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Stephanie Cohen, Scott Golden, Jack Cohen


Making a difference: Stephanie Cohen is working to help insurance companies work more effectively with providers

In an effort to help the medical provider community better understand how insurance companies work with providers, Golden & Cohen CEO Stephanie Cohen has embarked on a program to bring the relevant parties together to have a meaningful and productive discussion as to how to work more effectively together.

"Lack of communication between carrier and provider is one of the major issues in the health care delivery system," Cohen believes.

On March 24, she kicked off the program with a presentation featuring Debra Carter, Director of Provider Relations for Maryland, Delaware and the District of Columbia of United Healthcare at the Inova Practice Administration in Alexandria.

"More than 45 people were in attendance for this useful presentation which outlined the tools that are available to each provider – and ways to use them best so we can make the filing process easier for everyone involved," Cohen explains, noting that much of the presentation addressed how to navigate through United's system. "Most of the information offered was actually applicable to all insurance carriers. I found it very helpful."

Cohen adds that what was most interesting was that the goals of both United and the providers seemed to be aligned. "Obviously, the primary goal is to enhance the performance of the health and well-being of the people they serve in each community. United is committed to getting claims paid, and the providers are committed to getting paid for their services. During the group discussion, it was clear to all who attended that communication and teamwork are the key to a successful relationship."

Alberta Seith, the Physician Liaison at Inova Alexandria Hospital, says: "The meeting drew a large audience that included practice administrators, billing managers and physicians," Seith says. "Stephanie Cohen gave a detailed presentation that was easy to follow and generated active participation from the group. Participants agreed it was valuable information and they appreciated receiving contact information for additional questions."

Cohen says she was honored to be able to get these parties together in a very constructive dialogue that can help everyone in the health care system. "I am looking forward to hosting more of these events with additional doctors and hospitals this year."


Stephanie Cohen reports that the kickoff luncheon for the Maryland Women Ambassadors for Business on March 25 was a huge success. "My co-host Debbie Klis and I could not have been happier with the turnout," she says. "Everyone had a wonderful time and we're looking forward to our next event." Watch for details here:

From all of us at Golden & Cohen, here's to your good health!

Stephanie Cohen, CEO,
Scott Golden, CFO,
Jack Cohen, COO,


Stephanie Cohen

Stephanie Cohen offered insights into what insurance customers can expect from the new health bill at the first monthly breakfast series on health reform, hosted by Robin Strongin, president of Amplify Public Affairs and the Disruptive Women in Health Care Blog (, and its media partner, The Hill (

The topic of the event was, Health Reform: US Patience (not a typo) Pay the Price.

Strongin opened the meeting asking, "Now that Health Care Reform Legislation has finally passed – what's going to happen next?"

"The law is an outline, now the novel has to be written," said Cohen. "This is changing daily."

Another panelist, Mary Grealy, President of the Healthcare Leadership Council, added, "Americans waited and waited for the new legislation (this is where the patience comes in) like kids waiting for Christmas morning. But now, we have to open the presents and see what's inside. Did we get what we wanted? Or did we just get socks? We either had one of the greatest achievements or the downfall of the Republic."

Grealy went on to discuss both the positives and the negatives of the new legislation before concluding, "Just because the legislation passed, doesn't mean the work is done. Congress is really going to have to revisit this."

The third panelist of the morning, Judy Feder, Professor of Public Policy and former Dean of the Georgetown Public Policy Institute, talked about the history and politics of the new legislation.

"I am beside myself with excitement [about the health care reform bill]," Feder said. "You couldn't have a more dramatic process – we were up, we were down, we were dead, we were alive. I am of the camp that calls this a bloody miracle."

Cohen finished up the morning meeting by providing attendees with a detailed outline of the incredible quantity of changes that will be put into practice in the coming months and years.

"The legislation is still a work in progress, and there are a lot of misunderstandings," Cohen told Disruptive Women. "This new book is being written chapter by chapter. It has to be revised. This is just the beginning."

