Beyond Structured Settlements

NAELA 2016 Summit

As a benchmark for planning and/or evaluating 2016 professional association educational conferences, the National Academy of Elder Law Attorneys (NAELA) Second Annual Summit, hosted January 26-27 in Newport Beach, California, established multiple impressive standards.

Organized by Co-Chairs Michael Amoruso and Professor Roberta Flowers into a series of overlapping three-hour Immersion Sessions and one-hour Breakout Sessions, the NAELA Summit fulfilled its promise of "div[ing] deep" into real-life elder law and special needs law case situations and challenging office practices. Designed to support different types of learning, individual sessions were supplemented with workshop documents made available online in advance of the conference.

Approximately 200 NAELA members attended the Summit - including a significant number of first-time NAELA member conference attendees plus an additional 20 sponsoring exhibitors. Combining the old with the new, two of NAELA's original founding members (Michael Gilfix and Vincent Russo) appeared as featured speakers. Networking was encouraged and multiple opportunities were scheduled including a First-Time Attendee Orientation Session.

Featured Summit Sessions

Personality Evaluation - Organizational anthropologist and marketing strategist Kimberly Dodson Gilbey delivered the Summit keynote address titled "How My Communication Style Can Help My Bottom Line." As a keynote supplement, attendees were encouraged to participate in a pre-conference personality type assessment and to wear their resulting "personality type badge" throughout the conference. Combined objectives included: 1) understanding how different personality styles interact in a professional context; 2) recognizing the impact of clients' communication styles; 3) learning to recognize problems resulting from conflicting communication styles; and 4) acquiring skills to address conflicting communication styles.

Technology Training - The NAELA Summit offered three separate technology breakout sessions:

• An iOS clinic led by Scott Grossberg profiling aps specifically recommended for elder law and special needs attorneys.
• A social media introduction by Robin Krooks focused on useful sites, marketing advice and consultative resources.
• An interactive technology clinic organized by Apple representatives to teach Apple technology accessibility features.

Peer Instruction - "Peer Instruction" is an increasingly popular, interactive teaching methodology developed by Harvard Physics Professor Eric Mazur in the 1990s as an alternative to the traditional lecture format. S2KM was introduced to peer instruction by Forge Consulting, a personal injury settlement planning company which utilizes peer instruction to accelerate learning among its new employees. As described on wikipedia, peer instruction is "a student-centered approach that involves flipping the traditional classroom by moving information transfer out and moving information assimilation, or application of learning, into the classroom."

With the exception of Forge Consulting, S2KM had not witnessed or participated in any peer instruction educational exercise prior to the NAELA Summit. Without referencing the term "peer instruction", or consciously utilizing this learning methodology, both of the NAELA Summit Immersion Sessions led by Frank Johns ("Skills and Law When Serving Clients with Diminished Capacity") and Michael and Mark Gilfix ("Advanced Elder Law, Tax, and Estate Planning from Start to Finish, Part 1") represented (from S2KM's perspective) highly successful peer instruction educational prototypes worth additional evaluation and replication by NAELA. Note: S2KM was unable to attend Part 2 of the Advanced Elder Law Immersion Session led by Mark Munson.

Practice Management - Especially useful for the many Summit attendees beginning their elder law and/or special needs practice, NAELA scheduled several sessions addressing practice management topics:

• Michael Weeks - Explaining the Value of Your Fees to Clients.
• Jennifer VanderVeen - Practice Management Idea Sharing.
• Vincent Russo - Staff to Success.
• Shirley Berger Whiteneck - Communicating "Bad News" to Clients.
• Kirsten Davis - Writing Concise Letters.
• Sue Bronson and Michael Kirtland - Dealing with High Conflict Families.

Public Policy - As the professional practice of NAELA members continues to expand beyond traditional elder law to include special needs planning and personal injury settlement planning, NAELA is likewise challenged to expand its public policy focus. NAELA Public Policy Committee Co-Chairs Morris Klein and Jason Frank and Public Policy Manager David Goldfarb provided Summit attendees with an overview of potential legislative and regulatory changes that could affect their professional practice. Although the Special Needs Trust Fairness Act remains NAELA's most important lobbying priority, NAELA has proactively addressed several other public policy issues:

• Submitting comments about proposed FINRA rules relating to financial exploitation of seniors and persons with disabilities.
• Urging CMS to ban pre-dispute arbitration provisions in long-term care facility agreements.
• Recommending expanded Medicare home health coverage for persons with chronic illnesses to the Senate Finance Committee Chronic Care Working Group.
• Highlighting unanticipated harms to care giving spouses that could result from H.R. 1771 - a Bill to amend the Social Security Act to count portions of income from annuities of a community spouse as income available to institutionalized spouses for purposes of eligibility for medical assistance.
• Urging the U.S. Department of Housing and Urban Development (HUD) to issue new guidelines to ensure that HUD rental assistance providers apply consistent rules for Special Needs Trust distributions throughout the U.S.
• Submitting an amici curiae brief (jointly with the Special Needs Alliance and National Housing Law Project) in the United States Court of Appeals for the First Circuit case of Kimberly DeCambre v. Brookline Housing Authority et al. on the issue of "whether 42 U.S.C. Section 1437a as construed by the Department of Housing and Urban Development permits a local housing authority to treat the return of principle from a resident's self-settled special needs trust as "income" for purposes of the Housing Choice Voucher Program."

Special Needs Trusts - As evidenced by separate annual conferences sponsored by Stetson and the University of Texas Law Schools, Special Needs Trusts (SNTs) continue to represent a primary focus of practice for many elder law and special needs attorneys. The NAELA Summit did not overlook this important topic offering the following related presentations:

• Stuart Zimring - Drafting SNTs.
• Patricia Kefalas Dudek - Navigating SNT Trustees Through Rough Waters.

Advanced Elder Law Review - The NAELA Summit was preceded by a two-day advanced Elder and Special Needs Law review course consisting of 14 sessions designed in part to help attendees prepare for the CELA Exam.

As a relatively new addition to professional educational conferences, the NAELA Summit significantly exceeded S2KM's expectations and should become an important educational priority for an increasing number of NAELA members.

For S2KM reporting about prior NAELA conferences as well as conferences sponsored by other professional associations addressing special needs, settlement planning and structured settlement issues, see the structured settlement wiki.

ASNP 2015 Annual Conference

The Academy of Special Needs Planners (ASNP), one of three national associations of special needs attorneys (the others being the National Academy of Elder Law Attorneys (NAELA) and the Special Needs Alliance (SNA), hosted its ninth annual educational conference March 26-28, 2015 in Charlotte, North Carolina.

Special needs attorneys are one of several professional groups who participate in, and are helping to define, the evolving personal injury settlement planning market. Other settlement planning professionals and associations include: structured settlement consultants (SSP and NSSTA); Medicare set-aside professionals (NAMSAP) and life care planners (AANLCP).

Unlike educational programs sponsored by NAELA and SNA, ASNP's annual conferences are open to non-members. ASNP's programs consistently provide superior learning experiences featuring prominent speakers and comprehensive handout materials.

ASNP 2015 SPEAKERS AND TOPICS

• Avram Sacks - "Childhood Disabled Beneficiary Benefits"
• Janet Lowder - "Family Law Issues for a Child or Spouse with Special Needs"
• Thomas Brinker and Vincent Russo - "Tax Traps for Families with Special Needs Children"
• Theresa Varnet and Fredrick Misilo - "SSA's New Trust Guide"
• Larry Rocamora - "Leaving Retirement Benefits to Persons with Special Needs"
• Theresa Varnet and Nancy Chudacoff - "Understanding the ABLE and the Disabled Military Child Protection Act"
• Scott Solkoff and Ann Koerner - "How the Affordable Care Act has Changed Settlement Planning and Special Needs Planning"
• Ask the Experts Panel

Based upon the settlement planning mandate "know your client", which should include your client's legal and financial challenges before, during and following settlement, all of these topics arguably are relevant to settlement planners. Three of ASNP's 2015 educational topics, however, ("SSA's New Trust Guide", "Understanding the ABLE Act" and the "Affordable Care Act") are especially important.

