Is coconut really more hydrating? Clarifying myths and fact on waters.
Originally posted by Ellie Krieger on July 7, 2015 on washingtonpost.com.
It’s sweltering outside and you’ve worked up a big thirst, so you duck into a grocery store to pick up a bottle of water. But these days there are so many brands and types on the shelves that you could drop from dehydration before figuring out which one to buy.
Regardless of their prices or promises, all the waters on the market hydrate you equally well, and no better than tap water does. So if that is all you care about, just grab the cheapest. Even better, remember to fill up a bottle at home before you leave next time. But if you want something that tastes different or has the possibility of added health benefits, here’s the lowdown on what’s out there.
Bottled water, as defined by the Food and Drug Administration, which regulates the industry, is simply water fit for human consumption that is bottled safely. It could be packaged tap water. But beyond that baseline there are official definitions for terms such as “purified,” “spring,” “artesian” and “mineral” that specify how the water is processed and sourced.
“Purified” means the water — from any viable source, even, say, a municipal water supply — has been filtered or distilled to remove impurities such as chlorine and other elements that affect taste. Spring and artesian waters come from specific sources: spring water from an underground formation that flows naturally to the surface, and artesian water, which is tapped from an underground aquifer that’s under pressure. Although spring and artesian are often more expensive and have chic packaging, they do not offer any benefits beyond, perhaps, a special taste and status appeal.
Mineral water is defined as having 250 parts per million dissolved solids naturally present (no minerals may be added) and must originate from a protected underground source. Most of these waters are so mineral-rich that drinking them can significantly boost your intake of the nutrients, especially calcium and magnesium, which many people lack. Plus, mineral water tends to be alkaline, which may help bone health. (More on that later.) Depending on the brand, one liter a day can cover you for 20 to 58 percent of calcium and 16 to 41 percent of magnesium needs. On the flip side, it can also contribute a significant amount of sodium, so read the label carefully to decide what is right for you.
For those who don’t care for the taste of plain water, there is a vast array of flavored options. Some are simply treated with a hint of natural fruit and/or herbal essences. Others have sweeteners, food colorings and artificial flavors, making them, to me, more like soft drinks than water. Many sweetened waters contain considerable calories from refined sugar, upwards of 50 calories per cup (120 in a typical 20-ounce bottle), which can really add up if you are chugging several each day. Many also have promising names like “Revitalize” or “Focus,” which are mainly marketing tools that are better ignored, and vitamin and herb enhancements that probably won’t hurt you but won’t benefit you much, either. When picking up flavored water, I suggest going for one that is as much like actual water as possible, unsweetened and with minimal additives.
When coconut water first burst onto the scene, it promised better hydration than water, but marketers have since backed off on that unjustified claim. What it can claim to be is a lightly sweet liquid with a somewhat nutty taste that hydrates as well as water and provides a significant dose of potassium. Coconut water comes from the inside of the young green fruit and, unlike coconut milk, has no fat. If you want a change of pace flavor-wise and you take into account the 45 calories it has per cup (if you get the unsweetened variety), it can be a good way to change things up. But there is nothing magical about it. You could also hydrate and replenish your potassium (plus get other nutrients and filling fiber) by drinking a cup of water and eating a small banana.
A new kid on the shelf in the same category is maple water, the liquid (sap) from the maple tree that is usually boiled down to make a syrup. In its unconcentrated form, it is clear and has a subtle sweetness, plus some minerals, for about 20 calories per cup. There isn’t enough research to back the many claims about its health benefits, including the “cleansing” power I was told it has by the woman providing tastes of it at my local market. (I hope she didn’t see me rolling my eyes.) But I thought it was delicious, if expensive, at $4 for a small bottle, and, like coconut water, a healthy way to switch things up taste-wise.
An overwhelming trend in the beverage aisle is the emergence of “pH-balanced” alkaline waters — boasting a pH greater than 7. The trend stems from a popular but unfounded theory that if we consume too much water that is on the acidic side (which tap water often is), we wind up acidifying our body and compromising our health in myriad ways. The fact is, our body’s pH is maintained in a tight range, thanks to our kidneys and other buffering systems, and there is no substantial research to show that drinking more acidic water does any harm per se. But while there is no need to stress about your water’s pH, there is one well-documented “pro” to drinking water that is more alkaline: It could benefit your bones.
Several studies show that drinking water that is more alkaline because of its electrolyte and mineral content (whether naturally occurring, as with mineral water, or added) can help preserve bone by reducing the kidney’s need to tap into calcium reserves to balance normal acid in the body. So, not only do you ingest more important minerals and nutrients like potassium when you drink this kind of water, you also help keep calcium in your bones instead of breaking it down. Skip brands that have been made alkaline through a process of ionization, which won’t give you the nutrient benefit that minerals and electrolytes do. Also keep in mind that more alkaline (a higher pH) is not necessarily better. Aim for a pH somewhere between 7.5 and 8.5, because once you get above that, the water tends to have a slippery feel and less appealing taste. With all the options out there, you shouldn’t settle for less than one that delivers both good health and good taste.