The next Disruptive Women breakfast meeting, "News (Hot) Flash: Sex, Drugs & Menopause," will be April 29, 2010 from 7:30 a.m. to 9 a.m. To attend, register here:

Stefan C. Nicholas


By Stefan C. Nicholas, Esq., Director / Chair
Logan H. Winn and Jedediah R. Bodger, Jackson & Campbell, P.C.,

For the past few years, the joke among estate planning practitioners and their clients has been that 2010 would be a good year to die.

The one-year "death" of the estate tax, however, has been greatly exaggerated. The Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA) actually put in place a much more complex and burdensome estate and gift tax system that will impact more taxpayers than the traditional estate tax that has caused so much uncertainty. As a result, 2010 may be anything but a good year to "go gentle into that good night."

The current state of affairs has made many, including many members of Congress, yearn for the simpler days of the estate tax.

Key issues

The key issue at hand involves a provision that "repealed" the estate tax for only one year – this year, 2010 – although the estate tax may be retroactively reinstated at any time. Yes, it's really that confusing. Congress failed to act prior to the end of 2009 to extend the estate tax, despite repeated promises to do so.

Moreover, if Congress fails to act prior to the end of 2010, the estate tax will return in 2011 — but not as it was in 2009, rather as it was prior to 2001. Did you follow all of that? This state of confusion and uncertainty is the unintended, and unwanted, legacy of EGTRRA. What, if anything, should you do about it?

The State of the Law

Prior to January 1, 2010, each U.S. person could have given away, during their lifetime, a gift of up to $1 million free of tax, or at death a total of $3.5 million worth of property free of estate tax. Gifts and inheritances over those amounts were taxed at 45 percent.

Additionally, prior federal tax law provided for an unlimited marital deduction. This meant that each U.S. person could have transferred an unlimited amount of property between spouses without incurring any federal estate taxes. Combining the $3.5 million exemption with the unlimited marital deduction meant that a married couple could have a combined estate of $7 million, which passed tax-free (for federal purposes) at the death of the second spouse to die.

In 2010, there is currently no estate tax and the top marginal rate for the gift tax is 35 percent. Without further action, in 2011 there will be a reduced estate tax exemption of $1 million per person and a top marginal rate of 55 percent (with an additional 5 percent surtax for certain large estates).

And there's more.

•The federal gift tax exemption will remain fixed at $1 million, but gifts over that amount will be taxed at an increased rate of 55 percent beginning in 2011.

•In addition to the repeal of the estate tax, new "basis" rules are in effect for estates inherited in 2010. Prior to 2010, assets transferred at death were transferred with a basis equal to the assets' fair market value at the date of the decedent's death.

•Any appreciation realized by the donor was essentially forgiven and passed tax-free. This "step up" in basis has been repealed and replaced with "modified carryover" basis rules.

In short, for the year 2010, any property owned by a decedent is transferred to the recipient with the decedent's basis (i.e., the original purchase price).

Therefore, although exempt from estate and gift tax, the assets received may be exposed to capital gains taxes when the inherited property is sold by the recipient, to the extent that the gain exceeds $3 million for assets transferred to a spouse and $1.3 million for assets transferred to anyone else, such as children, with gains calculated from the assets' original purchase price.

This switch to "modified carryover" basis rules from "stepped-up" basis rules is one of the major changes to be aware of for 2010. In 2011, the "step-up" in basis rules will return along with the estate tax.

How do these changes impact you and your current or anticipated estate planning?

As noted, no one expected such legislative inaction and estate planning practitioners are now trying to grapple with the unintended consequences of EGTRRA. Congress is looking at ways to fix the problem, including the possibility of retroactive legislation.

This solution will almost certainly lead to litigation, which will only lengthen the current state of confusion. Fear not, there may be some concrete steps you can take now. Click here for more details.

