Category Archives: Regulatory Risk

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Highway Traffic Deaths Preventable with Better State Laws

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A report on highway safety urges state legislatures to examine safety laws and take proactive steps to enact effective rulings. The Advocates for Highway & Auto Safety report “2015 Roadmap of State Highway Safety Laws: Lethal Loopholes,” found that more than 5.6 million crashes in 2013 caused about 32,700 fatalities and 2.3 million injuries. Motor vehicle crashes cost society $871 billion, based on 2010 data.

Federal action and safety requirements can address part of the problem, but state laws have direct impact on promoting safer driver and occupant behavior, according to the report, released in January. An example of the difference state laws can make is with seat belt use, which has been shown to save lives. In 2013, states with primary enforcement seat belt laws for front seat passengers had a 91% belt use rate, while states with secondary enforcement laws had an 80% belt use rate, according to NHTSA data. A study conducted by the Insurance Institute for Highway Safety (IIHS) found that, when states strengthen their laws from secondary to primary enforcement, driver death rates decline by about 7%.

“In 2015, Advocates urges state leaders to close lethal loopholes in their highway safety laws,” Jacqueline S. Gillan, Advocates president, said in the report. “The emotional, economic and societal cost of inaction to improve safety is too high especially considering we know what steps can be taken. Complacency and lack of action have resulted in a dangerous and deadly patchwork of laws across the nation. Lethal loopholes in traffic safety laws are literally killing us—we can and must do better.”

Key facts, according to Advocates:

  • 32,719 people were killed in motor vehicle crashes in 2013—a decrease of 3% from 2012. Automobile crashes remain a leading cause of death for Americans between the ages of five and 34.
  • About 2.3 million people were injured in motor vehicle crashes in 2013.
  • In 2013, almost half (49%) of passenger vehicle occupants killed were unrestrained.
  • Crashes involving young drivers (aged 15 – 20) resulted in 4,333 total fatalities in 2013.
  • 4,668 motorcyclists died in 2013. Though this is a decrease from 2012, this death toll accounts for 14% of all fatalities.
  • 1,149 children age 14 and younger were killed in motor vehicle crashes in 2013.
  • 300 children aged four through seven were killed in motor vehicle crashes in 2013.
  • More than 3.5 million people have been killed in motor vehicle crashes in the U.S. since 1899.
  • The more than 5.6 million police-reported motor vehicle crashes in 2013 had a societal impact in excess of $870 billion. Thirty-two percent of this figure ($277 billion) is economic costs including property and productivity losses, medical and emergency bills and other related costs. Dividing this cost among the total population amounts to a “crash tax” of $897 for every person, every year.

To meet basic safety recommendations, Advocates said states need to adopt 327 new laws:

  • 17 states need an optimal primary enforcement seat belt law for front seat passengers.
  • 33 states need an optimal primary enforcement seat belt law for rear seat passengers.
  • 31 states need an optimal all-rider motorcycle helmet law.
  • 19 states need an optimal booster seat law.
  • 174 graduated driver licensing laws need to be adopted to ensure the safety of novice drivers; no state meets all the criteria recommended in the report.
  • 42 critical impaired driving laws are needed in 39 states and D.C.
  • 11 states need an optimal all-driver text messaging restriction.

Captives under Scrutiny

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A mere decade ago, captive insurers were viewed by most regulators as a small, even exotic part of the insurance industry. Most were assumed to be offshore and aroused little attention. Now, captives have gone mainstream. A sizable, but undetermined, portion of the property casualty coverage is placed through, or issued by, captives. A good guess is 30% to 40%, but no one has been able to establish an accurate number. Thirty-nine states have some form of captive or self-insurance law. Captives are now part of everyday life for regulators and the result is more scrutiny.

The issues now on the agenda for captives are significant:

• XXX and AXXX Reinsurance Captives

According to Superintendent Joseph Torti (Rhode Island), 80% to 85% of life and annuity insurance is ceded to reinsurers. Much of the so-called “excess reserves” required by Rules XXX and AXXX are ceded to captive reinsurers or special purpose vehicles owned by the same licensed life and annuity companies which cede the risk. Because the amount of this risk is so large, any trouble collecting this reinsurance could have a major effect on the industry. Some regulators, even a few who approved these cessions, have criticized these arrangements. In some cases, the collateral for the reserves has been subject to parental guarantees, which tends to undermine the confidence which can be placed in the transaction. The NAIC is continuing its examination and has met some stiff resistance from the industry.