Birth Control Coverage Rules Announced by Obama Administration
Originally posted by Louise Radnofsky on July 10, 2015 on wsj.com.
WASHINGTON—The Obama administration on Friday set final rules for contraception coverage in workers’ health insurance plans, putting in place rules that are unlikely to satisfy some religious employers who object to birth control.
The rules reaffirmed that most health plans have to include birth control with no out-of-pocket costs as part of the 2010 Affordable Care Act. The regulations include alternative arrangements for employers such as Catholic universities that have moral objections to most forms of contraception, and other Christian institutions that object specifically to forms of emergency contraception such as the “morning-after pill.”
Under the rules, employers with such objections must tell their insurance company or the federal government. The insurance company then takes over responsibility for providing the coverage to employees who want it.
Federal officials said the arrangements also would be available to closely held for-profit companies such as Hobby Lobby Stores Inc. that last year won a Supreme Court case against the coverage requirement under the Affordable Care Act.
The high court said the Obama administration hadn’t done enough to take into account the religious objections of the owners of companies such as the arts-and-crafts chain. The justices didn’t specify what the federal government should do to address those concerns.
The White House and Christian leaders have tussled for years over the health law’s requirement that most insurance plans cover preventive services without charging co-pays or deductibles, and that prescription methods of contraception such as the pill and intrauterine device be counted among them.
Churches are excluded from the requirement, but Catholic bishops, in particular, have argued that religiously affiliated hospitals, universities and charities should be given the same exemption so they do not have to violate Catholic teachings by paying for something they believe to be immoral.
Women’s health advocates, for their part, have pushed the White House to hold firm and ensure that the provision of the 2010 health law is widely available.
To qualify for the alternative system outlined by the government, companies must be privately held and controlled by five or fewer individuals, federal officials said Friday. The company’s board must adopt a resolution stating the company’s objection to covering some or all forms of contraception.
Catholic bishops and other religious leaders have said the revised system is inadequate because it still uses the insurance plan they set up to provide something they believe to be wrong.
They have challenged the alternative system in the courts. Many of those challenges are working their way through the legal system, and the federal government has prevailed in several cases so far.
Attorneys representing many of the religiously affiliated litigants in those cases derided the final rules.
“The government keeps digging the hole deeper,” said Adèle Auxier Keim, legal counsel at the Becket Fund for Religious Liberty, adding that “there is no reason at all the government needs religious employers to help it distribute these products.”
A spokeswoman for the Department of Health and Human Services said she couldn’t comment on continuing litigation.
In a statement, HHS Secretary Sylvia Mathews Burwell said the regulations were intended to balance the religious objections with the government’s desire to guarantee access to no-cost contraception for women, regardless of where they worked.
“Women across the country should have access to preventive services, including contraception,” Ms. Burwell said.
“At the same time, we recognize the deeply held views on these issues, and we are committed to securing women’s access to important preventive services at no additional cost under the Affordable Care Act, while respecting religious beliefs,” she said.
Communicating With Your Doctor On Facebook May Be The Future Of Healthcare
Originally posted by Carolyn Gregoire on June 20, 2015 on huffingtonpost.com.
We communicate with our friends, our families and our coworkers via email and Facebook, and apparently, most Americans also wish that they could keep in touch with their health care providers this way.
A national survey of 2,252 pharmacy customers conducted by Johns Hopkins University's Bloomberg School of Public Health highlights the gap between what patients want from their health care providers in terms of communication and engagement, and what they're actually getting.
"This study tells us that for most patients, healthcare isn’t quite ready for the future," Joy Lee, a post-doctoral fellow at the university, told The Huffington Post.
In fact, there's something of a patient engagement paradox in healthcare, Lee said.
"On the one hand, doctors, policymakers, and researchers often talk about the need to engage patients," she explained. On the other hand, many patients are already engaged -- in Facebook and other online communities. Yet instead of embracing this connection, medicine is preoccupied with confidentiality and drawing professional boundaries.
Fifty-seven percent of respondents -- who were generally educated, healthy and regular users of Facebook -- said that they were very interested in using Facebook and email to communicate with their physicians and to manage their health. More than half of respondents also said that they wanted to use their physicians' websites to access health information.
More than a third said that they already communicated with their doctors via email, and 18 percent said they connected with their doctors on Facebook, a surprising finding considering that many health care providers have rules barring this mode of interaction with patients due to privacy concerns and ethical guidelines for physicians.
Young adults -- as well as caregivers, patients with chronic conditions, and regular Facebook users -- were more likely to communicate with their doctors via email and Facebook.
Lee emphasized that of course, it's critical to safeguard patient information. But "Health care organizations need to figure out how to take advantage of resources like Facebook," she added.
