Beyond Structured Settlements

University of Texas 2016 SNT Conference

Perhaps less well known nationally than the Stetson Law School Special Needs Trust (SNT) Conference, the annual SNT conference presented by the University of Texas (UT) Law School represents a unique and complementary program that more structured settlement and personal injury settlement planning professionals should consider as an educational priority.

Attended by attorneys, financial advisors, trust officers, government agency representatives and care managers, the 12th Annual UT SNT program not only offered an outstanding faculty and comprehensive resource materials, it also integrated federal and Texas state-specific considerations (laws; regulations; current issues and trends; case examples; strategies; best practices) into a detailed learning mosaic that other national (non-state specific) special needs programs are unable to replicate.

Even for attendees venued outside of Texas, however, this integrated federal/state educational perspective provided a valuable analysis of the challenges and alternatives created by the interaction of the multiple sources of ever-changing special needs laws and regulations which sometimes conflict and often are subject to inconsistent administrative rulings.

Kudos to conference co-chairs, Patricia Sitchler and Renee Lovelace, as well as the entire conference faculty. Given the complicated scope and objectives of the UT SNT program, the resulting synthesis could easily have resulted in confusion. Instead, the 12th annual UT SNT conference served both as an excellent updated guidebook for Texas special needs professionals and as a potential model for other state special needs educational institutions and practitioners.

Topics and Speakers

• How to Make a Special Needs Trust - Craig Reaves
• Maximizing Public Benefits - H. Clyde Farrell and Christina Lesher
• Case Law Update - Rebecca Morgan and Elisa Dillard Rainey
• Medicaid Planning for Kids - Christina Lesher
• Texas Health and Human Services Commission Update - Shari Nichols
• Accessible, Available and Affordable Healthcare Resources - Leah Cohen; Anna Marie Mendez; Tresi Moore Weeks
• Working with SSA and the Trust Reviewer Teams - Pi-Yi Mayo (Moderator); Amanda Flood; Dana Marquez
• SNTs and the New SSA Trust Review Procedures - Neal Winston
• The New Texas Supported Decision-Making Agreement Act - Tresi Moore Weeks and Renee Lovelace
• Texas Legislative Update - Craig Hopper
• SNTs and Tax Planning - Bradley Frigon
• IRAs and SNTs - Renee Lovelace
• The Texas ABLE Act - Stephen Dale and Chris Masey
• Veterans Benefits and SNTs - Hon. Robert Davis
• Getting Families to Spend More Time Planning Ahead - Stephen Dale (Moderator); Matthews Badders; H. Clyde Farrell; Nancy Sosa; Scott Stebler
• Paying Caregivers - Katherine Barr; Scott Stebler
• The Role of SNT Attorneys in Personal Injury Settlement Planning - Patricia Flora Sitchler
• Ethical Issues in SNT Planning - Mary Alice Jackson

S2KM Comments About Selected Issues and Presentations

• UT SNT Conference Resources - As stated above, the conference handout materials (1481 pages of conference-specific legal papers and power points, plus sample forms, drafting tips, and other resources) provide valuable and recommended reference and learning resources. These materials are available for purchase in multiple formats on the UT CLE website.
• SNT Professional Education Resources - The number and quality of educational resources available for special needs professionals continues to increase and improve. In addition to the UT SNT conference, S2KM has attended and reviewed the most recent related conferences sponsored by Stetson, the National Academy of Elder Law Attorneys (NAELA ) and the Academy of Special Needs Planners (ASNP ). ASNP has also sponsored a series of special needs planning webinars. Hal Wright's book: "The Complete Guide to Creating a Special Needs Life Care Plan" represents another valuable resource. Wright, a certified financial planner who focused much of his career on special needs clients, recommends and explains "a comprehensive approach integrating life, resource, financial, and legal planning to ensure a brighter future for a person with a disability."
• Personal Injury Settlement Planning - As S2KM has discussed in numerous blog posts (example), personal injury settlement planning represents a strategic, underdeveloped market for both structured settlement and special needs professionals. UT SNT Conference co-Chair Patricia Sitchler's presentation in Austin (see above) highlighted these opportunities for SNT attorneys. Both the National Structured Settlement Trade Association (NSSTA) and the Society of Settlement Planners (SSP) have taken recent steps to expand their collaboration with special needs attorneys. NSSTA has appointed a Special Needs Trust Task Force to develop strategic relationships with special needs attorneys and also featured Sitchler as a speaker at NSSTA's 2015 Fall Conference. SSP's 2016 Annual Conference (March 10-12 in Tucson, Arizona) will include a joint session and social event with ASNP which recently hosted its own settlement planning webinar series.
• Supported Decision-Making - Effective Sept. 1, 2015,Texas became the first state to recognize supported decision-making agreements as a less restrictive alternative to guardianship. As defined under Texas' new law, a supported decision-making agreement is an alternative to guardianship for an adult with a disability who may need assistance with making decisions regarding daily living but is not so incapacitated that he or she needs a guardianship. As explained by Tresi Moore Weeks and Renee Lovelace in their UT conference presentation (see above) and accompanying paper, the supported decision-making process "is an outgrowth of person-centered planning" which in turn "is based on the belief that people with disabilities are people first, with their own gifts and contributions. A person-centered plan develops a life plan for the future by focusing on the individual’s preferences and capacities. It provides supports to the individual while giving the individual as much self determination and independence as he or she wants and is able to take on." Article 12 of the Convention on the Rights of Persons with Disabilities (CRPD), which was adopted by the U.N. in 2006 and signed (but not yet ratified) by the United States and signed or ratified by 159 other countries, requires states to "take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity."
• New SSA Trust Review Procedures - As S2KM has previously reported (see: ASNP 2015 Annual Conference and the Stetson 2015 SNT Conference ), the process by which the Social Security Administration (SSA) reviews SNTs has changed dramatically during the past two years as the result of meetings between SSA representatives and advocates who deal with SNT issues. The UT 2016 SNT Conference featured two complementary video presentations explaining the background, processes, status and impact of these changes: 1) Pi-Yi Mayo moderated a discussion with SSA representatives Amanda Flood and Dana Marquez; 2) Neal Winston explained why the problems with inconsistent, erroneous, or vaguely defined SSA SNT decisions occur; reviewed sources of SSA SNT written policy; discussed current SSA SNT policy trends; detailed the new centralized SSA SNT review procedure; and recommended current best practices for communicating with the SSA about SNTs. Both presentations were supported by excellent papers.
• The Texas ABLE Act - Stephen Dale and Chris Masey reported on the Texas ABLE Act under which eligible individuals with disabilities could start an ABLE account, modeled after current Section 529 savings accounts. For additional ABLE Act background, see this S2KM blog post. Their presentations summarized proposed, related IRS regulations as well as new POMS, issued December 21, 2015, in which the SSA explains ABLE accounts and provides instructions for developing and documenting account balances and distributions. In addition, Dale and Masey identified and addressed multiple practical ABLE-related issues to help attendees educate and advise their special needs clients and communities how best and when to utilize this new disability funding option.

For additional S2KM reporting about structured settlements and government benefit issues, see the structured settlement wiki.

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.

Structured Settlements 2015 - 1

Market Metrics

Although its new "Growth Initiative" has represented a well-publicized, number one priority of the National Structured Settlement Trade Association (NSSTA) during 2015, the results of this initiative have not yet produced a noteworthy impact on structured settlement annuity sales.

As reported by Melissa Evola Price, the United States structured settlement primary market has continued to slowly recover from its 2012 nadir during 2015 with first nine months annuity sales of $3.96 billion resulting from 18,635 cases - a premium increase of 3% compared to $3.86 billion resulting from 19,778 cases for the same period in 2014. The average per case annuity premium has increased to $212,703 from $195,305.