S2KM has reported previously about the ABLE Act as well as the impact of the ACA on structured settlements and settlement planning - including a featured article in the Winter 2014 Journal of Nurse Life Care Planning written by S2KM Managing Director Patrick Hindert titled "How the Affordable Care Act Affects Life Care Planners."

SSA New Trust Guide

Theresa Varnet and Fredrick Misilo's 2015 ASNP presentation about the Social Security Administration's (SSA) new Trust Guide introduced a new settlement planning topic which was repeated with permission and acknowledgments at the SSP 2015 Annual Conference by ASNP National Director Kevin Urbatsch.

The background to the new SSA Trust Guide was a lack of uniformity among SSA Regions especially in reviewing (d)(4)(A) self-settled special needs trusts (SNTs) which are frequently funded with structured settlements as part of personal injury settlement plans. Growing frustrations among SNT stakeholders peaked in May 2012 when the SSA issued a new POMS (SI01120.203b) , without advance notice, creating changes to the "sole benefit rule" resulting in the disqualification of many SNTs.

Note: The Program Operations Manual System (POMS) is "a primary source of information used by Social Security employees to process claims for Social Security benefits."

Responding to complaints from a group of SNT advocates, then SSA Commissioner Michael Astrue initiated a series of meetings in January 2013 between SSA senior staff members and the advocates who had organized themselves into the SSI Advocacy Committee. Many issues/problems were identified and discussed. One result was the new SSA Trust Guide released April 23, 2014 to be used for national SSA trust training and SSA Regional trust evaluation - with the POMS still considered the SSA's primary resource.

Unfortunately, there are some problems with the new SSA Trust Guide - and one of the problems concerns structured settlements. The Trust Guide states that additions to a (d)(4)(A) SNT after age 65 results in disqualification with no mention of the exception that exists in the POMS (SI 01120-203b.1.C) for structured settlements.

NOTE: during the SSP 2015 Annual Conference, NSSTA Executive Director Eric Vaughn identified another problem (d)(4)(A) SNT's funded with structured settlements are experiencing in some states. Although no evidence exists the Deficit Reduction Act of 2005 (DRA) annuity rules are applicable to structured settlements, some state SSA and/or Medicaid employees have attempted to disqualify SNTs if they include structured settlements that violate those rules. For background, see S2KM's 2007 series titled "Inconvenient Questions".

The SSI Advocacy Committee has requested special needs attorneys and other settlement planners to report problems with the SSA Trust Guide to committee members Neil Winston, Mary O'Byrne and/or Theresa Varnet. Although barriers to progress exist, including hostility from the current Congress toward SSI as a welfare dependency and uncertainty whether SSA will continue to meet with advocates, the SSI Advocacy Committee hopes to expand upon its initial success.

ASNP Webinar Series

During the past 18 months, in addition to its annual educational conferences, ASNP has sponsored two separate 12-part webinar series addressing "settlement planning" and "special needs planning". Not only do ASNP's webinars identify topical components of these complex, overlapping professional disciplines, they also raise fundamental questions: what are the similarities and differences between "settlement planning" and "special needs planning"?

Some of the similarities and differences are apparent from the ASNP webinar topics themselves. Others are not.

Settlement Planning vs. Special Needs Planning

Both settlement planning and special needs planning involve disabled clients and require multi-professional teams including special needs attorneys, life care planners, care managers and financial advisors. In addition to personal injury victims, special needs attorneys represent and advise individuals suffering from birth defects and developmental disabilities and their families.

Although special needs attorneys play a variety of roles and provide a variety of products and services, their signature products are special needs trusts (SNTs). For settlement planning, the SNTs are most typically (d)(4)(A) self-settled and pooled trusts. For non-personal injury special needs clients, third party special needs trusts play a more important role.

While many special needs attorney move easily between settlement planning and special needs planning, the financial planning communities for each respective discipline are divided and their products are different. For example: MetLife is an important product provider for both settlement planning (structured settlement annuities) and special needs planning (life insurance; Medicaid annuities). Their respective internal departments, marketing resources and sales forces, however, are completely separate.

Settlement planners (particularly financial planners who sell structured settlements) are one-and-done product providers. They focus on the settlement recipient and how to distribute settlement funds. Their role ends when the settlement occurs. Regardless of discipline, the roles of special needs planners are more diverse (attorney; trustee; guardian); holistic (family and estate planning); and long-term (with settlement planning, for example - continuing well beyond the settlement).

Settlement planning, of course, includes many priority issues which rarely, if ever, occur with non-personal injury special needs planning. For examples: Medicare set-aside arrangements; IRC 468B qualified settlement funds; lien resolutions). Nonetheless, one of the key factors for the successful development of personal injury settlement planning is a better understanding of its relationship with special needs planning. ASNP's webinars and annual conferences provide an excellent continuing resource to accomplish this educational objective.

Links to S2KM reports about prior ASNP conferences: 2014; 2013; 2012; 2011; 2010; 2009; 2008; 2007.

Achieving a Better Life Experience Act (ABLE Act)

Some personal injury victims and their families will have a new tax-preferenced funding option following enactment of the Achieving a Better Life Experience Act (ABLE Act) of 2014 which was signed into law last month by President Barack Obama.

The ABLE Act will allow eligible, disabled individuals and their families to establish ABLE savings accounts with tax-exempt earnings that will not affect their eligibility for SSI, Medicaid and other public benefits. Individuals with $2000 or more in assets currently are not eligible for SSI or Medicaid. Although ABLE accounts may be used to supplement special needs and/or pooled income trusts, their anticipated cost will be considerably less. They will also provide more control for beneficiaries and their families.

Qualification will require proof of onset of a disability prior to age 26. Recipients of SSI and/or SSDI who meet this criteria will be automatically eligible. Non-recipients of SSI and/or SSDI who meet the age 26 criteria must also prove their blindness or disability meets Social Security Act definitions. Treasury Department regulations are expected to provide additional explanations concerning standard of proof and required medical documentation.

The ABLE Act was promoted by numerous disability organizations and advocates including the American Association for People with Disabilities (AAPD). “The ABLE Act unlocks the doors of financial freedom for many Americans with disabilities,” according to Mark Perriello, president and CEO of AAPD. “It allows people with disabilities to start saving for their future.”

ABLE accounts, which will not be available until the Treasury Department publishes regulations, are expected to resemble qualified college savings programs (“529 accounts”) available under IRC section 529 since 1996. Qualifying Individuals will be limited to one ABLE account. Total annual contributions by all individuals (including family and friends) to any one account for each year cannot exceed the gift tax annual exclusion ($14,000 in 2015).

Although ABLE account investment income will be tax exempt, contributors will not receive any tax deductions for their deposits. Similar to (d)(4)(A) special needs trusts, ABLE accounts will be required to repay any funds remaining in the account to the Federal government or the state upon the death of the disabled beneficiary.

Distributions from ABLE accounts must be used for “qualified disability expenses,” including higher education expenses, a primary residence, transportation, obtaining and maintaining employment, and certain other health, wellness and personal support expenses. Any non-qualifying distribution will cause an ABLE account to lose its exempt Medicaid status and subject the account to a 10 percent income tax penalty.

Individual states will be responsible for setting up and managing their own ABLE programs. Individual states will also determine the total amount of lifetime contributions to an ABLE account consistent with their limits for education-related 529 accounts. Many states currently have established 529 account limits of $300,000 or more.

