Understanding Advanced Directive Language

The law is filled with vocabulary that makes decisionmaking by lay people complex. The purpose of this article is to help lawyers (and their clients) more clearly understand the purpose of what New York State calls “advance directives” relating to health care.

Additionally, the goal is to help people understand why you should decide today how you would want things handled in the event you are unable to speak for yourself in the future.

The money spent with an attorney can help you and your family avoid future problems.

During the COVID-19 pandemic, the legal field has experienced first-hand what happens when people feel they are too young to “think about the future.” You are never too young—and this includes students who are heading to college.

As for attorneys who practice in other fields—this article is for you as well!

Health care advanced directives are a series of legal documents by which you may make provisions for future health care decisions. A COVID related stroke is one example of a health care event that may prevent you from communicating clearly about your desires.

For young people, too much alcohol can render them incapable of making their decisions and at 18 their parents can no longer make decisions for them.

In New York, there are three types of advanced directives: Health Care Proxy and Living Will and may also include a Do Not Resuscitate Order (known as a “DNR”) or a “Medical Order Life Sustaining and the Living Will (known as a “MOLST”). This article will focus on the Health Care Proxy and Living Will.

The first question is: if you cannot speak for yourself is there someone you trust to make medical decisions for you? This is a serious question and for most people (Continued on page 28)

David R. Okrent,Esq.,CPA

Principal owner of The Law Offices of David R. Okrent. Former IRS Agent, CPA Attorney, Co-Chair of the Suffolk County Bar Association. OkrentLaw.com

The term “Attorney wellness” has become a catch phrase for so many organizations, movements and products on the market that, sadly, many of us are starting to tune them out. As a colleague and a perpetual explorer (albeit, not “expert”) on all things positive and healthy, I ask you vehemently - Please don’t! At the same time, I urge you — by all means — be proactive, selective and reasonable in your quest for wellness.

What does “attorney wellness” mean anyway? “Attorney wellness” is no more than similarly careeraligned individuals recognizing that we each have our own personal need to be healthy to effectively perform the specific role we fill as part of our chosen profession. The fact that our profession is such that we can have quite a significant impact on the wellness of others (our clients), adds weight to the importance of our own wellness. You know the air mask analogy – you can’t help anyone until you put on your own? Well, it applies.

What constitutes an “air mask” for attorneys? The answers are obvious, though not necessarily easy for professionals so used to operating day-in-day-out in crisis mode for countless clients, often simultaneously.

Common sense, right? Even better, each of these components of attorney wellness are readily within each of our grasp. Most require no money (except food, but you are going to eat anyway, so why not make better choices?) and no special skill. They only require commitment to ourselves to make them happen.

For most attorneys, we know and understand what we should do to take better care of ourselves, and we often vow, to ourselves and others, that one day soon we will actually start doing so. I’m here to remind you, and offer you a gentle push, that “one day soon” is now.

In the interest of brevity, here are the biggies, with the most significant “why,” respectively –1. Eat a healthy diet, because you get out of your body what you put into your body. 2. Stay hydrated, to keep your body functioning smoothly and to prevent dehydration, which is the most common cause of fatigue. 3. Exercise, to reduce stress, give you more energy and improve your overall disposition. 4. Get sufficient sleep – at least eight hours — because your body’s systems and chemicals need that much time to recharge. 5. Get fresh air every day, to strengthen your bones and immune system, improve digestion and blood pressure, clear your lungs and make you happier. 6. Communicate daily, to stay connected, process emotions and prevent isolation. SherylL.Randazzo, Esq.

Partner, Randazzo & Randazzo, LLP. The firm concentrates its practice on the areas of elder law and estate planning/administration. Sheryl is the current Chair of the Town of Huntington Board of Ethics and served as President of the Suffolk County Bar Association (2010-2011).

Yes, ERISA Compliance Applies to Health Insurance Plans as Well as Retirement Plans

By William J. Rowley

The Employee Retirement Income Security Act (ERISA) was passed in 1974 and protects retirement assets and other employee benefit plans for all Americans. In addition to retirement plans, all employer-sponsored group insurance plans, such as medical insurance, also fall under ERISA’s protections.

From its inception, ERISA has required that certain documents and disclosures pertaining to all group insurance plans be created, maintained, and distributed to employees each year. This applies to all employersponsored group insurance plans, regardless of the employer’s employee count. However, these requirements were not actively enforced by EBSA (The Dept. of Labor) until the Affordable Care Act (ACA) was passed in 2010. EBSA revisited these ERISA requirements and began enforcement to generate fines and penalties to help pay for the ACA’s provisions. The EBSA has over 1,900 employees involved in compliance reviews, and fines were up 72 percent in 2017 to a total of $1.1 billion.

A Summary Plan Description, with all attached notices including a copy of the carrier’s certificates of coverage, is the first thing they will ask for in an audit. In addition, here is a partial list of other documents that are required: • Summary of Material Modification • Notice of Model Exchange • Newborn’s Act Description of Rights • Women’s Health & Cancer Rights Act Notices

Have you ever heard of these? About 90 percent of the employers I speak with have no idea what these documents are and are unaware of their responsibility to maintain and distribute them annually. (Continued on page 30) William J. Rowley

Senior Vice-President, Bradley & Parker, Inc. William specializes in the firm’s employee benefit consulting practice. Reach him directly at 631-650-4004 or via email at wrowley@bradley-parker.com