Based upon these results, 2015 annual structured settlement annuity sales can be expected to approximate $5.4 billion. The projected 2015 annual premium totals, however, will still fall substantially short of the historic 12 month industry high ($6.2 billion in 2008) after consistently averaging close to $6 billion annually from 2001-2007.

Recent Annual Structured Settlement Annuity Premium

• 2015 (third quarter) - $3.96 billion
• 2014 - $5.25 billion
• 2013 - $5.13 billion
• 2012 - $4.82 billion
• 2011 - $4.97 billion
• 2010 - $5.5 billion
• 2009 - $5.4 billion
• 2008 - $6.2 billion

Adding the 2015 Third Quarter results to historic U.S. structured settlement totals, S2KM estimates the following primary market metrics from 1976 thru September 2015:

• Total annuity premium: $148.7 billion.
• Total structured settlement cases: 847,200
• Average annuity premium: $175,600.

Nine month 2015 sales results (in millions) for individual structured settlement annuity providers (per Price's report) which are members of the National Structured Settlement Trade Association (NSSTA) plus the rounded increase (+) or decrease (-) from comparable 2014 results:

• Berkshire Hathaway: $974 MM (-12%)
• Pacific Life: $642 MM (+16%)
• MetLife: $592 MM (-13%)
• Prudential: $563 MM (+22%)
• Liberty Life: $422 MM (-2%)
• Amgen: $408 MM (+8%)
• New York Life: $298 MM (+45%)
• Mutual of Omaha: $65 MM (+63%)

Low Interest Rates

Many structured settlement industry participants attribute decreased sales to low interest rates. Market yields on U.S. Treasury securities at 30 year constant maturity peaked at 13.45 percent in 1981. Here are several historic average annual rates for 30 year Treasury securities (source: U.S. Department of the Treasury):

• 2015 (as of December 28) - 2.95%
• 2014 - 2.97%
• 2013 - 3.96%
• 2012 - 2.95%
• 2011 - 3.91%
• 2010 - 4.25%
• 2009 - 4.08%
• 2008 - 4.28%
• 2007 - 4.84%
• 2000 - 5.94%
• 1990 - 8.61%
• 1980 - 11.27%

Submarkets - Multiple noteworthy submarkets, each with significant structured settlement growth potential, are incorporated within the annuity production numbers set forth above. With the exception of non-qualified assignments funded with life insurance annuities sold by NSSTA members, S2KM is not aware of published metrics for these submarkets.

• Non-Qualified Assignments
  • Non-qualified assignments represent transfers of periodic payment obligations that do not meet the requirements of IRC section 130. They are generally used to defer taxable damage awards such as punitive damages as well as contingent attorney fees. Because they do not benefit from the favorable tax treatment of IRC 130, most non-qualified assignees are "off-shore" companies located in jurisdictions which do not tax the funds received by the assignee as income.
  • Two NSSTA-member annuity providers (Liberty Life and American General) currently offer and separately report non-qualified sales
  • Reported nine month 2015 non-qualified structured settlement sales by Liberty and Amgen totaled $159.0 million compared with $113.2 million in 2014 - a substantial increase which does not include non-qualified sales by a growing number of non-NSSTA member companies.
  • Release 58 of "Structured Settlements and Periodic Payment Judgments" (S2P2J) features an expanded analysis of the non-qualified market.
• Medicare Set-Asides
  • A Medicare set-aside (MSA) is an administrative and funding mechanism utilized in certain categories of settlements to protect Medicare's interests as "secondary payer" under the Medicare Secondary Payer (MSP) statute.
  • Although Federal law does not define MSAs, or mandate specific types of MSA funding mechanisms, CMS (the responsible federal agency) has established certain basic requirements for workers compensation MSAs (WCMSAs).
  • Under current CMS rules, structured settlement annuities have an inherent cost advantage over lump sum alternatives for funding WCMSAs resulting from the method CMS prescribes for calculating present values.
  • Although industry reporting does not currently separate MSA annuity sales, S2KM has previously estimated that eight (8%) percent of 2013 structured settlement premium and 24 percent of 2013 structured settlement annuities were attributable to WCMSAs.
  • Although no specific CMS rules or requirements currently exist for liability MSAs, one professional MSA administrator has informed S2KM that liability MSAs now represent 30% of his company's cases and the percent is growing.
• Special Needs Trusts
  • Established by Congress in 1993 as part of the Omnibus Budget and Reconciliation Act, Special Needs Trusts (SNTs) provide an authorized method for disabled individuals to hold an unlimited amount of assets in trust without disqualification for certain means-tested government benefits including Social Security Income and Medicaid.
  • When utilized as part of a personal injury settlement, SNTs are frequently funded with structured settlement annuities.
  • Similar to MSAs, industry reporting does not currently separately report SNT annuity sales.
  • Although an important strategic relationship clearly exists between structured settlement brokers and special needs attorneys, neither professional community have fully embraced the other for reasons explained in prior S2kM blog posts.
  • As a result, continuing opportunities exist to expand structured settlements funding of SNTs as well as other government benefit programs promoted by special needs attorneys such as the ABLE Act and the Affordable Care Act.

How large is the potential U.S. annual structured settlement market?

Based on recent Towers Watson studies, S2KM has previously estimated that more than $170 billion of United States tort costs (excluding workers compensation) represented payments to injury victims and their attorneys during 2014. Within that framework, and in the context of an S2KM interview, NSSTA President Michael Goodman recently stated his own estimate of potential market size for the structured settlement industry to be $8 to $10 billion range per year.

Secondary Market

Unlike the primary structured settlement market, which has experienced modest annual sales increases since 2012, the secondary market appears to have regressed according to industry experts. As a point of reference, based on interviews with industry experts in 2012, S2KM estimated 2012 structured settlement secondary market activity to be:

• 12,000 secondary market transfers - with less than 120 contested by annuity owners and/or providers.
• $360 million of total secondary market purchases (money paid to transferors).
• $30,000 average individual transfer.

Following zero (0%) percent growth in 2013, the number of secondary market transfers appears to have declined as much as 15% during 2014 with another decrease of as much as 7% predicted in 2015, according to various industry sources.

This decline in secondary market transfers received further confirmation from:

• An exhibit to J.G. Wentworth's December 10, 2015 SEC Form 8-K which indicates a $48 million drop in structured settlement revenue for the first three quarters of 2015 compared with the same 2014 period ($764MM vs. $812 MM).
• J.G. Wentworth's current stock price - which closed on the New York Stock Exchange at $1.82 per share on December 28, 2015 down from its historic high of $19.59 on February 28, 2014.

Industry experts estimate J.G. Wentworth currently controls between 65-72% of the U.S. secondary structured settlement market.

Based upon the 2013-2015 transfer estimates indicated above, S2KM further updates its estimates of historic (1986-2015) structured settlement secondary market metrics as follows:

• 168,000 transfers - involving 84,000 structured settlement recipients.
• $5 billion - aggregate sums paid to transferor structured settlement recipients.
• $12.9 billion - aggregate periodic payments purchased by secondary market companies.

For S2KM's summary of 2015 structured settlement issues and developments, see this blog post.
For S2KM's prior year summaries of the structured settlement market, see the structured settlement wiki.

Stetson 2015 SNT Conference

Sponsored by Stetson University College of Law, the 17th Annual Special Needs Trust (SNT) National Conference, held October 14-16, 2015 in St. Petersburg, Florida, fulfilled its promised objective of providing "an in-depth review of major issues presented in the creation, administration and monitoring of special needs trusts."

