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Commentary from Counsel - PPP Loan Forgiveness - Timely Appeal of Denials

Posted By IIAW Staff, Tuesday, November 30, 2021
Updated: Wednesday, December 1, 2021

By: Josh Johanningmeier, IIAW General Counsel 

 

The Paycheck Protection Program, or PPP, was one of the federal government’s earliest Covid-19 pandemic programs.  The PPP loan program is administered by the U.S. Small Business Administration (SBA).  According to the SBA, just under 11.5 million PPP loans were made, totaling about $792 billion.  For many small businesses, including independent insurance agencies and countless agency clients, PPP loans were a lifeline during uncertain and disruptive economic times.


One of the key aspects of the PPP loan program was that, under certain circumstances, the loans would be forgiven.  The process for seeking loan forgiveness has been underway for many months at this point, and nearly 8 million borrowers have filed forgiveness applications, with nearly 97% of the loans forgiven and repaid by the SBA.  That is good news for those borrowers, but leaves thousands either unforgiven, or pending.  Some of the pending PPP loan forgiveness applications will be granted, of course, but there will be no shortage of denials as well.  It is important to understand that the SBA’s forgiveness decision is appealable, but borrowers must act quickly.

In mid-September, the final rule covering Borrower Appeals of Final SBA Loan Review Decisions took effect, and it provides the framework for aggrieved borrowers to appeal to the SBA Office of Hearings and Appeals (OHA).  Here are the key requirements to ensure an appeal is heard by OHA.


First, only the actual borrower on a loan, or its legal successor in interest, for which SBA has issued a final SBA loan review decision has standing to appeal the SBA loan review decision to OHA. This means that the lending bank cannot appeal on behalf of borrowers.


Second, SBA decisions are appealable only if SBA’s completed review of a PPP loan finds any of the following:

• The borrower was ineligible for a PPP loan—this looks

   back at whether the loan should have been made in

   the first instance.  A denial on this basis will mean that no

   portion of the loan is forgiven.

• The borrower was ineligible for the PPP loan amount

   received or used the PPP loan proceeds for unauthorized

   uses.

• The borrower is ineligible for PPP loan forgiveness in

   the amount determined by the lender (lenders

   processing forgiveness applications make

   recommendations for full or partial forgiveness amounts).

   In this situation, the SBA final loan review decision

   will disagree with the lender, but remember—only the

   borrower can appeal, the lender cannot do so.

• The borrower is ineligible for PPP loan forgiveness in any

   amount when the lender has issued a full denial decision

   to SBA.   Here too the SBA final loan review decision will

   differ from the lender’s recommendation, but in a way

   that is favorable to the borrower.


Finally, the appeal must be filed with OHA within thirty (30) calendar days after the borrower’s receipt of the final SBA loan review decision.  This timing is critical, and because most forgiveness applications were handled through the same lender that made the loan, the borrower will most likely receive the final SBA loan review decision from the lender.


Within that framework, borrowers will need to consider their appeal options in light of a very deferential standard of review by OHA—the final SBA forgiveness decision will be altered only where the OHA administrative judge determines that the SBA’s decision was based on a clear error of fact or law.  That said, with the volume of forgiveness applications being reviewed by the SBA, and the complexities of the PPP loan program in terms of eligibility and use of loan proceeds, borrowers should be prepared to quickly evaluate their appeal options with counsel and file their appeal by the 30-day deadline.


It is also important to note that the loan deferment period is extended during the pendency of the appeal, so borrowers will not enter repayment until their appeal is decided.  The timeframe for OHA to decide an appeal of an SBA loan review decision is laid out in the final rule and could be as fast as 90 days, though there is ample discretion for the judge to extend certain deadlines.  Considering the anticipated volume of appeals, it is likely that 90 days will be the exception, rather than the norm.


If your agency, or a client, is facing a full or partial denial of forgiveness of a PPP loan, act quickly to evaluate a potential appeal and consult with competent counsel to assist.

