational requirements. They also should review and update family and medical leave act and other sick leave policies, group health plan medical coverage continuation rules and notices and other associated policies and plans for compliance with existing regulatory requirements, which have been subject to a range of statutory and regulatory amendments in recent years.
If considering allowing or requiring employees to work from home, for instance, employers need to implement appropriate safeguards to monitor and manage employee performance, and to protect the employer’s ability to comply with applicable wage and hour, worker’s compensation, safety, privacy and other legal and operational requirements. They also should review and update family and medical leave act and other sick leave policies, group health plan medical coverage continuation rules and notices and other associated policies and plans for compliance with existing regulatory requirements, which have been subject to a range of statutory and regulatory amendments in recent years.
In light of the growing responsibilities and exposures of business to medical privacy and disability liabilities associated with knowledge, collection, protection and use of information about the health and medical conditions of workers and their families, businesses also should review and update their procedures regarding the use, collection, disclosure, and protection of this and other sensitive information. Businesses, health care providers, schools, government agencies and others concerned about preparing to cope with pandemic or other infectious disease challenges also may want to review the publication “Planning for the Pandemic” authored by Curran Tomko Tarski LLP partner Cynthia Marcotte Stamer available at http://www.cynthiastamer.com/documents/speeches/20070530%20Pan%20Flu%20Workplace%20Privacy%20Issues%20Final%20Merged.pdf. Schools, health care organizations, restaurants and other businesses whose operations involve significant interaction with the public also may need to take special precautions. These and other businesses may want to consult the special resources posted at http://www.pandemicflu.gov/health/index.html.
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. Ms. Stamer in particular has worked extensively with health care providers, government officials, and businesses to plan for and deal with pandemic and other absence, disease management and disaster preparedness concerns. 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 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.
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Absenteeism, COBRA, Disease Management, EEOC, Employee Benefits, Employers, Employment Agreement, ERISA, Health Plans, Human Resources, Insurance, Internal Controls, Pandemic, Privacy, Swine Flu, Telecommuting, Wellness | Tagged: Absenteeism, ADA, COBRA, Disability, Disability Discrimination, Disease Management, Employee Benefits, Employer, Employment, Employment Agreements, Family Leave, Health, Health Plans, Human Resources, Labor, Leave, Medical Coverage, Minimum Wage, Overtime, Paid Time Off, Pandemic, Privacy, PTO, Risk Management, Swine Flu, Wellness |
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Posted by Cynthia Marcotte Stamer
May 2, 2009
On March 27, 2009, the Internal Revenue Service issued Notice 2009-31, 2009-16 I.R.B. 856, providing guidance to multiemployer defined plans making elections described in sections 204 and 205 of the Worker, Retiree, and Employer Recovery Act of 2008, P.L. 110-458 (WRERA). These elections relate to provisions of Section 432 of the Internal Revenue Code (Code) by the Pension Protection Act of 2006, P.L. 109-280 (PPA) that impose requirements on multiemployer defined benefit plans that are significantly underfunded.
Notice 2009-42 to be published at I.R.B. 2009-20 on May 18, 2009, extends the time period for making elections described in section 204 of the WRERA. In addition, if (1) as of the otherwise applicable deadline (i.e., the deadline for a plan as modified by this notice) for making an election under section 204 or 205, a plan sponsor has been unable to reach agreement as to whether to make the election, so that the decision must be resolved through an arbitration process; (2) the plan sponsor makes an election by the otherwise applicable deadline that is contingent on the resolution of the arbitration; and (3) the resolution is to not make an election, then the IRS will automatically approve a request to revoke the election.
Cynthia Marcotte Stamer and other members of Curren 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 Curren Tomko Tarski, LLP attorney. For additional information about the experience and services of Ms. Stamer and other members of the Curren Tomko Tarksi, LLP team, see the Curren Tomko Tarski Website or Cynthia Marcotte Stamer, P.C. Website.
More Information
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 current 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.
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Employee Benefits, Employers, ERISA, Retirement Plans | Tagged: defined benefit plan, Employee Benefits, IRS, PBGC, WRERA |
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Posted by Cynthia Marcotte Stamer
May 2, 2009
The U.S. Department of Labor (“DOL”) today (May 1, 2009) continued its efforts to increase awareness of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provisions in the American Recovery and Reinvestment Act of 2009 (“ARRA”) by sharing information with state agencies and asking their assistance in helping dislocated workers, businesses, and partners in understanding the new law.
Under ARRA, employees involuntarily terminated between September 1, 2008 and December 31, 2009 and their dependents may be able to qualify for a 65% discount in the required premium they must pay to maintain COBRA coverage under their former employer’s group health plan for up to 9 months. Special rules also apply to former employees who qualify for Trade Adjustment Assistance or affected by certain Pension Benefit Guarantee Corporation insurance programs.
Employers must pay the remaining amount of the otherwise required COBRA premium, but can request reimbursement from the Internal Revenue Service by filing for a payroll tax credit under the provisions of ARRA.
Group health plans were required to begin complying with the new ARRA rules beginning February 17, 2009 and to notify workers of the new rules no later than April 18, 2009. Many employers and their group health plan sponsors are still working to complete the necessary arrangements to comply with these new requirements.
The communication of information about the new provisions by the DOL, group health plans, employers and the media have prompted an outpouring of questions from many employees and their dependents, confused about their eligibility for the ARRA COBRA Subsidy and its workings.
In Training And Employment Notice No. 42-08, which is addressed to state workforce agencies, labor commissioners and other state workforce regulators, the Employment and Training Administration (“ETA”):
- Shared certain basic information about ARRA’s COBRA, Trade Adjustment Assistance and other workforce assistance relief;
- Detailed some of the training and other resources provided by the DOL to help States and their citizens understand these new provisions and the procedures for their use; and
- Asked the regulators to assist in communicating and disseminating the information to individuals who might qualify for benefits and other interested parties.
Interested persons can review the announcement at http://wdr.doleta.gov/directives/attach/TEN/ten2008/TEN42-08acc.pdf.
Cynthia Marcotte Stamer is nationally known for her knowledge and experience on COBRA and other health benefit and employee benefit matters,. You will find several of these previous publications on the new ARRA COBRA provisions on prior editions of the Solutions Law Press HR & Benefits Update. You also can access some of the many practical updates that she has prepared on these and other COBRA matters by e-mailing or contacting her. She and other members of Curren 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 COBRA or other employee benefit or human resources practices, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402 or your favorite Curren Tomko Tarski, LLP attorney.
For additional information about the experience and services of Ms. Stamer and other members of the Curren Tomko Tarksi, LLP team, see the http://www.cttlegal.com.
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COBRA, Corporate Compliance, Employers, Employment Tax, ERISA, Health Plans, Insurance, Stimulus Bill, Tax | Tagged: Compensation, Corporate Compliance, Employee Benefits, Employer, Employers, ERISA, Health Insurance, Health Plans, HealthP Plans, Human Resources, Insurance, Insurer, Managed Care, Medical Coverage, Risk Management, Stimulus Bill, Subsidy Bill, Tax |
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Posted by Cynthia Marcotte Stamer
April 29, 2009
With U.S. officials confirming the first swine flu attributed death in the U.S. today and warning Americans to take precautions to guard against a likely swine flu pandemic, U.S. employers are asking what steps they should take to defend their organization and its people against the risk of a widespread outbreak among members of their workforce and the attendant lost time, health and disability costs, OSHA and other liability exposures and other personal and financial consequences likely to result from an outbreak.
Whether or not the swine flu outbreak reaches the level of an official pandemic, official reports reflect a legitimate need for concern. According to officials from the Centers for Disease Control and Prevention, victims of the virus already have been reported in 10 states, and the number of people known to be infected with the 2009 H1N1 influenza strain grew to 91 in the U.S. as of Wednesday. That number includes the first U.S. swine flu fatality: a 22-month-old child from Mexico who died of the illness Monday at a Houston, Texas hospital while visiting the United States. While swine flu victims have been reported in more than 11 countries, the majority of the incidents of the disease and deaths as of Wednesday morning had occurred in Mexico.
While the CDC says getting employees and their families to get a flu shot remains the best defense against a flu outbreak, it also says getting employees and family members to consistently practice good health habits like covering a cough and washing hands also is another important key to prevent the spread of germs and prevent the spread of respiratory illnesses like the flu. Employers should encourage employees and their families to take the following steps:
- Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
- Stay home when you are sick to help prevent others from catching your illness. Cover your mouth and nose.
- Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
- Clean your hands to protect yourself from germs.
- Avoid touching your eyes, nose or mouth.
- Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
- Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
Employers also should be sensitive to workplace policies or practices that may pressure employees with a contagious disease to report to work despite an illness and consider whether the employer should adjust these policies temporarily or permanently in light of the impending health risk. For instance, financial pressures and the design and enforcement of policies regarding working from home and/or qualifying for paid or unpaid time off significantly impact the decisions employees make about whether to come to work when first experiencing symptoms of illness. Employers of workers who travel extensively – may wish to delay or restrict travel for some period.
Many employers may want to evaluate and appropriately revise existing policies with an eye to better defending their workforce against a major outbreak. If considering allowing or requiring employees to work from home, employers need to implement appropriate safeguards to monitor and manage employee performance, and to protect the employer’s ability to comply with applicable wage and hour, worker’s compensation, safety, privacy and other legal and operational requirements. They also should review and update family and medical leave act and other sick leave policies, group health plan medical coverage continuation rules and notices and other associated policies and plans for compliance with existing regulatory requirements, which have been subject to a range of statutory and regulatory amendments in recent years.
To help promote health habits within their workforce, many businesses may want to download and circulate to employees and families the free resources published by the CDC at http://www.cdc.gov/flu/protect/habits.htm. Businesses and other concerned parties also can track governmental reports about the swine flu and other pandemic concerns at http://www.pandemicflu.gov/index.html.
Businesses also should begin preparing backup staffing and production strategies to prepare for disruptions likely to result if a significant outbreak occurs. Employers also should be sensitive to workplace policies or practices that may pressure employees with a contagious disease to report to work despite an illness and consider whether the employer should adjust these policies temporarily or permanently in light of the impending health risk. For instance, financial pressures and the design and enforcement of policies regarding working from home and/or qualifying for paid or unpaid time off significantly impact the decisions employees make about whether to come to work when first experiencing symptoms of illness. Many employers may want to evaluate and appropriately revise existing policies with an eye to better defending their workforce against a major outbreak.
If considering allowing or requiring employees to work from home, employers need to implement appropriate safeguards to monitor and manage employee performance, and to protect the employer’s ability to comply with applicable wage and hour, worker’s compensation, safety, privacy and other legal and operational requirements. They also should review and update family and medical leave act and other sick leave policies, group health plan medical coverage continuation rules and notices and other associated policies and plans for compliance with existing regulatory requirements, which have been subject to a range of statutory and regulatory amendments in recent years.