Similar to 529 accounts, states are expected to offer multiple investment options for ABLE accounts. The ABLE Act limits changes to the types of account investments to two times per year. For disabled individuals who receive SSI and/or Medicaid, the ABLE Act imposes additional limitations. If a state decides not to establish an ABLE program, it has the option of contracting with another state to allow qualifying residents the opportunity to open an ABLE account.

It remains to be determined who will promote ABLE accounts and what impact they will have upon various markets including settlement planning, special needs planning and structured settlements. The Congressional Budget Office has estimated the ABLE Act will increase the number of beneficiaries of means-tested programs and federal spending from such programs.

For additional S2KM reporting about settlement planning and government benefits, see the structured settlement wiki.

Government Medicaid Reports

Despite continuing evidence and predictions of expanded enrollment for private health insurance pursuant to the Patient Protection and Affordable Care Act (ACA), Medicaid planning, especially for long-term care costs, continues to represent a settlement priority for many past and present personal injury victims.

Medicaid is a means-tested program jointly funded by the Federal government and the states that provides health insurance to eligible low-income individuals. Each state manages its own Medicaid program with flexibility to determine eligibility and other criteria.

Two recent government reports addressing Medicaid issues should interest settlement planners and structured settlement consultants, as well as special needs and elder law attorneys.

CEA Medicaid Expansion Report

In addition to expanding private health insurance, the ACA also expanded eligibility for Medicaid by offering financial support to states that expand Medicaid eligibility to non-elderly individuals in families with incomes below 133 percent of the Federal Poverty Level. Through 2016, the Federal government has committed to paying participating states 100 percent of the related costs reducing to 90 percent in 2020 and subsequent years.

The U.S. Supreme Court ruled in 2012 that the Federal government could give states a choice to accept Medicaid expansion but could not require them to do so. To date, 26 states and D.C. have expanded Medicaid and 24 states have not. A political battle continues between President Obama's administration and states that have declined to expand Medicaid.

To promote further Medicaid expansion, the Council of Economic Advisers (CEA) published a report this month titled "Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid" (CEA report). The report states that 5.2 million people have gained Medicaid or CHIP coverage in states that have expanded Medicaid. It also cites an Urban Institute estimate that 5.7 million people will be deprived of health insurance coverage in 2016 if the other 24 states do not.

The CEA report concludes: "by expanding their Medicaid programs, States can improve access to essential medical care, reduce financial hardship, improve their citizens' mental health and longevity, and claim billions of dollars in Federal funding that could boost their economies today."

To quantify the benefits of expanded Medicaid to newly insured individuals, the CEA report relies on estimates from the Oregon Health Insurance Experiment (OHIE). The OHIE, which the CEA characterizes as "a unique research opportunity", resulted from Oregon's 2008 decision to allocate Medicaid coverage by lottery.

Acknowledging "[t]he limited sample size of the OHIE makes it more difficult to reach firm conclusions about the effect of Medicaid on objective measures of physical health", the CEA report also relies on parallel research literature that uses "quasi-experiments created by past policy changes."

The CEA report quantifies the following purported benefits for newly insured individuals on a state-by-state basis with supporting maps and tables:

• Improved access to care
• Greater financial security
• Better mental and overall health

In addition, the CEA report utilizes data from the Congressional Budget Office and Urban Institute to quantify the following projected benefits of expanding Medicaid for state economies with supporting state-specific maps and tables:

• Additional Federal funds
• Increased employment
• Greater overall economic activity

CEA Report Criticism

Perhaps predictably, given the political debate that surrounds the ACA and Medicaid expansion, many commentators have criticized the CEA report. One example is Robert Samuelson, whose op-ed titled "The Real Medicaid Problem" appeared in the July 14, 2014 issue of the Washington Post.

Samuelson questions whether the promised 90 percent Federal reimbursement rate will remain permanent. He quotes Matt Salo of the National Association of Medicaid Directors: “The ACA says what it says. Future Congresses can repeal or modify it.”

Samuelson also points out how demographic trends ("ignored by the [CEA] report") could become a financial albatross for the states. As one result of rising Medicaid costs, according to Samuelson, "[t]he competition between nursing homes and home health care — on the one hand — and classroom teachers, higher education, police and other governmental services — on the other — will intensify."

In a similar critique, a July 11, 2014 Wall Street Journal article , written by Chris Jacobs and titled "Why States are Hesitating to Expand Medicaid", highlights a recent study of "State Healthcare Spending on Medicaid" sponsored by the Pew Charitable Trusts and findings by the Commerce Department’s Bureau of Economic Development to explain why many states have not rushed to expand Medicaid.

For a state-specific example (Virginia) of opposing political viewpoints concerning Medicaid expansion, compare this July 11, 2014 Wall Street Journal op-ed by Fred Barnes with this July 11, 2014 Washington Post editorial.

GAO Medicaid Report

The Government Accountability Office (GAO) has also published a recent Medicaid report titled "Medicaid: Financial Characteristics of Approved Applicants and Methods Used to Reduce Assets to Qualify for Nursing Home Coverage" which may prove cause for concern among special needs and elder law attorneys.

As justification for its study, which was requested by Senators Tom Coburn (R-OK) and Richard Burr (R-NC) and Representatives Darrell Issa (R-CA) and Trey Gowdy (R-SC), the GAO points out:

• "Medicaid paid for nearly one-third of the nation’s $158 billion in nursing home expenditures in 2012"; and
• Many individuals utilize various planning techniques to reduce their assets and qualify for Medicaid - despite continuing efforts by Congress to discourage such activity and to address financial eligibility requirements for Medicaid coverage of nursing home care. See, for example "The Deficit Reduction Act of 2005".

Historically, many special needs and elder law attorneys have devised these asset reduction techniques and advised their clients when and how to utilize them.

In responding to the Congressional request for information about the extent of asset reduction techniques to qualify for Medicaid nursing home coverage, the GAO report:

• Examined financial characteristics of applicants approved for Medicaid nursing home coverage in selected states; and
• Identified methods used to reduce countable assets to qualify for Medicaid as well as information state Medicaid workers consider most useful in assessing an applicants’ financial eligibility.

Among its findings, the GAO report identifies four main methods used by applicants to reduce their countable assets (income and resources) and qualify for Medicaid coverage:

• "Spending countable resources on goods and services that are not countable towards financial eligibility, such as prepaid funeral arrangements;
• "Converting countable resources into noncountable resources that generate an income stream for the applicant, such as an annuity or promissory note;
• "Giving away countable assets as a gift to another individual—such gifts could lead to a penalty period that delays Medicaid nursing home coverage; and
• "For married applicants, increasing the amount of assets a spouse remaining in the community can retain, such as through the purchase of an annuity."

NAELA Response

Promising a thorough analysis of the GAO report, the National Academy of Elder Law Attorneys (NAELA) has responded with a press release recommending the GAO report as "a starting point for an urgent review of the long-term crises that millions of Americans and their families are facing."

The GAO report, according to NAELA, "highlights the impact of a public policy that requires persons needing long-term services and supports for chronic diseases such as dementia, ALS, and Parkinson's to impoverish themselves to be eligible for treatment under Medicaid while those with heart disease and more acute maladies receive health care coverage through Medicare."

For additional NAELA resources addressing long-term care and Medicaid, see:

• NAELA position paper
• "Myths and Realities about Medicaid Planning"

For additional S2KM reporting about Medicaid and the ACA, see the structured settlement wiki.

 

ACA and Future Medical Expenses - 2

The Affordable Care Act (ACA) refers to two controversial laws enacted in March 2010, the Patient Protection and Affordable Care Act and the Health Care Education and Reconciliation Act, which restructure the fundamental relationship among government, health care providers and health care recipients and profoundly impact persons with disabilities.

