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January 25, 2007

Comments

Norman Stein

My brother is a doctor and he left a medical practice because of disputes about expenses. I suspect that in the case about which I wrote, the doctor believed that at least a significant portion of the overcharges were at least arguably improper (and if he left mid-year, it is easy to imagine a scheme where some expenses were accelerated, and in any event, that some expenses more fairly charged elsewhere--to the university or the hospital, for example, might have been charged against practice income). I would not simply assume that there was a drastic drop in revenues produced by the doctor. I do think that such an issue would have been expensive to litigate relative to the amount of damages that could be recovered under ERISA. Essentially, though, the hospital was able to dock the money without resorting to a judicial remedy, and, in any event, it was only the serendipity that the doctor had an account that made it possible for the hospital to unilaterally dock him. There was no administrative hearing or indeed any procedure available to him to adminstratively challenge the decision.

Moreover, if the purpose of the plan was to pay the doctor more in good years but have that amount as a security interest against bad years, it is hard to see that the plan had as its primary purpose the deferral of income (it would have been a secondary purpose).

Carl Johnson

What's always fascinated me about this situation is the DOL's failure to address the elements of the top cat plan with an interpretative regulation at some point in the past thirty plus (30+) years or so.

Richard Rogers

1. I think these doctors have enough negotiating power to be classifed as select employees. Who else in the university system could command such a complicated arrangement to get pay in excess of the limits? These are highly educated who have the sophistication to understand what they are getting into and they have alternatives to working for the hospital - that makes them select.

2. The forfeiture is not such an unreasonable feature in that it is really a refund of overpayments received by the doctors. The deferred compensation arrangement is an obligation of the hospital to pay the doctors, but the doctors have an obligation to repay the hospital for overpayments - the obligations cancel each other out. The doctors could have negotiated a prepaid salary that was less than what they received, but they decided (reasonably) to get as much as they could upfront.

3. Do the doctors constitute 15% of the university system? Doubtful. I would think the university system, and not some smaller group of hospital employees or professionals, would be the measure of the 15%.

Judy Mazo

These are interesting issues. I'm glad you're looking into them.

I was intrigued by the case you describe when it was reported, although a little less sympathetic when I saw the depth of the doctor's practice deficit, which (as I recall the facts as stated in the opinion) was large and seemed to have materialized fairly suddenly, leading to the inference that it may have been connected to the doctor's termination from the hospital.

Several observations:
1) A test for whether or not a program is subject to ERISA vesting and funding, based on something as extraordinarily subjective as the ability of a covered individual to influence its terms, would be impossible to handle. What happens when a covered individual has a lot of influence over the deal, such as at the time she is being recruited, but then falls out of favor with the decisionmakers, whether because of performance issues, interpersonal problems, or simply a change in the identity of the decisionmakers through retirement or a corporate transaction? Does it stop being a top-hat plan at that point, for this person or everyone? Would future accruals for the executive with the cloudy future have to be vested and funded, or all her accruals accruals? Or would the person just have to be dropped from the plan at that point? Can you imagine the resulting management and HR issues?

2) These plans are, by definition, set up to give executives more than the employer is willing to give to a broad swath of employees. Often they are designed to give more than the IRC would allow without regard to discrimination, i.e., more than the 415 and 401(a)(17) limits permit (adding benefits based on compensation above the (a)(17) limits takes it out of the "excess plan" category, of course). Limiting the people allowed to participate to those who have provable clout with the decision makers in the corporate structure would, once again, hurt the lower-echelon of the higher-paid, such as the other high-producing doctors in the case you described, or middle managers in the standard corporate case.

3) The facts of your case, where the forfeiture related to after-tax dollars, may be an artifact of the peculiar restraints imposed by section 457 on non-qualified deferred compensation in the tax-exempt arena. As you explore this area, consider the possibility of reforming section 457 as it applies in the private sector and hobbles tax exempt institutions in the acclaimed "war for talent."

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