They're already on the way. As part of the growing telehealth movement, many doctors and health care organizations have electronic systems that patients can use for things like messaging, accessing test results and personal information, and health tracking.
"Many patients are interested in [these services] but few are actually using them -- possibly because patients don’t know they’re available," Lee said. "Doctors and health care organizations should take steps to publicize and educate patients of these opportunities. Either way, it starts with a conversation between patients and doctors on how they prefer to communicate online."
The study was published this month in the Journal of General Internal Medicine.
Penalties Increased for Filing Errors
Originally posted on July 7, 2015 on acatimes.com.
Penalties in sections of the Internal Revenue Code relating to the failure to timely file correct and complete information in a return as well as the failure to timely distribute correct and complete statements were substantially increased – by up to 150% – with the passage on June 29 of the Trade Preferences Extension Act of 2015 (“TPE Act”).
The penalties are related to IRC Sections 6721 and 6722. Section 6721 pertains to the failure to file correct and complete information in a return. Section 6722 pertains to the failure to furnish complete and correct information in the payee statements. Section 806 of the TPE Act substantially increases the penalties set forth separately under these IRC Sections.
The penalty for failing to timely file and/or failing to file correct and complete information will be $250 per return (previously $100.) The cap on all such failures is raised to $3,000,000 (previously $1,500,000) under Section 6721.
This increase also applies to penalty for the failure to furnish complete and correct information in the payee statements, under Section 6722.
Under provisions of Section 6721 and 6722 for reduced penalties if corrections are made within 30 days after the required filing date, those lower penalties are now $50 per return (previously $30), with a maximum of $500,000 (previously $250,000).
The reduced penalties under each Section 6721 and 6722 where the corrections are made by August 1 is increased to $100 (previously $60) per return, with a maximum of $1,500,000 (previously $500,000).
The lower limitations under each Section 6721 and 6722 for persons with gross receipts of not more than $5,000,000 have also been increased. Such persons are subject to a cap of (a) $1,000,000 (previously $500,000) for failing to timely file and/or failing to file correct and complete information, (b) $175,000 (previously $75,000) for corrections made within 30 days of filing deadline, and (c) $500,000 (previously $200,000) for corrections made by August 1.
Penalties under Section 6721 and 6722 in case of intentional disregard as would be applicable to ACA reporting is increased to $500 per return (previously $250), and no cap applies.
These penalties apply with respect to returns and statements required to be filed after December 31, 2015.
The timing of when these penalties will impact ACA reporting appears to be after December 31, 2016. This is in view of the IRS’s previously announced availability of short-term relief for 2015 from ACA reporting penalties under Sections 6721 and 6722 if the employer can make a showing of good faith effort to comply with the ACA reporting requirements.
The penalties may also be abated based on reasonable cause and not due to willful neglect.
Presumably, the IRS could continue with that short-term relief and allow the TPE Act to go into effect with respect to ACA reporting penalties starting the following year, after December 31, 2016.
Take safety steps during most dangerous month for lightning strikes
Originally posted by Ben Smart on July 2, 2015 on cnn.com.
A lightning strike -- a brief but intense burst of electricity -- affected as many as 16 hikers. Three were rushed to a local hospital and eight others required medical treatment, according to the Clear Creek County Sheriff's Office. All the hikers survived the incident, but one hiker's dog was killed.
Across the country in Greeleyville, South Carolina, lightning may have caused a fire at Mount Zion African Methodist Episcopal Church that gutted the interior and collapsed the roof, according to the FBI.
And now it is July, the month when the number of lightning strikes -- and fatalities -- is at its highest. So far in 2015, 14 people have been killed by lightning. On average, 49 people are killed and hundreds more are injured in the United States each year by lightning strikes.
The odds of being struck in your lifetime are about 1 in 12,000, the National Weather Service estimates. But experts say there are a few rules to help keep people safe.
"We need to look at lightning safety proactively, not reactively," said Dr. Mary Ann Cooper, a physician and lightning researcher who directed the Lightning Injury Research Program at the University of Illinois at Chicago. "Avoiding situations where lightning can strike is key."
One simple rule
The National Weather Service recommends one rule to avoid lightning injuries: "When thunder roars, go indoors."
No place outside is safe when there are thunderstorms in the area, they say, as lightning can strike 10 to 15 miles away from a storm. If there isn't a structure nearby, a metal-topped vehicle with closed windows can provide safety.
Stay safe indoors
Although the safest place from lightning is indoors, there a number of extra precautions to take once inside.
A common misconception is that metal objects or water "attract" lightning. In reality, they're no more likely to be struck than a piece of cardboard or a person. The danger occurs because metal and water better conduct electricity once they're zapped.
The National Weather Service recommends people avoid washing hands or taking a shower, and touching or even unplugging electrical devices plugged into walls, as these can conduct electricity from a lightning strike.
