The “Principal Purpose” Driven Life: How Hospitals Should Apply ERISA’s Church Plan Exemption After Advocate v. Stapleton

The United States’ health care industry is filled with numerous protections for individuals and entities who have objections based on religious beliefs and moral convictions. For example, there is a long history of conscience protections for individuals that object to performing or assisting in the performance of abortion or sterilization procedures or assisted suicide (including euthanasia or mercy killing). Over time, as more medical entities declare affiliation with religious entities, Congress has expanded conscience protections to cover more than just the daily activities of medical professionals. Generally, churches have to comply with the Employee Retirement Income Security Act (ERISA or the Act) just like any other employer. Yet, Congress provided an exception from ERISA for the administration of “church plans.” This exemption has existed for many years without issue until recently, when this exemption became the subject of increased litigation. ERISA defines “church plan” to apply more broadly than merely to plans covering people who work in houses of worship; schools, nursing homes, and hospitals may also comply if they are controlled or owned by religious entities. Most recently, questions have risen regarding whether the employee pension plans used by religiously-affiliated hospitals have been correctly classified as “church plans” exempt from ERISA. The answers to these questions carry with it large consequences because qualified church plans are excused from certain coverage, vesting, benefit accrual, and funding requirements of ERISA and the Internal Revenue Code (IRC) that otherwise apply to tax-qualified plans. In the 2017 landmark case Advocate Health Care Network v. Stapleton, one question that had long been debated between circuit courts regarding the extent of this exemption was resolved; the Court determined that a plan established and maintained by a church includes a plan maintained by a principal purpose organization. This ruling means that any religiously-controlled entity that manages an employee benefit plan no longer must be created by a religious entity in order to qualify for this exemption. Regardless of how (and by whom) the entity was first established, an organization may still take advantage of this exemption from ERISA as long as the entity is maintained by a principal purpose organization. This Supreme Court ruling is far from a full resolution of the issue. Advocate left a few issues unresolved, such as the definition of “principle purpose organization.” This leaves religiously-affiliated hospitals in a sticky place: unsure if they qualify for—and therefore can rely on—the ERISA church exemption. Since there are many potentially devastating effects on non-qualifying hospitals that mistakenly relied on this exemption, it is important for the qualifying factors to be clear. No longer should religiously-affiliated hospitals seek and rely on non-binding (and sometimes inaccurate) private letter rulings (PLRs) issued by the IRS in order to determine their exemption status. In Part I, this Comment will discuss ERISA’s church plan exemption pre- and post-Advocate. Additionally, it will cover a brief overview of the history of employee benefit plans in the healthcare system and describe the roles of different governmental entities. In Part II, this Comment will discuss the landmark case Advocate v. Stapleton and its impact on the employee benefit industry, and the current status of ERISA’s principal purpose requirement. Last, Part III will suggest a new set of factors that each religiously-controlled hospital and its employee benefit subcommittees can rely on in determining if it meets the “principal purpose” requirement

Understanding the experience of discovering a kindred spirit connection: a phenomenological study

Preliminary existential-hermeneutic phenomenological analysis of data based on 24 protocols, and our own reflexive discussion, reveals how “kindred spirit connections” manifest in myriad elusive, evocative ways. These special connections are experienced variously from briefly felt moments of friendship to enduringly profound body-soul love connections. This paper explicates five intertwined dimensions: shared bonding; the mutual exchange and affirmation of fellowship; the destined meeting or relationship; immediate bodily-felt attraction; and the pervasive presence of love. A wide ranging literature around the theme of love is outlined and the concept of kindred spirit is briefly applied to the psychotherapy practice context

Phenology and Trap Selection of Three Species of \u3ci\u3eHylaeus\u3c/i\u3e (Hymenoptera: Colletidae) in Upper Michigan

