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Do Not Resuscitate Order For U.S. Bancorp Employees

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Healthcare Provider Update: Healthcare Provider for U.S. Bancorp U.S. Bancorp, the parent company of U.S. Bank, primarily partners with UnitedHealthcare for its corporate health insurance offerings. This relationship allows U.S. Bancorp to provide a range of health benefits to its employees through UnitedHealthcare's extensive network and services. Potential Healthcare Cost Increases in 2026 In 2026, U.S. Bancorp may face substantial healthcare cost increases, influenced predominantly by rising insurance premiums driven by multiple factors. Record hikes in premiums are anticipated as federal subsidies from the Affordable Care Act expire, which could result in over 22 million enrollees experiencing steep out-of-pocket expenses. With major insurers like UnitedHealthcare requesting rate increases upward of 66% in certain markets, U.S. Bancorp's healthcare costs could rise significantly, compelling both the company and its employees to navigate a more expensive healthcare landscape. This situation highlights the urgent need for strategic planning to mitigate the financial impact on employees and the company's overall benefits strategy. Click here to learn more

What Is It?

As a U.S. Bancorp 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 U.S. Bancorp 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 U.S. Bancorp 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 U.S. Bancorp 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 U.S. Bancorp 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 U.S. Bancorp 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 U.S. Bancorp 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 U.S. Bancorp Employees

Income Tax

None

Gift And Estate Tax

None

Questions & Answers for U.S. Bancorp 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 U.S. Bancorp 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 U.S. Bank Legacy Pension Plan calculate the Final Average Total Pay and Final Average Base Pay for employees, and what implications might these calculations have for retirement planning? What factors should employees at U.S. Bank consider when planning for their eventual retirement based on their pay history?

The U.S. Bank Legacy Pension Plan calculates Final Average Total Pay by taking the average of an employee's Total Pension Pay for the five consecutive calendar years during the last ten years of employment that provide the highest average. Similarly, Final Average Base Pay is calculated by averaging the Base Pension Pay for the same five-year period. Total Pension Pay includes base pay plus commissions, bonuses, and overtime, while Base Pension Pay only includes base salary and a few other components such as shift differentials and premium pay. These calculations significantly affect retirement planning, as higher pay during the last years of employment can lead to a more substantial pension benefit​(US Bancorp_January 2023…).

What steps does U.S. Bank require for employees who wish to commence their pension benefits, and how does the timing of this commencement affect the benefits they will ultimately receive? Employees at U.S. Bank should understand the critical timelines associated with the retirement process, including the importance of initiating their requests within specific timeframes.

Employees who wish to commence their pension benefits must initiate the process at least 30 to 90 days before their intended benefit commencement date. The timing affects the benefits, as early retirement (before age 65) results in reduced monthly benefits due to the extended period over which benefits are paid. Conversely, delaying the commencement of benefits until the full retirement age (65) or later ensures the maximum monthly pension benefit​(US Bancorp_January 2023…).

What are the different forms of payment options available under the U.S. Bank Legacy Pension Plan, and how might these options change based on the employee’s age and years of service? U.S. Bank employees need clarity on how to choose the best payment option to meet their individual needs in retirement.

The Plan offers several payment options, including a single life annuity, joint and survivor annuities (50%, 75%, or 100%), and estate protection annuities. These options can vary based on the employee's age and years of service. For example, younger employees may have a reduced monthly benefit if they choose early retirement, while older employees nearing or beyond age 65 will receive full benefits without reduction. The employee's choice of annuity type also affects the monthly payout and survivor benefits​(US Bancorp_January 2023…).

How does U.S. Bank ensure the security of employees' pension plan information and personal benefits data, and what measures should employees take to protect their information? Employees should be informed about the company’s security protocols and best practices for safeguarding sensitive information related to their pension.

U.S. Bank implements several security measures, including encouraging employees to use strong, unique passwords for accessing benefit information and enabling multifactor authentication. Employees should also regularly monitor their account for unauthorized transactions, update contact information to receive notices, and use secure networks when accessing their pension plan data​(US Bancorp_January 2023…).

In the event that an employee at U.S. Bank undergoes reemployment after retirement, how does this impact their pension benefits and what should they be aware of regarding benefit accrual? Employees need guidance on how transitioning back to work could affect their pension plans and retirement strategies.

If a retired U.S. Bank employee is rehired, their pension payments continue as usual. However, they will not accrue any additional benefits under the Legacy Pension Plan but may be eligible for participation in the Legacy 2010 Cash Balance Portion of the Plan. It is essential for rehired employees to understand the implications on their pension accrual and benefits​(US Bancorp_January 2023…).

What are the eligibility requirements for participation in the U.S. Bank Legacy Pension Plan, and how do changes in employment status affect an employee's pension benefits? U.S. Bank staff should have a comprehensive understanding of eligibility criteria and how various employment changes can impact their pension rights.

Eligibility is limited to employees who had earned a benefit before January 1, 2020, or those rehired in an eligible position. Employment status changes, such as termination or reemployment, can affect whether an employee remains in the Plan. For example, employees rehired after January 1, 2020, may not accrue additional benefits under the Legacy Pension Plan​(US Bancorp_January 2023…).

What specific rights do U.S. Bank employees have under the Employee Retirement Income Security Act (ERISA) in relation to their pension plan benefits, and how can they enforce these rights? U.S. Bank employees must be made aware of their legal rights to access plan information and contest any disputes regarding their benefits.

Employees have rights under ERISA to access plan information, file claims, and appeal denied claims. U.S. Bank employees can enforce these rights by submitting claims or appealing denials through the Plan's claims and appeals procedures. Additionally, employees may bring legal action if they exhaust the Plan's internal processes​(US Bancorp_January 2023…).

How does U.S. Bancorp ensure that its pension plan complies with current IRS limits, and what should employees know about potential tax implications on their pension benefits? Clear communication from U.S. Bank regarding tax consequences and IRS guidelines for retirement benefits is crucial for employees to manage their finances effectively post-retirement.

The Plan adheres to IRS regulations, including limits on annual earnings ($330,000 in 2023) that can be considered for pension benefit calculations. Employees should understand the potential tax implications on their pension distributions and are encouraged to consult tax advisors to ensure proper tax handling​(US Bancorp_January 2023…).

What processes are in place for U.S. Bank employees to file claims or appeals if they believe they are entitled to additional benefits under the pension plan? Employees at U.S. Bank should be informed about the claims process and know their options for seeking justice if their claims are disputed.

Employees can file claims or appeals by contacting U.S. Bank Employee Services or accessing the Plan’s claims procedures. Deadlines apply, and employees must submit claims within the specified time limits to avoid losing their rights to additional benefits​(US Bancorp_January 2023…).

How can U.S. Bank employees contact the company for further assistance regarding the U.S. Bank Legacy Pension Plan, and what resources are available to them through the Employee Services division? It’s essential that U.S. Bank staff knows how to reach out for support regarding their retirement benefits and understands the services provided to help them navigate their pension plans.

Employees can contact U.S. Bank Employee Services by calling 800-806-7009 and selecting "Savings and retirement." Additionally, the Your Total Rewards website provides 24/7 access to pension information and support. Employees are encouraged to use these resources for assistance with their pension plan​(US Bancorp_January 2023…).

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