Audit firm, partners charged for deficient audits

(Washington, DC – Insurance News 360) – On Dec. 21, the Securities and Exchange Commission filed settled charges against national audit firm Crowe LLP, two of its partners, and two partners of a now-defunct audit firm for their significant failures in audits of Corporate Resource Services Inc., which went bankrupt in 2015 after the discovery of approximately $100 million in unpaid federal payroll tax liabilities.

The SEC’s order against Crowe finds that its audit team identified pervasive fraud risks in connection with its 2013 audit of Corporate Resource Services yet failed to:

Include procedures designed to detect the company’s undisclosed payroll tax obligations;

Properly identify and audit the company’s related-party transactions;

Obtain sufficient appropriate audit evidence to respond to these fraud risks, support recognition of revenue, and otherwise support the audit opinion;

Evaluate substantial doubt about the company’s ability to continue as a going concern; and

Conduct a proper engagement quality review.

According to the order, Crowe was not independent, because of an ongoing direct business relationship with Corporate Resource Services. Audit deficiencies occurred despite the involvement of Crowe’s national office, which was aware of the high-risk nature of the engagement and the inability to obtain appropriate evidence. The order also finds that Crowe’s engagement partner, Joseph C. Macina, and engagement quality reviewer, Kevin V. Wydra, caused Crowe’s audit failures.

A related order finds that Mitchell J. Rubin and Michael Bernstein, former partners at Rosen, Seymour, Shapps, Martin & Co., LLP, engaged in fraud and performed a highly deficient audit of Corporate Resource Services’ 2012 financial statements, which amounted to no audit at all, and that Bernstein caused the firm to lack the required independence when he failed to comply with partner rotation requirements.

“The audit standards are designed to ensure that public accounting firms have reasonable procedures to identify and respond to illegality and issues that pose material risks to the integrity of an issuer’s financial statements,” said Anita B. Bandy, Associate Director in the Division of Enforcement. “As set out in our order, the pervasive audit failures of Crowe and these accountants left investors with a misleading picture of Corporate Resource Services’ financial condition.”

Crowe will pay a $1.5 million penalty, be censured, and retain an independent compliance consultant to review its audit policies and procedures. Macina, Rubin, and Bernstein each agreed to pay a $250,000 penalty. Wydra will pay a $15,000 penalty. Macina, Wydra, Rubin, and Bernstein are suspended from appearing and practicing before the SEC as an accountant, which includes not participating in the financial reporting or audits of public companies. The SEC’s order permits Macina and Wydra to apply for reinstatement after three years and one year, respectively. Crowe, Macina, Wydra, Rubin, and Bernstein, who settled without admitting or denying the findings, also were ordered to cease and desist from future violations.

The SEC’s investigation continues and has been conducted by Sharan K.S. Custer, Ernesto Amparo, Regina Barrett, and Kam Lee, and supervised by Ms. Bandy and Kristen Dieter.

Source: U.S. Securities and Exchange Commission.

U.S. Department of Commerce Finds Dumping and Countervailable Subsidization of Imports of Plastic Decorative Ribbon from China

(Washington, DC – Insurance News 360) – On Dec. 21, 2018, the U.S. Department of Commerce announced the final determinations in investigations into the antidumping duty and countervailing duty (CVD) of imports of plastic decorative ribbon from China. These investigations revealed that exporters sold plastic decorative ribbon at less than fair value in the United States at rates ranging from 54.21 to 370.04 percent. Exporters also received countervailable subsidies at rates ranging from 14.27 to 94.67 percent.

After publication of the final affirmative antidumping determination, the Department of Commerce is to direct U.S. Customs and Border Protection to take antidumping cash deposits equal to the applicable final weighted-average dumping margins. Regarding the CVD determination, if the International Trade Commission makes an affirmative injury determination, the U.S. Department of Commerce will also tell U.S. Customs and Border Protection to collect CVD cash deposits that equal subsidy rates.

In 2017, imports of certain plastic decorative ribbon from China were valued at an estimated $22.5 million.