Disregard outdated advice
Experts said there's some truth in the idea that lightning is more likely to strike the tallest object in an area -- for example, a tree or a skyscaper -- and that "pointier" objects are more likely to be hit.
But being outside at all during a thunderstorm puts you at risk of getting struck. The "lightning crouch," which was once thought to keep people safe during a lightning storm, is no longer recommended, Cooper said. There is no "safe" place outdoors during stormy weather.
"Lightning doesn't know if you're 6 feet tall or 3 1/2 feet tall after it's traveled miles through the air," said Cooper, who is the founding director of the African Centre for Lightning and Electromagnetics.
It's not always a direct hit
It's a common misconception that a person needs to be struck directly to be injured by lightning, Cooper said. Only 3% to 5% of injuries are from direct strikes, she said.
There are several ways lightning can reach a victim's body and cause injury. More than half of lightning-related injuries result from what's called a "ground strike," where lightning strikes the Earth and spreads through the ground, eventually reaching a person, Cooper said.
"A lightning 'side flash' also kills a tremendous portion of people," Cooper said. "That's where lightning travels down a tree and sideways where a person might be standing."
After lightning strikes
The surge of electricity from a lightning strike can wreak havoc on a person's heart, brain and nervous system, and it can cause instant death by "short-circuiting" the heart. A survivor of a lightning strike might live with severe brain damage that can make activities such as memory, learning and task organization difficult.
"Ninety percent of people who are injured by lightning survive, but disabilities can last for a lifetime," Cooper said. "I've seen significant devastation to families from lightning injuries."
If you witness someone struck by lightning, get emergency medical help right away. If multiple people are impacted, help anyone unconscious first. If the person has stopped breathing or has no pulse, correct CPR should be attempted immediately.
"If the person is breathing, talking and making sense, there is no emergency and generally little a physician would find or be able to treat," Cooper said. Some symptoms may not be noticeable until later, when a person is unable to carry out daily responsibilities in the way they did before.
"Many people who are struck by lightning describe it as a blunt force... like being impacted by an explosion," Cooper said. "Others may feel the sensation creeping up one leg, or as a burning or searing pain."
What Employers Need to Know About Court’s Gay-Marriage Ruling
Originally posted by Rachel Emma Silverman on June 30, 2015 on wsj.com.
The Supreme Court on Friday ruled that same-sex couples have a constitutional right to marry, meaning that same-sex marriages must be recognized nationwide. The ruling will have vast implications for employers, which until now have been operating under a patchwork of different state and federal laws governing the legal and tax treatment of same-sex unions.
Here’s what businesses should keep in mind as they navigate the new landscape.
If an employer offers spousal health-insurance benefits, do they need to offer them to all married employees, gay or straight?
In general, yes.
Companies that offer spousal health benefits and use a separate insurance company to fund their benefits will now be required to cover both gay and straight spouses. “Based on the court’s ruling. there is simply one type of spouse,” says Todd Solomon, a law partner in the employee-benefits practice group at McDermott Will & Emery in Chicago, who has been tracking same-sex employee benefits for nearly two decades.
But companies that are self-insured, which means they assume the insurance risks for their own employees, a common practice among large companies, aren’t under the same legal constraints. “There is technically no legal requirement that a self-insured company has to include a same-sex spouse,” Mr. Solomon says. As a result, self insurance “is where we are going to see a lot of activity and a lot of litigation.”
Companies should think twice about self-insuring but denying benefits to gay spouses because they will be vulnerable to discrimination suits, he says.
What if an employer has a religious objection to gay marriage?
They have limited options.
Companies could choose not to offer benefits to spouses altogether. Or they could self-insure and attempt to offer benefits to only straight spouses, but they run a high risk of discrimination suits, Mr. Solomon says.
Now that same-sex marriage is legal, will it add a lot of people to employers’ benefits plans? Will this be expensive for employers?
It could, but it depends on what type of plan a company already had.
If a company already covered unmarried same-sex domestic partners, it could be cheaper because covering spouses doesn’t have negative tax implications and is easier to administer than most domestic partnership benefits, Mr. Solomon says.
But if a company only offered spousal benefits, the ruling will add new couples that previously weren't allowed to marry.
Will the Supreme Court ruling lead to fewer employers offering spousal benefits?
Yes—that has been the trend, and the ruling might exacerbate it.
Employers have been cutting spousal benefits to save money, either dropping spousal coverage or imposing surcharges on spouses who can obtain health insurance elsewhere. A survey from consulting firm Mercer of more than 1,100 large employers found that 17% either excluded spouses with other coverage available or imposed a surcharge in 2014, compared with 12% in 2012.
The Supreme Court ruling might spur some employers who were already inclined to cut spousal benefits to do so, Mr. Solomon says.
What are the tax implications?
It equalizes the tax treatment of gay and straight married couples.