Employers should begin preparing backup staffing and production strategies to prepare for disruptions likely to result if a significant outbreak occurs. Whether or not the disease afflicts any of its workers, businesses can anticipate the swine flu outbreak will impact their operations -either as a result of occurrences affecting their own or other businesses or from workflow disruptions resulting from safeguards that the business or other businesses implement to minimize swine flu risks for its workforce or its customers.
Businesses, health care providers, schools, government agencies and others concerned about preparing to cope with pandemic or other infectious disease challenges also may want to review the publication “Planning for the Pandemic” authored by Curran Tomko Tarski LLP partner Cynthia Marcotte Stamer available at http://www.cynthiastamer.com/documents/speeches/20070530%20Pan%20Flu%20Workplace%20Privacy%20Issues%20Final%20Merged.pdf. Schools, health care organizations, restaurants and other businesses whose operations involve significant interaction with the public also may need to take special precautions. These and other businesses may want to consult the special resources posted at http://www.pandemicflu.gov/health/index.html.
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. Ms. Stamer in particular has worked extensively with health care providers, government officials, and businesses to plan for and deal with pandemic and other disease management and disaster preparedness concerns. 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 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 www.cttlegal.com.
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Employers, ERISA, Health Plans, Human Resources, Insurance, Wage & Hour |
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Posted by Cynthia Marcotte Stamer
April 23, 2009
U.S. businesses should review the adequacy of their existing antitrust Federal Sentencing Guidance Compliance policies and internal controls in light of a series of recently announced antitrust enforcement actions recently announced by the Department of Justice (“DOJ”). U.S. and other businesses and their employees and agents who engage in prohibited antitrust activities face substantial criminal and civil penalties in actions brought by the DOJ, civil judgments brought by private plaintiffs, or both. To effectively manage these exposures, businesses and leadership must ensure that their organization has in place appropriate employment, corporate ethics and internal controls and procedures for preventing, investigating and redressing potential violations. The management and discipline of employees and other service providers that violate these and other compliance policies is an increasingly important responsibility of human resources and other management leaders.
On Monday (April 20, 2009), DOJ announced that two subsidiaries of the Swedish company Trelleborg AB, one based in Virginia and the other in France, have agreed to plead guilty and pay a total of $11 million in criminal fines for participating in separate conspiracies affecting the sales of marine products sold in the United States and elsewhere. The plea agreements are among at least 9 major antitrust enforcement actions announced by the DOJ since the first of the year, including the longest sentence yet imposed for an antitrust criminal conviction.
Trelleborg Engineered Products Inc. &
Trelleborg Industries S.A.S. Plea Agreements
The plea agreement resolves a two-count felony charge filed in U.S. District Court in Norfolk, Va., against Virginia Harbor Services Inc., formerly known as Trelleborg Engineered Products Inc. (VHS/TEPI), a manufacturer of foam-filled marine fenders, buoys and plastic marine pilings headquartered in Clearbrook, Va. Foam-filled marine fenders are used as a cushion between ships and either fixed structures, such as docks or piers, or floating structures, such as other ships. Foam-filled buoys are used in a variety of applications, including as channel markers and navigational aids. Plastic marine pilings are substitutes for traditional wood timber pilings and are often used in port and pier construction projects in conjunction with foam-filled fenders. According to the charges, VHS/TEPI participated in a conspiracy between December 2002 and August 2005 to allocate customers and rig bids for contracts to sell foam-filled marine fenders and buoys, and also participated in a separate conspiracy between December 2002 and May 2003 to allocate customers and rig bids for contracts to sell plastic marine pilings. Under the terms of the plea agreement, which is subject to court approval, VHS/TEPI has agreed to pay a $7.5 million criminal fine and to cooperate fully in the Department’s ongoing antitrust investigation. To date, six individuals and two corporations have pleaded guilty or agreed to plead guilty in the Antitrust Division’s ongoing investigation of fraud and collusion in the marine fenders and pilings industries.
In addition, a one-count felony charge was filed today in U.S. District Court in Fort Lauderdale, Fla., against Trelleborg Industries S.A.S. (TISAS), a manufacturer of marine hose headquartered in Clermont-Ferrand, France. TISAS is charged with participating in a conspiracy from at least as early as 1999 and continuing until as late as May 2, 2007, to allocate market shares, fix prices and rig bids for contracts to sell marine hose to purchasers in the United States and elsewhere. Marine hose is a flexible rubber hose used to transfer oil between tankers and storage facilities. Under the terms of the plea agreement, which is subject to court approval, TISAS has agreed to pay a $3.5 million criminal fine and to cooperate fully in the Department’s ongoing antitrust investigation. To date, three corporations have pleaded guilty or agreed to plead guilty in the Antitrust Division’s ongoing investigation in the marine hose industry. Twelve individuals have also been charged to date, nine of whom have pleaded guilty.
The plea agreements announced this week are part of a continuing DOJ investigation, which already lead to five former executives of TISAS and VHS/TEPI entering guilty pleas to participating in the conspiracies charged. Former VHS/TEPI president Robert B. Taylor was sentenced in January 2008 to serve 24 months in prison and pay a $300,000 criminal fine. Former VHS/TEPI chief financial officer Donald L. Murray was sentenced in March 2008 to serve 18 months in prison and pay a $75,000 criminal fine. William Alan Potts, a former vice president of VHS/TEPI, was sentenced in June 2008 to serve six months in prison and six months in home detention, and to pay a $60,000 criminal fine. Former TISAS executives Christian Caleca and Jacques Cognard were each sentenced in December 2007 to serve 14 months in prison and to pay criminal fines of $75,000 and $100,000, respectively.
Other Recent Antitrust Enforcement Activities
The plea agreements announced this week are the latest in a series of antitrust enforcement actions recently taken by the DOJ. Since the first of the year alone, DOJ also has announced a series of other major antitrust enforcement actions, including, for instance:
On April 9, 2009, DOJ announced that Cargolux Airlines International S.A., Nippon Cargo Airlines Co. Ltd. and Asiana Airlines Inc. plead guilty and agreed to pay a total of $214 million in criminal fines to settle price fixing charges.
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On March 31, a San Francisco federal grand jury indicted Hitachi Displays Ltd. executive Sakae Someya with conspiring with unnamed co-conspirators to suppress and eliminate competition by fixing the price of Thin Film Transistor-Liquid Crystal Display (TFT-LCD) panels sold to Dell Inc. for use in notebook computers. With this indictment, four companies and eight individuals have been charged in the Department’s ongoing antitrust investigation into the TFT-LCD industry and more than $585 million in fines have been imposed as a result.
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On March 10, Somey’s employer, Japanese electronics manufacturer Hitachi Displays Ltd., agreed to plead guilty and pay a $31 million fine for its role in a conspiracy to fix prices in the sale of TFT-LCD panels sold to Dell Inc.
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On February 10, 2009, a federal grand jury in San Francisco indicted former Chairman and Chief Executive Officer of Chunghwa Picture Tubes Ltd. with conspiring with others to suppress and eliminate competition by fixing prices, reducing output and allocating market shares of color display tubes (CDTs) to be sold in the U.S. and elsewhere. The indictment also charges C.Y. Lin with conspiring with others to suppress and eliminate competition by fixing prices for color picture tubes (CPTs) to be sold in the U.S. and elsewhere.
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On February 3, 2009, a San Francisco federal grand jury indicted two former executives from Chunghwa Picture Tubes Ltd. (Chunghwa) and one former executive from LG Display Co. Ltd. (LG) for participation in a global conspiracy to fix prices of Thin Film Transistor-Liquid Crystal Display (TFT-LCD) panels.
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On January 1, 2009, former high-level shipping executive Peter Baci was sentenced to serve the longest jail sentence ever imposed for a single antitrust charge, 48 months in jail, and to pay a $20,000 criminal fine for his role in an antitrust conspiracy involving the transportation of goods to and from the continental United States and Puerto Rico by ocean vessel by agreeing to allocate customers, agreeing to rig bids submitted to government and commercial buyers, and agreeing to fix the prices of rates, surcharges, and other fees charged to customers. Related antitrust charges remain pending in the U.S. District Court in Jacksonville against three other shipping executives: R. Kevin Gill and Gregory Glova, of Charlotte, N.C. and Gabriel Serra, of San Juan, Puerto Rico. A related obstruction of justice charge is also pending against a fifth shipping executive, Alexander Chisholm, of Jacksonville.
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On January 22, 2009, three air cargo carriers, LAN Cargo S.A. (LAN Cargo), Aerolinhas Brasileiras S.A. (ABSA), and EL AL Israel Airlines Ltd. (EL AL), plead guilty and agreed to pay criminal fines totaling $124.7 million for their roles in a conspiracy to fix prices in the air cargo industry, the Department of Justice announced today. Under the plea agreements, LAN Cargo, a Chilean company, and ABSA, a Brazilian company that is substantially owned by LAN Cargo, have agreed to pay a single criminal fine of $109 million. EL AL, an Israeli company, has agreed to pay a criminal fine of $15.7 million. According to the charges against the airlines, each airline engaged in a conspiracy in the United States and elsewhere to eliminate competition by fixing the cargo rates charged to customers for international air shipment.
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Under a plea agreement announced January 15, 2009, Chang Suk “C.S.” Chung, a Korean LG executive, Chieng-Hon “Frank” Lin, a Taiwanese former executive from Chunghwa, and Chih-Chun “C.C.” Liu and Hsueh-Lung “Brian” Lee, Taiwanese current employees of Chungwha, agreed to serve a term of imprisonment, pay a criminal fine and assist the government in its ongoing TFT-LCD investigation.
Businesses & Business Leaders Must Have
Effective Internal Controls & Compliance Practices
These DOJ actions and a host of others in recent years document provide examples of DOJ’s willingness to investigate and prosecute price-fixing, bid-rigging and other antitrust violations. The felony penalties associated with federal antitrust violations bring antitrust sanctions within the purview of the Federal Sentencing Guidelines. As a result, businesses that fail to take adequate steps to prevent or redress antitrust violations risk vicarious liability for violations committed but their employees or agents. Furthermore, business leaders investigating suspected violations must exercise caution to appropriately investigate and redress alleged or suspected violations to both protect themselves and their organization against liability based on allegations of endorsement by tolerance, potential cover up or other misconduct in connection with the investigation and redress process. At the same time, timely investigation, oversight and redress can substantially mitigate these liability exposures under the Federal Sentencing Guidelines. Accordingly, to prevent and position themselves and their organizations to defend against potential antitrust complaints, businesses and businesses leaders should both adopt appropriate policies prohibiting their organizations and its employees and agents from engaging in price-fixing, bid rigging and other anticompetitive practices prohibited by federal or state antitrust laws, as well as establish and administer well-documented training and oversight practices to prevent, detect and redress potential or attempted violations of these policies.
