New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

Do Not Resuscitate Order For Southwest Gas Holdings Employees

Healthcare Provider Update: Healthcare Provider for Southwest Gas Holdings Southwest Gas Holdings provides healthcare benefits through a variety of insurers, primarily utilizing Aetna for their healthcare plans. This partnership enables employees to access a broad network of healthcare services. Expected Healthcare Cost Increases in 2026 As we approach 2026, healthcare costs are anticipated to soar, significantly impacting those affiliated with Southwest Gas Holdings. This expected surge stems from factors such as the expiration of enhanced federal subsidies for Affordable Care Act (ACA) plans, which could lead to a staggering increase of over 75% in out-of-pocket premiums for many enrollees. Moreover, aggressive rate hikes from major insurers, combined with rising medical costs, suggest that employees and retirees may face a challenging financial landscape in the coming year. Proactive management of health benefits and planning will be crucial for individuals navigating these increasing costs. Click here to learn more

What Is It?

As a Southwest Gas Holdings employee, you have the right to decline medical treatment, even if you die as a result of your decision. Depending on your medical condition, your prognosis, and your views on the quality of life, you may wish to refuse lifesaving measures, such as cardiopulmonary resuscitation (CPR). Executing a do not resuscitate (DNR) order is one way of doing this. A DNR is a doctor's order that tells all other medical personnel not to perform CPR if you go into cardiac arrest. Cardiac arrest occurs when your heart stops beating, blood flow to your brain stops, and you stop breathing. If the blood flow is not quickly restored, permanent damage to the brain and other organs can occur. CPR simulates heartbeat and breathing, while attempting to restart these functions.

The term CPR actually encompasses a variety of separate procedures, including cardiac compression, endotracheal intubation, assisted ventilation, defibrillation, and cardiac medications. Most states recognize two types of DNRs. One is effective only while you are hospitalized. The other is used by people outside the hospital--for example, nursing home residents, hospice patients, and even those who are not receiving medical treatment.

Typically, terminally ill patients and elderly individuals execute DNRs to avoid prolonging their final illnesses. However, some states allow healthy adults to execute the orders, as well. Depending on the laws of your state, a DNR used outside the hospital may be called a 'pre-hospital DNR,' 'out-of-hospital DNR,' 'outpatient DNR,' 'DNR for EMS,' or 'CPR directive.' As a result of your request, your doctor generally notes an in-hospital DNR order on your chart. Out-of-hospital DNRs take various forms, depending on the laws of your state. ID bracelets, MedicAlert necklaces, and wallet cards are some methods of noting DNR status.

When Can It Be Used?

Availability of DNRs Is Determined By State Law

Not all states have DNR laws. For Southwest Gas Holdings employees, you may want to consider how your state's laws govern whether DNRs are permissible, who can execute a DNR, and what form the order must take. These laws may permit in-hospital DNRs, out-of-hospital DNRs, both of these, or neither of these. Some state laws allow any person of legal age to execute a DNR, while others permit DNRs only for individuals with terminally ill conditions. Some states allow children to participate in decisions regarding DNR in certain cases. Check the laws of your state and any other states where you spend a significant amount of time.

Strengths

Allows You to Exercise Choice In Medical Treatment

Cardiopulmonary resuscitation (CPR) has produced some miraculous results when used on normally healthy individuals in trauma situations. However, it can be a painful and even violent procedure. Its effectiveness is limited when used on terminally ill or hopelessly deteriorated patients. In some cases, CPR only delays the moment of death.

For example, CPR could restore your heartbeat, but if permanent brain or organ damage occurs during cardiac arrest, you may be dependent on life support machines. Executing a do not resuscitate (DNR) order allows you to choose a natural death.

Example(s): Hal is hospitalized with a terminally ill condition. He is on a respirator and knows he has only a short time to live. Hal consults his doctor and learns that the laws of his state permit in-hospital DNRs. This will allow him to forego CPR if his heart fails. Hal asks his doctor to execute a DNR as soon as possible. The following week, Hal's heart stops. Because of Hal's DNR, hospital personnel do not attempt CPR.

Specifically Intended for an Emergency Situation

If you go into cardiopulmonary arrest, your DNR lets medical personnel know that you don't want CPR. Because of the emergency nature of this situation, other types of advanced directives are usually not timely enough to accomplish this goal.

Tradeoffs

Extremely Limited Usefulness

Although a do not resuscitate (DNR) order is a very powerful instrument, it is only effective under specific conditions. Generally, a DNR comes into play only if you go into cardiac arrest, and it frequently only allows you to refuse cardiopulmonary resuscitation (CPR), although in some states it may allow you to decline other drastic medical treatment as well. A living will or durable power of attorney for health care may be needed to convey other medical treatment instructions, such as your wishes regarding life support and intravenous feeding.

Out-of-Hospital DNR May Not Be Effective In Other States

As a Southwest Gas Holdings employee, it is beneficial to understand how an out-of-hospital DNR that is valid in your state may not be valid in other states. Therefore, if you spend a significant amount of time in another state, you should find out whether that state's laws recognize DNRs, whether you are eligible to have a DNR in that state, and what restrictions are placed on the form of the DNR.