Until the ruling, there were a patchwork of state and federal tax laws governing same-sex couples. Employers, depending on the state, sometimes faced additional payroll taxes for same-sex employees, and workers sometimes faced additional income taxes.
Now, for both federal and state tax purposes, companies and employees won't face different tax treatment for gay and straight married couples. That will make benefits easier for companies to administer, Mr. Solomon says.
What does this mean for domestic partnership benefits?
This is a particularly complicated issue for employers.
Over the past decade, a growing number of companies offered “domestic partnership” coverage for gay employees and their partners as a way to provide equal benefits for couples who couldn’t legally wed. Others companies offer coverage more broadly to unmarried domestic partners, regardless of sexual orientation, recognizing that some employees simply prefer not to marry.
Companies that offer unmarried partnership benefits to both gay and straight couples will likely continue to do so.
But companies that offer partnership benefits just to gay couples may begin to phase them out because now all their employees can legally marry. Offering domestic partnership benefits just to gay couples but not straight ones might make firms vulnerable to reverse discrimination lawsuits, lawyers say.
On the other hand, firms may choose to keep domestic partnership benefits to help protect gay employees from discrimination. The majority of U.S. states lack anti-discrimination protection for gay employees, so workers can be fired for their sexuality. Because marriage certificates are public, forcing employees to get married for spousal benefits may end up “outing” an employee, while domestic partnerships are typically private matters, gay advocates say.
12 Ways Your Pet Can Improve Your Mental Health!
Originally posted by Danielle Hark on July 14, 2013 on HuffingtonPost.com.
When I am feeling down and weary, and I can barely lift myself off the couch, my dog comes to my rescue. She cuddles with me, then motivates me to get up, dressed, and out the door for a walk or some play time. Somehow my fur-baby even gets me to smile, no matter how miserable or stressed I feel.
I am not alone. It turns out that all pets, not just therapy pets, can help your mind, body, and spirit.
Here are a dozen reasons why:
1. They get you outside: Sun and fresh air elevate your mood and the sun gives you an extra dose of vitamin D. Vitamin D exposure helps fight physical and mental conditions, including depression, cancer, obesity, and heart attacks. Also, when you go outside with your pet, you are engaging with nature. Try taking a moment to listen to the trees rustling, feel the wind rushing past, and the sun upon your face. The sounds and feeling of nature can be incredibly calming.
2. They get you moving: Walking your dog and engaging in outdoors activities like tossing a Frisbee gives you a natural energy boost, and allows you to let off steam. It also makes you more physically fit, strengthening your muscles and bones, which helps not only your body, but also your self-esteem. Studies have shown that animal owners, both adults and children, have lower blood pressure, as well as lower cholesterol and triglycerides, which may be in part attributed to the more active lifestyle pets promote. Pet owners also have been noted to have better circulation, and a lower risk of experiencing major cardiac issues. And when your body feels stronger, you are less susceptible to mental health issues.
3. They lessen allergies and asthma, and build immunity: This one may sound counterintuitive, but children who grow up in homes with furry friends are actually less likely to develop common allergies. Studies have shown that children who were exposed to two or more dogs or cats as babies were less than half as likely to develop allergies, including dust, grass, ragweed and pet allergies, and were at a lower risk for asthma. Allergies can cause people to become lethargic, apathetic, and suffer from insomnia, which can make them more vulnerable to mental health issues, such as depression.
4. Petting reduces stress: Rhythmic petting or grooming can be comforting to your dog or cat, and you. Concentrate on the texture of his soft fur, the warmth he radiates, and his deep breaths. When you connect with your pet, oxytocin, the hormone related to stress and anxiety relief, is released, helping to reduce blood pressure and lower cortisol levels.
5. They both distract you and keep you present: Being present and engaged with your pet takes your thoughts off of the issues that are plaguing you. When you are fully in the moment, you are not worrying about the past or the future. It's just you and your pet. Another way to keep distracted and present with your furry friend is to take photos or videos of his or her cute antics.
6. They lessen loneliness: If you don't like to be alone, pets can be great domestic companions. Often a pet is very intuitive and will seek you out when you're feeling down, refusing to allow you to remain alone. Just make sure you can fully care for and love a pet before you take her home. Pets should not be used to fill a temporary void and then pushed aside. A dog or cat is a long-term commitment, and it's not always easy, but if you are up to it, they can provide much love through the good times and the bad.
7. They're great listeners: You can talk to your pet about anything -- your day, your hopes, your dreams. You can practice a speech with them, lament about a breakup, or utter truths that you may be afraid to actually share with someone else. A dog or cat can be the perfect "person" to go to when you want to vent without any potential repercussions.
8. They love you unconditionally: Seeing her enthusiasm when you walk in the door can be an instant mood-lifting boost. Her tail wagging, tongue hanging out her mouth making it look like she is smiling, the way her ears perk up. Her grunts or purrs. She doesn't care if you just screwed up a deal at work, or bombed a test, she loves you for being you, whatever that means on any given day. She's just happy to seeyou. She wants to be around you, to love you, and be loved by you.