• Multistate Insurers 

The proposal to amend the preamble to the NAIC Accreditation Standards to treat captive reinsurers as “multistate insurers” (with some limited exceptions) was withdrawn at the last NAIC meeting in Louisville. A new proposal should be forthcoming (and may have already been issued by the date of publication of this Newsletter). The premise of this proposed change is that non-domiciliary regulators need to know how insurance issued in another state may affect the citizens of their state. The opposite point of view is that the regulators of the domicile have done their job and should be trusted by their regulator colleagues and that the transaction should not affect third parties, anyway. Some say the risk to the domestic captive industry is existential. If enacted and enforced, the proposed change could, ironically, drive much of the industry offshore and therefore beyond the authority of the regulators promoting it.

• Nonadmitted Risk and Reinsurance Act

Captives have been inadvertently drawn into the regulatory structure imposed by this federal legislation intended to streamline the reporting and payment of surplus lines taxes. It has shined a spotlight on the payment (or non-payment) of state self-procurement taxes, but, ironically, does not in any way alter either the application of them or their payment. While risk retention groups (RRGs) were able to get an exemption from the law during its formative phase, captives, because they are (generally) single state entities and therefore not doing business as a “non-admitted” insurer, did not even attempt to get an exemption. Now there is a group, the Coalition for Captive Insurance Clarity, which is seeking a legislative exemption on Capitol Hill.

• Insurance Company Income Taxation

The Internal Revenue Service is investigating several insurance pooling mechanisms and, in some cases, the captives that have utilized them to establish third party risk—which is essential for an insurer to get the benefit of insurance tax treatment. This investigation is presumably a response to the rapid growth of “micro-captives” as mechanisms to assist with avoidance of taxation in estate planning and wealth transfer. This process is in its early stages, but is likely to produce some dramatic results.

• Federal Home Loan Bank (FHLB)

Who would have thought that the FHLB would have anything to do with captives?  It appears that some captives, and at least one risk retention group, are members of the FHLB, which allows them to obtain federal funds at advantageous rates. The Federal Housing Finance Agency (FHFA), which regulates the twelve FHLBs, has proposed a rule that would exclude all captives from membership by defining “insurance company” to mean an entity which “has as its primary business the underwriting of risk for nonaffiliated persons.”

Why is this happening now? While there are numerous reasons for these kinds of actions, there are two primary motivators. First, regulation is always subject to the problem of “what’s worth doing is worth overdoing.” Reasonable minds can differ on the interpretation of statutes and regulations. Each of the above includes an element of “pushing the envelope,” which can be significant or insignificant issues depending on your point of view. Second, captives have been caught in the vortex of regulatory competition. As we have discussed before in this column, the National Association of Insurance Commissioners (NAIC), the Federal Insurance Office (FIO), and the International Association of Insurance Supervisors (IAIS) are jockeying for position and power. Add to the mix the position of the Organization for Economic Cooperation and Development (OECD) that captives may be used as a device to avoid taxation (“base erosion” in OECD parlance), and you have a tumult of regulatory action which at the same time can be challenging and conflicting in its goals and implementation.

What does this bode for the future of captives? Once you have been seen on the radar, it is hard to drop off. Captives can expect more of the same for the foreseeable future.

This blog was previously published on the Morris, Manning & Martin, LLP website.

How Active Governance Can Advance Proactive Risk Intelligence

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Boards, regulators and leadership teams are demanding more and more of risk, compliance, audit, IT and security teams. They are asking them to collaboratively focus on identifying, analyzing and managing the portfolio of risks that really matter to the business.

As risk management programs evolve to more formal processes aligned with business objectives, leaders are realizing that by developing a proactive mindset in risk and compliance management, teams can provide added value to help the organization gain agility by identifying new opportunities as well as managing down-side risk. Organizations with this new perspective are more successful in orchestrating change to provide a 360-degree view of both risk and opportunity.

Risk teams that are further along on the journey of leveraging proactive approaches to risk management look not only within the organization but beyond to supplier, third party and customer ecosystems. This means developing a view across the larger enterprise infocosm, to ensure alignment of people, processes and technologies.

An essential prerequisite to proactive risk management is a shift from passive to active governance. To build an active governance competence effectively, governance needs to be “active, engaged and embedded,” rather than “passive, reactive and irrelevant.”

Active governance means being thoughtful about alignment and interlocks policy, risk, compliance, quality and operational programs. Proactive risk intelligence throughout the organization can help it advance by aligning policies, procedures, facilitating an enterprise view of issues and orchestrating change to mitigate risk.