To effectively manage these exposures, businesses and leadership must ensure that their organization has in place appropriate procedures for preventing, investigating and redressing potential violations. Among other things, businesses and their leaders should be certain their organization:
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Has up to date policies in place and a process to monitor regulatory and enforcement developments for necessary updates;
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Can demonstrate that it is appropriately administering well-documented audit, training and enforcement practices to prevent and redress potential violations as part of its corporate ethics and human resources practices;
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Uses appropriate vendor selection, contracting, audit and oversight processes to promote compliance by business partners, agents and others with which it does business;
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Has identified experienced counsel and developed a process for engaging counsel to assist in the audit of ongoing compliance efforts as well as the timely conduct of internal investigations of possible infractions within the scope of attorney-client privilege;
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Designated an ethics or compliance officer, or other appropriate party to receive and investigate suspected compliance concerns and reports;
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Has effective privacy, investigations, employment and other policies and procedures to enable the business to investigate, discipline and defend employment actions against employees or other workers for improper conduct;
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Has appropriate processes and procedures for responding to government investigations and private compliance complaints; and
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Promptly investigates and responds to reports of infractions or other compliance concerns in an appropriate and well documented manner.
Curren Tomko and Tarski LLP and its attorneys have significant experience assisting businesses and business leaders to establish, administer, enforce and defend antitrust and other compliance and internal control policies and practices to reduce risk under federal and state antitrust and other laws covered by the Federal Sentencing Guidelines. If you need assistance with these or other compliance concerns, wish to inquire about arranging for compliance audit or training, or need legal representation on other matters please contact Cynthia Marcotte Stamer, CTT Labor & Employment Section Chair, at cstamer@cttlegal.com, 214.270.2402; Edwin J. Tomko, CTT White Collar Crime Section Chair, at etomko@cttlegal.com, 214 270-1405 or any of the other following members of the Curren Tomko Tarski LLP team experienced in these and other internal controls matters.
For additional information about the experience and services of Ms. Stamer and other members of the Curren Tomko Tarksi, LLP team, see the Curren Tomko Tarski Website or Cynthia Marcotte Stamer, P.C. Website.
More Information
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 CynthiaStamer.com 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 current contact information – including your preferred e-mail- by creating or updating your profile at CynthiaStamer.com or registering to receive these Solutions Law Press HR & Benefits Update at the above link.
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Corporate Compliance, Employers, Internal Controls, Internal Investigations, Risk Management | Tagged: Antitrust, Corporate Compliance, Employer, Employment, Employment Agreements, Internal Controls, Internal Investigations, Risk Management, Whistleblower |
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Posted by Cynthia Marcotte Stamer
April 23, 2009
Many Texas businesses view non-competition agreements as a critical component to their strategy to protect their trade secrets and other intellectual property. In its April 19, 2009 decision in Frankfort Stein & Lipp Advisors, Inc. v. Fielding (“Frankfort Stein”), the Texas Supreme Court gave a another boost to the ability of Texas employers to enforce non-compete agreements signed by existing at-will employees during their employment under the Texas Covenants Not To Compete Act (the “Act”) Section 15.50, which governs the enforceability of employee agreements not to compete in Texas. Despite this helpful ruling, however, Texas employers still must exercise care to comply with all requirements of the Act if they want to position their non-compete agreements for enforceability in Texas.
Building on its prior October 20, 2006 employer-helpful decision in Alex Sheshunoff Management Services, L.P v. Johnson (“Sheshunoff”), the Texas Supreme Court in Frankfort Stein clarified that an employer’s implied covenant to provide confidential information to an at-will may constitute adequate consideration to support enforcement of a non-compete under the Act.. The holding expands the Supreme Court’s prior holding in Sheshunoff to apply to both express or implied employer covenants to provide confidential information.
In Sheshunoff, the Texas Supreme Court previously ruled that that an employer’s express promise to provide confidential information to an at-will employee in exchange for the employee’s express promise not to disclose or use such information, may create an enforceable non-compete covenant under the Act. However, the Supreme Court made clear that employers that desire enforce non-competition agreements still must fulfill the Act’s requirement to provide access to confidential information, training or other appropriate consideration for the employee’s promise not-to compete and the other requirements of the Act before Texas courts will enforce an at-will employee’s agreement not to compete in Texas.
The Frankfort Stein decision further clarifies the Court’s interpretation of the Act in Sheshunoff by holding that an implied promise to provide confidential information to an at-will employee also can constitute the required consideration for the employee’s promise to disclose serve as the provision of confidential information required to support enforcement of a non-compete under Texas law.
The Frankfort Stein decision may offer an additional opportunity for employers that have provided at-will employees access to confidential information to enforce a less than optimally drafted or implemented written non-competition agreement that otherwise complies with the Act under circumstances where the employer can establish it provided the information subject to an implied promise by the employee not to disclose the information. To avoid the cost and uncertainty of proving the existence and scope of such an implied promise, however, Texas employers desiring to best position their non-compete agreements for enforceability should consult with experienced employment counsel for assistance in reviewing their existing non-competition agreements and practices. These (and as appropriate, the employer’s employee handbook) should be written and administered:
ü To require employees to sign non-competition agreements that expressly and appropriately set forth the employers promise to provide the confidential information conditional upon the employee’s agreement not to compete and to protect the confidential information;
ü To ensure that the agreement appropriately defines confidential information and expressly requires that the employee protect and maintain the confidentiality of trade secrets and other confidential information;
ü To ensure that the agreement incorporates other procedural provisions that can help minimize the cost and burden to the employer to enforce its provisions;
ü To ensure that the agreement between the employer and the employee otherwise clearly fulfills all otherwise applicable conditions of the Act and to maintain the confidentiality of the information the requirements of the Act; and
ü To position the employer to be able to easily prove that it actually engaged in the sharing of confidential information that the Sheshunoff decision identifies as a necessary step to enforce the non-competition agreement under Texas law.
Employers also should position themselves to best investigate possible breaches of these protections by securing written background check consents in accordance with the Fair Credit Reporting Act and ensuring that their handbooks and employment agreements include appropriate privacy, investigations and other policies.
Cynthia Marcotte Stamer and other members of Curren 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 cstamer@cttlegal.com, (214) 270-2402; or your favorite Curren Tomko Tarski, LLP attorney. For additional information about the experience and services of Ms. Stamer and other members of the Curren Tomko Tarksi, LLP team, see the www.cttlegal.com.
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Employers, Employment Agreement, Non-Compete, Non-Competition Agreement | Tagged: Employer, Employers, Employment, Employment Agreements, Human Resources, Non-Compete, Non-Competition Agreement |
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Posted by Cynthia Marcotte Stamer
April 17, 2009
Employers that pay differential pay to employees absent on active duty military leave job must withhold income tax, but need not withhold or pay Federal Insurance Contributions Act (“FICA”) or Federal Unemployment Tax Act (“FUTA”) taxes on those payments, according to an Internal Revenue Service (IRS) ruling to be published May 4, 2009.
According to Revenue Ruling 2009-11, employers must withhold income tax and include military duty differential pay in wages reported on the recipient employee’s Form W-2. It also states employers may use the aggregate procedure or optional flat rate withholding to calculate the amount of income taxes required to be withheld on these payments.
Proper tax withholding and reporting is one of the expanding responsibilities that employers must juggle when a member of their workforce is a current or former members of the military and their family members including, for example, federal and state military leave mandates and new military caregiver and other family leave requirements for family members of members of the military that took effect during the past year. Employers should review their employment and employee benefit practices to confirm they are up to date with these expanded requirements.
Cynthia Marcotte Stamer and other members of Curren 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 Curren Tomko Tarski, LLP attorney. For additional information about the experience and services of Ms. Stamer and other members of the Curren Tomko Tarksi, LLP team, see the Curren Tomko Tarski Website or Cynthia Marcotte Stamer, P.C. Website.
More Information
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 current 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.
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Corporate Compliance, Employment Tax, Human Resources, Tax | Tagged: Compensation, Corporate Compliance, Employer, Employers, Human Resources, Military Leave, Tax, Wages, Withholding |
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Posted by Cynthia Marcotte Stamer
April 15, 2009
U.S. employers should audit existing wage and hour practices and documentation and take other steps to defend against the heightened emphasis on enforcement of federal wage overtime, minimum wage, child labor and other wage and hour laws announced by the U.S. Department of Labor Wage & Hour Division (WHD). In a March 5, 2009 WHD Press Release, recently appointed Obama Administration Secretary of Labor Hilda Solis announced that WHD is adding 250 new field investigators and taking other steps to strengthen its enforcement of federal minimum wage, overtime and child labor laws. In her March 5, 2009 Press Release, Secretary Solis stated, “The addition of these 250 new field investigators, a staff increase of more than a third, will reinvigorate the work of this important agency, which has suffered a loss of experienced personnel over the last several years.”
The announced expansion of staffing comes in part in response to two reports made to Congress by the Government Accounting Office (GAO) over the past year, which were highly critical of the enforcement activities of the WHD under the Bush Administration. In a 2009 GAO Report To Congress released March 25, 2009, the GAO reported that a recent GAO audit of WHD enforcement found that sluggish response times, a poor complaint intake process, and failed conciliation attempts, among other problems left workers vulnerable to wage theft. The 2009 Report followed up on a 2008 GAO Report To Congress that case studies showed that WHD inadequately investigated minimum wage and overtime complaints by inappropriately rejecting complaints based on incorrect information provided by employers, failing to make adequate attempts to locate employers, not thoroughly investigating and resolving complaints, and delaying initiating investigations for over a year and then dropping the complaint because the statute of limitations for assessing back wages was close to expiring.
The continuing emphasis of the DOL upon FLSA enforcement, coupled with the growth in FLSA enforcement actions by private plaintiffs, provides an important warning to employers of low wage workers specifically, as well as employers generally, of the importance of being prepared to defend their worker classification and overtime practices against DOL and/or private litigant investigations. When it updated its regulations governing the classification of workers as exempt versus non-exempt under the FLSA in 2004, the DOL urged employers to review and update their worker classification and overtime practices to comply with the updated regulations. At the same time, the DOL announced its intention to vigorously enforce its FLSA regulations against employers failing to adhere to these updated rules. Despite these widely publicized compliance efforts, DOL studies of employer compliance with overtime rules continue to reflect that 50 percent of employers are not in compliance with these mandates. Therefore, in addition to adjusting existing rates of pay to comply with the increased minimum wage, employers also should:
Audit overtime pay practices to verify they comply with applicable federal and state requirements,
Review workers classified as exempt employees and/or non-employee contractors in light of the FLSA and applicable state wage and hour laws to assess the sustainability of these characterizations against a legal challenge; and
Audit the adequacy of current practices for tracking and documenting time worked by non-exempt workers in light of the FLSA and applicable state wage and hour laws.