The ITC is set to make final determinations on Feb. 4. If there are affirmative injury determinations, Commerce will issue orders to Customs and Border Patrol. If the determinations are negative, the investigations will be dropped.

As a primary focus of the Trump Administration, Commerce has initiated 137 new antidumping and countervailing duty investigations since President Trump took office. This is an increase of more than 300 percent over the same time frame in the previous administration.

Click HERE for a fact sheet on  these decisions.

Source: U.S. Department of Commerce.

Lloyd’s confirms 2019 targets for electronic placement mandate

(London, UK – Insurance News 360) – On Dec. 20, the Corporation of Lloyd’s confirmed 2019 targets for electronic placement.

For the first quarter of 2019, syndicates must have written no less than 40 percent of risks with a recognised electronic placement system. The target will increase to 50 percent in the second quarter, when a quote target will be introduced.

Lloyd’s brokers will be required to connect to a recognised electronic placement platform by June 1. Lloyd’s will be working closely with LIIBA to achieve this.

“Since we implemented this mandate across the Lloyd’s market, we’ve seen a marked increase in the adoption of electronic trading, which is fast-tracking our transformation,” said Shirine Khoury-Haq, Lloyd’s Chief Operating Officer. “The latest developments, including quote targets and the Lloyd’s broker requirement, are essential next steps in our journey to digitise our market and to provide the best possible service to our clients. I am thankful to have so much support across the broking community and [the London and International Brokers’ Association in these efforts.”

By the end of the Q3 2018, 29.8% of ‘in scope’ contracts were placed electronically in the Lloyd’s market and almost reaching the Q4 target of 30%. Syndicates meeting and exceeding the targets will receive a rebate on their annual subscriptions.

Source: Lloyd’s.

Pending Home Sales See 0.7 Percent Drop in November

(Washington, WA – Insurance News 360) – The National Association of Realtors announced that although pending home sales dropped slightly in November, there were increases in certain regions – the northeast and the west.

The Pending Home Sales Index decreased 0.7 percent to 101.4 in November, down from 102.1 in October. However, year-over-year contract signings dropped 7.7 percent, making this the eleventh straight month of annual decreases.The pending home sales index is a forward-looking indicator based on contract signings.

NAR’s Chief Economist, Lawrence Yun cautioned that the current sales numbers don’t fully account for other data.

“The latest decline in contract signings implies more short-term pullback in the housing sector and does not yet capture the impact of recent favorable conditions of mortgage rates,” he said. “The west crawled back lightly, but is still experiencing the biggest annual decline among the regions because of unaffordable conditions.”
Affordability challenges in the west are partly to blame for the drop in sales. Yun suggests that affordability challenges in the West are part of the blame for the drop in sales.

“Land cost is expensive, and zoning regulations are too stringent. Therefore, local officials should consider ways to boost local supply; if not, they risk seeing population migrating to neighboring states and away from the West Coast.”

Yun indicated the latest government shutdown will harm the housing market. “Unlike past government shutdowns, with this present closure, flood insurance is not available. That means that roughly 40,000 homes per month may go unsold because purchasing a home requires flood insurance in those affected areas,” Yun said. “The longer the shutdown means fewer homes sold and slower economic growth.”

November Pending Home Sales Regional Breakdown

The PHSI in the Northeast rose 2.7 percent to 95.1 in November, and is now 3.5 percent below a year ago. In the Midwest, the index fell 2.3 percent to 98.1 in November and is 7.0 percent lower than November 2017.

Pending home sales in the South fell 2.7 percent to an index of 115.7 in November, which is 7.4 percent lower than a year ago. The index in the West increased 2.8 percent in November to 87.2 and fell 12.2 percent below a year ago.

The National Association of Realtors® is America’s largest trade association, representing 1.3 million members involved in all aspects of the residential and commercial real estate industries.

Source: Realtors®

Compliance Assistance Resources are available to protect workers from falls

(Washington, DC – Insurance News 360) – The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has created a collection of compliance assistance resources for falls in the workplace, the most common cause of worker deaths in the construction industry.

