105(h) Rules for Fully-Insured Plans Delayed

In a welcome development for employers who sponsor fully-insured heath plans, the implementation of Section 105(h) non-discrimination rules contained in the Patient Protection and Affordable Care Act (PPACA), as applied to fully-insured plans, has been delayed. At the earliest, the new rules will not apply until later in 2011. The actual effective date will not be determined until the regulations are released.

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Rule Amended – Changing Carriers No Longer Causes Loss of Grandfathered Status

On Monday November 15th, the DOL, HHS and IRS (The Departments) jointly released an amendment to the interim regulations regarding grandfathered plans status (originally released June 17th, 2010) which changes the rules regarding the effect changing insurance companies has on a plan’s grandfathered status under the Patient Protection and Affordable Care Act (PPACA). According to the new rule, fully insured plans can now change insurance carriers without affecting their grandfathered status.

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Oldco/Newco and the Transfer of Company Ownership

Transferring the ownership of an existing company can be a daunting process. In the most common scenario, employees without ownership interest seek to purchase a firm but lack sufficient capital to buy it outright. The current credit markets can make the process of obtaining a purchase loan difficult or even impossible. In addition, the purchase value of the company may be too high, based on projected future cash flow, when goodwill and other intangibles are considered. However, there are significant benefits to transferring ownership rather than establishing a new company. When facing RFP-based job procurement and surety bonding requirements, which would bar undercapitalized and inexperienced firms from entry into the construction industry, the new ownership benefits from the company’s established track record, balance sheet and project resume.

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Defense Against Patent Infringement Suits

With the cost and complexity of Patent Infringement litigation increasing, many companies are now looking to insurance for specialized coverage to transfer this risk.

Trends in Patent Infringement Suits

PricewaterhouseCoopers (PWC) recently published their report, 2009 Patent Litigation Study, which discusses the current trends in patent litigation. In 2008, 2,896 patent infringement actions were filed and the median award was about $2.5 million. The study also found that roughly two thirds of infringement cases brought to trial were successful.

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The Role of Risk Management in Healthcare Operations

Our current economic climate is continuing to force healthcare organizations to evaluate operational efficiencies. Maximizing profits, or at least not operating at a loss, has long been at the forefront of business objectives. Very few organizations can survive in the long run without meeting their expenditures.

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Lights Out: Are you ready

We are heading into the time of year when power interruptions become more frequent, but we are often unprepared when the outage is unexpected and more severe that anyone could predict. The 2006 windstorm was a perfect example of a force of nature exceeding anyone’s expectations.

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The Beneficiary-Controlled Trust

It has long been ingrained in American property law that we have the right to determine who will receive our property after we pass away. In the United States the majority of laws on disposition of property at death are governed by the states. Some laws are more liberal, permitting flexibility in determining who can receive property. Some require at least a portion of the property to be passed to specific individuals (i.e. spouses, children, etc.).

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Food Processors: Products Recall & Contamination

Whether your company processes complex recipes to make exotic foods or your operations involve fish or vegetable preservation, you have unique exposures that require unique insurance coverages. One pertinent and important coverage is Products Recall & Contamination.

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Do You Need Real Estate Development Professional Liability Insurance?

In addition to General Liability coverage, which responds to claims involving bodily injury and property damage to third parties, a Real Estate Development Company should also consider Professional Liability exposures and the need for Professional Liability insurance.

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Healthcare Reform October Update

A considerable amount of attention has been given to the healthcare reform regulations that extend coverage for children to age 26, and the IRS section 105 non-discrimination rules that previously applied to self-insured plans, but will now also apply to fully-insured plans as well.

The new regulations relating to preventive care and FSA coverage of over-the-counter medications have escaped notice due to the attention given the topics mentioned above.

Preventive Care

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Preventive Care Services Regulations Released


The IRS, DOL and HHS (The Agencies) have jointly released regulations (The Regulations) regarding the preventive care coverage requirements contained in The Patient Protection and Affordable Care Act of 2010 (ACA). The Regulations, which will be published in the Federal Register on July 19th, define the preventive health services that a health plan must provide coverage for with no cost-sharing requirements such as a copayments, coinsurance, or deductibles. The rules do not apply to grandfathered health plans.

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The Moral of the Story: Pre-Loss Planning Creates Happy Ending

The story you are about to read is fictitious and intended to illustrate scenarios that we see in reality every day. The setting could be any city, state or region where medium-sized clothing, specialty food or mercantile retailers operate.

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