Employers are cautioned to keep in mind that employers generally bear the burden of proving that their existing worker classification, wage and overtime practices meet or exceed the minimum standards imposed by the FLSA and any applicable state wage and hour law.
Cynthia Marcotte Stamer, and other members of Curren Tomko and Tarski LLP are experienced with assisting businesses to audit, administer and defend minimum wage, overtime and other wage and hour practices under federal and state wage and hour laws, as well as with other labor and employment, employee benefits 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 cstamer@cttlegal.com, (214) 270-2402; or your favorite Curren Tomko Tarski, LLP attorney. For additional information about the experience and services of Ms. Stamer and other members of the Curren Tomko Tarksi, LLP team, see www.cttlegal.com or CynthiaStamer.com.
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Corporate Compliance, Human Resources, Internal Controls, Internal Investigations, Risk Management, Stimulus Bill, Wage & Hour | Tagged: Compensation, Corporate Compliance, Employer, Human Resources, Labor, Minimum Wage, Overtime, Risk Management |
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Posted by Cynthia Marcotte Stamer
April 14, 2009
The release yesterday (April 13, 2009) by the Internal Revenue Service of its 2009 “Dirty Dozen” Tax Scams List reminds businesses of the need to act to minimize exposures to tax related whistleblower or other retaliation claims by employees and other service providers that allege the potential involvement of the business in tax scams or other improper tax transactions.
Businesses face whistleblower, tax fraud prosecution, additional tax and penalty liability and other sanctions for involvement in tax shelters or other tax schemes. Employees and other service provider reports to the Internal Revenue Service (IRS) are the leading means through which the IRS identifies and proves fraudulent tax activities.
Yesterday’s IRS announcement of its 2009 “dirty dozen” list of tax scams heightens whistleblower risks for businesses by encouraging employees and others who may have knowledge of a business or other taxpayer’s involvement in these or other prohibited tax practices to report their suspicions to the IRS and sharing instructions on how to report suspected tax fraud to the IRS as a whistleblower. As part of these instructions, the announcement notes that “[w]histleblowers also may provide allegations of fraud to the IRS and may be eligible for a reward.”
The 2009 “dirty dozen” list of tax scams warns businesses about getting involved in 12 tax transactions that the IRS views as likely to create tax fraud and whistleblower risks. The tax schemes that made the 2009 Dirty Dozen List include:
- Hiding Income Offshore
- Filing False or Misleading Forms
- Abuse of Charitable Organizations and Deductions
- Return Preparer Fraud
- Making Frivolous Arguments
- Making False Claims for Refund and Requests for Abatement
- Abusive Retirement Plans
- Disguised Corporate Ownership
- Zero Wages
- Misuse of Trusts
- Fuel Tax Credit Scams
Taxpayers participating in the 2009 Dirty Dozen Tax Scams and other tax transactions listed as tax scams by the IRS risk exposure to additional taxes and penalties, prosecution for tax fraud, and potential whistleblower claims. The Dirty Dozen list singles out for special attention some of the many tax transactions that the IRS views as tax shelters or tax fraud. Depending on the nature of a business and its tax and compensation activities, businesses also may need to be concerned about scrutiny by the IRS for involvement in various other types of transactions that the IRS has identified as suspect. The IRS is urging U.S. businesses and other taxpayers to avoid participation in these common schemes.
Businesses engaged or accused of engaging in these or other transactions listed as tax scams or tax shelters by the IRS should exercise caution to confirm the appropriateness of the proposed transaction, to document their investigation of allegations of improper tax activities. For profit and non-profit businesses should include appropriate tax compliance oversight in their internal controls and federal sentencing guideline compliance programs. Businesses should review their activities in light of lists of IRS abusive transactions, should evaluate whether any of their transactions may be subject to scrutiny by the IRS, and take other appropriate steps to mitigate their exposure to prosecution for tax fraud, to tax related whistleblower liability and other risks. Businesses also should exercise care when dealing with employees or service providers who make allegations that the business may be involved in improper tax activities. Businesses also need to be prepared to demonstrate that they have not retaliated against individuals who report suspected tax fraud. The best defense to retaliation claims is a consistent, well documented legitimate performance and discipline record. Businesses should strengthen and consistently apply their employee performance and discipline processes to improve performance and deter whistleblower or other retaliation judgments. As part of this process, businesses also should adopt and enforce policies requiring employees and other service providers to report suspected tax or other compliance concerns, administer documented processes for receiving and investigating allegations of potential fraud or other noncompliance, and should document their conclusions and any corrective actions in response to these investigations.
Cynthia Marcotte Stamer, and other members of Curren Tomko and Tarski LLP are experienced with assisting establish and administer employment, corporate compliance, internal and external fraud and other controls; to investigate potential fraud or other misconduct; to defend employment, whistleblower, Federal or state criminal or civil investigations, audits and prosecutions and to address other employment, employee benefits and corporate compliance matters. If your organization needs assistance with assessing or managing its risk management and compliance responsibilities or liabilities under health care, employment, environmental, antitrust, securities or other federal or state laws, wishes to inquire about compliance audit or training or other services; or would like to review or engage and experience of Ms. Stamer, or other Curren Tomko Tarski LLP attorneys, please contact Ms. Stamer at cstamer@cttlegal.com, (214) 270-2402; or see CTTLegal.com or CynthiaStamer.com.
More Information
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 http://cynthiastamer.com/human_resources.asp 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 current 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 at https://slphrbenefitsupdate.wordpress.com.
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Corporate Compliance, Employers, ERISA, Internal Investigations, Risk Management, Tax, Uncategorized | Tagged: Corporate Compliance, Employer, Human Resources, Tax, Tax Fraud, Whistleblower |
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Posted by Cynthia Marcotte Stamer
April 7, 2009
A federal Fair Housing Act lawsuit recently filed by the U.S. Justice Department against a large Dallas-based construction and development company and a series of its other releases signal that Department of Justice is gearing up for stepped up enforcement of the Public Accommodations and other provisions of the Americans With Disabilities Act. To defend against this risk, all U.S. businesses should evaluate the adequacy of their existing business practices.
On Tuesday, March 10, 2009, JPI Construction L.P. (JPI) and six JPI-affiliated companies in U.S. District Court in Dallas for failing to provide accessible features allegedly required by the Fair Housing Act and the Americans with Disabilities Act at multi-family housing developments in Texas and other states. Today, the Justice Department followed up by
The Justice Department’s proclamation in its announcement of its filing of the suit against JPI that “Fighting illegal housing discrimination is a top priority” affirms this commitment under the Fair Housing Act. See “Justice Department Sues Large Multi-Family Housing Developer Alleging Disability-Based Housing Discrimination, U.S. Justice Department (March 10, 2009) at http://www.usdoj.gov/opa/pr/2009/March/09-crt-187.html. According to the complaint, the JPI defendants failed to design and construct accessible dwelling units and public and common use areas at Jefferson Center Apartments in Austin, Texas; Jefferson at Mission Gate Apartments in Plano, Texas; and additional multi-family housing complexes in other states. The complaint alleges certain complexes designed and constructed by the JPI defendants have inaccessible steps and curbs leading to units, steeply sloped routes leading to units, and no accessible routes to site amenities, including inaccessible trash facilities, barbeque grills and cookout tables. In addition, certain housing units have narrow doors and hallways; kitchens that lack accessible clear floor space at the sinks, ranges and refrigerators; bathrooms that lack accessible clear floor space at the toilets and tubs; and thermostats that are mounted too high to be accessible to a person using a wheelchair. The Justice Department complaint asks the court to order monetary damages to victims of the alleged discrimination, to issue a court order requiring the defendants to modify the complexes to bring them into compliance with federal law, to prohibit future discrimination by the JPI defendants, and to assess civil penalties.
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Uncategorized |
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Posted by Cynthia Marcotte Stamer
April 7, 2009
Register Now
April 21, 2009 ABA JCEB Teleconference
1:00-2:30 pm ET / 12:00-1:30 pm CT / 11:00 am-12:30 pm MT / 10:00 am-11:30 am PT
Moderator:
Cynthia Marcotte Stamer, Curren Tomko Tarski LLP, Dallas, TX
Speakers:
James McKown, Recovery Data Connect, L.L.C., Leawood, KS
Scott Douglas Marquardt, Total Plan Services, Inc, Dallas, TX
Properly designed and administered subrogation provisions in ERISA-covered group health plans and group insurance contracts can provide invaluable tools for managing costs. Unfortunately, various legal and practical problems often prevent ERISA-covered group health plans and insurers from realizing many of these benefits. With health care costs continuing to rise, many health plan administrators, insurers and fiduciaries are placing renewed emphasis on the design and enforcement of their plan’s subrogation provisions. Listen and learn as a distinguished and experienced panel discusses the legal and practical ins and outs of the design, administration, and defense of effective group health plan policies and practices in ERISA-governed group health plans including:
ü Legal Basis of Subrogation Under ERISA
ü Why, When & When Not To Subrogate
ü The Law
ü The Process From Drafting, to Adjudication, to Recovery
ü Who Gets Hired To Do What, Why & When
ü Sticking Points & Plan Problems
ü Practical Dos & Don’t
For more information or to register, go to http://meetings.abanet.org/meeting/jceb/JCEB042109.
If you have questions or concerns about the matters discussed in this publication or other human resources, employee benefits or compensation matters, wish to obtain information about arranging for training or presentations by Ms. Stamer, wish to suggest a topic for a future program or publication, or wish to request other information or materials, please contact Ms. Stamer via telephone at (214) 270-2402 or via e-mail to Cstamer@Solutionslawyer.net.
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Employers, ERISA, Health Plans, Human Resources, Insurance | Tagged: Employee Benefits, Employer, ERISA, Health Plans, Insurance, Insurer, Managed Care, Subrogation |
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Posted by Cynthia Marcotte Stamer
April 3, 2009
In a March 19, 2009 ruling, the U.S. District Court for the Northern District of Texas recently recognized that the Texas Whistleblower Act prohibits health care organizations run by the State of Texas from retaliating against employees for making good faith complaints of violations of the Privacy Rules of the Health Insurance Portability Act (“HIPAA”). Nevertheless, the court dismissed the wrongful discharge lawsuit brought by a former Terrell State Hospital security guard who alleged he was wrongfully fired for complaining to the U.S. Department of Health and Human Services Office of Civil Rights (“OCR”) that the Hospital violated the HIPAA Privacy Rules because the plaintiff had failed to present sufficient proof that he was terminated in retaliation for filing a HIPAA complaint.