Although legal challenges, political debate and disputes about future insurance premiums and health care costs continue, the Supreme Court upheld almost all of the ACA's provisions in June 2012, including the individual mandate and elimination of pre-existing condition restrictions, which became effective nationally on January 1, 2014.

With the ACA's primary constitutional framework now largely operational, various "experts"  increasingly are discussing and debating what impact the ACA will have upon future medical expenses in personal injury cases - as well as its related impact on structured settlements.

In a prior blog post, S2KM re-introduced these issues by summarizing an article written by Seth Cardeli, titled "Thwart the Assault on Future Medical Expenses", which appeared in the May 2014 issue of the American Association for Justice (AAJ) Trial Magazine.

The new and evolving legal construct for future medical expenses in personal injury cases created by the ACA is complicated, controversial and important. Continuing discussions and analysis should not proceed within an intellectual vacuum. In additional to the ACA, related laws and legal developments such as Medicaid (including the Bipartisan Budget Act of 2013), Medicare (including WCMSAs , liability MSAs and MMSEA) and/or state specific collateral source and subrogation rules must be considered.

This blog post summarizes ACA-related analysis by speakers at professional conferences S2KM has previously attended and includes excerpts from prior S2KM reviews of those conferences. The purpose is to provide a point of reference for future S2KM reporting about the legal interplay involving the ACA, personal injury cases and structured settlements. A subsequent blog post (ACA and Future Medical Expenses - 3) will summarize similar ACA analysis from articles and papers previously reviewed by S2KM.

Conference Speakers Addressing ACA Issues

Academy of Special Needs Planners (ASNP) - Among the professional association conferences S2KM has attended since 2010, the ASNP has provided the most consistent and comprehensive ACA reporting.

Cynthia Barrett - During the 2011 ASNP Annual Conference, Cynthia Barrett highlighted the following questions she anticipated plaintiff attorneys would most likely ask about health care reform and the ACA on behalf of their personal injury clients:

• Will my disabled client be able to get health insurance now?
• For settlement purposes, can future medicals be reduced to estimated lifetime insurance premiums until my client becomes eligible for Medicare or Medicaid?
• Do private health plans have “set-aside” or special needs trust requirements?
• If my client can get private health coverage, will he/she still need public benefits?
• If my client can obtain private health insurance, why do I need a special needs attorney or a special needs trust?
• As a plaintiff attorney, is there anything else I need to know about health care reform or related legislation?
• Barrett also advised special needs attorneys to:
  • Exclude from their services health coverage options advice;
  • Screen claimants to determine whether needs-based Medicaid will be important.

David Lillesand - Based upon his experience in Florida, where the Affordable Care Act (ACA) prohibition against pre-existing exclusions already existed in 2010, David Lillesand offered the following preliminary observations during the ASNP 2012 Annual Conference:

• The need for self-settled (first party) special needs trusts has decreased (except when a beneficiary requires long term institutional care) because the ACA provides better insurance options than Medicaid for many persons with pre-existing medical conditions including personal injury victims.
• Existing self-settled (first party) special needs trusts should be reviewed, in the context of the ACA's prohibition against pre-existing condition exclusions and available medical insurance options, and in many cases terminated.
• Damages for future medical costs in personal injury lawsuits could be reduced assuming the premium costs of newly available insurance premiums become admissible in proving and/or defending damages.

ASNP 2013 Annual Conference

Scott Solkoff - Continuing its analysis of the ACA, the ASNP 2013 Annual Conference featured Scott Solkoff who predicted:

• Reduced personal injury verdicts and settlements.
• A different calculus for determining future medical damages based upon health insurance costs.
• Fewer first party special needs trusts (SNTs).
• Reduced demand for Medicare and Medicaid for persons with disabilities under age 65.
• New opportunities for special needs attorneys because of the complexity of the ACA.

Social Security Administration Representatives - During a subsequent question and answer session at the ASNP 2013 Annual Conference, moderated by Kevin Urbatsch and featuring representatives of the Social Security Administration, the following exchange occurred:

• Question: will the SSA allow early termination of SNTs to comply with ACA?
• SSA Answer: right now, any early termination of a SNT will require payment of reversionary interest.

ASNP 2014 Annual Conference

The ASNP 2014 Annual Conference expanded previous ASNP educational programs about the ACA and coincided with news the ACA had exceeded enrollment expectations and achieved its primary objective of substantially expanding healthcare in America.

ASNP's 2014 conference featured two ACA presentations:

• A multi-professional "ACA Panel" consisting of: David Lillesand (attorney); Ann Koerner (life care planner); and Scott McDonald (investment adviser).
• "Special Needs Trust (SNT) Taxation" discussion by Bradley Frigon - focusing on strategies for maximizing health care coverage and minimizing costs.

Both of ASNP's 2014 ACA presentations highlighted the importance of health insurance education and the need for health insurance expertise as part of the settlement planning and/or special needs planning team. Some of the ACA resources and issues addressed:

• ACA's definition of "health insurance" - 10 key requirements.
• The ACA's definition of "modified adjusted gross income" (MAGI) - to determine eligibility for ACA premium tax credits and Medicaid expansion.
• Calulating MAGI - and whether structured settlements are included or excluded.
• ACA assessment questions - and how they expand "needs analysis".
• ACA flowchart - for determining the proper plan under the ACA.
• When to use a SNT vs. purchasing ACA insurance - four alternative strategies.
• Defining the settlement planning process.
• ACA's financial impact on settlement planning.
• Lump sums vs. structured settlements under the ACA.
• Coverage comparisons - based upon types of provider networks, services and authorization requirements.
• Coverage gaps - in states that do not adopt Medicaid expansion.

NAELA and SSP 2014 Annual Conferences

With permission from ASNP and acknowledgments to David Lillesand, Kevin Urbatsch, National Director of ASNP and 2014 Editor-in-Chief of the "NAELA Journal' repeated for both the National Academy of Elder Law Attorneys (NAELA) 2014 Annual Conference and the Society of Settlement Planners (SSP) 2014 Annual Conference substantial portions of ASNP's 2014 ACA Panel summarized above.

In addition, NAELA awarded its 2014 John Regan Writing Award, honoring the authors of the best article published in the "NAELA Journal" during the past year to Alfred Chiplin, Jr. and Bethany Lilly, for their article titled "Medicare’s Future: Letting the Affordable Care Act Work, While Learning From the Past" analyzing various ACA cost-saving components on Medicare.

NAMSAP 2014 Conferences

Roy Franco, a featured speaker at the National Alliance of Medicare Set-Aside Professionals (NAMSAP) 2014 Regional Conference, addressed the settlement planning changes likely to result from the Bipartisan Budget Act of 2013, implementation of the ACA and anticipated CMS rules for liability MSAs.

Franco predicted "workers' compensation, liability and no-fault insurers will all become primary payers vis a vis Medicare, Medicaid and ACA health providers" as part of integrated settlement planning models similar to WCMSAs. He added, however, that different state-specific models may develop as state Medicaid agencies begin responding October 1, 2014 to the new Medicaid reimbursement rules promulgated by the Budget Act of 2013.

Medicare Set-Aside Arrangements (MSAs) represent one strategic link between Medicare cost savings and future medical costs in both workers compensation and personal injury cases as well as the primary defining topic of every NAMSAP educational conference including NAMSAP's 2014 Annual Meeting.