Doctors May Be Hesitant to Broach This Topic or Reluctant to Write a DNR

If you are hospitalized with a serious illness, your doctor may not bring up the option of executing a DNR. If you don't want to be resuscitated, you should initiate this discussion with your doctor. Also, studies indicate that many doctors are slow to write DNRs, even when they are aware of their patients' preferences, although the reasons for this vary. If you are a Southwest Gas Holdings employee and want to ensure your wishes are followed, you should touch base with your doctor to make sure the DNR is placed on your chart.

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How to Do It

Research Your State's Laws Regarding Dnrs

Not all states provide for these orders. Each state has its own eligibility requirements, particularly for out-of-hospital DNRs.

Discuss Your Wishes With Your Doctor

Your doctor should be able to provide information on your prognosis and counsel you on your options. If you are a Southwest Gas Holdings employee, your doctor's signature will most likely be required on any DNR you execute.

Execute Your Out-of-Hospital DNR Properly And Keep It With You

If you are a Southwest Gas Holdings employee interested in DNR, you must consider how if your state allows out-of-hospital DNRs, there is probably a required format for the order. Examples of state-required DNR formats include ID bracelets, necklaces, wallet cards, and letter-size forms. If your DNR is not in the required form, it may not be honored. If medical personnel can't find your DNR order, they are obligated to give full and immediate care. Thus, it is extremely important to execute your DNR order properly and keep it with you (or in an appropriate place) at all times.

Example(s): Hal is a resident of an assisted-living facility. Hal is 89 years old and feels he has lived a good life. He does not want to die in a hospital or be dependent on machines for his survival. Hal discusses his feelings with his doctor. Hal's doctor suggests executing an out-of-hospital DNR, which will instruct medical personnel not to perform cardiopulmonary resuscitation (CPR) if Hal goes into cardiac or respiratory arrest. Hal agrees and receives an ID bracelet noting his DNR status. Hal wears his bracelet faithfully. Six years later, Hal's heart fails as he jogs in the park. Medical personnel arrive on the scene, but immediately notice Hal's DNR ID bracelet. CPR is not attempted.

Tell People About Your Decision

In general, other people cannot reverse your decision once you execute a DNR. As a Southwest Gas Holdings employee however, if your DNR is misplaced or for some reason is not followed, it would be important for your family and friends to understand your wishes. Although this topic may be difficult to discuss, those close to you are more likely to support and uphold your decision if they understand how you feel and why you feel that way. If you have appointed a representative in a durable power of attorney for health care (DPAHC) , it is especially important that this person be aware of your decision.

Coordinate All Advanced Directives

Since a DNR is so limited in scope, you may wish to establish a living will and/or DPAHC as well. If you do so, make sure your wishes are stated consistently throughout these documents. In some states, the most recent document will govern if there is a conflict, so you must make sure your wishes are clear.

Tax Considerations for Southwest Gas Holdings Employees

Income Tax

None

Gift And Estate Tax

None

Questions & Answers for Southwest Gas Holdings Employees

What If You Go Into a Coma Before Executing Your DNR, And You Can't Express Your Wishes?

Your healthcare representative, if you have appointed one, may be able to have a DNR executed on your behalf. As a Southwest Gas Holdings employee, there must be evidence that this is what you would want. You might include these instructions in your durable power of attorney for health care , especially if the laws of your state do not allow out-of-hospital DNRs. Be aware, however, that this method of instruction is useless in an emergency if your representative is not present. In some states, with your family's consent, your doctor may be able to execute a DNR on your behalf. Again, it would be unwise to rely on this course of action in an emergency.

Can You Change Your Mind?

Yes, it is possible to revoke a DNR order. If you have an out-of-hospital DNR, you may be able to revoke it by simply removing the bracelet or the wallet card. However, some states also have a database of DNR patients. If this is true in your state, you may need to take additional steps to revoke your DNR. When your doctor writes the DNR, ask what steps are necessary to revoke the order.

Additionally, medical personnel must give emergency care to anyone who requests it. For example, Emergency Medical Service guidelines in Wisconsin instruct personnel to perform cardiopulmonary resuscitation (CPR) if a person rips off his or her DNR bracelet or asks for CPR during cardiac arrest.

How does the Southwest Carpenters Pension Plan accommodate changes in benefits for employees who have been affected by the COVID-19 pandemic, and what specific provisions have been implemented to ensure continuity of pension credit during such interruptions? Employees of the Southwest Carpenters Pension Plan are particularly encouraged to review how these provisions may impact their retirement plans and benefits, especially given the unprecedented circumstances of the pandemic.

The Southwest Carpenters Pension Plan accommodated changes due to COVID-19 by extending various deadlines for participants, such as the 12-month deadline to apply for pension credit for periods of disability, and other deadlines regarding claims and appeals. These extensions were applied from March 1, 2020, to a period of up to one year after the original deadline or 60 days after the end of the COVID-19 national emergency, ensuring continuity of pension credit during the pandemic interruptions(Southwest Carpenters Pe…).