Tags:  commentary from counsel  insurance general counsel  insuring Wisconsin  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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Commentary From Counsel - Round 3: Supreme Court Agrees to Hear Effort to Overturn Affordable Care Act

Posted By IIAW Staff, Tuesday, June 9, 2020

By: Josh Johanningmeier | IIAW General Counsel

 

Not since the Thrilla in Manila has a third bout been as eagerly anticipated as the upcoming United States Supreme Court hearing of the latest challenge to Obamacare. Well, perhaps comparing the case to the 1975 finale of the Ali - Frazier rivalry is unfair (to Ali and Frazier), but the case does merit attention. Earlier this month, the Supreme Court agreed to again hear a case concerning the validity of the Affordable Care Act (“ACA”), President Obama’s signature healthcare legislation. If the Court takes this opportunity to overturn the law, the provision of health insurance in this country could fundamentally change. This change would be especially impactful for your business clients. 

 

 

Case Background

 

In 2017, congressional Republicans began their efforts to repeal and replace the ACA. When those efforts failed, Republicans changed tactics and instead, chipped away at one of the act’s most well-known, and unpopular, provisions: the individual mandate. To be clear, Congress did not eliminate the individual mandate itself, but, rather, eliminated the tax penalty for failing to acquire health insurance. President Trump quickly signed this change into law. 

 

Seeing an opportunity, a group of 20 states brought suit in the United States District Court for the Northern District of Texas, arguing that the entire ACA is invalid because of the changes to the law. In a previous challenge, the Supreme Court upheld the individual mandate as an exercise of Congress’ taxing power. The states challenging the ACA asserted that, with no tax penalty for violations, the individual mandate can no longer fall under Congress’ taxation powers and must be considered unconstitutional as a violation of individual liberty. Going further, the states argued that the individual mandate is a fundamental component of the ACA, and, as a result, the entire law must be overturned. In a December 2018 decision, District Judge Reed O’Connor agreed and ruled the ACA unconstitutional. 

 

Shortly thereafter, several groups, including Democratic state attorneys general and the House of Representatives, under Democratic control at that point, appealed the decision to the Fifth Circuit Court of Appeals. Given a choice between finding the individual mandate constitutional and overturning the entire law, the Fifth Circuit chose a middle way. The court agreed with Judge O’Connor that the individual mandate is unconstitutional, but sent the case back to the lower court to reconsider if such a holding renders the entire act invalid. The House and the states led by Democratic attorneys general appealed that the decision to the United States Supreme Court, which agreed to hear the case. Based on standard timeframes, the Court will likely issue a decision in spring or summer of 2021. 

 

 

Now What? 

 

Importantly, it is not clear how the Supreme Court will rule on this case. The ACA has come before the Court on two previous occasions, and it has upheld the law both times. While the makeup of the Court has changed significantly in recent years, all five Justices making up the majority in both decisions remain on the Court. However, the law has now changed, and in ways relevant to the Court’s previous opinions. The takeaway: while it is entirely possible the law will be upheld, you and your agencies should be prepared for it to be overturned. 

 

If the entire law is invalidated, a key impact will be the elimination of the “employer mandate.” As you are likely aware, currently, employers with 50 or more full-time employees, or full-time equivalents, must provide health insurance to 95% of those 

full-time employees and their children that is both affordable and ensures minimum value. Coverage is considered “affordable” if employee contributions do not exceed a specified percentage of that employee’s household income (9.78% in 2020). A plan provides “minimum value” if it pays for at least 60% of covered services (including deductibles, copays and coinsurance). If employers violate their mandate, they face a monetary penalty. 

 

If the ACA is overturned, however, there will be of course no employer mandate. This will likely result in many of your business clients evaluating changes to their employee health plans. It is critical that you and your agencies work with legal counsel so that you can make informed decisions when it comes time to design plans responsive to your clients’ needs. 

 

Conclusion

 

While it is unclear if the Supreme Court will take this opportunity to overturn the ACA, it is crucial to be prepared in the event that it does. Keep an eye on this column and other IIAW publications for developments on this case, and make sure to work with legal counsel to ensure that you and your agencies are able to successfully navigate what could be a complex path forward. 

 

Tags:  affordable care act  commentary from counsel  insurance general counsel  wisconsin insurance blog  wisconsin supreme court 

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