The Center for Medicare & Medicaid Services (CMS) has calculated WCMSA amounts totaling approximately $1.8 billion in FY 2013. CMS published a WCMSA Reference Guide (WCRG) on March 29, 2013 plus a WCRG Version 2.0 on November 7, 2013. The WCRG's intended purpose: to help WCMSA professionals, beneficiaries and other stakeholders "understand CMS' [WCMSA] amount approval process and to serve as a reference for those electing to submit such proposals to CMS for approval."

Both the CMS policy memoranda and the WCRG address structured settlement issues and provide guidelines for their utilization in funding WCMSAs. WCMSAs represent one of the few submarkets where structured settlements sales have increased since 2008 - in large part because the method CMS requires for calculating WCMSA present values provides an inherent cost advantage for annuities compared with lump sum alternatives.

CMS has not yet published definitive rules for using MSAs in liability cases (LMSAs). CMS did publish an Advanced Notice for Proposed Rule Making (ANPRM) on June 14, 2012 in the Federal Register which included seven different option to satisfy obligations for future medicals in liability cases. CMS also published RIN: 0938-AR43 in Spring of 2013 outlining a timetable for the proposed rule. No such LMSA rule, however, has yet been published.

For S2KM's complete reporting about the ACA and structured settlements, see the structured settlement wiki.

S2P2J Release 55

Publisher Law Journal Press anticipates a Spring 2014 distribution date for hard copy supplements for Release 55 of "Structured Settlements and Periodic Payment Judgments" (S2P2J) with online S2P2J subscribers receiving their update automatically and simultaneously. Online S2P2J includes a search feature and download capability as well as link features to access individual book sections, appendices, footnotes, cases and statutes.

First published in 1986 and updated semi-annually, S2P2J is co-authored by Daniel W. Hindert, Joseph J. Dehner and Patrick J. Hindert (S2KM's Managing Director). Both the National Structured Settlement Trade Association (NSSTA) and the Society of Settlement Planners (SSP) have utilized S2P2J as an educational resource for their certification programs.

Release 55 Highlights - Release 55 will feature new, updated and/or expanded sections for the following topics:

• Risks of using off-shore companies and re-cycled structured settlements to fund qualified assignments.
• Meeting professional responsibilities for product disclosures.
• Subrogation rights impacting structured settlements.
• Choice of law provisions for attorney compensation.
• Medicaid liens and the 2013 Bipartisan Budget Act.
• How the Brenston case impacts transfer applications.
• Document drafting and anti-assignment restrictions.
• Vermont's structured settlement protection act amendments.

Meta Structured Settlement Themes

Reviewing S2P2J Release 55 and other recent S2P2J highlights, S2KM notes two related structured settlement meta themes:

• Transformational market developments.
• Changing roles, responsibilities and work product.

Transformational Market Developments

A growing dichotomy exists between stagnant primary market sales and multiple, ongoing transformational developments impacting the structured settlement market - the most significant of which are addressed in S2P2J Chapter 15 ("Government Benefits and Structured Settlements") and Chapter 16 ("Transfers of Structured Settlement Payment Rights").

Supplemental resources - structured settlement market developments:

• Recent and upcoming structured settlement, settlement planning and special needs educational conferences.
• S2KM's 2013 structured settlement industry reports:
  • Part 1 - Primary market
  • Part 2 - Settlement planning
  • Part 3 - Secondary market
  • Part 4 - ELNY and Reliance
• S2KM's 2014 structured settlement market updates:
  • Primary market
  • Secondary market

Changing Roles, Responsibilities and Work Product

The transformational market developments outlined above are causing and requiring significant changes to structured settlement roles, responsibilities and work product.

These changes feature more prominent roles for new professional stakeholders (settlement planners, special needs planners, settlement trustees, lien resolution specialists, damage allocators, factoring companies, secondary market brokers and attorneys) as well as adjustments for traditional professional stakeholders (defense and plaintiff attorneys, defendants and liability insurers, structured settlement consultants and annuity providers, judges, mediators, and guardians).

Defense and Plaintiff Attorneys

The original S2P2J publication (1986) included comprehensive chapters detailing respectively the roles and responsibilities of defense attorneys (Chapter 4) and plaintiff attorneys (Chapter 5) in structured settlements. These chapters continue to be updated reflecting new legislative and regulatory developments as well as changing business models and practices.

Release 54, for example, substantially expanded and re-organized S2P2J's coverage of defendant structured settlement disclosure issues. Release 55 enumerates a list of "best practices" for defense attorneys and includes a new structured settlement Appendix document to disclose material information about the costs, commissions and other elements of case specific funding. Release 55 also identifies and summarizes new structured settlement case law related to plaintiff attorney settlement planning, compensation and document drafting responsibilities.

Structured Settlement Consultants

Release 54 expanded and updated S2P2J's existing coverage (Section 6.02) of structured settlement consultants to address: consultant selection criteria; structured settlement product suitability; and consultant business practice issues including laws and regulations, industry standards, commission disputes, privacy rules, and disclosure and representation requirements.

Release 55 adds, as a new Appendix document, the SSP "Standards of Professional Conduct for Settlement Planners" which SSP describes as "rules of reason ... intended to impose high standards on professional settlement planners" including structured settlement consultants.

S2KM's recent summary of the AAJ 2014 Winter Meeting highlighted continuing concerns about structured settlement business standards and practices including:

• Questions about product suitability, disclosure standards and informed consent in the context of expanding structured settlement product and service offerings.
• Misrepresentations in structured settlement sales materials plus a general failure of these same sales materials to provide any information about the transfer issues.

Judges Reviewing Transfer Applications

The recent Settlement Planning v. Brenston and Sanders v. JGWPT Holdings cases highlight changing standards for judicial review of anti-assignment restrictions. S2P2J Chapter 16 ("Transfers of Structured Settlement Payment Rights") already includes an entire section discussing "Judicial Review of Transfer Applications" plus detailed analysis of structured settlement anti-assignment restrictions (Sections 16.02[2][c] and [d] and 16.05[4][c]).

Release 55 expands S2P2J's anti-assignment analysis concluding that recent court decisions "should cause judges reviewing transfer petitions to require the full text of structured settlement documentation to see if an anti-assignment provision is present. Without such information, transfer approvals are subject to being found to be void ab initio and thus open to invalidation at any time."

S2P2J also features, as an Appendix document, NSSTA's Annotated and Non-annotated Model Qualified Assignment and Release Agreement. NSSTA's Model Agreement includes recommended language (Paragraph 7 - "Acceleration, Transfer of Payment Rights") for addressing anti-assignment issues in the context of IRC Section 5891 and the state structured settlement protection acts.

Sanders v. JGWPT Holdings

A new Class Action lawsuit has escalated the legal battle in Illinois concerning the impact of "anti-assignment" restrictions on transfers of structured settlement payment rights.

In the lawsuit, Plaintiff Valerio Sanders seeks to represent the following class: "Those individuals who sold part or all of their structured settlement annuities under the provisions of the Illinois [Structured] Settlement Protection Act, where the original structured settlement contract contained a valid and enforceable anti-assignment clause."

Filed February 11, 2014 in the Twentieth Judicial Circuit Court St. Clair County, Illinois, the Class Action Complaint accuses Defendants JGWPT Holdings, Inc., several affiliate companies including J.G. Wentworth and Peachtree Settlement Funding (JGWPT entities), and Illinois attorney Brian P. Mack of violating the Illinois Consumer Fraud and Deceptive Business Practice Act (ICFA).

The Class Action Complaint alleges "the JGWPT entities ... intentionally failed to inform potential sellers that a valid and enforceable anti-assignment clause prohibited the sale of deferred payment annuities because the JGWPT entity intended to defraud the seller and the Illinois courts by filing false pleadings under the Illinois [Structured] Settlement Protection Act in order to obtain large amounts of deferred cash payments for discounted present lump sum amounts and reap the tax benefits of the same in violation of federal law."