Falls can be prevented with planning for safety, provision of the right equipment, and training workers to use that equipment. OSHA’s informative compliance assistance resources include the following:

The sixth annual National Safety Stand-Down to Prevent Falls in Construction will be held May 6-10, 2019. The weeklong outreach event encourages employers and workers to pause during the workday to discuss fall hazards and how to prevent them.

A series of fall safety videos show how to prevent construction-related fall hazards from floor openings, skylights, fixed scaffolds, bridge decking, reroofing, and leading edge work.

OSHA’s Fall Prevention Training Guide provides a lesson plan for employers including several Toolbox Talks.

Fact sheets on ladders and scaffolding provide guidance on the safe use of these types of equipment while performing construction activities.

A brief video, 5 Ways to Prevent Workplace Falls, encourages employers to develop a fall prevention plan, and to provide workers with fall protection and training.

OSHA’s On-Site Consultation Program provides valuable services for job creators that are separate from enforcement. OSHA recently published an analysis demonstrating how the agency’s On-Site Consultation Program contributes $1.3 billion to the national economy each year. Job creators who implement workplace improvements can reduce lost time due to injuries and illnesses, improve employee morale, increase productivity, and lower workers’ compensation insurance premiums.

Source: U.S. Department of Labor.

Oklahoma Oil Service Waste Disposal Company Resolves Overtime, Child Labor Violations Found in U.S. Department of Labor Investigation

(Oklahoma City, OK – Insurance News 360) – Following an investigation by the U.S. Department of Labor’s Wage and Hour Division, Oklahoma City’s Backyard Energy Services paid $253,399 in back wages and a civil penalty of $2,163 for violations of the Fair labor Standards Act, child labor laws, and record keeping issues.

The Department of Labor notes that Backyard Energy Services violated federal overtime law by misclassifying employees as independent contractors paid a flat daily rate when they worked more than 40 hours in a week. They also misclassified intrastate drivers as exempt from FLSA-overtime rules, paying flat salaries without overtime pay for work over 40 hours in a week. The DOL also says they didn’t keep records of how long employees worked.

In addition, Backyard Energy Services violated child labor laws when it employed a 17-year-old to operate a front-end loader and track hoe.

“Employers have a legal responsibility to pay their employees for all of the hours that they work, including overtime hours,” said Wage and Hour Division District Director Michael Speer, in Oklahoma City, Oklahoma. “By enforcing the FLSA, the U.S. Department of Labor helps to level the playing field for all employers and ensure workers get the wages and employment protections they are due.”

Source: U.S. Department of Labor.

Model, dealer selection affected by word-of-mouth and online research when looking for a new car

(Singapore – Insurance News 360) – In the United Arab Emirates, nearly 75 percent of buyers ask friends or relatives for car advice, or do online research to choose a model and brand of vehicle to purchase, according to the JD Power 2018 UAE Sales Satisfaction Index study.

Vehicle pricing, features specifications, warranty, sale promotions, and dealer information are the most-cited information searched for by vehicle buyers who look online. But, 18 percent visit the dealer they end up purchasing from

Sixty-eight percent of new vehicle buyers who looked online did contact the purchasing dealership for one reason or another. The study did reveal that individuals who shop online are slightly less satisfied with their purchase than those who buy in person.

“As the path to new vehicle purchases increasingly relies on online sources, it is imperative for manufacturers and dealerships to design websites that feature the required information sought by buyers and are easy to navigate across multiple devices,” said Shantanu Majumdar, Regional Director Automotive Practice at J.D. Power. “Given that word-of-mouth plays a strong role in influencing purchase decisions, dealerships that can actively manage their reputation online stand a better chance to enhance their retail experience, and ultimately, win new customers.”

Study Rankings

In the mass market category, Kia ranks highest in sales satisfaction, followed by Ford and Nissan. In the luxury category, Land Rover has the highest satisfaction ratings, followed by BMW and Infiniti.  859. Ford ranks second with a score of 855, while Nissan ranks third with a score of 854.

The 2018 U.A.E. Sales Satisfaction Index (SSI) Study measures satisfaction with the sales experience among new-vehicle buyers. Buyer satisfaction is based on six measures: dealership facility (25%); delivery process (23%); dealer sales consultant (20%); paperwork completion (17%); working out the deal (10%); and dealership website (5%).