Align Policies, Procedures and Roles

Once proactive risk intelligence is understood and embraced as a concept, the next step is to develop agile and consistent policies that truly reflect and produce desired behavior. This means aligning business strategy and appetites with prescribed behavior, which is typically described not only through policies, but also through procedures, and embedded in role descriptions. It is important to make governance traceable in this way. Likewise, it is critical to make sure roles and responsibilities are aligned with policies and procedures so that employees, partners and third parties are empowered to do the right thing.

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Foundational is consistency between policies and procedures in similar roles across geographies, cultures and business units. Some key things you can do to help your organization include:

  • Align Policies to Business Objectives — Ensure responsible management and oversight of resources by aligning policy to business intent. You can do this by mapping policies to risk tolerances and compliance requirements. Be explicit when defining legal and ethical boundaries.
  • Resolve Global/Local Conflicts in Policies and Procedures — Improve active governance by resolving local/global dissonance—often a policy at one level can contradict a similar overlapping policy at another level—it’s important to iron out discrepancies so that people have confidence in the policy and know it stands for something the organization values.
  • Engage the Right Subject Matter Experts for Policy Creation and Review — Policy life-cycle management can really help. Be sure to include alerts and intelligence to ensure policies reflect compliance to new and changing regulations and business obligations. Establish the right roles and responsibilities for creating, editing, reviewing and publishing polices. Automated workflow can help make this seemingly monumental task achievable. Empower the right decision-making processes for governance of policies and allocation of resources.

Gain an Enterprise View of Issues and Remediation

Now that your organization is looking at risks in the context of appetites, tied to policies that reinforce desired behavior, based on a common language, the next step is rapid, complete issue resolution. Mature organizations can provide a portfolio of issues and incidents, facilitating a 360 view.

By looking at all the incidents and issues tied to a risk, process or asset, your team will begin to develop a preventive capability, and be able to ‘right-size’ remediation investments. Key things you can do to help your organization include:

  • Manage issues as a portfolio — Look at issues across all sources, through a common process, across all aspects of the organization. Not only issues arising from audit, risk management and privacy and compliance teams, IT and security, but also extended to research and development, quality, environmental health and safety and human resource groups.
  • Develop a Proactive, preventive capability  — Think in terms of future changes and what issues may arise in risk and compliance management. For example, getting teams involved early in initiatives such as mergers and acquisitions, new product or service launches or expansion into new markets.
  • ‘Right-Size’ remediation investments — Optimize investments in remediation through end-end root cause analysis—when business units look at an issue in isolation, investments can be made that solve the problem locally, but push symptoms to an upstream or downstream process. Looking at issues across, down and through will help build the 360 views that get at the real root cause and appropriate remediation.

Orchestrate Change across Risk Processes

Creating proactive risk intelligence as a competency is in many ways all about orchestrating change. Continuous value creation is demanded of successful organizations in today’s dynamic world. When collaborative risk teams focus on continuous improvement, they will spot opportunities for operational efficiency and savings that can be used to fund innovations. As organizations mature, collaborative teams can be supported by risk and compliance centers of excellence, shared services and innovation labs.

  • Build a community dedicated to the vision of risk intelligence — Bring people and partners on board with a proactive mindset. Make sure continuous improvement fuels and funds innovation across and within core processes of governance, risk, compliance, privacy and security.
  • Continuously innovate — Manage a portfolio of innovation projects to mature centers of excellence, shared services and distinctive risk and compliance competencies. Leverage technologies to accelerate innovation and gain economies of scale.
  • Continuously improve — A formal investment program identifies synergies and funds strategic initiatives, certification and training programs.

The GRC journey is about orchestrating change to gain a competency of risk intelligence. It requires a proactive mindset and anticipation of future problems needs and changes.

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Active governance is the first step in supporting change and building a competency of proactive risk intelligence by planning and thinking ahead at every stage of the risk management process.

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Active governance goes beyond general oversight to ensure alignment and interlock strategy, through policy, procedures and roles in the operational fabric of the organization and carries through to suppliers, customers and third parties. By starting with these core aspects of active governance, you are in your way to creating a competency of proactive risk intelligence in your organization.

Court Dismisses EEOC Lawsuit for Lack of Jurisdiction

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On Sept. 22, 2014, in EEOC v. Vicksburg Healthcare LLC, et al., Judge Keith Starrett of the U.S. District Court for the Southern District of Mississippi granted defendant’s motion to dismiss an EEOC lawsuit for lack of personal jurisdiction and insufficient service of process. The EEOC had filed a disability discrimination claim on behalf of a nurse who worked at a hospital owned by a subsidiary of the defendant. The court held that the EEOC, which sued a subsidiary hospital in Mississippi and its Tennessee-based parent corporation, did not put forth prima facie evidence of the necessary factors to satisfy personal jurisdiction requirements for the parent corporation in Mississippi.

