Tuesday, November 15, 2011
Saturday, November 12, 2011
Court Rules Actual Receipt of COBRA Election Notice Not Required
In Hearst v. Progressive Foam Technologies, Inc., the Eighth Circuit Court of Appeals recently considered whether an employer must ensure that employees who experience a COBRA “Qualifying Event” must actually receive COBRA election notices. Generally speaking, employers that sponsor group health plans are required to provide notices that explain the COBRA election rights to eligible employees and their dependents who experience a Qualifying Event, within 44 days after the occurrence of the event.
In Hearst, an employee was terminated after failing to return to work from a leave of absence. The employee later sued the employer, claiming that he never received the required COBRA election notice. The lower court dismissed the employee’s claim because the employer provided a “mailing manifest” (i.e., log of daily mailings verified and date-stamped by US. Post Office) to show the employee’s COBRA election notice was, in fact, mailed.
On appeal, the Eighth Circuit determined that the issue presented by Hearst was whether the employer sent the notice by means “reasonably calculated” to be received by the employee and not whether the employee actually received the notice. The Eight Circuit affirmed the lower court’s decision, agreeing that the employee’s claim of not receiving the COBRA election notice was insufficient to overcome the employer’s proof that the notice was mailed.
As a best practice, employers, or their COBRA administrators, should distribute COBRA election notices by using first-class mail, being sure to document such mailings with records that meet a court’s evidentiary requirements. In general, courts accept business records and testimony from individuals with first-hand knowledge of the employer’s compliance practices as sufficient evidence of mailing.
Sunday, October 18, 2009
If you think the point I am about to make is not valid - ask yourself why the above provision is in a bill that includes a public option.
- if 15% of the US economy goes from private insurance to a federal insurance program
- the remaining taxpayer and business will have to replace the local, state and federal income and property taxes that are lost when the Fed controls a program.
Before you scoff at these issues - read on to the end
and for those who think this is not an issue - 15% of the economy going from private to public sector will need to see at least a 20% tax increase on the private sector to replace lost revenues
... Today on Fox News Sunday and (I think also not sure) on ABC/ Stefanopoulos show, the figures for 'overhead' by the health insurance industry, ie the amount actually NOT paid out for delivery of health care services, ranged as high as 20%. That would mean up to 20% of a premium payment goes to marketing, salaries, bonuses, and other ancillary expenses...up dramatically from 1990 level. "
Government care - Medicare A is claimed to be a 5 - 8% overhead rate
Government care - Medicare B, and D added in takes total government overhead to somewhere close to 15%
for this dialog let's accept the conservative
15% overhead for government insurance
20% for private insurance overhead,
both sides can argue up to 30% for the other, but it does not matter for this review
Government overhead for insurance pays 0.00 to get buildings or renovate them - GSA pays for building remodeling services and for new facilities in a separate account
those grounds and buildings are not subject to state property taxes
Private insurance hires people or companies to build facilities and remodel them,
those contractors pay taxes that add to government revenue
those grounds and buildings, and the improvements are subject to local and state property taxes
(real property, real land, real assets)
Government overhead for insurance pays 0.00 to facilities management - GSA pays for building services and facilities management in a separate account
Private insurance hires people or companies to manage facilities management,
and those service providers pay taxes that add to local, state and federal government revenue
(boilers, AC, power, light, parking lots etc)
Government overhead for insurance pays 0.00 to property taxes
Private insurance pay local, state's property taxes that add to government revenue
Government overhead for insurance pays for the clerical employees in CMS to manage the program - but the government employee and employer do not pay all of the FICA and tax burdens to federal and state coffers a private person and employer do
the government worker has part of his/her health insurance paid for by taxpayers
the government workers have a part of their retirement funded by the taxpayer
Private insurance hires people to manage all aspects of the insurance program, and the employer pays for unemployment insurance, FICA, and state and federal payroll taxes
the individuals do not have government (taxpayer) funded retirement, so they invest their monies
the individuals pay for their health insurance, at a discount
Government overhead for insurance pays minimal for enrollment, and sub-contracts some work - as most is done thru federal and state employees in other agencies, funded by federal and state taxes, but not paid for by the government insurance agency
(social services is not a part of CMS or Medicare, it's paid for by taxpayers)
Private insurance hires people to manage enrollment into the insurance program, and hires 1099 workers to sell policies
the employer pays for unemployment insurance, FICA, and local, state and federal payroll taxes
the employed individuals pay for their health insurance, at a discount
the 1099 employee pay local, state and federal taxes and FICA, pays property taxes
Government overhead for insurance pays 0.00 toward profit
Private insurance pays taxes on profit that add to local, state and federal government revenue
Government overhead for insurance pays 0.00 toward mandatory reserves and set-asides
to meet financial needs it borrows money and prints money
Private insurance pays toward mandatory reserves and set-asides which make banks profitable, as the interest paid is less than the interest earned in lending those funds
that keeps the economy going
Banks and bank employees pay local, state and federal taxes, and fund the FDIC
Government overhead for insurance pays 0.00 toward mandatory fees, licenses, regulatory costs, audits or market conduct reviews, and pays no fines for non-payment of claims
(6.9% decline rate for part A)
Private insurance pays all costs born by states toward mandatory fees, licenses, regulatory costs, audits or market conduct reviews
Private insurance pays tort costs
Private insurance has a lower decline rate than Government
look up the AMA report for actual numbers
Government insurance is not held accountable for compliance to laws and state regulations
so it never pays a fine
Private insurance is held accountable for compliance to laws and state regulations, and pays state and federal fines when it is found to have not meet those guidelines and laws
Government insurance is not liable - so it rarely gets sued
Private insurance is held accountable for any tort issues, and pays fines when it is found to have not meet those guidelines and laws
the lawyers pay taxes, filing fees, and taxes on settlements that enrich local,state and federal coffers
after you read the analysis, consider if that 20% does go away - from a public option or a Universal mandate
notice all of the taxes and fees that local, state and federal government will have to replace from someone else
can you afford 20% more in taxes on top of what the insurance program would cost?