The study is based on responses from 2,083 buyers who purchased or leased their new vehicle between March through November 2018. The study is a comprehensive analysis of the new-vehicle purchase experience and measures customer satisfaction with the selling dealer (satisfaction among buyers). The study occurred  from July through November 2018.

Source: J.D. Power.

On Jan. 3, the Centers for Medicare and Medicaid Services released the final weekly enrollment snapshot for 2019.

(Baltimore, MD – Insurance News 360) – Each week, through the enrollment period,  CMS took enrollment snapshots that give point-in-time estimates of plan selections, call center activity, and visits to or This final report shows new plan selections, active plan renewals and automatic enrollments.

The snapshot includes the following:

Plan selections between Nov.1- Dec. 22: 8,411,614

New consumers: 2,072,115

Consumers renewing coverage: 6,339,499

Call Center volume: 5,781, 920

Calls with Spanish-Speaking Representative: 396,895 users; 15,857,282 users: 588,088

Window-Shopping users: 1,439, 953

CMS will release additional data in March, including final plan selection data from State-based Exchanges that do not use the platform.

Source: Centers for Medicare & Medicaid Services.

Center for Medicare Services releases final snapshot for 2019 Federal Exchange open enrollment period

(Baltimore, MD – Insurance News 360) – On Jan. 3, the Centers for Medicare and Medicaid Services (CMS) released a final snapshot for the 2019 Federal exchange open enrollment period. Enrollment was steady, with more than 8.4 million enrolling. The CMS says this represents steady enrollment when a strengthening economy and job Dmarket may be reducing need and demand for subsidized healthcare.

Several factors may have contributed:

More than two million jobs were added to the economy, compared to the prior year, which led to the lowest unemployment rate in nearly 50 years.

More people had access to job-based health coverage.

Virginia’s Medicaid population expanded, and that means 100,000 exchange enrollees would be eligible for expanded Medicaid.

“Congratulations to everyone at CMS who executed another very successful Open Enrollment period through  Our team worked day and night to ensure those who wanted coverage on the Exchange could easily pick a plan,” said CMS Administrator Seema Verma.

Similar to last year, CMS committed resources to cost-effective, high-impact outreach during this year’s Open Enrollment that increased as the deadline approached. For instance, CMS sent over 700 million reminder emails and text messages to consumers, as well as 3.2 million outreach emails to help Navigators, agents, and brokers assist consumers.  In addition, senior Administration officials, including the Secretary of the U.S. Department of Health and Human Services and the CMS Administrator, encouraged people to enroll through television and radio interviews broadcasted to more than 195 stations across the country.

To view the final enrollment snapshot, visit:

Source: Centers for Medicare & Medicaid Services.

Final Rule Creates Pathways to Success for the Medicare Shared Savings Program

(Baltimore, MD – Insurance News 360) – The Centers for Medicare and Medicaid Services (CMS) issued a final rule which creates a new direction for the Medicare Shared Savings Program. The new direction is called Pathways to Success and redesigns participation options to encourage Accountable Care Organizations to move to performance-based risk more quickly, and for those ACOs that are eligible to increase savings for trust funds. They also address additional tools and flexibilities for these organizations, as established in the Bipartisan Budget Act of 2018.

These additional tools include new beneficiary incentives, telehealth services and choice beneficiary assignment methodology. This final rule also finalizes the program’s policy for extreme and uncontrollable circumstances for performance year 2017.

CMS will offer an application cycle for a single new agreement period starting July 1, 2019, to avoid interrupting participation by ACOs  that elected on Dec. 31, 2018 to extend their agreement period for an additional six month performance year.

CMS will resume the usual annual application cycle for agreement periods starting on January 1, 2020, and in subsequent years.