Illustrative of a growing number of state law retaliatory discharge claims brought be employees claiming to have been retaliated against for complaining about alleged violations of HIPAA’s Privacy Rules, Faulkner v. Department of State Health Servs., 2009 U.S. Dist. LEXIS 22419 (N.D. Tex. Mar. 19, 2009), involved claims made by plaintiff Anthony Faulkner (“Faulkner”) that the Texas Department of State Health Services (“DSHS”); Terrell State Hospital; Texas DSHS Commissioner David L. Lakey, M.D.; Terrell State Hospital Superintendent Fred Hale; and Terrell State Hospital Risk Management Coordinator Clent Holmes, R.N. violated the Whistleblower Act and the First and Fourteenth Amendments by firing him seven days after he complained to OCR that Terrell State Hospital violated the HIPAA Privacy Rule by leaving admissions logs containing patient names and admission dates in a public area.
The Texas Whistleblower Act generally prohibits a state or local governmental entity from terminating or taking any other adverse personnel action against a public employee who in good faith reports a violation of law by the employing governmental entity or another public employee to an appropriate law enforcement authority. See Tex. Gov’t Code § 554.002(a). While the Court affirmed that the Texas Whistleblower Act permits a public employee of the State of Texas discharged or otherwise retaliated against for complaining in good faith to OCR that his public employer or its employee violated the HIPAA Privacy Rules, the Court nevertheless granted summary judgment to the defendants.
According to the court, Faulkner’s failure to introduce evidence rebutting defendant’s affidavit that he was terminated for repeatedly violating rules requiring him to report suspected abuse of patients precluded him from proving his termination was in retaliation for his filing of the HIPAA complaint. Meanwhile, the court also ruled that Faulkner’s claims against the individual defendants should be dismissed as the Whistleblower Act only creates a cause of action against governmental entities and not their employees. Having found Faulkner’s constitutional claims also without merit, the District Court granted the defendant’s motion for summary judgment.
While the defendants were able to overcome Faulkner’s retaliatory discharge claim, the decision highlights the need for health care providers and other HIPAA covered entities to take appropriate precautions to defend against potential wrongful discharge, retaliation or other claims by employees or other service providers for complaining of possible HIPAA violations or for attempting to exercise other HIPAA-protected rights. HIPAA covered entities now should avoid engaging in actions that might unnecessarily fuel claims of retaliation. They also should carefully document and preserve evidence necessary to demonstrate the legitimacy of their disciplinary actions on an ongoing basis.
We hope you found this information helpful. If your organization needs assistance with understanding or managing its responsibilities or liabilities under HIPAA or other health care or employment laws or wishes to inquire about HIPAA training or other services and experience of Cynthia Marcotte Stamer, please contact Ms. Stamer via e-mail at Cstamer@Solutionslawyer.net or by telephoning Ms. Stamer at 469.767.8872. You also can review other helpful resources and register to receive other updates at CynthiaStamer.com.
©2009 Cynthia Marcotte Stamer.
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Posted by Cynthia Marcotte Stamer
April 3, 2009
Employers, plan administrators and group health plan insurers have more information about what terminations are considered “involuntary” and the meaning of other requirements imposed by temporary modifications (COBRA Subsidy Rules) to the group health plan medical coverage continuation requirements of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (COBRA) enacted under the American Recovery and Reinvestment Act of 2009 (Stimulus Bill).
The Internal Revenue Service (IRS) yesterday (April 1, 2009) released additional guidance about the COBRA Subsidy Rules. Part of a series of guidance trickling out from the IRS, the Department of Labor (DOL) and the Department of Health & Human Services (HHS) about the COBRA Subsidy Rules. The IRS publication of this guidance follows the release by March 20, 2009 of its Model Notices notify certain current and former participants and beneficiaries about some of the Stimulus COBRA Rules.
IRS Notice 2009-27 includes guidance about:
ü Who qualifies as an “assistance eligible individual;
ü When the IRS views a reduction in hours or termination of employment as qualifying as an involuntary termination of employment for purposes of the COBRA Premium Assistance Rules;
ü How to calculate the 35% of the standard COBRA premium is calculated for purposes of determining the reduced COBRA premium amount (the “Reduced Premium”) that an assistance eligible individual must pay during the period (Premium Reduction Period) he qualifies for the premium subsidy assistance provided for under the Stimulus Bill;
ü The types of group health plan coverage eligible for the Reduced Premium under the Stimulus Bill;
ü The beginning and end of the Premium Reduction Period;
ü When and how an assistance eligible individual’s income and eligibility for Medicare or other group health plan coverage affects his eligibility for the Reduced Premium;
ü The mechanics that employers and highly compensated assistance eligible individuals must use if the individual wishes to waive the Reduced Premium and resulting COBRA Subsidy
ü The application of the second election period required for assistance eligible individuals not enrolled in COBRA Coverage on February 17, 2009 and
ü Other details of the COBRA Subsidy Rules.
Stimulus COBRA Rules In A Nutshell
Congress enacted the COBRA Subsidy Rules that took effect February 17, 2009 to help certain involuntarily terminated former employees and their dependents maintain COBRA coverage by requiring COBRA-covered group health plans temporarily to extend certain special COBRA treatment for “assistance eligible individuals.”
The Stimulus Bill temporarily limits the COBRA premium that a COBRA-covered group health plan can require an “assistance eligible individual” to pay for COBRA Coverage to 35% of the otherwise applicable COBRA premium (the “Reduced Premium”) for a period of up to 9 months (the “Subsidy Period”) beginning with the individual’s first period of COBRA Coverage beginning after February 17, 2009. The employer or insurer that collects this Reduced Premium must pay the remaining 65% of the COBRA premium (the “COBRA Subsidy”) for the assistance eligible individual during the Subsidy Period. However, the Stimulus Bill provides for that employer or insurer to claim a payroll tax credit equal to the amount of these COBRA Subsidy payments by complying with applicable IRS procedures.
The Stimulus COBRA Rules also requires group health plans to offer a second COBRA enrollment period to each assistance eligible individual not enrolled in COBRA Coverage on February 17, 2009. These second electors must be allowed to elect prospectively to enroll in COBRA coverage until the date that their COBRA Coverage eligibility otherwise would have ended if they had maintained COBRA Coverage since their termination.
Additionally, COBRA-covered group health plans that offer employees different plan options allow assistance eligible individuals the option to change their coverage choice from a higher cost option to a lesser cost option. Group health plan administrators also must provide certain notifications to assistance eligible individuals concerning these changes.
“Assistance Eligible Individuals”
The Stimulus COBRA Rules only apply to qualified beneficiaries whose loss of coverage resulted from the “involuntary termination of employment” of a covered employee. The Stimulus Bill definition of “assistance eligible individual” generally includes any COBRA “qualified beneficiary” who meets all of the following requirements:
ü Has a loss of coverage within the meaning of COBRA (“qualifying event”) as a result of the “involuntary termination of employment” of a covered employee from September 1, 2008 to December 31, 2009;
ü Is eligible for COBRA Coverage at any time during the period beginning September 1, 2008 and ending December 31, 2009; and
ü Elects COBRA coverage when first offered or as during the additional second election period required for assistance eligible individuals not enrolled in COBRA Coverage on February 17, 2009.
IRS Notice 2009-27 defines an “involuntary termination” as “a severance from employment due to the independent exercise of the unilateral authority of the employer to terminate the employment, other than due to the employee’s implicit or explicit request, where the employee was willing and able to continue performing services” based on all the facts and circumstances.
For COBRA Premium Assistance purposes, the facts and circumstances determine whether a termination is involuntary. Thus, IRS Notice 2009-27 states that a termination designated as voluntary or as a resignation nevertheless will be considered involuntary where the facts and circumstances indicate that the employer would have terminated the employee’s services, and that the employee had knowledge that the employee would be terminated.
Notice 2009-27 identifies as examples of terminations that fall within this definition of “involuntary termination” as including the following facts and circumstances:
ü The employer’s failure to renew a contract at the time the contract expires, if the employee was willing and able to execute a new contract providing terms and conditions similar to those in the expiring contract and to continue providing the services;
ü An employee-initiated termination from employment if the termination from employment constitutes a termination for good reason due to employer action that causes a material negative change in the employment relationship for the employee;
ü An involuntary reduction of hours of employment to zero hours, such as a lay-off, furlough, or other suspension of employment, resulting in a loss of health coverage;
ü An employee’s voluntary termination of employment in response to an employer imposed reduction of hours of employment where the reduction in hours is a material negative change in the employment relationship for the employee;
ü An employer’s action to end an individual’s employment while the individual is absent from work due to illness or disability (but not mere absence from work due to illness or disability before the employer has taken action to end the individual’s employment);
ü A termination designated on account of “retirement” if the facts and circumstances indicate that, absent retirement, the employer would have terminated the employee’s services, and the employee had knowledge that the employee would be terminated;
ü The covered employee resigned as the result of a material change in the geographic location of employment for the employee;
ü A lockout initiated by an employer but not a work stoppage as the result of a strike initiated by employees or their representatives; and
ü A termination elected by the employee in return for a severance package (a “buy-out”) where the employer indicates that after the offer period for the severance package, a certain number of remaining employees in the employee’s group will be terminated
Notice 2009-27 also clarifies that the termination of employment giving rise to the loss of group health plan coverage and the loss of the group health plan coverage both must occur between September 1, 2008 and December 31, 2009 in order for an individual to qualify as an assistance eligible individual. Consequently, if the involuntary termination occurs before September 1, 2008, but the loss of coverage resulting in eligibility for COBRA Coverage occurs after September 1, 2008 (but no later than December 31, 2009), Notice 2009-28 states that the individual will not qualify as an assistance eligible individual. Likewise, where an individual’s involuntary termination occurs by December 31, 2009, but the loss of coverage resulting in eligibility for COBRA Coverage occurs after December 31, 2009, the qualified beneficiary will not qualify as an assistance eligible individual for purposes of the Subsidy COBRA Rules. According to Notice 2009-27, where the involuntary termination of employment and loss of coverage as a covered employee or dependent occur between September 1, 2008 and December 31, 2009, the election of COBRA Coverage need not occur by December 31, 2009.
Many group health plans are drafted to provide that the date that employee or dependent coverage ends or changes as a result of an employment loss is the last day of the month or some other date after the actual date of the employment termination. Under group health plans where the loss of coverage due to the qualifying event is delayed, Notice 2009-27 also reminds employers and plan administrators of the need to focus on how group health plan provisions, separation agreements and other related documents define when the loss of coverage occurs under a group health plan when applying these rules.
For purposes of COBRA, Notice 2009-27 states that when a loss of coverage under a group health plan occurs under these circumstances depends on how the group health plan treats the provision of health coverage between the date of the employment loss and the date of the resulting loss of employee and/or dependent coverage. If the plan treats the provision of health coverage as deferring the loss of coverage, Notice 2009-27 indicates the loss of coverage generally occurs when the individual ceases to be entitled to employee or dependent coverage on the same terms and conditions as would have applied had he not experienced the qualifying event. However, if the plan treats the continued provision of health coverage from the termination date until employee or dependent coverage later ends as a result as reducing the period of required COBRA Coverage, then the loss of coverage occurs on the termination date or other later date. Appropriate drafting is important to support the desired characterization.