9. They can lessen your isolation: Dog parks allow for more opportunities for socialization for both your dog and you. Your dog makes friends pretty easily and will break the ice so you can connect with new people, and perhaps set up future dog dates, hikes, or playtimes at local parks. Your little cutie can be an instant conversation starter, and also a good way to get to know some of the people in your neighborhood.
10. They can give you a purpose: Having a pet to care for can give you a feeling of purpose, which can be crucial when you are feeling really down and overwhelmed by negative thoughts. By caring for your pet, or another person or animal in need, you are focusing on something other than yourself and your life. Your good deeds, and your pet's positive response, will give you a feeling of instant gratification.
11. They make you smile: When your dog does cute things like rolling on his back or putting a paw up on your arm, he can make you smile, which in turn triggers neurotransmitters to fire. These pet-time smiles can raise your serotonin and dopamine levels, which are nerve transmitters associated with calmness and happiness.
12. Playing is fun: With the grind of daily life, sometimes we forget to just let loose and have fun. Go ahead; wrestle, play catch, dance together, or just run around and act silly. Your dog will love you for it.
So go have some fun with your pooch or feline friend! Have a ball, with a ball, or anything else, and you will both benefit from the pleasurable together time.
And if you don't have a pet or can't get one right now, you can volunteer at a shelter. There are many animals that can still benefit from your love, and you will feel the benefits, too.
Limited Employer Impact Likely from Gay Marriage Ruling
Originally posted by Joanne Deschenaux on June 26, 2015 on shrm.org.
All 50 states must issue marriage licenses to same-sex couples and must recognize same-sex marriages legally performed out of state, the U.S. Supreme Court ruled June 26, 2015, in a historic victory for gay civil rights (Obergefell v. Hodges, No. 14–556).
“Under the Constitution, same-sex couples seek in marriage the same legal treatment as opposite-sex couples, and it would disparage their choices and diminish their personhood to deny them this right,” Justice Anthony Kennedy wrote for the majority. He was joined by the court’s liberal justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan.
Each of the four conservative justices who dissented from the opinion—Chief Justice John Roberts and justices Antonin Scalia, Clarence Thomas and Samuel Alito—wrote a separate opinion, saying that the court had usurped a power that belongs to the people.
Implications for Employers
The impact of this decision on many employers will be limited, Scott D. Schneider, an attorney in Fisher & Phillips’ New Orleans office, told SHRM Online.
In states where same-sex marriage is currently legal, this ruling will have no effect, he said. But in other states, “employers should sit down and ask, ‘Where do we stand in light of this ruling?’ ”
One area that may be impacted is the granting of leave under the Family and Medical Leave Act (FMLA), Schneider said. “Someone who enters into a same-sex marriage may be entitled to FMLA leave.”
Similarly, employers in states that have not allowed same-sex marriage to date should examine their medical insurance and retirement plans. Same-sex spouses may qualify as beneficiaries under these plans now, where previously they might have been legally excluded from participating.
“The bottom line is that all employer policies related to spouses should apply to same-sex marriages,” according to Nonnie Shivers, an attorney in the Ogletree Deakins Phoenix office. In addition, employers should require the same level and type of proof of a same-sex marriage as they would of any other marriage, she said.
In some ways, this will make things easier for employers, she noted. “They won’t have to try to figure out whether they need to recognize someone’s same-sex marriage performed in another state. Anyone who has entered into a same-sex marriage is protected as a spouse.”
But, as a practical matter, employers should be aware that in states that have not previously allowed same-sex marriage, things are not going to change overnight, Shivers added. “Some county clerks—the ones who issue marriage licenses—have said that they are going to wait to hear about changes from the attorney general,” she said. This means that employers should be somewhat cautious about changing certain policies. For example, if an employer has policies in place regarding domestic partnerships, it may not want to change those policies immediately, she suggested.
And she cautioned that just because the legality of same-sex marriage is now a settled issue, that doesn’t mean that it won’t sometimes be a “hot-button" issue in the workplace. Employers need to be prepared to deal with possible employee reactions—whether based on religious beliefs or other factors—to gay and lesbian employees in the workplace, she said.
Court Finds 14th Amendment Protection
Kentucky, Michigan, Ohio and Tennessee are four of the states that have defined marriage as a union between one man and one woman. Fourteen same-sex couples and two men whose same-sex partners are deceased had filed suits in federal district courts in their home states, claiming that state officials violated the 14th Amendment of the U.S. Constitution by denying them the right to marry or to have their marriages that were lawfully performed in another state given full recognition in their home state. Each district court ruled in the plaintiffs’ favor, but the 6th U.S. Circuit Court of Appeals consolidated the cases and reversed, ruling in favor of the states.