Section 2 of the ICFA provides in part: "[U]nfair or deceptive acts or practices, including but not limited to the use or employment of any deception, fraud, false pretense, false promise, misrepresentation, or the concealment, suppression of omission of any material fact .... in the conduct of any trade or commerce are hereby declared unlawful ..."

The Class Action Complaint alleges Defendants used their advertising and solicitations to cause Plaintiff Valerio Sanders and other sellers to believe they could obtain cash for their structured settlement payment rights, "but intentionally failed to inform the potential sellers that if there was a valid and enforceable anti-assignment clause in the settlement contract, no lump sum payment could be received in exchange for the seller assignment the deferred payments because any such "order" issued by an Illinois court approving such a transfer would be void. Moreover, the legal proceeding would violate federal law."

The Class Action Complaint further alleges:

• When a potential seller had a valid and enforceable anti-assignment clause, the JGWPT entities would routinely hire Brian P. Mack to obtain a "Qualified Order" pursuant to the Illinois Structured Settlement Protection Act so that the deferred payments could be purchased at a deeply discounted rate, and without any tax consequences.
• Attorney Mack "would personally counsel the seller ... on how to create Illinois jurisdiction and venue, how to find a 'friendly court', how to avoid appearing in court, how to obtain the services of 'independent counsel', ..... or inform them they could waive the right, and how to finalize the details to obtain the lump sum payment."
• Valerio Sanders' "Settlement Agreement and Release" included an anti-assignment clause which provided: "The periodic payments to be received by the Payee(s) pursuant to paragraphs 2B are not subject in any manner to anticipation, alienation, sale or transfer, assignment, pledge or encumbrance by Payee(s)."
• The Petition filed by Mack claimed: "That the assignment does not contravene any federal or state statutes or the order of any court or responsible administrative authority."
• "Mack knew that this allegation was false and misleading as Plaintiff's settlement contract had a valid and enforceable anti-assignment clause."
• "....[F]ailure to inform Plaintiff that the order obtained from the court was in violation of Illinois and federal law was fraudulent and a material omission under the ICFA and a violation of the ICFA."
• In a subsequent transfer involving Plaintiff Sanders and the Defendants, Mack's representation that jurisdiction and venue were proper was also a fraudulent misrepresentation because the action was filed in Madison County and the Plaintiff never lived in Madison County and the underlying action did not accrue there.
• Plaintiff and putative class members relied on materials misrepresentations made by JGWPT entities and attorney Mack and sold payment rights under circumstances where the sale was contrary to Illinois law as well as the laws of various other states, "thus rendering the alleged transfers void, and were a fraud on the Internal Revenue Service of the United States government under 26 U.S. Code section 130."

The Complaint requests the court for an Order awarding both Plaintiff Sanders and the Class compensatory and punitive damages plus injunctive relief against Defendants to prohibit them from continuing to defraud the Class and the courts of Illinois plus attorney fees and costs.

Brenston Case

To support their legal arguments in the Sanders Class Action, Plaintiff attorneys: Cates Mahoney, LLC and Brad L. Badgley, P.C. cite six Illinois Appellate Court decisions (including Settlement Funding v. Cathy Brenston) upholding the enforceability of an anti-assignment clause in a structured settlement contract. The Complaint alleges Mack was attorney of record in Brenston plus three of the additional cited cases.

In Brenston, an Illinois 5th District panel, sitting for the 4th District Illinois Court of Appeals, held that an Illinois state court, which had previously approved transfers requested by Brenston:

• Had a duty to enforce anti-assignment provisions in Brenston's original structured settlement documentation; and
• Had no authority under the Illinois protection act to approve the transfer petitions - even though all of the relevant parties had waived the anti-assignment provisions.

The Illinois Supreme Court subsequently denied Peachtree's petition for appeal of this decision leaving both primary and secondary structured settlement market participants uncertain about the case's precedential meaning and scope. In an Amicus curiae brief, NASP asserted the Appellate Court decision could render the Illinois transfer statute "a practical nullity"

A companion case involving Peachtree and Brenston remains on appeal in the 3rd District Illinois Court of Appeals and will be argued February 27, 2014. The parties had previously stayed their appeal waiting for the Illinois Supreme Court to rule on the 4th District case.

In a recent Florida case, summarized in this Drinker Biddle Structured Settlement Alert, a Sumter County Circuit Court Judge cited the Brenston case as authority in ruling that an April 2011 transfer order was void ab initio, and that resulting arbitration awards were “impotent and without substance.”

For additional recent developments impacting the structured settlement secondary market, see:

• Structured Settlements 2013 - Secondary Market
• Secondary Market Update

Brenston Appeal Denied

The Illinois Supreme Court has denied Peachtree Settlement Funding's petition for appeal of the 4th District Illinois Court of Appeals' decision in the Settlement Funding v. Cathy Brenston case.

The earlier Court of Appeals decision held the Illinois state court, which had previously approved transfers requested by Brenston:

• Had a duty to enforce anti-assignment provisions in Brenston's original structured settlement documentation; and
• “[The transfer court] had no authority under the Act to approve” the transfer petitions - even though all of the relevant parties had waived the anti-assignment provisions.

In other words, despite the existence of the Illinois transfer statute, the Appellate decision declared court orders approving assignments to be "void ab initio", as a matter of Illinois law, whenever structured settlement documentation purports to limit assignability.

For additional information about structured settlements and anti-assignment provisions, see S2KM's prior blog post "Anti-Assignment Restrictions".

Case Background

• Cathy Brenston resolved a medical malpractice case against the University of Illinois Board of Trustees in 2003 with a structured settlement.
• Subsequent to her settlement, Brenston completed multiple factoring transactions with Peachtree Settlement Funding (Peachtree) all of which were approved by Illinois Circuit Courts (Sangamon and Peoria Counties) in accordance with the Illinois transfer statute.
• All transactions were closed and funded. Brenston was paid. The structured settlement obligors and annuity issuers acknowledged and implemented the court orders.
• Brenston filed lawsuits in Cook County in 2011 to void the prior transfer orders arguing anti-assignment clauses in the settlement agreement and the qualified assignment agreements prevented the transfer courts from exercising jurisdiction. The defendants included:
  • Peachtree
  • Peachtree's transfer lawyer
  • Brenston's transfer counsel
  • The structured settlement obligors and annuity issuers
  • The defendant in the original lawsuit
• After Peachtree invoked an arbitration clause, Brenston re-filed the lawsuits in Sangamon and Peoria Counties where Peachtree moved to dismiss the petitions on the grounds that:
  • The transfer courts had subject matter jurisdiction to enter the orders;
  • Brenston has already received the financial benefits of the orders;
  • Brenston provided no reason to vacate said orders; and
  • The statute of limitations had expired.
• The trial court granted Peachtree's motions to dismiss and denied Brenston's motions to reconsider and motions for leave to file an amended petition.
• Brenston appealed arguing the Sangamon and Peoria County courts erred in dismissing her petitions where the pleadings sufficiently showed that the orders approving the transfers were obtained by fraud, and therefore void ab initio and subject to challenge at any time.
• An Illinois 5th District panel, sitting for the 4th District Illinois Court of Appeals, agreed with Brenston's argument and issued its decision - even though Peachtree and Brenston had:
  • Settled the case prior to the Appellate Court's decision; and
  • Filed motions to stay the Appeal.

Appellate Court Holdings

• Brenston's underlying settlement agreement contained an unambiguous, enforceable anti-assignment restriction.
• The transfer court had a duty to enforce that provision and "had no authority" under the Illinois transfer statute to approve the proposed transfers.
• The proposed transfers were improperly filed in Sangamon and Peoria Counties instead of Cook County where Brenston resided.
• Brenston's transfer orders are "void ab initio" because:
  • Peachtree did not file all settlement documents with the transfer court.
  • Peachtree concealed "by omission" the existence of the anti-assignment provision which "omission was material".
  • The conduct of Peachtree and it's attorney amounted to an "affirmative falsehood and a fraud upon the trial court".

