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Sometimes this connection is evident to patients, but often it is not, and concepts derived from motivational interviewing (MI) have been adapted to brief interventions used in ED settings to engage individuals in the process of making positive behavior changes through a 4 step process of engaging, focusing, evoking and planning [14, 15]

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(As the district court noted, it approached this issue differently than some other courts by analyzing it as a question of standing rather than one of what is required to state a claim under ERISA section 502(a)(2).) The basic argument by employers challenging the plaintiffs standing in these suits is that the plaintiffs generally did not ever attempt to complete the alternative standard to avoid the surcharge, even though many acknowledged they were aware of the option and of the consequences of not taking advantage