Hylaeus basalis, H. ellipticus and H. verticalis nested in wooden traps during a two-year study in Upper Michigan. Bees were given a choice of traps with varying bore diameters, heights, and entrance orientations. Nests were completed between 1 July and 15 September. These three Hylaeus species partitioned available nest site resources (traps) based on diameter and height. H. ellipticus selected traps with smaller bore diameters than did the other two species which selected traps of the same bore diameters. H. verticalis nested in traps at higher locations than H. basalis which limited its nesting to only the two lowest heights available. Entrance orientation had no effect on trap selection by any of the species. Seasonal differences in choice of traps are discussed

The analysis of the emotional reaction of high school girls participating in interscholastic and intermural basketball

Thesis (Ed.M.)--Boston Universit

Opportunity cost and prudentiality : a representative-agent model of futures clearinghouse behavior

Includes bibliographic references (p. 31-38)

Cleaning cooperatively : an analysis of the success and potential of a cooperative business

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2001.Includes bibliographical references (leaves 95-101).In this study, I evaluate a cooperative cleaning business's success in improving employment outcomes for immigrant workers. Cooperative business development is often undertaken as a community economic development strategy that seeks to promote better work experiences for those with limited employment options. The argument that ownership and control in the workplace are key features of such a strategy is superficially easy to accept, but becomes more problematic when trade-offs among goals and outcomes are introduced. To better understand the nature of these trade-offs, I compare employment outcomes and business strategy across four different cleaning companies: a cooperative cleaning business, a maid service franchise, a unionized janitorial firm, and an independent housecleaner. While wages and benefits do not differ substantially across the four cases, cooperatives provide opportunities for training and mobility, control over work and over management of the business, and a sense of satisfaction that are unusual in the cleaning industry and of value to their members. These findings are tempered by the observation that these cleaning cooperatives remain a scattered set of experiments that often must struggle to sustain themselves. Enjoying the benefits of cooperative ownership may require members to sacrifice time and salary, and may in the short-term hamper business growth and profitability. The strategies used by successful cooperative and non-cooperative cleaning businesses provide a useful guide to these businesses as they seek to meet the dual goals of providing better work experiences for their members and successfully competing within the cleaning industry.by Virginia L. Doellgast.M.C.P

MEASURING THE PRIMARY IMPACTS OF SEVERANCE TAXATION: A SPATIAL EQUILIBRIUM APPROACH

A spatial equilibrium model is used to quantify the effects of a severance tax on the Pennsylvania coal market. Two regions are identified: the Pennsylvania Market Area and an import/export region. The impacts on prices and quantities of coal supplied and demanded are found to be small. Little of the tax is exported from Pennsylvania, with a high proportion of the tax being passed back to Pennsylvania coal producers. Although the tax revenue exceeds the welfare losses in Pennsylvania, this result is very sensitive to the magnitude of the Pennsylvania own-price demand elasticity.Public Economics,

Opportunity cost and prudentiality : an analysis of futures clearinghouse behavior

Margin deposits, which serve as collateral to protect the clearinghouse, are typically the most important tool for risk management. The authors develop a model that explains how creating a futures clearinghouse may allow traders simultaneously to reduce both the risk of default and the total amount of margin that members post. Optimal margin levels are determined by the need to balance the deadweight costs of default against the opportunity cost of holding additional margin. Both costs are a consequence of market participants'imperfect access to capital markets. The simultaneous reduction in default risk and in the opportunity cost of margin deposits is possible because the creation of the clearinghouse facilitates multilateral netting. The authors characterize the conditions under which multilateral netting will dominate bilateral netting. They also show that it is credible for the clearinghouse to expel members who default, further reducing the risk of default. Finally, they show that it may (but need not) be optimal for the clearinghouse to monitor the financial condition of its members. If monitoring occurs, it will reduce the amount of margin required, but need not affect the probability of default. The empirical tests run by the authors indicate that the opportunity cost of margin plays an important role in determining margin. The relationship between volatility and margins indicates that participants face an upward-sloping opportunity cost for margin, which appears to more than offset the effects that monitoring and expulsion would be expected to have on margin setting.Environmental Economics&Policies,Banks&Banking Reform,International Terrorism&Counterterrorism,Economic Theory&Research,Insurance&Risk Mitigation