A Reflection on ERISA Claims Administration and the Exhaustion Requirement

This essay, prepared in connection with the Drexel Law Review Symposium, ERISA at 40: What Were They Thinking?, examines ERISA’s regime for administering benefit claims and, in particular, the requirement that participants exhaust their plan’s review procedures before filing suit to recover benefits. Like other key elements of ERISA’s claims regime, the exhaustion requirement is a judicial creation that is not articulated in ERISA’s text. Interestingly, former congressional staffers who attended the Symposium said they assumed participants would be required to exhaust plan review procedures but failed to include such a requirement in the legislation. After reviewing the development of the exhaustion requirement and the debate over its merit as a matter of policy, the essay concludes with an examination of evidence from the text and legislative history of ERISA’s remedial provisions. This evidence suggests that ERISA’s drafters rejected the idea that participants should have to satisfy a prerequisite, such as the exhaustion requirement, before filing suit to enforce benefit rights

The Most Glorious Story of Failure in the Business : The Studebaker-Packard Corporation and the Origins of ERISA

The Studebaker-Packard Corporation occupies a distinctive place in the lore of the Employee Retirement Income Security Act of 1974. No single event is more closely associated with ERISA than the shutdown of the Studebaker plant in South Bend, Indiana. Soon after the plant closed in December 1963, Studebaker terminated the retirement plan for hourly workers, and the plan defaulted on its obligations. The plight of Studebaker employees quickly emerged as a symbol of the need for pension reform. This article examines the history of the Studebaker-Packard Corporation to understand why and how the shutdown came to play a role in the political history of ERISA. Briefly, the shutdown played an important role in pension reform because the United Auto Workers union was prepared to take advantage of the political opportunity the shutdown created. By the time the plant closed, the UAW was well aware that default risk - the risk that a pension plan will terminate without enough funds to meet its obligations - threatened union members. Studebaker-Packard had terminated the retirement plan for employees of the former Packard Motor Car Company in 1958. Packard workers got even less than their counterparts at Studebaker would receive in 1964. The Packard termination convinced UAW president Walter Reuther that the union needed to protect its members from default risk. In the early 1960s, the UAW devised a remedy - a proposal for pension reinsurance - that is a precursor of the termination-insurance program created by Title IV of ERISA. The Studebaker shutdown gave the union an opportunity to move default risk and termination insurance onto the legislative agenda. The success of this effort in agenda-setting indelibly linked Studebaker to the cause of pension reform

IRAS 16293-2422: A very young binary system?

We present 4".5 x 2".5 resolution millimeter wavelength observations of the young far-infrared source IRAS 16293-2422 which resolve the continuum emission into two sources, MM 1 and MM 2. These sources coincide with known radio continuum sources and may constitute a very young binary system with a projected separation of 840 AU. Flux measurements from 18 cm to 25 μm show that the majority of the millimeter wavelength emission arises from dust within 300 AU of the individual central objects. The total dynamical mass of 1.1-1.3 M_⊙, coupled with our mass estimates for MM 1 and MM 2, suggests that the mass in circumstellar material is comparable to that of the central stellar cores. Since the stellar masses are constrained to be ≤ 0.5 M_⊙ each, it is likely that the bolometric luminosity of 30-40 L_⊙ is derived mainly from accretion of the observed circumstellar material. Maps of the J = 2, 3-1, 2 transition of SO obtained simultaneously show that this emission is centered on MM 1, with weaker emission in a clumpy distribution to the east and west. No SO emission is detected toward MM 2, indicating an upper limit to the fractional abundance which is a factor of 10 below that toward MM 1. We propose that the SO emission toward MM 1 is a result of the outflow activity associated with this source and that the outlying emission clumps trace regions of mild interaction between the outflow and the ambient cloud

Biodistribution and PET Imaging of pharmacokinetics of manganese in mice using Manganese-52