Calculation of 35% of COBRA Premium
Based on the guidance in Notice 2009-27, many employers will want to terminate severance or other arrangements under which former employees are allowed to pay less than the maximum COBRA premium for some period of time. According to Notice 2009-29,.the premium used to determine the 35% share that must be paid by (or on behalf of) an assistance eligible individual is the cost that would be charged to the assistance eligible individual for COBRA Coverage if the individual were not an assistance eligible individual. If absent the Stimulus COBRA Rules, the group health plan would require the assistance eligible individual to pay 102% of the “applicable premium” for continuation coverage, i.e., generally the maximum permitted, the Reduced Premium equals 35% of the 102% of the applicable premium. As no good deed goes unpunished, however, if the premium the group health plan would charge the assistance eligible individual is less than the maximum allowable COBRA premium, the Reduced Premium will be 35% of that lesser amount. In determining whether an assistance eligible individual has paid 35% of the premium, payments on behalf of the individual by another person (other than the employer with respect to which the involuntary termination occurred) are taken into account.
Coverage Eligible For Premium Reduction
Notice 2009-27 also provides guidance about what types of group health plan coverage qualifies for premium reduction. According to the Notice, the premium reduction is available for COBRA Coverage of any group health plan, except a health flexible spending arrangement (FSA) under section 106(c) offered under a section 125 cafeteria plan. This includes vision-only or dental-only plans, “mini-med plans” and certain health reimbursement accounts (HRAs).
The Notice 2009-27 distinguishes exempted FSAs from covered health reimbursement arrangements (HRAs) for purposes of these rules. According to Notice 2009-27, while an HRA may qualify as an FSA under section 106(c), the exclusion of FSAs from the premium reduction is limited to FSAs provided through a section 125 cafeteria plan, which would not include an HRA.
Notice 2009-27 also indicates that retiree coverage can qualify for the premium reduction where the retiree coverage does not differ from the coverage made available to similarly situated active employees.
Premium Reduction Period Duration
Notice 2009-27 also provides guidance about when periods of coverage and the Premium Reduction Period begin and end. Under the Stimulus COBRA Rules, the premium reduction applies as of the first period of coverage beginning on or after February 17, 2009 (February 17, 2009) for which the assistance eligible individual is eligible to pay only 35% of the premium and be treated as having made full payment. For this purpose, a period of coverage is a monthly or shorter period with respect to which premiums are charged by the plan with respect to such coverage.
According to Notice 2009-27, when the Premium Reduction Period begins for an assistance eligible individual depends on the period the plan charges COBRA premiums. Where a group health plan requires an individual who loses coverage other than on the last day of the month who wishes to enroll in COBRA Coverage to pay a pro-rata portion of the monthly premium, Notice 2009-27 states the first period of coverage to which the premium reduction applies for an assistance eligible individual who loses coverage after February 17, 2009 generally is the individual’s first partial month of coverage. A different rule applies when the assistance eligible individual elects COBRA Coverage under the second election period required by the Stimulus Bill Rules, however. Whether a plan requires COBRA Coverage be paid for based on a calendar month or pro rata basis, March 1, 2009 is the beginning of the first period of coverage within the Premium Reduction Period for any assistance eligible individual enrolling during the second enrollment period and the Reduced Premium only applies to that individual for COBRA Coverage from March 1, 2009 through the end of his otherwise applicable Premium Reduction Period.
End Of Premium Reduction Period
An assistance eligible individual ceases to qualify for the premium reduction on the earliest of:
ü The first date the assistance eligible individual becomes eligible for other group health plan coverage (with certain exceptions) or Medicare coverage,
ü The date that is nine months after the first day of the first month for which the Stimulus Bill premium reduction provisions apply to the individual, or
ü The date the individual ceases to be eligible for COBRA Coverage.
Notice 2009-27 confirms that the Premium Reduction Period of an assistance eligible individual ends on the first date he becomes eligible for other group health plan coverage or Medicare effect even if the assistance eligible individual does not enroll in the other group health plan coverage.
According to Notice 2009-27, whether an offer of retiree coverage that is not COBRA Coverage simultaneously with the offering of COBRA Coverage ends the Premium Reduction Period depends on whether the retiree coverage is offered under the same group health plan as the COBRA Coverage or under a different group health plan. If offered under the same group health plan, the offer of the retiree coverage has no effect on the Premium Reduction Period. If offered under a different group health plan, the offer of retiree coverage that is not COBRA coverage ends the Premium Reduction Period. However Notice 2009-27, however, If offered to someone whose eligibility for COBRA coverage arose between September 1, 2008 and February 17, 2009, the offer render the individual ineligible for the premium reduction only if the period the individual is given for enrolling in the retiree coverage extends to at least February 17, 2009.
Notice 2009-27 also addresses when eligibility for coverage under an HRA ends eligibility for the premium reduction. It states that becoming eligible for HRA coverage ends the Premium Reduction Period unless the HRA qualifies as an FSA under section 106(c). Under section 106(c), an FSA is health coverage under which the maximum amount of reimbursement which is reasonably available to a participant of the coverage is less than 500% of the value of the coverage. For this purpose, the maximum amount of reimbursement which is reasonably available is generally the balance of the HRA and the value of the HRA coverage would generally be the applicable premium for COBRA continuation of the HRA coverage.
Notice 2009-27 also clarifies that the Premium Reduction Period of an eligible individual may extend beyond December 31, 2009 for individuals who qualify as assistance eligible individuals on or before December 31, 2009. For example, the Premium Reduction Period of an assistance eligible individual whose Premium Reduction Period begins on December 1, 2009 could extent until August 31, 2010, assuming the individual does not become eligible for other group health plan coverage or Medicare or lose eligibility for COBRA Coverage before that date.
With regard to the effect of Medicare eligibility on an assistance eligible individual’s Premium reduction Period, Notice 2009-27 indicates that an individual currently enrolled in Medicare when the involuntary termination of employment occurs is ineligible for premium reduction, even though they may be eligible to elect COBRA continuation coverage by paying the otherwise applicable unreduced COBRA premium.
Dealing With Assistance Eligible Individuals Not Eligible For Premium Subsidy Based On Eligibility For Other Group Coverage
Under the Stimulus Bill, assistance eligible individuals are required to provide notification and resume paying the unreduced usual COBRA premium when they become eligible for Medicare or other group health coverage. Where an assistance eligible individual fails to provide the required notice and continues to take advantage of the premium reduction after his Premium Reduction Period terminates due to his becoming eligible for other coverage or Medicare, Notice 2009-27 states the employer is not responsible for recovering the additional premium or otherwise recouping the COBRA premium.
Dealing With Assistance Eligible Individuals Subject to Phase Out of Premium Subsidy Eligibility Based On Income
The Stimulus COBRA Rules include tax provisions designed phase out the COBRA Subsidy for certain highly compensated employees by taxing a portion of those amounts. Notice 2009-7 discusses the mechanics through which highly compensated employees can avoid this tax liability by electing to waive the Premium Reduction and Premium Subsidy.
An assistance eligible individual who wants to make a permanent election to waive the right to the premium reduction makes the election by providing a signed and dated notification (including a reference to “permanent waiver”) to the employer or other person who is reimbursed for the premium reduction under the COBRA Premium Subsidy provisions of Code § 6432. No separate additional notification to any government agency. If an assistance eligible individual makes the permanent election to waive the right to the premium reduction, the individual may not later reverse the election and may not receive the premium reduction for any future period of COBRA Coverage in 2009 or 2010, regardless of modified adjusted gross income in those years.
Notice 2009-27 makes clear that these rules don’t allow employers to deny the Reduced Premium to these assistance eligible individuals. According to Notice 2009-27, “Even if an assistance eligible individual’s income is high enough that the recapture of the premium reduction would apply, COBRA Coverage must be provided upon payment of 35% of the premium unless the individual has notified the plan that the individual has elected the permanent waiver of the premium reduction (or the period for the premium reduction has ended).
Second COBRA Election Period
The Stimulus Bill also requires group health plans to offer a second election period to assistance eligible individuals not enrolled in COBRA Coverage on February 17, 2009 whose employment terminated between September 1, 2008 and February 16, 2009. Notice 2009-27 confirms that any individual (including a dependent) who did not have an election of COBRA Coverage in effect on February 17, 2009, but who would have been an assistance eligible individual if the election were in effect must be offered this second election period. For those electing COBRA Coverage during this second election period, the resulting coverage begins with the first period of COBRA continuation coverage beginning on or after February 17, 2009. Notice 2009-27 confirms that this extended election period is available for all individuals who are qualified beneficiaries as the result of an involuntary termination during the period from September 1, 2008, through February 17, 2009, even if they still have an open COBRA election period as of February 17, 2009. If these individuals elect COBRA under their original COBRA election period, COBRA coverage is retroactive to their loss of coverage and the premium reduction does not apply to the periods of coverage prior to the first period of coverage beginning on or after February 17, 2009 (generally, periods of coverage before March 2009 for plans with monthly coverage periods).
If, as a result of the extended election period, an assistance eligible individual becomes eligible for COBRA Coverage under a group health plan that requires payment of COBRA premiums on a calendar month basis, the individual’s first period of coverage will begin on March 1 and the Reduced Premium only applies prospectively from that date. According to Notice 2009-27, this does not change even if the plan otherwise requires individuals who lose coverage before the last day of the month and who wish to enroll in COBRA continuation coverage to pay a pro-rata portion of the monthly premium for the first partial month of coverage.
In contrast, where a group health plan determines the required COBRA premiums based on the loss of coverage, Notice 2009-27 states that the first period of coverage begins on the first day after the loss of coverage and ends on the day of the following month corresponding to the day of the loss of coverage. For example, if the last day of coverage was October 3, 2008, the period of coverage runs from the fourth of the month to the third of the following month, and thus the first period of coverage on or after February 17, 2009, is the period March 4, 2009, through April 3, 2009.
Notice 2009-27 also discusses the operation of these rules as applied to certain HRAs
Who Pays The Premium Subsidy & Claims The Payroll Tax Credit
In previously issued guidance, the IRS indicated that between the sponsoring employer or union and a group insurer, the party that collects the Reduced Premium bears responsibility to pay the 65% Premium Subsidy then claiming the payroll tax credit under the Stimulus COBRA Rules. According to Notice 2009-27, if the insurer and the employer of insured, single employer group health plan have agreed that the insurer will collect the premiums directly from the qualified beneficiaries, the insurer must treat an assistance eligible individual paying 35 of the premium as having paid the full premium, even before the employer pays the insurer the remaining 65%. If the insurer fails to treat a 35% payment by an assistance eligible individual as a payment of the full premium, the insurer may be liable for the excise tax under Code § 4980B(e)(1)(B), which applies to persons responsible for administering or providing benefits under the plan and whose act or failure to act caused (in whole or in part) the failure, if the person assumed responsibility for the performance of the act to which the failure relates.