The three-day conference included an optional one day "Pre-Conference" featuring two alternative curriculum choices - "Tax Intensive" and "Pooled Trust Intensive" - plus a one day "Basics of SNTs" as well as the "SNT National Conference" itself.

Except for the Tax Intensive Pre-Conference, the other three programs each included multiple breakout sessions - for a total of 45 SNT-related presentations delivered during three days. Befitting this highly regarded program, the speakers represented a "who's who" of nationally-recognized SNT experts. In addition to power point presentations, almost every speaker also provided an original supporting handout paper.

More than 500 professionals attended the conference - many of whom are themselves recognized national SNT experts. Twenty-five (25) companies exhibited.

In addition to the outstanding speakers, the diversity of topics, the exceptional networking opportunities, the organizational acumen as well as the attractive conference setting and amenities, S2KM found the following conference issues to be noteworthy from a structured settlement and personal injury settlement planning perspective.

SNT Advocacy

• Working through their national associations [especially the National Academy of Elder Law Attorneys (NAELA) and the Special Needs Alliance (Alliance)] as well as less formal groups such as the SSI Advocacy Committee, special needs attorneys have become increasingly involved in legislative and regulatory lobbying. The SNT Fairness Act, which, if enacted, would allow persons with disabilities to create their own SNTs, represents one important current example.
• Among the highlights of the Stetson SNT Conference were two interactive video conferences featuring national and regional Social Security Administration (SSA) representatives. This dialogue followed, and may have resulted from, a series of meetings between individual SNT attorneys (the SSI Advocacy Committee) and SSA senior staff members which began in 2013 to address problems identified by, and complaints from, SNT stakeholders with the SSA's SNT approval process.
• The SSA representatives addressed numerous questions from the Stetson attendees in addition to outlining their internal processes and challenges. They also announced their intention to "retire" the controversial SSA Trust Training Guide (released April 23, 2014) which unfortunately conflicts with the POMS, SSA's primary technical resource, in several important respects. Among its problems, the SSA Trust Training 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.
• Additional legislative and regulatory issues exist that impact both structured settlements and special needs trusts and provide a growing rationale for collaborative lobbying to benefit their shared client communities. For examples, both professional groups would benefit from regulatory authority confirming that 1) the Deficit Reduction Act annuity rules do not apply to structured settlements; and 2) the mere existence of a secondary market does not disqualify SNTs funded with structured settlements.

Affordable Care Act

• From S2KM's perspective, Stetson's 2015 SNT conference allocated insufficient time to the Affordable Care Act (ACA). Presentations included one Pre-Conference Tax Intensive session titled "The Role of MAGI in Special Needs Planning" plus a two-part Basic's session titled "The Planner's Evolving Tool Box" during which the ACA shared conference time with SNTs, ABLE Accounts and other public benefits such as SSI, SSDI, Veteran's Pensions, the Disability Military Child Protection Act, CHIP, Section 8 Housing, and SNAP (formerly Food Stamps). By comparison, three separate, additional one hour sessions were devoted to ABLE Accounts during the three days of presentations.
• In fairness, Janet Lauder, who was allocated only 20 minutes to discuss the ACA, provided a valuable written analysis of the ACA as part of her conference handout materials.
• The ACA, however, is clearly a "game changer" for special needs planning and may prove a "career changer" for many special needs attorneys. Scott Solkoff points out the reasons in his excellent Spring 2015 NAELA Journal article titled "Report on the Patient Protection and Affordable Care Act: Its Impact on the Special Needs and Elder Law Practice", (reviewed here by S2KM).
• SNTs and Medicaid are now options and no longer necessities for many special needs clients. The ACA's elimination of pre-existing condition restrictions in health insurance policies complicates the insurance decision making process, as well as fundamental "needs and/or cost analysis", for special needs clients - as Solkoff illustrates with a suggested and valuable list of post-ACA client information questions.
• As ACA experts such as attorney David Lillesand have pointed out, ACA private health insurance offers special needs clients several potential advantages compared with SNTs. These advantages include: 1) ability to select your own insurer and insurance plan - and change annually if not satisfied; 2) a wider range of doctors; 3) no ongoing re-certification or sole benefit rule; 4) no estate repayment requirements; plus 5) reduced costs by eliminating SNT attorney, trustee and annual tax preparation fees.
• Given the many complicated ACA issues, continuing ACA developments and their profound impact on special needs individuals and special needs attorneys, Stetson conference attendees would have benefited from more time allocated to detailed ACA analysis and practice recommendations.

Structured Settlements

• Structured settlement brokers and special needs attorneys frequently play important and complementary roles in personal injury settlement planning. Historically, SNTs have represented a strategic submarket for structured settlements. Arguably, both the ACA and the ABLE Act provide additional opportunities for these two professional groups to collaborate. As suggested above, multiple legislative and/or regulatory issues exist involving both structured settlements and SNTs. Clearly, an important strategic relationship exists between these two professional communities.
• Somewhat surprisingly, therefore, the 2015 Stetson conference exhibited virtually no indication of this strategic relationship. For example, by S2KM's count, only one National Structured Settlement Trade Association (NSSTA) broker and zero NSSTA annuity provider representatives attended the conference. No NSSTA brokers or NSSTA annuity providers exhibited or spoke at the conference. This lack of attendance and participation by structured settlement participants at a prestigious SNT conference constitutes a notable missed opportunity - for learning, networking and improving the image of structured settlement brokers.
• For examples of why NSSTA and its members might want to improve their image with at least some special needs attorneys, see S2KM's 2012 blog review of the legal treatise "Special Needs Trusts: Planning, Drafting and Administration", edited by Kevin Urbatsch. In this two volume SNT treatise, structured settlements are the only SNT "funding product" that receives detailed coverage. Chapter 8 authors Donna Bradshaw and Leslie Ann Barnett justify devoting 12 subsections to "structured settlements" by stating: "special needs planners need to understand how structured settlements work with first party SNTs to best advise personal injury attorneys, persons with disabilities, and their families." Rather than endorse structured settlements, however, they provide several warning and cautionary notes.
• Although it was impossible for S2KM to attend every Stetson conference presentation, not one presentation S2KM did attend mentioned structured settlements. Significantly, during her presentation titled "Marketing Your Special Needs Planning Skills to Others; Expanding Your Practice Focus", Shirley Whitenack, current President of NAELA, emphasized a team-oriented special needs practice and recommended networking with other allied professionals "who can be an excellent source for referrals." Among allied professionals she identified: other attorneys; accountants; financial planners; financial advisors; insurance agents; trust officers; life care planners; care managers; teachers; family members; and medical providers - but did not mention structured settlement consultants.
• Both the structured settlement and the special needs attorney professional communities appear to be undergoing generational transitions at the same time the ACA is transforming both of their traditional practices. Now is an appropriate time for both professions to re-examine collaborative opportunities as they re-think their own future direction and growth.