<div><p>Manganese is essential to life, and humans typically absorb sufficient quantities of this element from a normal healthy diet; however, chronic, elevated ingestion or inhalation of manganese can be neurotoxic, potentially leading to <i>manganism</i>. Although imaging of large amounts of accumulated Mn(II) is possible by MRI, quantitative measurement of the biodistribution of manganese, particularly at the trace level, can be challenging. In this study, we produced the positron-emitting radionuclide ⁵²Mn (<i>t</i>_<i>1/2</i> = 5.6 d) by proton bombardment (<i>E</i>_<i>p</i><15 MeV) of chromium metal, followed by solid-phase isolation by cation-exchange chromatography. An aqueous solution of [⁵²Mn]MnCl₂ was nebulized into a closed chamber with openings through which mice inhaled the aerosol, and a separate cohort of mice received intravenous (IV) injections of [⁵²Mn]MnCl₂. <i>Ex vivo</i> biodistribution was performed at 1 h and 1 d post-injection/inhalation (p.i.). In both trials, we observed uptake in lungs and thyroid at 1 d p.i. Manganese is known to cross the blood-brain barrier, as confirmed in our studies following IV injection (0.86%ID/g, 1 d p.i.) and following inhalation of aerosol, (0.31%ID/g, 1 d p.i.). Uptake in salivary gland and pancreas were observed at 1 d p.i. (0.5 and 0.8%ID/g), but to a much greater degree from IV injection (6.8 and 10%ID/g). In a separate study, mice received IV injection of an imaging dose of [⁵²Mn]MnCl₂, followed by <i>in vivo</i> imaging by positron emission tomography (PET) and <i>ex vivo</i> biodistribution. The results from this study supported many of the results from the biodistribution-only studies. In this work, we have confirmed results in the literature and contributed new results for the biodistribution of inhaled radiomanganese for several organs. Our results could serve as supporting information for environmental and occupational regulations, for designing PET studies utilizing ⁵²Mn, and/or for predicting the biodistribution of manganese-based MR contrast agents.</p></div

A study of the structure of jet turbulence producing jet noise

Characteristics of turbulent structure of mixing region near outlet of circular subsonic jet and production of jet nois

Predictors of Acute Liver Failure in Patients With Acute Hepatitis A: An Analysis of the 2016-2018 San Diego County Hepatitis A Outbreak.

Background:Between 2016 and 2018, San Diego County experienced a hepatitis A outbreak with a historically high mortality rate (3.4%) that highlighted the need for early recognition of those at risk of developing acute liver failure (ALF). Methods:A retrospective case series of adult hospitalized patients with acute hepatitis A. Results:One hundred six patients with hepatitis A were studied, of whom 11 (10.4%) developed ALF, of whom 7 (6.6%) died. A history of alcohol abuse, hyperbilirubinemia, hypoalbuminemia, hyponatremia, and anemia were associated with increased odds of developing ALF. Initial Maddrey's and Model of End-Stage Liver Disease Sodium (MELD-Na) scores were also associated with the development of ALF. Multivariable analysis showed that a higher initial MELD-Na score (odds ratio [OR], 1.205; 95% confidence interval [CI], 1.018-1.427) and a lower initial serum albumin concentration (OR, 9.35; 95% CI, 1.15-76.9) were associated with increased odds of developing ALF. Combining serum albumin and MELD-Na (SAM; C-statistic, 0.8878; 95% CI, 0.756-0.988) yielded a model that was not better than either serum albumin (C-statistic, 0.852; 95% CI, 0.675-0.976) or MELD-Na (C-statistic, 0.891; 95% CI, 0.784-0.968; P = .841). Finally, positive blood cultures were more common among patients with ALF compared with those without ALF (63.6% vs 4.3%; P &lt; .00001). Conclusions:Hypoalbuminemia was associated with an increased risk of ALF in patients with acute hepatitis A. Positive blood cultures and septic shock as a cause of death were common among patients with ALF. Providers caring for patients with acute hepatitis A should monitor for early signs of sepsis and consider empiric antibiotics, especially in patients presenting with hypoalbuminemia