January 27, 2023

Bucks: Employer Error Causes Tax Problem for Gay Couple

What if You're Gay - Your Money - Bucks Blog - NYTimes.com

Most of us pay income taxes because we know we have to. But what happens when you fail to pay an obscure tax that you never heard of — and that your employer should have told you about?

That’s the predicament that Thomas Satterwhite, a plastic and reconstructive surgery resident at Stanford Hospital Clinics, and his partner, Harald Frohlich, a kindergarten teacher at the San Francisco School, have found themselves in.

Since Stanford generously offers health insurance to its employees and their families for free, Mr. Frohlich said he decided to use its health coverage, which the hospital also extends to domestic partners. Unlike married couples, those who use domestic partner coverage must pay taxes on the value of that coverage unless the partner is considered a dependent. If same-sex couples were allowed to marry, they could avoid the tax like their heterosexual counterparts.

Employers who offer domestic partner insurance usually take care of the tax issue by including the “imputed income” on their employees’ paychecks, and the appropriate taxes are withheld. Or, as an increasing number of employers have chosen to do, they reimburse employees for those extra costs.

But Stanford never properly accounted for the income. Nor is it the first employer to run into this issue. Yale University made a similar error earlier this year that affected 61 employees.

Dr. Satterwhite received a letter in April from the hospital’s human resources department, which said it had discovered the error during a system audit. “We were not aware there was a tax when you are a domestic partner,” Mr. Frohlich said. “And then we got that letter, which was a big surprise.”

By his estimation, the hospital didn’t include the taxes, of about $270 a month, for nearly three years. As a result, he said his partner would have to amend his tax returns for those years, and will probably owe $7,000 to $8,000 in back taxes, plus any penalties or interest. If the couple had known about the extra taxes, Mr. Frohlich said, he would have used the insurance provided by his own employer.

The couple wrote a letter to the hospital’s benefits manager saying they believe that Stanford should cover the costs because it didn’t properly inform them from the start. At the very least, the letter said, they would like Stanford to pay for the costs associated with amending Dr. Satterwhite’s tax returns for the past three years, plus any potential penalties or interest.

Stanford declined to say whether this issue was isolated to the one couple, or if the problem was more widespread. “Our benefit program here for domestic partners provides the same level of coverage as it does for spouses,” said Gary Migdol, a spokesman for Stanford Hospital Clinics. “Due to confidentiality issues, we cannot comment on a specific employee. However, if an employee raises concerns about an issue related to his/her benefit package, it is investigated thoroughly and appropriate action is taken.”

Do you know of any other employees at Stanford Hospital employees or elsewhere who have encountered this problem? And what do you think Stanford should do?

Article source: http://feeds.nytimes.com/click.phdo?i=d97b3a1e403ada47cac501f71455e6d3

Patient Money: Using Hypnosis to Gain More Control Over Your Illness

So the news that she needed brain surgery again was hardly welcome. Determined to make her second operation a better — or at least less traumatic — experience, Ms. Ritchie, an insurance marketing representative in Cleveland, turned to an unusual treatment.

At the Cleveland Clinic’s Center for Integrative Medicine, she had four hypnosis sessions in the month before her procedure, during which she addressed her fear of the coming surgery. She also practiced self-hypnosis every day.

Eventually, she said, “I got to a place where I felt a sense of trust instead of fear.”

In February, doctors removed a plum-sized tumor from her brain. But there the similarity to her previous experience ended. Ms. Ritchie woke up from the procedure, she said, feeling “alert and awesome.” She ate a full dinner that night and went home in two days.

“My neurosurgeon was stunned at how little medication I required before and after surgery, and how quickly I bounced back,” she said.

Ms. Ritchie attributes her speedy recovery and calm state to her hypnosis sessions. Used for more than two centuries to treat a host of medical problems, particularly pain management and anxiety, hypnosis is now available to patients at some of the most respected medical institutions in the country, including Stanford Hospital, the Cleveland Clinic, Mount Sinai Medical Center and Beth Israel Medical Center in New York.

Some critics find the research into mind-body therapies unconvincing, but their skepticism has not deterred patients like Ms. Ritchie. And there are researchers who say they believe that by helping patients feel in better control of their symptoms, hypnosis can reduce the need for medication and lower costs.

“It is an effective and inexpensive way to manage medical care,” said Dr. David Spiegel, director of the Center on Stress and Health at Stanford University School of Medicine and a leading authority on hypnosis.