Settlement Planning

• In a second article appearing in the Spring 2015 issue of the NAELA Journal, titled "The Affordable Care Act and the Continued Commoditization of Elder Law", (also reviewed here by S2KM) E. Spencer Ghazey-Bates warns that key provisions of the ACA, when combined with the anticipated addition of predictive technology "will either enable nonattorneys to compete with [elder and special needs] attorneys for clients or result in clients simply self-educating to the point of no longer needing attorney guidance."
• Ghazey-Bates is not alone in predicting some negative consequences for traditional special needs law practice as a result of the ACA. Attorney Lillesand, for example, observed during the Academy of Special Needs Planners (ASNP) 2012 Annual Conference and continues to opine that: "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."
• Assuming the ACA restricts their traditional SNT practice, special needs attorneys presumably will be forced to expand and/or redirect their practice by providing new services to new and/or existing clients. Both the Stetson conference two-part panel discussion titled "The Planner's Evolving Tool Box" and Whitenack's "Expanding Your Practice Focus" presentation highlighted, at least indirectly, this new reality. Indeed, the broad knowledge and skill sets associated with special needs law as a practice field should permit many special needs attorneys to successfully transition their practice.
• One expanding opportunity for special needs attorneys, actually a strategic component of special needs practice that deserves and requires greater independent market and product analysis, is personal injury settlement planning. Rather than restrict settlement planning opportunities for special needs attorneys, the ACA and other continuing legislative and regulatory developments actually increase those opportunities in S2KM's opinion.
• ASNP, an association of special needs attorneys, appears to support S2KM's opinion. ASNP recently sponsored a 12-part webinar series about "Settlement Planning" as distinct from "Special Needs Planning". And the distinctions are important - from both a marketing and work product perspective. S2KM highlighted some of the differences between these two related professional disciplines in this recent blog post.
• Although multiple speakers at Stetson's 2015 conference made references to personal injury settlement planning, future Stetson conferences could benefit from greater attention to both the settlement planning market itself as well as post-ACA settlement planning specific analytic and work product opportunities for special needs attorneys.

For prior S2KM reporting about the ACA as well as professional association conferences addressing structured settlement and settlement planning issues, see the structured settlement wiki.

2015-2016 Educational Conferences

During a transitional era for both personal injury settlement planning and structured settlements, participating professionals are fortunate to have multiple upcoming educational opportunities to update and expand their knowledge. Here is an overview of recommended upcoming national conferences listed chronologically. Note: some associations restrict conference attendence to association members.

1. NAMSAP 2015 Annual Conference - September 30 - October 2 in New Orleans. The National Alliance of Medicare Set-Aside Professionals (NAMSAP) is "the only non-profit association exclusively addressing the issues and challenges of the Medicare Secondary Payer Statute and its impact on workers’ compensation and liability settlements". Medicare set-aside arrangements (MSAs) represent an increasingly important submarket for structured settlements. One of the innovative features of this conference: NAMSAP has developed an App so attendees can stay connected before, during and following the conference. Among the speakers, S2KM's Managing Director, Patrick Hindert, and Ann Koerner will lead a discussion titled: "How the Affordable Care Act Impacts Medicare, Medicare Compliance and MSAs". For S2KM's most recent NAMSAP reporting, see: NAMSAP 2015 Winter Regional Conference .
2. Stetson 2015 SNT Conference - October 14-16 in St. Petersburg, Florida. Stetson Law School's National Conference on Special Needs Trusts (SNTs) is widely recognized as the preeminent educational forum for this topic. The two-day conference offers one day of "Basics" plus one day of "Advanced" SNT education plus two additional and optional pre-conference half-day programs ("The Tax Intensive" and "Pooled Trusts"). Similar to MSAs, SNTs represent a strategic submarket for structured settlements. Among important recent developments: 1) the impact of the Affordable Care Act (ACA) on existing and prospective SNTs; 2) The Special Needs Trust Fairness Act, recently approved unanimously by the U.S. Senate, would correct a previous legislative error and allow individuals with disabilities, who have capacity to create their own SNTs.
3. NSSTA 2015 Fall Educational Conference - October 28-30 in Phoenix, AZ. The National Structured Settlement Trade Association (NSSTA) is "the leading voice of the structured settlement industry" with nearly 1200 individual members. NSSTA has previously announced an "Industry Growth Initiative" - "designed to identify opportunities to expand the use of structured settlements and bring those opportunities to the structured settlement marketplace" - which appears to focus multiple growth-oriented goals NSSTA president Michael Goodman identified during NSSTA's 2015 Annual Meeting. The first progress report for this Growth Initiative is scheduled to occur during NSSTA's Fall Conference. As a prelude to its Growth Initiative, NSSTA commissioned a three-part survey of traditional structured settlement stakeholders which S2KM reviewed in previous blog posts: senior claims executives (Part 1); front line claims professionals (Part 2); and plaintiff attorneys (Part 3).
4. NASP 2015 Annual Conference - November 10-12 in Las Vegas. The National Association of Settlement Purchasers (NASP), "the only trade association related to the secondary market for structured settlements, ... is dedicated to ensuring the secondary market for [such] transfers remains fair, competitive, and transparent." Following years of conflict between the primary and secondary structured settlement markets, an historic "President's Panel" will highlight NASP's 2015 conference featuring the respective presidents of NSSTA (Michael Goodman) and NASP (Patricia LaBorde). This event was preceded by NSSTA inviting LaBorde to speak at the NSSTA 2014 Fall Educational Conference. and appears to signify increased cooperation between the two associations extending to legislation as well as education. Among other speakers, S2KM's Patrick Hindert will provide "A Primer on Special Needs Trusts and Medicare Set-Asides" for secondary market attendees. For S2KM's most recent NASP reporting, see: NASP 2014 Annual Conference .
5. Evolve 2015 QSF Symposium - November 12-13 in Memphis. Organized "to provide a forum for open dialogue that helps shape industry developments", Evolve Bank and Trust's Annual Qualified Settlement Fund (QSF) Symposium offers a valuable and unique addition to the growing number of personal injury settlement planning conferences and educational resources. Although Rev. Proc. 93-34 permits QSFs to make IRC 130 qualified assignments, and no tax authority exists prohibiting single claimant QSFs, structured settlement annuity providers currently refuse to accept single claimant QSFs which they broadly define to encompass claims by family members, plaintiff attorneys, lien holders and creditors. Evolve's recent symposiums have avoided the single claimant controversy and focused instead on other important QSF and settlement planning issues. For S2KM's most recent Evolve reporting, see: Evolve 2014 QSF Symposium.
6. NSSTA 2015 MSSC Program - November 18-21 at the University of Notre Dame. Complementing and extending its Certified Structured Settlement Consultant (CSSC) Professional Certification Program, NSSTA has added a new Master's Certificate in Structured Settlement Consulting (MSSC). This program is one of multiple new educational initiatives, including Structures 202 (a comprehensive program of case management fundamentals and business development opportunities) and "NSSTA University" (whereby NSSTA will partner with any member to secure CE credits for member-sponsored educational seminars or insurance claims departments or law firms), which NSSTA is offering to attract and train "Next Generation" professionals to grow the structured settlement market.
7. NAELA 2016 Summit - January 28-30 in Newport Beach, CA. The National Academy of Elder Law Attorneys (NAELA) was the first and remains the largest U.S. professional association focused on the needs of elder and special needs law attorneys. NAELA was founded in 1986 and now consists of more than 4300 attorney members. Because NAELA was slow to embrace special needs as a separate strategic market, NAELA members independently formed the Special Needs Alliance (Alliance) and the Academy of Special Needs Planners (ASNP). Most Alliance and ASNP member, however, remain active NAELA members and look to NAELA as their primary political lobbying resource. NAELA member resources include the NAELA Journal which has published a series of excellent articles about the Affordable Care Act.
8. AANLCP 2016 Annual Conference - February 5-8 in San Antonio. The increasing number, importance and roles of life care planners represents one of the most significant developments S2KM has observed while attending recent structured settlement and settlement planning stakeholder educational conferences. Life care planners predominate the membership of NAMSAP and have been featured speakers at other recent structured settlement and settlement planning stakeholder conferences. Multiple life care planners exhibit at American Association for Justice (AAJ) national conferences. The American Association of Nurse Life Care Planners (AANLCP) is one of two national associations of life care planners. During 2014, S2KM published an interview with nurse life care planner Wendie Howland. Patrick Hindert's article "How the Affordable Care Act Impacts Life Care Planners" was featured in the 2014 Winter Issue of the AANLCP Journal.
9. AAJ 2016 Winter Conference - February 27 - March 1 - Boca Raton, FL. The American Association for Justice (AAJ, formerly ATLA) "is the world's largest trial bar" whose mission includes supporting "the work of attorneys in their efforts to insure that any person who is injured by the misconduct or negligence of others can obtain justice in America's courtrooms ..." Plaintiff attorneys, however, also perform essential settlement planning roles which include recommending appropriate product and service providers to their clients. As one result, plaintiff attorneys represent the primary marketing target for companies and professionals offering settlement planning products and services - as well as a logical priority marketing target for growing the structured settlement market. Multiple companies offering structured settlement, lien resolution, MSA compliance, life care planning, legal finance and economic consulting services were among the 141 sponsors and exhibitors at the AAJ 2014 Annual Meeting. NSSTA recently commissioned a Plaintiff Attorney Structured Settlement Survey.
10. ASNP 2016 Annual Conference - March 10-12 in Tucson, AZ. The Academy of Special Needs Planners (ASNP) and the Special Needs Alliance are both national associations of special needs attorneys most of whom are also members of NAELA and many of whom also increasingly specialize in personal injury settlement planning. ASNP recently opened its membership (with a vetting process) to non-legal (finance/insurance) professionals and also sponsored a 12-part Settlement Planning Webinar Series. Unlike educational programs sponsored by NAELA and SNA, ASNP's annual conferences are open to non-members. For S2KM's most recent ASNP reporting, see: ASNP 2015 Annual Conference - which includes a comparison of settlement planning vs. special needs planning.
11. SSP 2016 Annual Conference - March 10-12 - Tucson, AZ. Society of Settlement Planners (SSP) members "work with the injured party to create a comprehensive and integrated settlement plan focused on meeting the needs of the claimant." They also "seek to elevate the profession of settlement planning by promoting ethical industry standards, providing education and certification and knowledge transfer among its members." For the first time, SSP's 2016 conference will feature joint educational sessions and social events with ASNP. For S2KM's most recent ASNP reporting, see: SSP 2015 Annual Conference Part 1 and Part 2.
12. NSSTA (April 6-8 in Palm Springs, FL), NAELA (April 7-9 in Denver) and AAJ (July 23-26 in Los Angeles) have also separately announced their 2016 Annual Meetings.

