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

Stepping in New Directions: The Canadian Army’s Observer Program in the Asia-Pacific Region, 1944-45

In early 1944, and in anticipation of a government decision to commit ground forces to the war against Japan, the Canadian army launched a program that sent officers to the Asia-Pacific region to observe Allied operations. The observer program was well underway when, in November 1944, the Canadian government ordered the army to prepare a division to serve under American command in the Pacific theatre. The observer program helped the army deal with two significant challenges: learning how to fight a largely unfamiliar enemy in a tropical environment, and learning how to operate as part of an American force

Three-dimensional laser velocimeter simultaneity detector

A three-dimensional laser Doppler velocimeter has laser optics for a first channel positioned to create a probe volume in space, and laser optics and for second and third channels, respectively, positioned to create entirely overlapping probe volumes in space. The probe volumes and overlap partially in space. The photodetector is positioned to receive light scattered by a particle present in the probe volume, while photodetectors and are positioned to receive light scattered by a particle present in the probe volume. The photodetector for the first channel is directly connected to provide a first channel analog signal to frequency measuring circuits. The first channel is therefore a primary channel for the system. Photodetectors and are respectively connected through a second channel analog signal attenuator to frequency measuring circuits and through a third channel analog signal attenuator to frequency measuring circuits. The second and third channels are secondary channels, with the second and third channels analog signal attenuators and controlled by the first channel measurement burst signal on line. The second and third channels analog signal attenuators and attenuate the second and third channels analog signals only when the measurement burst signal is false

Prospects for weak lensing studies with new radio telescopes

I outline the prospects for performing weak lensing studies with the new generation of radio telescopes that are coming online now and in the future. I include a description of a proposed technique to use polarization observations in radio weak lensing analyses which could prove extremely useful for removing a contaminating signal from intrinsic alignments. Ultimately, the Square Kilometre Array promises to be an exceptional instrument for performing weak lensing studies due to the high resolution, large area surveys which it will perform. In the nearer term, the e-MERLIN instrument in the UK offers the high sensitivity and sub-arcsec resolution required to prove weak lensing techniques in the radio band. I describe the SuperCLASS survey -- a recently accepted e-MERLIN legacy programme which will perform a pioneering radio weak lensing analysis of a supercluster of galaxies.Comment: to appear in the proceedings of the 2012 Moriond cosmology meetin

Gimbaled, partially submerged rocket nozzle Patent

Gimbaled partially submerged nozzle for solid propellant rocket engines for providing directional contro

Postpartum Depression Screening of Women Veterans in Alaska Quality Improvement Project

A Project Submitted in Partial Fulfillment of the Requirements for the Degree of MASTER OF SCIENCE in Nursing SciencePostpartum depression screening guidelines were updated by the American College of Obstetricians and Gynecologists and the United States Preventive Services Task Force in 2015 and 2016, respectively. Universal postpartum depression screening is recommended where previously it was not. Postpartum depression screening is relevant to the rapidly growing population of women Veterans served by the Veterans Health Administration (VA) as part of their comprehensive health care benefits. Little information was available on the postpartum depression screening practices within the Alaska VA Healthcare System. Using a quality improvement methodology, the author identified postpartum depression screening as a topic of interest. Current practice was assessed through a retrospective chart audit of all maternity consults placed during the fiscal year 2014. The chart audit revealed an 81% postpartum depression screening rate. Incomplete data limited a full statistical analysis; however, all women who returned to an Alaska VA clinic, received screening and treatment. An informational brochure was developed for women and their health care providers highlighting postpartum depression screening and treatment resources.Title Page / Abstract / Table of Contents / List of Tables / List of Appendices / Introduction / Purpose / Literature Review / Implications for Nursing Practice / Methods / Results / Discussion / Conclusion / References / Appendice

Simple spectroscope used with solid state image amplifier over wide spectral range

Prism plus image amplifier panel provides visual image of many infrared spectral lines from carbon arc impregnated with metal compound. Different metal compounds generate various desired spectra. Panel also aligns and focuses simple spectroscopes for detecting spectral lines inside and outside visible region

Effect of distributed energy systems on the electricity grid

A feasibility study is being carried out at Ecotricity into a distributed energy storage system comprising Energy stores (batteries) placed at consumer level (in customer’s homes). The aim is to flatten consumer demand and make better use of home-based generation. The Study Group considered the mechanism of connecting batteries to the local distribution system, the ability to meet engineering requirements for the standard of the connection, and the potential impact of large numbers of such connections on stability of the local distribution network. Network and (DC-AC) invertor models were used to examine network connection transients. A statistical model was proposed to estimate the distribution of key electrical parameters to determine the likelihood of engineering standards being exceeded. The Study Group also considered stochastic methods of modelling wind speed, to better understand the requirements for battery energy storage as a complement to wind power

Improved radiographic image amplifier panel

Layered image amplifier for radiographic /X ray and gamma ray/ applications, combines very high radiation sensitivity with fast image buildup and erasure capabilities by adding a layer of material that is both photoconductive and light-emitting to basic image amplifier and cascading this assembly with a modified Thorne panel