A study by radiologists at Harvard Medical School, published in 2000, found that patients who received hypnosis during surgery required less medication, had fewer complications and shorter procedures than patients who did not have hypnosis. In a follow-up study in 2002, the radiologists concluded that if every patient undergoing catheterization were to receive hypnosis, the cost savings would amount to $338 per patient.

“When patients are groggy from anesthesia drugs, it costs more to recover them,” said Dr. Elvira Lang, an associate professor of radiology at Harvard Medical School and a lead author of both studies. “Hypnosis calms patients.”

If you have a medical condition for which conventional medicine is not working, or you’d like to try a gentle mind-body alternative, hypnosis may be worth considering. Here are some things to keep in mind.

THE THERAPIST There is no uniformly accepted definition of hypnosis, but most experts generally agree that it is an altered mental state in which a patient becomes highly focused and more receptive to social cues.

During a session, the practitioner guides the subject into a relaxed state and then makes specific suggestions to help change a behavior, a perception or a physiological condition. Someone who is trying to quit smoking, for instance, might be told under hypnosis that cigarettes are poisons and that it’s important to care for and respect his body.

Some patients find that hypnosis is a helpful adjunct to traditional psychotherapy.

“Talk therapy engages the conscious mind, which is overwhelmingly facile at creating blocks to avoid hurtful problems,” said Dr. Tanya Edwards, director of the Center for Integrative Medicine at the Cleveland Clinic. “In hypnosis, the therapist is dealing with the subconscious mind and can get at core problems more quickly.”

Whatever the approach, it’s important to find a highly skilled practitioner.

“Hypnosis is like a surgeon’s knife,” said Edward Frischholz, a clinical psychologist in Chicago who has written more than 50 papers on clinical and experimental hypnosis. “In the right hands it can be life-saving, but in the wrong it could cause harm.”

There is no universal licensing process for practitioners who do hypnosis, so look for a licensed health professional — for instance, a psychologist, medical doctor or social worker — who has been trained in hypnosis. Ask your doctors and therapists for recommendations, or go to the Societies of Hypnosis Web site, which allows you to search by ZIP code and specialty.

THE SESSION At your first session, the practitioner will discuss your condition and may administer a short test to assess how hypnotizable you are.

Most people are susceptible to hypnosis. But if someone is clearly not, then the therapist or doctor may try another technique or suggest a different approach to the patient’s problem. Most sessions last about 50 minutes.

Specific conditions — like smoking, a fear of dogs or flying or temporary insomnia — may require just one session. In 2008, the personal health columnist Jane E. Brody recalled in this newspaper that her husband was able to stop smoking after just one session of hypnosis.

“For very circumscribed disorders, hypnosis works very quickly or not at all,” said Dr. Frischholz.

If your problem is more complex, like post-traumatic stress disorder or depression, it may require multiple sessions. “I might spend the first two sessions taking a history and learning about someone’s background,” said Carol Ginandes, an assistant clinical professor of psychology at Harvard Medical School who uses hypnosis in her private practice. “Then I would work with the patient in a very individualized way.”

A session costs between $75 and $200, depending on where you live and the credentials of the practitioner. If the therapist or doctor is in your insurance network, then you may pay only a standard co-payment. Insurers do not cover hypnosis itself, however; it will have to be billed as a part of your counseling, or as an office visit.

THE DO-IT-YOURSELF APPROACH If the thought of someone putting you in a trancelike state makes you uncomfortable, hypnosis with tape or CD at home may be a practical alternative.

CDs made for a general audience, available at Web sites like HypnosisNetwork.com or HealthJourneys.com, may not be able to help you with a particular or complicated condition, like a lifelong struggle with depression, but they may help train you to calm down before a big test or surgical procedure.

Some practitioners may send you home with a custom-made CD or tape that you can use on your own.

Your therapist or doctor may also teach you self-hypnosis, as Ms. Ritchie’s therapist did. You learn how to put yourself in a deeply relaxed, receptive state in which you repeat statements such as “My body is strong and can handle this surgery,” or “I feel calm and relaxed.”

“People think hypnosis is about giving up control,” said Dr. Spiegel. “But it’s actually giving control back to the patients.”

Article source: http://feeds.nytimes.com/click.phdo?i=6e5123ece05d85805454ddbfa38b1962