NAELA Journal - Recent ACA Articles

With last week's Supreme Court decision in King v. Burwell, upholding tax credits for individuals purchasing health insurance through the federal insurance exchange in addition to state insurance exchanges, the Patient Protection and Affordable Care Act (ACA) further imbedded its sweeping changes into America's health care system.

If they have not done so already, structured settlement consultants and other personal injury settlement planners should now be thinking strategically about how the ACA impacts their clients as well as their own work product and professional services. S2KM has previously reported on ACA analysis by speakers at conferences attended by S2KM as well as ACA analysis by authors reviewed by S2KM.

Among settlement planning professionals, special needs attorneys within the Academy of Special Needs Attorneys (ASNP) and the National Academy of Elder Law Attorneys (NAELA) have been notably proactive in analyzing the ACA. Not coincidentally, San Francisco attorney Kevin Urbatsch serves as both National Director for ASNP and as Editor in Chief of the NAELA Journal.

ASNP has featured ACA speaker presentations at each of its annual conferences beginning in 2011 (Cynthia Barrett); 2012 (David Lillisand); 2013 ( Scott Solkoff); 2014 (Lillesand, Ann Koerner, Scott McDonald, and Bradley Frigon); and 2015 (Solkoff and Koerner).

The "NAELA Journal", which featured a comprehensive ACA review in its Spring 2011 issue plus an additional Medicare article detailing various cost-saving components of the ACA in its Spring 2013 issue, has added two additional ACA articles in its most recent Spring 2015 issue.

Although written for special needs and elder law attorneys (and available only to NAELA members), the two most recent "NAELA Journal" articles raise important issues and offer valuable insights about the ACA which are applicable to all settlement planning professionals. This blog post summarizes those articles and considers their analyses from a structured settlement and settlement planning perspective.

Scott Solkoff's NAELA Journal Report

In his Spring 2015 NAELA Journal article titled "Report on the Patient Protection and Affordable Care Act: Its Impact on the Special Needs and Elder Law Practice", Scott Solkoff discusses the consumer provisions of the ACA, as opposed to the industry and regulatory provisions.

Solkoff characterizes the ACA as "a big new law that includes a mass of new statutes, state and federal regulations, court decisions, and variances that differ from state to state and county to county." He maintains that trained professionals (presumably including structured settlement consultants and settlement planners), as well as consumers (presumably including personal injury claimants), will be challenged to understand and navigate this new system.

How has the ACA changed health insurance? Quoting attorney David Lillesand, Solkoff emphasizes: the ACA "creates a whole new definition of ‘health insurance.’” Solkoff explains this "new ACA definition" by highlighting some of the deficiencies of the "old definition" of health insurance:

"policies with annual and lifetime limits, policies with no “medical loss ratio” to control excess administrative expenses and profits, policies that could limit or deny coverage to people with disabilities or pre-existing conditions, parental policies that would not accept children beyond a certain age or status, policies with less preventive care coverage, and policies that could be more restrictive or punitive on doctor choice or emergency room access."

ACA health insurance policies now must include all these features.

Solkoff's article discusses the ACA's impact on: Medicaid; Special Needs Trusts (SNTs); Medicare; personal injury settlements; tax and financial planning - all of which are significant for structured settlements and settlement planning.

Medicaid and SNTs

The ACA's elimination of pre-existing condition restrictions in health insurance policies profoundly impacts persons with disabilities who formerly relied on Medicaid as their only health insurance option. It also complicates the insurance decision making process, as well as "needs analysis" (a structured settlement and settlement planning priority) as Solkoff illustrates with a suggested list of post-ACA client information questions.

For many clients, Solkoff points out, SNTs and Medicaid are now options and no longer necessities. Although SNTs continue to serve the same purpose, the ACA has changed the determination of whether creation of a SNT is appropriate. For some clients, Solkoff concludes, the best solution may require the creation of a SNT as well as the purchase of an ACA health insurance policy.

Solkoff summarizes the ACA provisions which expand Medicaid eligibility to permit individuals who lack the resources to purchase private insurance through the exchanges, even with credits and subsidies, to gain access to health care. This Medicaid expansion, however, was restricted by the U.S Supreme Court. In the same 2012 decision in which it upheld Congress' power to enact most of the ACA's provisions, the Supreme Court ruled the federal government cannot mandate states to expand the Medicaid eligibility pool. To date, 22 states have refused to expand Medicaid leaving 4.3 million Americans uninsured.

Another important Medicaid feature Solkoff discusses: the ACA does away with asset cap eligibility tests and substitutes a new uniform eligibility measure, the Modified Adjusted Gross Income (MAGI) standard. Certain Medicaid applicants, however, such as SSI beneficiaries who automatically qualify for Medicaid, are exempt from the MAGI calculation.

Medicare

Many people mistakenly believe the ACA does not affect Medicare, perhaps Solkoff suggests, because the health insurance exchanges do not affect Medicare. To the contrary, according to Solkoff, changes to Medicare are among the most significant ACA reforms to affect the elderly and people with disabilities. Although Medicare remains a single-payer system run by the federal government, Solkoff highlights several important Medicare-related changes resulting from the ACA:

• Increased coverage for prescription medications and preventive care;
• Rewards for health care providers for enhancing services;
• Gradually closing of the gap in drug coverage (known as the “donut hole”);
• Rewards for Accountable Care Organizations (ACOs) that save money through the Medicare Shared Savings Program (MSSP);
• Creation of the Independent Payment Advisory Board (IPAB) to oversee Medicare costs with authority to make changes to the Medicare program.