In reversing the 6th Circuit decision, the high court first examined the history of marriage as a union between two persons of the opposite sex, noting that while state officials arguing against same-sex marriage claimed that “it would demean a timeless institution if marriage were extended to same-sex couples,” the plaintiffs “far from seeking to devalue marriage, seek it for themselves because of their respect—and need—for its privileges and responsibilities.”
The court then noted the changes over time in the nature of marriage—such as the decline of arranged marriages and the abandonment of the laws that declared a wife the property of her husband—noting that these changes “have worked deep transformations in the structure of marriage, affecting aspects of marriage once viewed as essential.” These new insights “have strengthened, not weakened, the institution,” the court said.
The opinion next discussed the country’s experience with gay and lesbian rights. Well into the 20th century, many states condemned same-sex intimacy as immoral, the court noted, and homosexuality was treated as an illness. Later in the century, public attitudes shifted, allowing same-sex couples to lead more open lives. Then, questions about the legal treatments of gays and lesbians began reaching the courts, with numerous same-sex marriage cases reaching the federal courts and state supreme courts.
The Supreme Court’s majority opinion now sets forth its holding that the U.S. Constitution requires a state to license a marriage between two people of the same sex and to recognize a same-sex marriage performed out of state.
The court has long held that the right to marry is protected by the 14th Amendment, the opinion noted, and the reasons marriage is fundamental under the Constitution apply with equal force to same-sex couples. “The right to personal choice regarding marriage is inherent in the concept of individual autonomy. This is true for all persons, whatever their sexual orientation.”
Supreme Court's Ruling Means No ACA Compliance Reprieve
Originally posted by Stephen Miller on June 26, 2015 on shrm.org.
In what many are viewing as an anticlimax, the U.S. Supreme Court’s June 25 ruling in King v. Burwell left the status quo in place regarding the Affordable Care Act’s (ACA's) tax-credit subsidies for individual “marketplace” coverage and, indirectly, the employer mandate to provide group health care coverage. Under the ACA, employer penalties are triggered when employees receive insurance tax credits because their employer-provided plan failed to meet ACA coverage specifications.
But health care policy wonks are pointing out what should have been obvious, though it is a lesson that some plan sponsors may have forgotten: As long as the law is the law, it's the law. In other words, some might wish that the courts, Congress or a future administration will alter or rescind the statute. But unless and until that happens, employers should take all necessary steps to maintain compliance with the ACA's coverage and reporting requirements—and not delay doing so in the hopes of a last-minute penalty reprieve.
Ruling's Impact for Employers
In an online commentary posted the day of the ruling, Timothy G. Verrall and Hera S. Arsen, attorneys with law firm Ogletree Deakins, explained that:
Importantly, the Court’s decision does not alter employer responsibilities under the ACA’s “employer mandate” and its related tax reporting obligations. Since the enforcement mechanism behind the employer mandate—tax penalties under Code Section 4980H—are premised on the availability of tax-credit subsidies for exchange coverage, had the Court rejected the IRS’s approach, the “teeth” of the employer mandate would have effectively been removed in the majority of states where federal exchanges operate. However, the Court’s decision affirms the IRS’s regulatory approach, thereby preserving the employer mandate as well.
“This court’s decision confirms the advice we have given since the Affordable Care Act was adopted,” added Joel A. Daniel, the practice group leader for Ogletree Deakin’s employee benefits practice, in the same commentary. “Employers should plan their compliance strategies based on the assumption that the act and the regulations issued under it are here to stay.”
In a similar vein, Shawn Jenkins, CEO of benefits management and administration firm Benefitfocus, commented that the ruling “is another strong indication that ACA is here to stay. The result is more clarity for employers and carriers as to the stability of ACA allowing them to move confidently forward in their benefits planning.”
Driving the point home, the takeaway highlighted in an analysis of the decision by consultancy PricewaterhouseCoopers confirmed that “full on implementation of the ACA may now proceed,” adding:
Employers and insurers are facing the ACA mandates and associated reporting, and must be diligent to gather all the required information and implement the processes and procedures to comply with these requirements and provide the annual forms to individuals and the IRS next January. Planning to avoid the employer mandate penalties, as well as the 2018 tax on high cost plans, will occupy the attention of tax professionals, HR administrators and payroll departments, as well as internal audit and finance.
Many HR benefit managers will consider that an understatement.
Options for Small Businesses
Maintaining the status quo doesn't imply there will be no other ramifications from the ruling beyond affirming the need for vigilant compliance, but the effects will likely be most pronounced on firms that are not subject to the ACA’s “shared responsibility” mandate to provide health coverage.
By upholding premium tax credits to individual policyholders for health care purchased through the ACA’s public exchanges, including the federal Healthcare.gov marketplace, the King ruling makes it more likely that small employers not subject to the coverage mandate (those with fewer than 50 full-time employees or part-time equivalents) will shift away from group coverage.