The Bottom Line

Although we are faced with uncertainty until Congress finally attends to the estate tax, at a minimum your existing estate planning documents should be reviewed to ascertain the effects of the one year repeal on your individual plan. Unfortunately, there is no one-size-fits-all "band-aid," but your advisors can help you avoid any unintended estate and gift tax consequences in 2010, as well as take advantage of any of the benefits to you during the one year "repeal."

About Stefan C. Nicholas

Stefan C. Nicholas is a Director and Chairman of Jackson & Campbell's Estates and Trusts practice group and a member of the Business Law practice group. He has extensive experience in drafting wills, trusts and all ancillary documents in connection with estate and gift tax planning, as well as asset protection planning including both on- and off-shore asset protection trusts and the use of corporate entities. Stefan also has extensive experience with sophisticated wealth transfer techniques such as grantor retained interest trusts, qualified personal residence trusts and defective grantor trusts. Contact him at


Chapter 5 – YOU GOTTA LAUGH: Life in the Trenches of the Health Insurance Business

Stephanie Cohen, Scott Golden

A new book by Stephanie Cohen and Scott Golden

This month's health insurance nightmare:

You submit your health insurance payments through a third party administrator but the administrator does not remit payments to the carrier, therefore all coverages for all employees are canceled.

The situation: The Alagassi Companies uses a broker for their insurance needs. The broker chooses where to submit the business – sometimes it is directly with the carrier, but many times there is a third party intermediary such as a wholesaler or a third party administrator.

Here's how that works: There is no difference in cost for the company purchasing the insurance. A broker chooses either a wholesaler or a Third Party Administrator (TPA) based on additional services that can be received from that organization. A wholesaler typically does not remit payment to the insurance company as the insurance carrier bills the customer directly. The organization processes renewals, runs quotes and handles problems on behalf of the client.

A TPA typically submits payment to the insurance carrier on behalf of the client thus creating another level between the client and the carrier. In fact, it would not be unusual for the TPA to do the billing, rather than the carrier.

The problem: In this case, the Alagassi Companies was using a TPA through their old broker thus submitting payment for their health insurance premiums to the TPA. The TPA unfortunately was not remitting payment to the carrier; thus the employees all received a notice that their coverage was canceled. The client was embarrassed – and furious – all at the same time.

The solution: If this is the process your company uses, make sure you ask your broker if they use a wholesaler or a TPA. It is always better to submit directly to the carrier to avoid these potential issues. With online technology, direct debit payment availability and other useful tools, there is no need to have an administrator collect the money. You want broker representation without multiple layers.

If we were the Health Insurance Ambassadors: We would not allow third party billing and collection of premiums. All insurance carriers should be paid directly from the customer thus alleviating cause for delay and loss of money.

The painful truth: If you are submitting your payments through a third party vendor, do not assume that your premium payment has reached the carrier – even though you have a canceled check. Yes, it's sad but true.

Share your stories: We encourage you to tell us about your insurance nightmares. Send an email to our newsletter editor,

By Jack Cohen, COO
Golden & Cohen,

Jack Cohen

Every year in the U.S., 5% to 20% of the population gets the flu and more than 200,000 people are hospitalized from flu complications. Ultimately, 36,000 people die from the infection.

What it is: This contagious respiratory illness that is caused by the influenza virus can be prevented by getting a flu vaccination each year.

When should you get the shot? According to experts, October or November is the best time to get vaccinated – but you can still get the shot in December, or later, for it to ward off the flu.

What the vaccine does: All the viruses in the vaccine are killed, so they cannot infect anyone. In one to two weeks after it is given, the vaccine will provide protective effects. Be aware, however, that 10% to 30% of those who get the shot still have a chance of getting the flu – but their symptoms will be much less severe than if they hadn't gotten the shot.

Next steps: Golden & Cohen works closely with employers to make sure their team is protected during cold and flu season. For more information, send me an email:

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