Tax and Financial Planning

Solkoff identifies several ACA-created tax and financial planning provisions that could impact structured settlement and settlement planning calculations: 1) tax credits for premium payments and subsidies using the new MAGI calculations; 2) increased thresholds for taxpayers to deduct unreimbursed medical expenses from 7.5% to 10% of Adjusted Gross Income (AGI); and 3) a new Net Investment Income Tax of 3.8% on certain net investment income of individuals, estates and trusts with AGI above statutory thresholds.

Personal Injury Settlements

In addition to the ACA-related changes summarized above, structured settlement consultants, settlement planners and their clients will need to consider the ACA's impact on the size of individual personal injury settlements - and, more specifically, on the calculation of future medical expenses. S2KM has addressed this issue in a series of prior blog posts beginning with this review of an article by plaintiff attorney Seth Cardeli featured in the May 2014 issue of the AAJ's "Trial Magazine".

Similar to Cardeli, Solkoff anticipates defendants will now argue their exposure for annual future medical expenses, before considering inflation and present value discounting, "should be no greater than the predictable cost of premium payments, deductibles, and copays that are capped by the total [out of pocket] expense limits imposed by the ACA for the plaintiff’s actuarial life expectancy. In 2014, this cap was $6,350."

Like Cardeli, Solkoff also recognizes potential counter-balancing legal issues created by state-specific collateral source rules and subrogation clauses. Perhaps most significantly, Solkoff points out, quoting Professor Victor Matheson: "[t]he most expensive component of most big life care plans is either home nursing care or institutional care, neither of which is covered by ACA compliant insurance plans."

Strategic Impact?

Solkoff's article highlights how the ACA fundamentally changes the health care system for persons with disabilities - individuals who represent clients for special needs attorneys as well as structured settlement consultants and personal injury settlement planners.

What strategic impact will the ACA have on these professionals - individually and/or collectively?

Solkoff's article does not confront this existential issue directly or in depth. His analysis, however, encourages readers to reach their own conclusions. For S2KM, these include: 1) disabled persons now have more health insurance options and potential benefits; 2) the ACA creates new knowledge requirements, business opportunities and anticipated competitive challenges, for professionals who advise, and/or negotiate benefits and/or provide products for, disabled persons and their families; 3) the new, overlapping health insurance/settlement planning market can be expected to expand in scope and complexity and also to attract and develop new professionals, products and business models.

E. Spencer Ghazey-Bates NAELA Journal Warning

In a second article appearing in the Spring 2015 issue of the NAELA Journal, titled "The Affordable Care Act and the Continued Commoditization of Elder Law", E. Spencer Ghazey-Bates warns that key provisions of the ACA, when combined with the anticipated addition of predictive technology "will either enable nonattorneys to compete with [elder law] attorneys for clients or result in clients simply self-educating to the point of no longer needing attorney guidance."

The ACA provision which most concerns Ghazey-Bates is the new Modified Adjusted Gross Income (MAGI) test which streamlines Medicaid enrollment by replacing all state-defined Medicaid eligibility criteria - regardless of whether a state opts to expand Medicaid. At least for elder law attorneys, he views the new MAGI test as "[t]he single largest change resulting from the ACA" because it "effectively unified 50 separate eligibility methodologies into a single system."

This new unified Medicaid enrollment process, according to Ghazey-Bates, will facilitate nonattorney services to enter the Elder law market by combining new (anticipated) Internet technologies with the ACA's Certified Application Counselor, Navigator, and In-Person Assister consumer assistance programs.

Ghazey-Bates frames his Medicaid analysis in the context of of Richard Susskind's more general transitional theory of the legal profession. Susskind postulates "The End of Lawyers" resulting from an inevitable continuum beginning with unique, customized advice ("bespoke" model) transitioning next to service that draws upon precedents ("standardized" model) and finally to a "systematized" or "packaged" model resulting in the loss of perceived attorney value whereby legal service becomes a commodity differentiated solely by price.

Ghazey-Bates is not alone in predicting some negative consequences for traditional elder law (and special needs law) practice as a result of the ACA. David Lillesand, for example, observed 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."

Ghazey-Bates' article does end with an optimistic observation for elder law attorneys ("demographic shift toward an older population makes Elder Law a growth industry") and this advice: "perhaps the best counterpunch to the forces of commoditization: educating consumers about the value an Elder Law professional brings beyond simple statutory knowledge."

Lessons To Be Learned

What lessons, if any, can structured settlement and settlement planning participants learn from Ghazey-Bates' warnings about potential industry obsolescence and/or professional commoditization as a result of the ACA?

To paraphrase President Obama's words to Republicans in 2009: "Legislation has consequences." Although not yet fully determined, the significant consequences of the ACA for persons with disabilities, combined with advancing Internet technologies, will almost certainly transform the personal injury settlement planning market resulting in new products, new competitors and new business models. In S2KM's opinion, however, special needs attorneys (as knowledge resources) and structured settlements (as strategic products) should both generally benefit from the ACA.

What about individual structured settlement brokers? Their post-ACA success may depend upon whether and how they address the following strategic questions: 1) has your product-specific knowledge become a commodity? 2) what new, unique "value added" knowledge, if any, will you provide to your clients, customers and other settlement planning professionals? 3) what new marketing initiatives, if any, are needed to grow your business? 4) how does the ACA impact your educational priorities? 5) your business model?

For all of S2KM's blog posts about the Affordable Care Act, see the structured settlement wiki.

To read Patrick Hindert's article "How the Affordable Care Act Impacts Life Care Planners", see the 2014 Winter Issue of the Nurse Life Care Planning Journal.

SSP 2015 Annual Conference - 2

The Society of Settlement Planners (SSP) hosted its 2015 Annual Conference last week in Las Vegas with an unprecedented number of structured settlement association leaders as speakers and attendees including representatives from the National Structured Settlement Trade Association (NSSTA) and the National Association of Settlement Purchasers (NASP). For a list of SSP speakers and topics, see this prior S2KM blog post.

In his keynote address, SSP President Neil Johnson re-affirmed SSP's traditional commitment to "open dialogue" of industry issues with a mandate for "healthy, respectful discussion of all industry issues, controversial or not - rejecting the the temptation to sweep the uncomfortable under the carpet."

While seeking to engage all perspectives to identify shared permanent interests and discuss industry problems and issues, Johnson acknowledged and accepted that conference attendees would not agree on all issues - and they did not.

Some of the issues discussed:

• The need for structured settlement industry unity - encompassing education and, in some situations, political lobbying.
• How NSSTA and NASP are collaborating to improve state structured settlement protection statutes.
• Improving public relations by first acknowledging and addressing structured settlement primary and secondary market problems.
• The uniqueness of the structured settlement product and the need for better primary market self-regulation.
• The impact of "fiduciary standards" on settlement planning and the future of structured settlements.
• Collaborative primary/secondary market strategies for addressing "the darker side of factoring".
• Settlement planning as an important and distinctive growth strategy for structured settlements.
• Differentiating settlement planners from single-product plaintiff structured settlement brokers.
• Financial planners - a competitive threat or the next generation of structured settlement consultants and settlement planners?
• The inevitability and risks of "off-shore" settlement planning products in a globalized world.
• Lessons learned from the Executive Life debacle for claimants and their attorneys and advisors.
• How settlement planners and structured settlement consultants misuse life care planners and life care plans.
• The Social Security Administration's recent hostility toward special needs trusts (SNTs) and what it means for structured settlements.
• How and why settlement planners must learn to take control of the Medicare set-aside (MSA) process.
• The explosion of multi-claimant QSFs - a missed market for structured settlements?