If you have questions or concerns about the matters discussed in this publication or other human resources, employee benefits or compensation matters, wish to obtain information about arranging for training or presentations by Ms. Stamer, wish to suggest a topic for a future program or publication, or wish to request other information or materials, please contact Ms. Stamer via telephone at (214) 270-2402 or via e-mail to Cstamer@Solutionslawyer.net. .
More Information
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 other helpful resources or additional information about Ms. Stamer at CynthiaStamer.com or by contacting 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 current contact information – including your preferred e-mail- by creating or updating your profile at CynthiaStamer.com. 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 at https://slphrbenefitsupdate.wordpress.com.
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COBRA, Employers, Health Plans, Human Resources, Stimulus Bill | Tagged: COBRA, Employers, Health Insurance, Health Plans, Medical Coverage, Premium Subsidy, Subsidy Bill |
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Posted by Cynthia Marcotte Stamer
April 2, 2009
U.S. employers must begin using the revised U.S. Citizenship and Immigration Services (USCIS) Employment Eligibility Verification Form known as the I-9 (Form I-9) on April 3, 2009. Meanwhile, certain federal contractors and subcontractors also must prepare to comply with impending requirements to use USCIS E-Verify when hiring employees scheduled to take effect May 21, 2009.
New Form I-9
The use of the new Form I-9 is required under an interim rule published by USCIS in December 2008. The interim rule also changes the types of acceptable identity and employment authorization documents employers can accept from new hires and prohibits employees from using expired identification documents to verify their work eligibility beginning April 3, 2009. Employers will be required to use the new Form I-9 and to secure documentation of proof of eligibility to work in accordance with the revised rules contained in the interim rule for all new hires and to reverify any employee with expiring employment authorization in accordance with the interim regulations beginning on April 3, 2009.
Employers can download a copy of the new Form I-9 at http://www.uscis.gov/files/form/I-9_IFR_02-02-09.pdf. The interim regulations are available for review at http://edocket.access.gpo.gov/2008/E8-29874.htm. USCIS presently is updating the Handbook for Employers, Instructions for Completing the Form I-9 (M-274).
The new Form I-9 replaces the June 5, 2007 edition of the Form I-9 (the Old Form I-9), which will not be valid for use after April 2, 2009. A big change in the new Form I-9 requirements is that expired documents cannot be accepted as proof of eligibility to work. All documents presented during the Form I-9 completion process now must be unexpired. The new Form I-9 and interim regulations also add and remove certain documents to the list of documents that employers can accept of proof of identity and/or eligibility to work in the U.S.
The interim rule originally was scheduled to take effect on Feb. 2, 2009. The Obama Administration extended the effective date to April 3, 2009 under a directive issued in January.
Federal Contractor E-Verify Rule Scheduled To Take Effect May 21, 2009
Certain federal contractors and subcontractors also need to prepare to comply with a new federal rule that will require them to use E-Verify to verify the employment eligibility of new hires scheduled to take effect May 21, 2009. The rule will only affect federal contractors who are awarded a new contract after May 21st that includes the Federal Acquisition Regulation (FAR) E-Verify clause. Federal contractors may NOT use E-Verify to verify current employees until the rule becomes effective and they are awarded a contract that includes the FAR E-Verify Clause.
The new rule implements Executive Order 12989, as amended by President George W. Bush on June 6, 2008, directing federal agencies to require that federal contractors agree to electronically verify the employment eligibility of their employees. The amended Executive Order reinforces the policy, first announced in 1996, that the federal government does business with companies that have a legal workforce. This new rule requires federal contractors to agree, through language inserted into their federal contracts, to use E-Verify to confirm the employment eligibility of all persons hired during a contract term, and to confirm the employment eligibility of federal contractors’ current employees who perform contract services for the federal government within the United States.
Interested persons can review the final regulation and read frequently asked questions about this new rule on the internet at the following cites:
ü Final Regulation at http://edocket.access.gpo.gov/2008/E8-26904.htm
ü Frequently Asked Questions at http://www.uscis.gov/portal/site/uscis/menuitem.5af9bb95919f35e66f614176543f6d1a/?vgnextoid=cb2a535e0869d110VgnVCM1000004718190aRCRD&vgnextchannel=75bce2e261405110VgnVCM1000004718190aRCRD
If you have questions or concerns about the matters discussed in this publication or other human resources, employee benefits or compensation matters, wish to obtain information about arranging for training or presentations by Ms. Stamer, wish to suggest a topic for a future program or publication, or wish to request other information or materials, please contact Ms. Stamer via telephone at (214) 270-2402 or via e-mail to Cstamer@Solutionslawyer.net. .
More Information
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 other helpful resources or additional information about Ms. Stamer at CynthiaStamer.com or by contacting 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 current contact information – including your preferred e-mail- by creating or updating your profile at CynthiaStamer.com. 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 at https://slphrbenefitsupdate.wordpress.com.
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Corporate Compliance, Employers, Human Resources, I-9, Immigration, Uncategorized | Tagged: Corporate Compliance, E-Verify, Employers, Employment, Human Resources, I-9, Immigration |
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Posted by Cynthia Marcotte Stamer
March 22, 2009
A federal Fair Housing Act lawsuit filed by the U.S. Justice Department against a large Dallas-based construction and development company Tuesday, March 10, 2009 and the settlement of a United Airlines employment disability discrimination lawsuit announced by the Equal Employment Opportunity Commission (EEOC) on March 16, 2009 provide a warning to all U.S. businesses to strengthen their employment and other nondiscrimination policies and practices. The actions highlight the growing exposures that businesses face to employment and other discrimination claims under Federal law.
JPS Fair Housing Act & ADA Suit
The Justice Department’s suit against JPS coincides with a surge in filings of employment discrimination claims and on the heels of Congresses enactment of pro-plaintiff amendments to employment and other federal discrimination laws like those enacted under the ADA Amendments Act of 2008 signed into law last September. As the Obama Administration and the Democratic Majority in Congress continue to push for further liberalization of these laws, the JPI lawsuit provides tangible confirmation of the Obama Administration’s emphasis on enforcement of federal nondiscrimination laws. The Justice Department’s proclamation in its announcement of its filing of the suit against JPI that “Fighting illegal housing discrimination is a top priority” affirms this commitment under the Fair Housing Act. See “Justice Department Sues Large Multi-Family Housing Developer Alleging Disability-Based Housing Discrimination, U.S. Justice Department (March 10, 2009) at http://www.usdoj.gov/opa/pr/2009/March/09-crt-187.html.
The Justice Department lawsuit charges JPI Construction L.P. (JPI) and six JPI-affiliated companies (JPI) with violating the Fair Housing Act and the public accommodations provisions of the Americans With Disabilities Act (ADA) by the failing to provide allegedly required accessible features at multi-family housing developments in Texas and other states. The Fair Housing Act prohibits discrimination in housing on the basis of race, color, religion, sex, familial status, national origin and disability.
According to the complaint, the JPI defendants failed to design and construct accessible dwelling units and public and common use areas at Jefferson Center Apartments in Austin, Texas; Jefferson at Mission Gate Apartments in Plano, Texas; and additional multi-family housing complexes in other states. The complaint alleges certain complexes designed and constructed by the JPI defendants have inaccessible steps and curbs leading to units, steeply sloped routes leading to units, and no accessible routes to site amenities, including inaccessible trash facilities, barbeque grills and cookout tables. In addition, certain housing units have narrow doors and hallways; kitchens that lack accessible clear floor space at the sinks, ranges and refrigerators; bathrooms that lack accessible clear floor space at the toilets and tubs; and thermostats that are mounted too high to be accessible to a person using a wheelchair. The Justice Department complaint asks the court to order monetary damages to victims of the alleged discrimination, to issue a court order requiring the defendants to modify the complexes to bring them into compliance with federal law, to prohibit future discrimination by the JPI defendants, and to assess civil penalties.
United Airlines & Other Evidence of Rising Employment Discrimination Exposures
The JPI lawsuit is one of many signs of the rising discrimination exposures businesses face under federal discrimination laws. Employment discrimination risks also are soaring and the tightening economy promises to add further fuel to the fire. Equal Employment Opportunity Commission (EEOC) statistics show workplace discrimination charge filings nationwide soared to an unprecedented level of 95,402 during Fiscal Year (FY) 2008, up 15 percent over the previous fiscal year. All major categories of charge filings in the private sector including suits against private employers, as well as state and local governments increased. Charges based on age and retaliation saw the largest annual increases, while allegations based on race, sex and retaliation continued as the most frequently filed charges. The surge in charge filings may be due to multiple factors, including economic conditions, increased diversity and demographic shifts in the labor force, employees’ greater awareness of the law, EEOC’s focus on systemic litigation, and changes to EEOC’s intake practices.
The EEOC also continues to vigorously pursue disability and other discrimination charges. On March 16, 2009, for example, the EEOC announced United Airlines has agreed to pay $850,000 and to change its light duty policies to settle a federal lawsuit brought by the EEOC that alleged that the company’s policy of denying overtime work to anyone on light duty violated the Americans With Disabilities Act (ADA). The EEOC charged that the policy had greater repercussions for employees with disabilities, since these workers were more likely to be assigned to light United will pay the $850,000 to a class of employees with disabilities denied the opportunity to work overtime while placed on light or limited duty. duty when medically cleared to work overtime. The settlement also requires United to notify all current and former employees at the San Francisco Airport who were subject to the rescinded policy and invite them to submit claims to share in the $850,000.
Businesses Must Act To Manage Risks
In this increasingly risky climate, businesses should review and update their existing policies and practices prohibiting unlawful discrimination in employment and the provision of services based on race, color, religion, sex, familial status, national origin, disability, veteran status or other grounds prohibited by law and take other steps to prepare to demonstrate their compliance with federal nondiscrimination laws in operation as well as form. While adopting and communicating appropriate policies prohibiting unlawful discrimination in the provisions of goods, services, and employment is an important element of these compliance efforts, businesses also must take appropriate steps to ensure their operations match the words of their policies. Businesses should not assume that the usual recital of their equal employment and services policies alone will suffice. Businesses also need to have and administer well-documented practices and procedures governing the report, investigation and disposition of complaints. These procedures should include clearly written and well communicated procedures to be used to report suspected violations. Businesses also must establish and communicate clear procedures requiring employees both to comply with these rules and to report known or suspected violations. Businesses also should train workforce members on these policies and procedures and consequences for their violation. Businesses also should consider establishing compliance hotlines and using other compliance audit processes to monitor and address possible violations. They should be prepared to demonstrate they take seriously and take appropriate action to investigate suspected violations, to rectify confirmed violations, and to appropriately discipline employees or others that participate in prohibited violations.