While this ruling is favorable for non-Mississippi parent corporations operating subsidiaries in Mississippi, it has larger significance for employers. It shows that nationwide jurisdiction is not a given when the EEOC sues. Additionally, the ruling provides the framework for how to prevent liability by avoiding personal jurisdiction.

Case Background

The EEOC filed an action on behalf of Beatrice Chambers alleging disability discrimination under Title I of the Americans with Disabilities Act of 1990. The complaint named Community Health Systems, Inc. (CHSI) and Vicksburg Healthcare, LLC (VHL) as Defendants, alleging that both CHSI and VHL have been continuously doing business as River Region Medical Center (River Region) in Vicksburg, Mississippi.

The EEOC alleged that the defendants terminated Chambers–who had worked as a nurse at River Region for about 36 years–because of her unspecified disability, and additionally failed to provide her with reasonable accommodations in violation of the ADA. VHL was a subsidiary of CHSI, which was incorporated in Delaware and had its principal place of business in Tennessee. While VHL admitted doing business as River Region and admitted employing Chambers, CHSI denied doing business as River Region and denied employing Chambers. Further, in its motion to dismiss, CHSI asserted the affirmative defenses of lack of personal jurisdiction, insufficient process, and insufficient service of process.            

The Court’s Decision

In granting CHSI’s motion to dismiss, the court held that the issue of personal jurisdiction was controlling. The EEOC has the burden of establishing a prima facie case for personal jurisdiction. The court noted that a non-resident defendant is amenable to being sued in Mississippi if: (1) Mississippi’s long-arm statute confers jurisdiction over the defendant; and (2) the exercise of personal jurisdiction comports with the requirements of federal due process. The Mississippi long arm statute consists of three prongs, including: the contract prong; the tort prong; and the doing-business prong. It was undisputed that the “doing-business” prong was case dispositive.

CHSI submitted an affidavit from its Senior Vice President and Chief Litigation Counsel to the effect that it did not conduct business in Mississippi and that it lacked sufficient minimum contacts to be hauled into court in Mississippi.

The affidavit confirmed that CHSI is a holding company with no employees; CHSI indirectly owned subsidiaries including VHL; CHSI neither operated nor controlled the day-to-day operations of River Region; CHSI and River Region maintained separate banking records and did not co-mingle funds; CHSI did not employ nor have control over any River Region staff; CHSI never made any employment decisions regarding Chambers; CHSI and River Region observed corporate formalities (including no overlap between the Board of Trustees of River Region and the board of directors of CHSI; the respective boards of River Region and CHSI each convened separate meetings, (the boards maintained separate minutes and records); and CHSI is not qualified to do business in Mississippi–owns no property there, has no offices there, does not market there, and does not pay taxes there.

Following well-established precedent, the court found this aggregation of factors to be dispositive. It held that the EEOC lacked personal jurisdiction to sue CHSI in Mississippi.

The court rejected the EEOC’s three arguments in opposition of dismissal. First, the EEOC argued that the 10-K form submitted by CHSI to the SEC demonstrated CHSI’s intent to do business in Mississippi as it often used language such as “we” when referring to the hospital.  The court rejected this argument, noting that the 10-K form also contained a provision saying the hospitals are expressly owned and operated by the subsidiaries. Next, the EEOC mistakenly speculated that the River Region employee handbook contained references to CHSI. The court cited an affidavit from CHSI’s litigation counsel clarifying that the entity referred to in the handbook was a different indirect subsidiary, and not the parent corporation. Finally, the EEOC erroneously relied on another case involving CHSI – Bass v. Community Health Systems, Inc., Case No. 2:00cv193 (N.D. Miss.). The court noted that no facts from that case illustrated that CHSI should be amenable to personal jurisdiction.

Implications for Employers

 When out-of-state parent corporations conduct business in Mississippi through subsidiaries, it is imperative that they observe corporate formalities to clearly maintain the parent-subsidiary relationship. Further, in documents such as 10-K forms and employee handbooks, employers must explicitly indicate that subsidiaries, and not the parent, own and operate local entities. If parent corporations follow the teachings of EEOC v. Vicksburg Healthcare, LLC, et al., they can avoid unwittingly submitting to personal jurisdiction in Mississippi courts while their subsidiaries do business there.

This blog was previously posted on the Seyfarth Shaw website.