“Small business owners, who are most affected by increasing premiums, now have the certainty needed to help transition themselves and employees to the individual market, which we expect to increase to more than 100 million by 2025," predicted Zane Benefits, which helps small businesses reimburse employees for individual health insurance plans. “We expect small businesses [not subject to the employer mandate] to continue to offer health benefits to employees in the form of monthly allowances (or ‘stipends’)” in lieu of providing group health coverage.
Not the End of the Story
While it should not deter employers from complying with the act, there could still be some rather significant fixes and adjustments made to the ACA. “Knowing that the ACA will be upheld, one would expect Congress to get more aggressive in working to improve it rather than rescind it,” said Jenkins.
Congress is already moving to pass and send revisions of the law to the president (which he, of course, may veto). These include, as Zane Benefits pointed out, measures to simplify the overly complex employer IRS reporting requirements, and to change the definition of a full-time employee to 40 hours per week (versus the current 30), while at the same time adjusting the definition of large employers to only include employers with 100 or more employees.
Similarly, the ERISA Industry Committee (ERIC), representing benefit plan sponsors, issued a statement contending that while the Supreme Court had removed a source of potential uncertainty with its decision, much legislative work is still needed to fix the underlying law.
“With the legal case settled, Congress should use this opportunity to repeal the burdensome and unnecessary taxes, mandates and reporting requirements imposed by the ACA,” said Annette Guarisco Fildes, president and CEO of ERIC. “Specifically, we want Congress to repeal the 40 percent health care excise tax, the employer mandate and all the related reporting requirements.”
The Society for Human Resource Management (SHRM) also took note that “While [the tax-credit subsidy] provision of the statute remains intact, other challenges in the ACA remain for employers. SHRM pledges to work with policymakers to address these challenges, including the definition of a full-time employee, the pending excise tax on high-value health care plans, and employer flexibility in offering wellness programs.”
Adding to the litany, the Business Roundtable, representing corporate CEOs, released a statement saying that “Moving forward, we believe Congress and the administration should address the problems that still accompany the Affordable Care Act, such as the medical device tax, insurance tax, pharmaceutical tax and the complexity of complying with the regulatory requirements.”
So while the Supreme Court's ruling ends a frontal assault on the act that could have undermined the foundation on which employer penalties rest, legislative skirmishes will continue. But that's no excuse for employers not complying with the ACA as it currently stands.
Final Rule Issued on Summary of Benefits and Coverage
Originally posted by Stephen Miller on June 16, 2015 on shrm.org.
The departments of Health and Human Services, Labor, and the Treasury issued a final rule regarding the health care Summary of Benefits and Coverage (SBC) and uniform glossary that must be provided to employees under the Affordable Care Act (ACA). The new rule was published in the Federal Register on June 16, 2015.
However, revisions to the SBC template and the uniform glossary included with the SBC, along with new coverage examples, are not anticipated to be finalized until January 2016, after the departments complete consumer testing and receive additional input from the public, including the National Association of Insurance Commissioners. The revisions will apply to SBCs for coverage beginning on or after Jan. 1, 2017.
The final regulation make few changes to the rule proposed in December 2014, which itself was a revision to an earlier final rule published in February 2012. However the new rule does include streamlined processes to help health insurance issuers and group health plans provide the required information to employees. For instance, it allows for avoiding unnecessary duplication when a group health plan uses a binding contractual arrangement in which another party assumes responsibility to provide the SBC. The rule also adopts the safe harbor for electronic delivery set forth in earlier FAQs.
“These clarifications will also make it easier for issuers and group health plans to provide the most accurate health coverage information to consumers,” according to a statement from the federal Centers for Medicare and Medicaid Studies, which also posted a fact sheet about the final rule.
SBC Requirements
In commentary on the final rule posted on the Health Affairs blog, Timothy Jost, a professor at the Washington and Lee University School of Law in Lexington, Va., noted that:
• A group health plan or group health insurer must offer participants and beneficiaries an SBC for each benefit package offered by the plan or insurer for which the participant or beneficiary is eligible.
• If the plan or insurer distributes application materials for plan enrollment, the SBC must be provided with the application materials.
• If the plan or insurer does not distribute application materials, the SBC must be provided no later than the first date on which a participant or beneficiary is eligible to enroll.
Under the new rule, health insurance issuers must also provide online access to a copy of the individual coverage policy for each plan or group certificate of coverage. And these documents must be made publicly available to all potential enrollees so that these individuals are clearly informed about what a plan will and will not offer.
“The SBC must include 12 elements under the statute and the 2012 rule,” Jost said. “The final rule does not address most of these elements, although the proposed template did and the final template is likely to do so.”
Also, the ACA requires that SBCs be presented in a uniform format not exceeding four pages in length, with a font size not smaller than 12 points. The federal departments interpreted the four-page requirement to mean four double-sided pages, or eight pages. “The departments indicated they will address the page length issue upon the publication of the final template,” Jost noted.