Businesses needing advice or assistance to review or defend existing disability and other non-discrimination policies and practices should contact Cynthia Marcotte Stamer at 469.767.8872 or via e-mail to cstamer@solutionslawyer.net. To register for future updates or to review other recent updates, helpful links and information about employment and other internal controls matters, or the author, see CynthiaStamer. com.
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Corporate Compliance, EEOC, Employers, Human Resources, Internal Controls, Internal Investigations, Risk Management | Tagged: ADA, Disability Discrimination, Light Duty, Occupational Injury |
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Posted by Cynthia Marcotte Stamer
March 22, 2009
Businesses applying policies that limit or restrict the availability of overtime for employees on light duty should review their practices in light of a settlement with United Airlines announced by the Equal Employment Opportunity Commission last week.
On March 16, 2009, the EEOC announced United Airlines has agreed to pay $850,000 and make policy changes to settle a federal lawsuit brought by the EEOC that challenged that the company’s policy of denying overtime work to anyone on light duty violated the Americans With Disabilities Act (ADA). United will pay the $850,000 to a class of employees with disabilities denied the opportunity to work overtime while placed on light or limited duty. The EEOC charged that the policy had an impermissable disparate impact for employees with disabilities, since these workers were more likely to be assigned to light duty when medically cleared to work overtime. The settlement also requires United to notify all current and former employees at the San Francisco Airport who were subject to the rescinded policy and invite them to submit claims to share in the $850,000. Businesses with similar light duty policies or other workplace rules that disproportionately impact persons with disabilities or in other protected status hould review and update their policies in response to these and other potential challenges.
If your business that has questions about this development or needs assistance managing discrimination or other employment risks, contact Cynthia Marcotte Stamer at 469.767.8872 or cstamer@solutionslawyer.net. To register for future updates or for other helpful information, see CynthiaStamer.com.
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Corporate Compliance, EEOC, Employers, Human Resources, Internal Controls | Tagged: ADA, Disability Discrimination |
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Posted by Cynthia Marcotte Stamer
March 20, 2009
Businesses that fire or discipline employees increasingly face retaliation claims by disgruntled workers. A host of federal and state employment and other laws prohibit businesses from retaliating against employees for reporting possible prohibited conduct or seeking to exercise certain rights legally protected rights. The U.S. Supreme Court’s recent decision in Crawford v. Metropolitan Gov’t of Nashville and Davidson County, No. 06-1595, highlights the need for employers to exercise constant viligence to potential retaliation claims and the need to act to avoid retaliating, or appearing to retaliate against employees when conducting internal investigations, terminations, promotions or other workforce management activities.
In its February 2, 2009 unanimous Crawford decision, the Supreme Court ruled that the anti-retaliation provisions of Title VII protect employees against retaliation for giving a “disapproving account” of unlawful behavior when responding to questions asked during the employer’s investigation of a sexual harassment discrimination, even if the employee took no further overt action to complain about, seek to remedy or stop the misconduct..
Vicky Crawford sued the employer under Title VII’s anti-retaliation provision, which prohibits an employer from terminating a worker because she “has opposed any practice made an unlawful employment practice” under Title VII. The Crawford case arose from statements Ms. Crawford made in response questions addressed to her as part of her employer’s investigation of sexual harassment rumors. Asked if she’d witnessed any inappropriate behavior by a supervisor, Ms. Crawford answered told the employer about a series of harassing acts by the supervisor toward herself. Besides reporting her experience in reply to employer questions during the investigation, however, Ms. Crawford did not file a sexual harassment complaint or otherwise report her alleged sexual harassment experience to the employer. Following the interview, the employer did not discipline the supervisor. However, the employer subsequently fired Ms. Crawford and two other employees who also reported being harassed by the supervisor. As part of its defense, the employer argued that Ms. Crawford’s report during the course of the investigation did not qualify as “opposition” prohibited under Title VII.
The question before the Supreme Court was whether simply disclosing an act of harassment in answer to a question constitutes “oppos[ing]” an unlawful practice, or whether – as the court of appeals had held – opposition within the meaning of the provisions requires something more assertive.
Applying the ordinary meaning of “oppose,” the Supreme Court unanimously found that “When an employee communicates to her employer a belief that the employer has engaged in . . . employment discrimination, that communication virtually always constitutes the employee’s opposition to the activity.” Accordingly, the Supreme Court ruled that protected opposition under Title VII includes giving a “disapproving account” of unlawful behavior, even if the employee takes no further action on her own to seek to stop or remedy the conduct.
In explaining its conclusions the Supreme Court stated that a contrary rule that would require a worker to engage in “active, consistent” behavior in order to engage in protected opposition would be inconsistent with common usage. For example, the Court explained, one can “oppose capital punishment” without doing anything active to end it. The Supreme Court rejected as “freakish” an interpretation of “opposition” that would protect an employee who reports discrimination on her own initiative but not one who reports the same discrimination in the same words when her boss asks a question.”
While concurring in the unanimous opinion, Justices Alito and Thomas cautioned against reading that opinion too broadly. Their opinion clarifies that in their view, covered opposition must be “active and purposive” to qualify as protected. Consequently, they warned that the Court’s opinion should not be read to suggest that Title VII protects merely opposing a practice in principle (like opposing capital punishment) without taking any action at all to express that opposition.
Although the report by Ms. Crawford involved her notification to the employer that she too may have been sexually harassed, the implications of the Crawford decision reach more broadly. The decision illustrates the need for businesses not to overlook the potential significance of the statements and conduct by employees involved in any internal investigation, performance, or other activity that might later form the basis of a retaliation complaint. Businesses should listen carefully when conducting investigations, employee counseling and discipline meetings, and exit interviews with an eye out for the need to investigate potential legal violations, defend against retaliation charges, or both. Although businesses should continue to require employees to report known or suspected discrimination or other prohibited conduct in accordance with a specified formal procedure, the Crawford decision reminds businesses not to overestimate the protection afforded by the establishment of formal reporting procedures. It also illustrates the need for businesses to be careful to investigate and properly respond to new charges of discrimination or other potential legal or policy violations that may be uncovered in the course of an investigation, disciplinary meeting or exist interview. At the same time, businesses also must evaluate the potential implications of their dealings with employees who previously have made charges, participated in investigations, or claimed other protected rights such as taking a protected leave or the like.
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Posted by Cynthia Marcotte Stamer
March 19, 2009
The U.S. Department of Labor (“DOL”) this morning (March 19, 2009) posted Model Notices and other additional guidance about temporary requirements 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 (“Stimulus Bill”). Employers, health plan administrators, and health insurers involved in the sponsorship or administration of COBRA-covered group health plans should consult with counsel about the suitability of using the Model Notices to provide required notifications of the new Stimulus Bill COBRA rules and other steps necessary to comply with the new requirements. Compliance with the Stimulus Bill COBRA rules is mandatory for all COBRA-covered group health plans and certain other arrangements including group health plans sponsored by businesses in bankruptcy where the entity or a commonly controlled or affiliated entity continues to maintain a group health plan.
The new guidance posed today includes:
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Various Model Notices
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New FAQs for Employers on the COBRA Premium Reduction
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Expanded FAQs for Employees on the COBRA Premium Reduction
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Updated FAQs for Employees on General COBRA Provisions
While the Model Notices and other guidance provides helpful insights about the new requirements, many group health plan sponsors, administrators and fiduciaries are likely to find it necessary or desirable to specifically tailor the notifications and other procedures they provide to more clearly communicate the workings of the new requirements as they relate to their specific plans so as to minimize administrative burdens of compliance and fiduciary risks.
The Stimulus Bill provisions that took effect on February 17, 2009 require special COBRA treatment for “assistance eligible individuals.” See “Stimulus Bill COBRA Amendments Require Immediate Group Health Plan Action” for more information. The Stimulus Bill COBRA amendments are intended to help certain involuntarily terminated former employees and their dependents maintain COBRA coverage. Employers must amend their plans to comply with these mandates and, if they wish to seek reimbursement for COBRA Subsidies, must comply with IRS requirements. Meanwhile, group health plan administrators and insurers must take immediate action to provide required notifications and implement other administrative changes necessary to comply with the new rules.
The Stimulus Bill definition of “assistance eligible individual” generally includes any COBRA “qualified beneficiary” who meets all of the following requirements:
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Is eligible for COBRA continuation coverage at any time during the period beginning September 1, 2008 and ending December 31, 2009;
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Elects COBRA coverage (when first offered or during the additional election period): and
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Has a qualifying event for COBRA coverage that is the employee’s involuntary termination during the period beginning September 1, 2008 and ending December 31, 2009.
This definition includes both involuntarily terminated employees and their dependents who lost coverage under a group health plan due to the involuntary termination.
As part of their COBRA amendments, the Stimulus Bill limits the COBRA premium that a COBRA-covered group health plan can charge an “assistance eligible individual” to 35% of the otherwise applicable COBRA premium for a period of up to 9 months (the “Subsidy Period”) beginning March 1, 2009. 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. However, the Stimulus Bill allows an employer to seek reimbursement by claiming a payroll tax credit for these COBRA Subsidy payments by complying with applicable IRS procedures.
The Stimulus Bill also requires certain assistance eligible individuals whose employment terminated between September 1, 2008 and February 16, 2009 and did not elect COBRA coverage when previously offered or who allowed COBRA coverage to lapse after electing that coverage be offered a second COBRA enrollment period in which to elect prospectively to enroll in COBRA coverage. It also requires that group health plans that offer employees different plan options allow assistance eligible individuals the option to change their coverage choice. Also Group health plan administrators must provide certain notifications to assistance eligible individuals concerning these changes.
The guidance posted today supplements preliminary guidance previously posted by the Internal Revenue Service and the Department of Labor over the past month. You can review the current Deparment of Labor Guidance at http://www.dol.gov/ebsa/COBRA.html and the current IRS Guidance at http://www.irs.gov/newsroom/article/0,,id=204505,00.html/COBRA.html .
The Stimulus Bill COBRA rules were among the updates discussed by Cynthia Marcotte Stamer during a March 11, 2009 Health Plan Update Teleconference. If you are an employer or other group health plan sponsor, administrator, insurer or fiduciary and need assistance in preparing required notifications or with other matters relating to the Stimulus Bill COBRA Rules or any other health or other employee benefits matter, contact Cynthia Marcotte Stamer at CStamer@SolutionsLawyer.net or via telephone at 972.419.7188.
For information about how to purchase a recording of this teleconference or to review other breaking news updates about these Stimulus Bill COBRA Rules, register at Cynthia Stamer.com.
©2009 Cynthia Marcotte Stamer, P.C.
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COBRA, Employers, Health Plans, Human Resources, Stimulus Bill, Uncategorized | Tagged: COBRA, Employers, Health Plans, HealthP Plans, Stimulus Bill |
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Posted by Cynthia Marcotte Stamer