None of these issues were resolved in Las Vegas. What did occur was a healthy exchange of ideas among leaders of historic structured settlement adversaries (NSSTA, SSP and NASP) with active participation from leaders of other settlement planning associations. The result: a unique industry gathering as much like a diplomatic conference as an educational event.

With NSSTA's President, Executive Director, and several members of its Board of Directors in attendance, whether and how NSSTA (as well as NASP) and its members will respond remains uncertain. NSSTA helped to initiate a more open industry dialogue during its own Fall 2014 Educational Conference by inviting SSP President Johnson and NASP President Patricia LaBorde to appear as featured speakers.

Structured Settlement Industry Unification

During the NSSTA Fall 2014 conference, Johnson outlined a "Blueprint for Industry Unification" which he and NSSTA President Kevin Silo continued to discuss in Las Vegas in a repeat performance of their "Presidents' Panel". Johnson's appeal for unity characterized "industry disarray" as a "threat to our future." Labeling diversity "good" and disparity "bad", he called for a united front before the public.

In Johnson's words: Lack of structured settlement industry unity is "a drain - a drain on financial resources ... a drain on productivity ... a drain on our public image ... a drain on physical and emotional health. Lack of unity diverts attention from productive projects. It always focuses attention on the negative, never on the positive. Lack of industry unity shows no partiality or favoritism for either NSSTA or SSP."

Both Johnson and Silo expressed optimism, however, about the future of structured settlements - especially in the context of generational transition. Johnson, in particular, highlighted potential opportunities amidst his self-described industry disparity, including a strengthened resolve and commitment for improvement and growth. According to Johnson and other settlement planners, the structured settlement industry needs a wakeup call - a fresh look and reevaluation that includes, but extends beyond, NSSTA's "protect and preserve" orientation.

Here are the core components of Johnson's proposed "solution" for structured settlement industry unity:

• Recognizing and accepting product and professional diversity.
• Identifying and pursuing permanent shared interests without necessarily agreeing on all issues.
• Engaging all perspectives to discuss industry problems and issues.
• Promoting and practicing settlement planning with the structured settlement annuity as a core strategic product.

The Future of SSP

Throughout its 15 year history, SSP has punched beyond its weight class. Born out of a troublesome recognition that the structured settlement playing field was seriously tilted to the disadvantage of plaintiffs and their advisors, SSP has helped bring respect and professionalism to the plaintiff side of the table by emphasizing "settlement planning", not "settlement selling".

Recognizing the strategic role of structured settlements, settlement planning nonetheless seeks the "best interest" of its injury victim clients and includes multiple products and multiple experts.

Despite these accomplishments, and perhaps because of them, SSP's future as an association is uncertain. NSSTA has more plaintiff structured settlement brokers than SSP and has been more successful in adding a new generation of members.

Other, well-organized, non-structured settlement professionals, such as special needs attorneys and life care planners, increasingly focus their marketing, educational programs and work product on settlement planning using SNTs and MSAs as their gateway.

As was evident in Las Vegas, however, SSP continues to raise the educational bar for an entire industry of settlement professionals. Settlement planning remains an evolving profession - largely unregulated with few industry standards. The ultimate role and growth potential for structured settlements within the settlement planning market have not yet been determined.

SSP's ability to organize an educational conference where an unprecedented cross-section of industry leaders engaged in civil discussions about strategic industry issues suggests SSP has an important continuing role within both the structured settlement and settlement planning markets.

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

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.

ASNP 2014 Annual Conference

Personal injury settlement planning and special needs planning represent two overlapping professions undergoing transformation and expansion as complex new legislation, regulations and case law interact to redefine their legal environment.

In addition to studying these new laws, settlement planners and special needs planners must address their impact on fundamental issues such as "know your client", "needs analysis", "best practices", "industry standards" and "product suitability", as well as "professional responsibility, qualifications and liability".

For the past eight years, the Academy of Special Needs Planners (ASNP) has sponsored some of the best educational programs addressing these laws and issues. The ASNP 2014 Annual Conference, which took place March 27-29 in Denver, was no exception.

Among other topics, the ASNP 2014 Conference expanded previous ASNP educational programs about the Patient Protection and Affordable Care Act (ACA aka "Obamacare"). ASNP's conference coincided with news the ACA has exceeded enrollment expectations and achieved its primary objective of substantially expanding healthcare in America:

• More than 7.1 million previously uninsured Americans purchased health insurance prior to the March 31, 2014 enrollment deadline; and
• Three million additional Americans enrolled in the ACA's expanded Medicaid coverage between October 1, 2013 (the start of the ACA's open enrollment period) and February 28, 2014 (the most recent figures available).

Although ACA political debate will continue, it is past time for settlement planners, including structured settlement professionals, and special needs planners to analyze how the ACA impacts their clients, their work product and their business model.

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 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.

David Lillesand also provided a comprehensive overview of "Supplemental Security Income (SSI) Regional Chief Counsel (RCC) Opinions" for first and third party SNTs, non-SNT asset transfers and resources exclusions. Lillesand's handouts included his own 714 page guide with every RCC opinion by state through March 3, 2014 organized by subject matter with a table of contents, index, one paragraph opinion summaries and hyperlinks to the actual text. Nine of these RCC opinions address structured settlement issues including problems involving minors and re-assignment of payment rights.

In leading a discussion about "SSI/POMS Changes", Theresa Varnet announced the formation of a new SSI Advocacy Committee, consisting primarily of special needs attorneys, which has begun meeting with Social Security Administration (SSA) representatives to identify and address various problematic SSI and SNT issues. As part of this project, the SSA is seeking input from a broad spectrum of disability advocates including members of the Arc, ASNP, NAELA, SNT, the Consortium of Citizens with Disabilities and representatives of pooled income SNTs.

Blaine Brockman and Patricia Kefalas Dudek spoke about "Housing, Food Assistance, Employment Benefits" - critical topics for many people with disabilities which are rarely addressed at structured settlement and settlement planning educational conferences. Their presentation and handout materials summarized "the complicated labyrinth of federal code, federal regulations, state regulations and local administrative decision making" which comprise affordable housing law and create "programs that are shamefully underfunded, dramatically understaffed, and obviously needed by many more people than they serve." Additional topics:

• The Supplemental Nutrition Assistance Program (SNAP) - formerly known as the "Food Stamp" program.
• Medicaid expansion and buy-in programs - which allow disabled persons to work and receive Medicaid.
• Vocational rehabilitation services and work incentives.

Sharon Pope (who also chaired this year's ASNP Conference with ASNP National Director Kevin Urbatsch) and Michele Fuller, provided complementary discussions about "SNT Administration" issues. Pope's presentation addressed "Law Firm Trust Departments" - with attorneys acting as trustees. Her handouts included example outlines for SNT "needs analysis" checklists and "personal care plans". Fuller spoke about the "Expanding Duty of Attorneys to Non-Clients". Her presentation highlighted recent cases and her handouts included numerous related articles.

Cynthia Barrett discussed "Post-Windsor Issues for LGBT Couples & Children" from a special needs perspective. Her presentation and handouts addressed such issues as:

• Review of Windsor and related marriage litigation.
• Same sex couple Special Needs Practice Checklist - emphasizing, similar to health care, the importance of state specific analysis.
• Medicaid planning techniques where marriage/parentage status must be established.
• SSA analysis for minor/disabled children of gay couples.
• Practice guide for same sex couples facing a Medicaid crisis.
• Veterans aid and surviving spouse benefits for same sex couples.