What enhancements to pension benefit calculations have been introduced for the years following January 1, 2021, under the Southwest Carpenters Pension Plan, and how do these changes affect participants working more than 1,800 hours? This question emphasizes the implications of increased benefit accrual rates and the actual processes employees must follow to calculate their pensions effectively.

Enhancements to pension benefit calculations effective January 1, 2021, under the Southwest Carpenters Pension Plan include an increase in the monthly benefit accrual rate for participants working 1,800 hours or more. The rate increased from $100 to $200, and for those working more than 1,800 hours, a maximum benefit accrual rate of $244.44 was introduced(Southwest Carpenters Pe…).

In the context of the Southwest Carpenters Pension Plan, could you explain the eligibility criteria for receiving a Service Pension and how employees can accumulate the necessary Pension Credits more quickly? This consideration is vital for members who wish to understand the retirement options available to them and the strategies they might employ in their careers to maximize their benefits under the Southwest Carpenters Pension Plan.

Employees of the Southwest Carpenters Pension Plan are eligible for a Service Pension after earning 30 years of Pension Credit. Additional Service Pension Eligibility Credit was introduced, allowing employees working over 1,800 hours annually to accumulate credits more quickly, up to a maximum of 2,200 hours(Southwest Carpenters Pe…).

How do temporary disability benefits interact with the accumulation of Pension Credits within the Southwest Carpenters Pension Plan? Specifically, employees may have questions about how their working history and service time might be affected should they take leave for health-related reasons, highlighting the intricate balance between pay and benefits during challenging times.

Temporary disability benefits under the Southwest Carpenters Pension Plan allow participants to accumulate Pension Credits during non-working periods if they are on short-term disability or receiving workers' compensation. Pension Credits can be granted for up to 1,200 hours annually, depending on the nature of the disability and employment history(Southwest Carpenters Pe…).

What are the implications of the revised definitions under the Required Beginning Date as specified by the Southwest Carpenters Pension Plan, particularly in compliance with the SECURE Act (Setting Every Community Up for Retirement Enhancement Act)? Employees should understand how these legislative changes affect their retirement strategies, especially in light of penalties for failing to comply with mandatory commencement dates.

The Required Beginning Date for the Southwest Carpenters Pension Plan was revised to comply with the SECURE Act. Participants born on or after July 1, 1949, must begin receiving benefits by April 1 of the calendar year following the year they turn 72. Failure to comply with this could result in a 50% excise tax(Southwest Carpenters Pe…).

How can employees of the Southwest Carpenters Pension Plan navigate the process for applying for pension credit during periods of Temporary Disability, and what specific documentation is required? This inquiry encourages a deeper understanding of protocol surrounding disability applications and the associated benefits that participants are entitled to under the Plan.

Employees applying for pension credit during periods of Temporary Disability must submit a written application within one year of the onset of the disability, and provide documentation such as state-approved short-term disability certification or workers' compensation benefits(Southwest Carpenters Pe…).

What are the implications of the retroactive increases to the Southwest Carpenters Pension Plan benefits aimed at participants who accrued credit during the years 2011 to 2020, and how can affected employees determine their eligibility for said increases? Employees often seek clarification on how historical contributions can manifest in current benefits.

Retroactive increases to the Southwest Carpenters Pension Plan benefits for the years 2011 to 2020 apply to participants who worked at least 1,000 hours in 2020 or under specific collective bargaining agreements. A 50% increase in benefit accrual rates was applied to these years, and eligible employees can determine their eligibility based on their hours worked(Southwest Carpenters Pe…).

What role does the Southwest Carpenters Administrative Office play in assisting employees who have questions regarding modifiability in their pension plans, and what are the best methods for contacting them for assistance? This question highlights the importance of communication within the organization concerning employee inquiries and issue resolution.

The Southwest Carpenters Administrative Office assists employees with questions regarding modifications to their pension plans. Participants can contact them at (213) 386-8590 or (800) 293-1370 for personalized assistance(Southwest Carpenters Pe…).

Can you detail the factors influencing the Benefit Accrual Rate for participants of the Southwest Carpenters Pension Plan for the calendar years after 2021, and how might employees calculate their expected pension benefits? Participants will want to understand the nuances of how their benefits are computed to make informed decisions regarding their retirement planning.

The Benefit Accrual Rate for participants of the Southwest Carpenters Pension Plan after 2021 increased to $200 for 1,800 hours worked, with higher accrual rates for additional hours. Employees can calculate their benefits by multiplying their benefit accrual rate by the applicable benefit factor(Southwest Carpenters Pe…).

In the event of legal actions regarding benefits under ERISA against the Southwest Carpenters Pension Plan, what venue restrictions apply, and what does this mean for participants seeking resolution in disputes? Employees need to be informed of the legal frameworks governing their benefits and understand their rights and the procedures that affect their claims within the Southwest Carpenters Pension Plan.

Legal actions regarding benefits under ERISA against the Southwest Carpenters Pension Plan must be filed in Federal District Court in Los Angeles County, California. This venue restriction defines the jurisdiction where participants must file claims(Southwest Carpenters Pe…).