Impact of Brenston

• An Amicus curiae brief filed by the National Association of Settlement Purchasers (NASP) states that the Appellate Court decision will render the Illinois transfer statute "a practical nullity".
• "Without the certainty and finality of a court order, there is no viable secondary market," the NASP brief states. "Because every structured settlement contains boilerplate language that purports to limit or restrict assignability, every Illinois court approved transfer could be subject to challenge at any time."

S2KM thanks NASP Executive Director Earl Nesbitt and NASP President Patricia LaBorde for their insights concerning the Brenston case and for granting S2KM permission to utilize materials from Nesbitt's 2013 NASP Annual Conference Litigation Update.

S2KM will continue reporting Brenston case developments including whether and how NASP and the National Structured Settlement Trade Association (NSSTA) will respond.

For S2KM's complete reporting about the structured settlement secondary market, see the structured settlement wiki.

Anti-Assignment Restrictions

Structured settlement transfers require that payment rights be assignable. Otherwise, transfer (factoring) companies have no direct right against the structured settlement obligor or annuity issuer.

Prior to enactment of IRC 5891 and the state protection acts, the validity and enforceability of structured settlement transfers typically depended upon three basic issues:

• Did the structured settlement documentation clearly forbid assignments?
• If yes did state law override the anti-assignment provision?
• Or, did the parties to the structured settlement waive the anti-assignment provision?

Although IRC 5891 and state structured settlement protection acts set forth procedures and conditions allowing transfers of structured settlement payment rights, courts continue to enforce anti-assignment restrictions when parties to the original structured settlement object.

Most transfer courts, however, have held that the anti-assignment restrictions are not self-executing and have granted transfers when no one objects. Objections to transfers by obligors and annuity issuers have become increasingly rare since the enactment of IRC 5891 and the state protection acts.

The Brenston Case

Settlement Funding v. Cathy Brenston represents a high profile and controversial case where an Illinois Appellate Court overruled prior state court approval of structured settlement transfers based upon anti-assignment restrictions - even though the parties to the original structured settlement waived the anti-assignment provisions. The case currently is subject to a petition for review by the Illinois Supreme Court.

In the Brenston case, an Illinois 5th District panel, sitting for the 4th District Illinois Court of Appeals, determined Brenston’s settlement agreement contained an enforceable anti-assignment provision. As a result, the panel decided the state court, which had previously approved requested transfers, had a duty to enforce the anti-assignment provision and “it had no authority under the Act to approve” the transfer petitions.

In other words, despite the existence of the Illinois transfer statute, the Appellate panel declared court orders approving assignments to be "void ab initio", as a matter of Illinois law, whenever structured settlement documentation purports to limit assignability.

If the Illinois Supreme Court upholds the Brenston appellate decision, or decides not to review it, the case would render the Illinois transfer statute "a practical nullity", according to an Amicus curiae brief filed by the National Association of Settlement Purchasers (NASP).

"Without the certainty and finality of a court order, there is no viable secondary market," the NASP brief states. "Because every structured settlement contains boilerplate language that purports to limit or restrict assignability, every Illinois court approved transfer could be subject to challenge at any time."

Public Policy

The validity of assignments, including structured settlement transfers, depends in part on public policy issues. Transfers arguably undermine the fundamental purpose of structured settlements - to provide spendthrift protection for injury victims and their dependents.

This public policy perspective is captured in the statutory history of the structured settlement tax exclusion. To qualify, IRC 130 provides in part "periodic payments cannot be accelerated, deferred, increased, or decreased by the recipient of such payments"

Over time, many structured settlement documents have expanded this IRC 130 prohibition to include "transferred, assigned, mortgaged or encumbered" or words to that effect. (emphasis added). Although anti-assignment provisions are incorporated into many state workers compensation statutes, they are not specifically required by IRC 130, I04(a)(1) or 104(a)(2).

Factoring advocates offer competing public policy arguments to support structured settlement transfers. Unanticipated needs or poorly constructed settlement plans may necessitate immediate cash and outweigh other public policy considerations. Factoring advocates also criticize the "paternalistic" viewpoint of factoring opponents. They argue the structured settlement recipient, as owner of payment rights, should have the right to decide whether to transfer or assign those rights.

Many other statutes either permit or favor assignment of payments rights. These statutes include the 48 state structured settlement protection acts, IRC 5891, and recent revisions to UCC Article 9 as well as the Restatement (Second) of Contracts. Unfortunately, the authors of revised UCC Article 9 did not carefully consider the impact of their revisions on structured settlement transfers which has resulted in conflicting statutory language and interpretations among various states.

Best Practices

The National Structured Settlement Trade Association (NSSTA) amended its Model Qualified Assignment and Release Agreement following the enactment of IRC 5891 and the Model State Structured Settlement Protection Act. Paragraph 7, titled "Acceleration, Transfer of Payment Rights", now provides:

"None of the Periodic Payments and no rights to or interest in any of the Periodic Payments (all of the foregoing being hereinafter collectively referred to as “Payment Rights”) can be

i. Accelerated, deferred, increased or decreased by any recipient of any of the Periodic Payments; or

ii. Sold, assigned, pledged, hypothecated or otherwise transferred or encumbered, either directly or indirectly, unless such sale, assignment, pledge, hypothecation or other transfer or encumbrance (any such transaction being hereinafter referred to as a “Transfer”) has been approved in advance in a “Qualified Order” as defined in Section 5891(b)(2) of the Code (a “Qualified Order”) and otherwise complies with applicable state law, including without limitation any applicable state structured settlement protection statute.

No Claimant or Successor Payee shall have the power to effect any Transfer of Payment Rights except as provided in sub-paragraph (ii) above, and any other purported Transfer of Payment Rights shall be wholly void. If Payment Rights under this Agreement become the subject of a Transfer approved in accordance with sub-paragraph (ii) above the rights of any direct or indirect transferee of such Transfer shall be subject to the terms of this Agreement and any defense or claim in recoupment arising hereunder." (NSSTA's emphasis).

Brenston Status

Peachtree Settlement Funding, the transfer company involved in the Brenston case, has filed a petition for review with the Illinois Supreme Court. The Illinois Supreme Court will likely act on Peachtree's petition by December, although a decision whether to review could be delayed until February, according to NASP Executive Director Earl Nesbitt who reported on the case during the NASP 2013 Annual Conference. Assuming the petition for review is granted, Nesbitt stated a final decision is not expected for nine to 12 months.

Brenston Issues

NASP President Patricia LaBorde characterized the Brenston case as "troubling" for several reasons during a recent S2KM interview:

• The Appellate Court decision challenges the finality of transfer orders. "No one wants litigation over closed cases."

• The only issue on appeal was timeliness. The Appellate Court expanded the issues to discuss anti-assignment restrictions.

• The case had settled before the appeal. Both Brenston and Settlement Funding filed motions to stay the appeal which the Appellate Court ignored.
• The trial judges who approved the transfers were experienced with structured settlement transfers and aware of existing anti-assignment clauses. They never mentioned or suggested they were defrauded.
• The Appellate Court ignored waiver language and references to IRC 5891 which appeared in some of the original structured settlement documents.
• All of the relevant parties had waived the anti-assignment provisions.
• Unlike Brenston, all of the cases cited by the Appellate Court supporting enforcement of anti-assignment restrictions involved objections by structured settlement obligors or annuity providers.
• Brenston had other potential remedies against Settlement Funding including a separate cause of action for fraud.
• The Brenston Appellate Court decision probably puts a hold on transfers in Illinois until the case is appealed or the Illinois transfer statute is amended.