Major changes include the availability of an optional 6-month extension for ACOs whose agreements expired on Dec. 31, 2018, methodology for determining financial and quality performance, ; a reduction in the Shared Savings Program core quality measure set by eight measures and a new Certified EHR Technology (CEHRT) threshold criterion to determine ACOs’ eligibility for program participation in order to promote interoperability among ACO providers/suppliers; refinements to the voluntary alignment process. They also implement policies to address the impact of these changes are expected to allow beneficiaries more flexibility when choosing medical providers.

Shared Savings Program ACOs serve more than 10.5 million Medicare fee-for-service beneficiaries. This program helps CMS payment systems to move from pay for volume to instead look at paying for value and outcomes.  The Shared Savings Program originally had three tracks, and the most popular seems to be a one-sided shared savings-only model in Track 1. ACOs receive a share of savings under their benchmark, but are not required to repay a share of spending over the benchmark.  Tracks two and three give ACOs a larger portion of savings under benchmark, but those ACOs are required to share the losses if they spend above the benchmark.

There are now two options starting July 1, 2019 and in subsequent years:

(1) BASIC track, which would allow eligible ACOs to begin under a one-sided model and incrementally phase-in higher levels of risk that, at the highest level, would qualify as an Advanced Alternative Payment Model (APM) under the Quality Payment Program, and

(2) ENHANCED track, based on the program’s existing Track 3, which provides additional tools and flexibility for ACOs that take on the highest level of risk and potential reward. Appendix A summarizes the characteristics of the participation options.

The BASIC track’s glide path offers an incremental approach to transitioning eligible ACOs to higher levels of risk and potential reward. The glide path includes 5 levels:  a one-sided model available only for the first two years to most eligible ACOs (ACOs identified as having previously participated in the program under Track 1 would be restricted to a single year under a one-sided model, but new, low revenue ACOs that are not identified as re-entering ACOs would be allowed up to three years under a one-sided model); and three levels of progressively higher risk in years 3 through 5 of the agreement period.

Under Levels A and B of the glide path, an ACO’s maximum shared savings rate under a one-sided model will be 40 percent based on quality performance, applicable to first dollar shared savings after the ACO meets the minimum savings rate. Under Levels C, D, and E of the glide path, an ACO can earn up to a maximum 50 percent sharing rate under a two-sided model, based on quality performance. The glide path concludes with a maximum level of risk that qualifies as an Advanced APM for purposes of the Quality Payment Program.

ACOs in the BASIC track glide path generally will be automatically advanced at the start of each performance year along the progression of risk/reward levels or could elect to move more quickly to a higher level of risk/reward, over the course of their agreement period. While the typical agreement period will be 5 years in duration, with 12-month performance years based on calendar years, ACOs entering an agreement period beginning on July 1, 2019, would participate in a first performance year of 6 months for the period from July 2019 – December 2019 plus 5 additional years in their first agreement period. For ACOs entering the BASIC track’s glide path for an agreement period beginning on July 1, 2019, the first automatic advancement occur at the start of performance year 2021.  Additionally, a new, low revenue ACO in the glide path that is not identified as a re-entering ACO will be permitted to choose to remain at Level B for an additional year, in exchange for agreeing to progress immediately to Level E at the start of the fourth performance year (or fifth, in the case of an agreement period starting on July 1, 2019).

The eligibility criteria for the BASIC track and ENHANCED track recognize differences in ACO participants’ Medicare FFS revenue and the experience of the ACO and its ACO participants with performance-based risk Medicare ACO initiatives. We will determine whether an ACO is a low revenue ACO versus a high revenue ACO, and whether an ACO is experienced or inexperienced with performance-based risk Medicare ACO initiatives. Based on stakeholder feedback, we have increased the threshold for low revenue ACOs to include ACOs with ACO participants’ total Medicare Parts A and B FFS revenue of less than 35 percent of the total Medicare Parts A and B FFS expenditures for the ACO’s assigned beneficiaries to capture additional ACOs, especially those that include clinics or smaller institutional providers, including rural ACOs. Ultimately, all ACOs are expected to transition to the ENHANCED track under the redesigned program. Low revenue ACOs are allowed additional time under lower-risk options within the BASIC track, while ACOs identified as high revenue are required to transition to the ENHANCED track more quickly.

Source: Centers for Medicare & Medicaid Services.