In addition to featured speakers and their presentation handouts, the following ASNP sponsors and exhibitors added to the educational value of ASNP's 2014 Conference:

• MassMutual
• Morgan Stanley
• MetLife
• Guardian Trust
• Elder Counsel
• National Care Advisors
• Krause Financial Services
• Elder Law Answers
• Evolve Bank and Trust
• Midland States Bank
• Stewart Home & School

For S2KM reporting about prior ASNP conferences, as well as other structured settlement and settlement planning conferences, see the structured settlement wiki.

ASNP 2013 Annual Meeting

Although special needs (SN) planning encompasses non-personal injury clients, settlement planning, with and/or without structured settlements, represents an increasingly important component of both the SN market and the educational focus of its practitioners.

The Academy of Special Needs Planners (ASNP) hosted its seventh annual meeting in Austin, Texas March 21-23 which featured the following topics and speakers:

• Impact of the Affordable Care Act on SN Planning - Scott Solkoff
• Modifying Problem Trusts into Effective Special Needs Trusts (SNTs) - Renee Lovelace
• SNT Issues at the Social Security Administration - Eric Skidmore, Sean Balser, Kevin Urbatsch
• The Jimmo v. Sibelius Medicare Settlement - Margaret Murphy
• SSI Update and New Social Security Strategies - David Lillesand
• Medicaid Third-Party Liability Liens Post-Ahlborn - Floyd Faigle
• Settlement Planning Under Changing Conditions - Donna Meyer, Sharon Pope, Patrick Hindert, Jason Lazarus
• Drafting Special Needs Trusts - Nancy Chudacoff, Sheri Sudweeks, Vincent Russo
• Establishing the Financial Needs of the Special Needs Beneficiary - Jerry Hulick
• Administration of SNTs - Travis Finchum, Kathy Christofell, Jerry Hulick, Renee Lovelace
• Determining a Reasonable Attorney Fee - Mary Alice Jackson

Settlement Planning and Structured Settlement Highlights

Affordable Care Act

• ACA and Settlement Planning - The Affordable Care Act (ACA) changes settlement planning in fundamental ways which speaker Scott Solkoff highlighted in his comprehensive review:
  • 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.
• ACA, Verdicts and Settlements - S2KM will address the impact of the ACA on personal injury verdicts and settlements in future blog posts.
• ACA, SSA and SNTs - During an ASNP question and answer session moderated by Kevin Urbatsch and featuring representatives of the Social Security Administration (SSA Question and Answer session), 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.

Settlement Planning and SN Attorneys

The ASNP settlement planning panel was one of several presentations which identified expanding opportunities for SN attorneys. Patrick Hindert, author of S2KM's blog, provided an analysis of the settlement planning market which emphasized changing structured settlement business and transactional models. Hindert highlighted the need for better standards and metrics as well as the importance of qualified settlement funds (QSFs) and the secondary structured settlement market. Sharon Pope discussed settlement planning practice issues and provided sample documents to help special needs attorneys expand their settlement planning practice. Jason Lazurus summarized new developments and cases impacting the use of Medicare set-aside arrangements in liability cases.

For SN attorneys to expand their settlement planning practice, ASNP's panel recommended more in-depth study of non-SNT settlement planning issues including the settlement planning market, the settlement planning team and the settlement plan itself. The panel's handout materials also identified a list of settlement planning documents organized among the following stages of the settlement planning process:

• Engagement
• Assessment
• Design
• Negotiation
• Implementation
• Monitoring

In addition to the settlement planning panel, multiple ASNP presenters discussed specific settlement planning issues. In addition to settlement topics and presenters mentioned elsewhere:

• Jimmo v. Sibelius - Margaret Murphy summarized this recent settlement which has important implications for anyone who needs skilled care as well as for skilled nursing facilities, home health and outpatient facilities. As a result of this settlement, Medicare claims should no longer be denied on a rule-of-thumb determination that a beneficiary's condition is not improving.
• WOS v. E.M.A. - Floyd Faiglie made a last minute addition to his Medicaid lien presentation to address this March 20, 2013 U.S. Supreme Court decision. The decision expanded the Supreme Court's previous Alhborn decision; rejected arguments by North Carolina defending its third party recovery statute; and further limits when a state may demand recovery from a portion of a settlement allocated to non-medical damages.
• Modifying Problem Trusts into Effective SNTs - Renee Lovelace recommended a cost benefit analysis formula for analyzing whether and when to modify a problem trust. Her analysis was process-driven and included: identifying problems, possible benefits, options, and cost of changes; quantifying costs and benefits; and determining the extent of any modification.
• Determining a Reasonable Attorney Fee - Mary Alice Jackson reviewed the eight factors listed in ABA Model Rule 1.5 for determining the reasonableness of a fee and discussed those factors in the context of SNTs. Note (added 3/31/2013): In his SSI update (see below), David Lillesand addressed the issue of whether and when SN attorneys need SSA approval of their attorney fees to avoid penalties resulting from poor quality draftsmanship in the Social Security Act attorney fee regulations.
• Establishing Financial Needs of the Special Needs Beneficiary - Jerry Hulick's presentation addressed special care, the special care team, special care information needs, and special care documents outside of the settlement planning context.
• Drafting Special Needs Trusts - Nancy Chudacoff, Sheri Sudweeks, and Vincent Russo presented ASNP's new Model Third Party SNT. Third party SNTs typically are used outside of the settlement planning context.

Structured Settlements

• ACA - Scott Solkoff noted in his ACA presentation that, after the ACA takes full effect January 1, 2014, structured settlements will more likely fund future health insurance costs, which should be lower and more predictable, than future medical expenses.
• "Over-structuring" - The ASNP panel discussing SNT administration (Travis Finchum, Kathy Christofell, Jerry Hulick, Renee Lovelace) emphasized a common complaint among SN attorneys: plaintiff attorneys frequently contact SN attorneys to draft a SNT on short notice after an "over-structured" settlement has already been reached. This panel discussion followed Lovelace's earlier presentation ("Modifying Problem Trusts") during which she highlighted expanding litigation against fiduciaries. S2KM's suggested solutions for fiduciaries to address the problem of "over-structuring": promote QSFs; enforce product suitability standards; or, as a last resort, utilize the secondary market to obtain increased liquidity for the trust.
• Deficit Reduction Act - The ASNP's SNT administration panel did not discuss whether the annuity rules in the Deficit Reduction Act of 2005 (DRA) are applicable to structured settlements. S2KM is not aware of any definitive authority addressing this issue. For S2KM's previous analysis of the DRA and structured settlements, summarizing a presentation by Sylvius von Saucken, see "Inconvenient Questions".
• Secondary Market - The SSA Question and Answer session did not address structured settlements. During a similar session at the ASNP 2012 Annual Meeting, Eric Skidmore, an SSA representative, confirmed an unpublished (and controversial) SSA position: the SSA believes the existence of the secondary market renders structured settlement annuities "available resources" that potentially disqualify special needs trusts beneficiaries from receiving Medicaid.

Congratulations to ASNP and conference Chairman David Lillesand for an outstanding 2013 educational program which also featured two special needs presentations by Lillesand: a supplemental "Back to Basics" program and a Supplemental Security Income (SSI) update.

For S2KM summaries of prior educational conferences of the ASNP, and other professional associations addressing settlement planning issues, see the structured settlement wiki.  For S2KM's listing of Spring 2013 educational conferences featuring settlement planning and structured settlement presentations, see this prior S2KM blog post.