Additional Resources

• For more detailed analysis concerning anti-assignment restrictions, see Chapter 16 of "Structured Settlements and Periodic Payment Judgments" (S2P2J).
• For the results of prior California transfer cases involving anti-assignment and finality of judgment issues, see - Fresno County Factoring Cases:
  • Report 1
  • Report 2
  • Report 3

NASP 2013 Annual Conference - 2

Primary market representatives attending their first National Association of Settlement Purchasers (NASP) Annual Conference are typically surprised - both by the exceptional quality of the educational experience and NASP's encouragement of diverse perspectives on controversial issues which have historically divided the primary and secondary structured settlement markets.

NASP President Patricia LaBorde's keynote remarks at NASP's 2013 Annual Conference last week in Las Vegas re-inforced NASP's policy of politically unobstructed learning. "We want to hear from all structured settlement stakeholders - even if they disagree with us or don't like who we are," LaBorde stated. "We are here to listen. We are here to improve."

Consistent with these educational objectives, previous NASP speakers have included critics from the primary market such as John Darer and Jack Meligan as well as attorneys who represent annuity providers in transfer hearings such as Stephen Harris and Peter Vodola. Regular NASP educational program features also include both a Primary Market Panel and a Judicial Panel.

In addition to other speakers who highlighted and criticized specific secondary market business practices during this year's NASP conference, former NASP President Robin Shapiro provided the most comprehensive and unanticipated assessment. Shapiro's unannounced critique, which preceded, but was unrelated to, his introduction of NASP's 2013 Hamilton Award recipient Jack Kelly, will be summarized and discussed in subsequent S2KM blog posts.

NASP 2013 Speakers and Topics

• Jack Kelly - State and Federal Legislative and Regulatory Developments.
• Earl Nesbitt - Litigation Update and the Impacts of Unethical Conduct.
• Rajiv Goel - Capacity Issues in Structured Settlement Transactions.
• Boris Ziser - Financing Structured Settlement Transactions.
• Break Out Sessions
  • Avoiding Pitfalls with the Problem Payees.
  • Non-Traditional Financing of Secondary Market Transactions.
  • Maximizing Results in Front of a Tough Judge.
  • Marketing: Reaching Your Audience Without Breaking Ethical or Legal Standards.
• Edward Stone - The ELNY Saga.
• Brian Robinson and Erik Friedman - Issues in Life Contingent Transactions.
• Patrick Hindert (Moderator) and Daniel Hindert, Anthony Prieto, Jr., William Schemmel - Primary Market Panel.
• Matthew Bracy (Moderator) and Judges Nancy Allf, Carter Bise, James McCarthy - Judicial Panel.

S2KM Comments and Observations

• Sponsors - NASP conferences invariably attract more sponsors than any other conferences S2KM attends. NASP sponsors this year included Google and NBC.
• Legislation and Regulation - Secondary market legislative and regulatory developments have decreased considerably during the past couple of years. 48 states have now enacted protection acts with Oregon amending its statute during 2013.
• Case Law - Several cases decided in 2013 have the potential to significantly impact secondary market business standards and practices. "Structured Settlements and Periodic Payment Judgments" (S2P2J) will report on the following cases discussed during the NASP conference in upcoming Release 55:
  • Settlement Funding v. Cathy Brenston
  • Symetra v. Rapid Settlements
  • Hartford Life v. Estate of Solomon
  • In re: Porter
  • J.G. Wentworth Originations v. Mobley
• Brenston Case - S2KM will discuss the Brenston case, which is currently subject to a petition for review by the Illinois Supreme Court, in subsequent blog posts. A 5th District panel, sitting for the 4th District Illinois Court of Appeals, previously held that because Brenston’s settlement agreement contained an enforceable anti-assignment provision, the transfer court had a duty to enforce that provision and “it had no authority under the Act to approve” the transfer petitions.
• Special Needs Attorneys - Rajiv Goel, addressing capacity issues, was the first special needs attorney to speak at a NASP conference. At prior special needs conferences S2KM has attended, attorneys frequently criticize primary market consultants for "over structuring" and for opposing single claimant qualified settlement funds. In addition, several state Medicaid agencies are attempting to disqualify structured settlement funded special needs trusts because of the potential liquidity (resources) available via the secondary market. Primary and secondary structured settlement market participants appear to have shared interests in improving their special needs public relations and lobbying strategy.
• Marketing Restrictions - In addition to promoting the Better Business Bureau Code of Advertising, NASP's Marketing Break Out discussions highlighted compliance requirements for:
  • New Telephone Consumer Protection Act.
  • The CAN-SPAM Act.
  • Truth in Caller ID Act.
  • Section 43(A) of the Lanham Act.
• Financing Transactions - Boris Ziser's overview of secondary market financing transactions explained: 1) the changing landscape of capital markets; 2) why lenders and investors like structured settlements; 3) what is needed for a successful transaction; 4) current lender challenges; and 5) various types of lending facilities - among other topics.
• Expanding Market Segments - Separate presentations about 1) life contingent transfers and 2) the sale of structured settlement payment rights to individual investors including personal injury victims indicate both market segments are growing.
• ELNY Saga - Among ongoing ELNY developments reported by Edward Stone:
  • Although a final Schedule 1.15 has not yet been published, benefit reductions for ELNY structured settlement recipients may be 3-4% greater than originally predicted.
  • Guarantee Association Benefit Company (GABC), ELNY's D.C.- based successor insurer under NOLHGA's control, has not yet disclosed any information about the expenses association with ELNY's liquidation or the investment performance of ELNY's assets during and/or following ELNY's liquidation.
  • Despite shortfalls experienced by more than 1400 ELNY structured settlement recipients, none of the participating state Guarantee Associations paid out their full coverage amounts.
  • GABC is flagging factoring transactions which are not receiving supplemental benefits.
  • The ELNY class action lawsuit remains on hold while the appeal of Judge Galasso's contempt order is pending.
• Judicial Panel - NASP's Judicial Panel provided opportunities for both the judges and conference attendees to ask each other questions and to communicate problems they have experienced during transfer proceedings. Speaking for the panelists, Judge Bise, who attended the entire conference, stated "I have learned a lot. We would appreciate NASP continuing to educate us on transfer issues."
• Primary Market Panel - Panelist William Schemmel, legal counsel for the Western & Southern Financial Group, which owns Integrity Life among other affiliates, was one of two representatives of former primary market annuity providers attending the NASP conference. Similar to the judicial panel, Schemmel's discussion of transfer issues and problems was practical and productive without the political invective which frequently and unfortunately characterizes transfer discussions at primary market conferences.
• METLife's New Transfer Policies - Despite IRC 5891 and state protections acts, structured settlement annuity providers retain the ability to prevent payment right transfers by enforcing anti-assignment clauses in applicable settlement documents. Generally, however, for the cost of an administrative fee, structured settlement annuity providers have cooperated with factoring companies and payee/transferors since 2002 to enable court-approved transfers. During his case law update, NASP Executive Director Earl Nesbitt reported METLife has now reversed course and has begun challenging this cooperative spirit with new transfer policies prohibiting two previously existing industry standards: 1) transfers of partial payments; and 2) factoring companies assuming administrative responsibility for post-transfer payments.

Congratulations to NASP - especially NASP President Patricia LaBorde, conference chairman Ken Barnett, conference administrators Susan Barnes and Leslie Wren, and conference speakers - for continuing and upgrading the quality of NASP's annual educational conference.

For S2KM reporting about prior NASP conferences, see the structured settlement wiki.