Atlanta Plumbers & Steamfitters-Redacted HW
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(b)(4)
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(b)(4) (b)(4)
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(b)(4) (b)(4) (b)(4)
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Pages 2 through 8 redacted for the following reasons: ---------------------------Exemption (b)(4)
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From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, November 23, 2010 5:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following applications: 1. Memphis Construction Benefit Fund 2. Atlanta Plumbers & Steamfitters Fringe Benefit Funds 3. South Central Laborers’ Health & Welfare Fund 4. Southeastern Pipetrades Health & Welfare Fund 5. Aerospace Contractors’ Trust 6. Southern Operators’ Health Fund 7. Sheet Metal Workers’ National Health Fund 8. Sheet Metal Workers Local No. 177 Health & Welfare Fund 9. Louisiana Electrical Health Fund I. In order to complete your applications, please provide the following information for all applications mentioned above: In each application, you state that a certain number of eligible employees are covered. For each plan, please provide the total number of individuals covered. Some applications state that the plans are comprehensive. Please confirm whether each plan listed above is a comprehensive or limited-benefit plan. Some of the plans above include lifetime limits. Please confirm that you are removing both overall lifetime limits as well as lifetime limits on essential health benefits in those plans.
For each plan listed above, please provide the current monthly premium rates and the projected monthly premium rates applicable to the plan if the plan were to comply with the restricted annual benefits. In other words, we would like a chart that reflects the following information: 2010 January Premium (current level) 2011 January Premium (renewal) 2011 January Premium (if $750,000 annual limit was applied)
EE EE + Child (if applicable or other appropriate tier)
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· Was each plan listed above in existence prior to March 23 rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions? · For each plan, what was the date of the last collective bargaining agreement pursuant to which each plan was designed?
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file:////co-adshare/...20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information.htm[11/02/2011 2:44:44 PM]
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EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier)
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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II. Please provide additional information for the following plans: 1. Aerospace Contractors’ Trust: In your cover letter, you state that the annual limit is (b)(4) . However, the schedule of benefits states that the annual limit is (b)(4) Please confirm which annual limit is correct. 2. Sheet Metal Workers Local No. 177 Health & Welfare Fund: In your cover letter, you state that the plan has an annual maximum of (b)(4) However, the schedule of benefits does not seem to have an annual limit. Rather, it seems as though the schedule of benefits has an annual limit of (b)(4) for hospitalization benefits. Please clarify this information. III. I will be in touch separately about Mid South Carpenters Regional Council Health and Welfare Fund.
file:////co-adshare/...20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information.htm[11/02/2011 2:44:44 PM]
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From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 07, 2010 2:25 PM To: Donny Dowlen Cc: Habit, Sandra (HHS/OCIIO); [email protected] Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Thanks, Donny. Lisa
From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 07, 2010 2:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO); [email protected] Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Atlanta Plumbers & Steamfitters Fringe Benefit Funds
Please provide the total number of individuals covered – 7,235 Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
Based on our conversation last week, the plan would be considered a limited benefit plan
Please confirm that you are removing both overall lifetime limit as well as lifetime limits on essential health benefits.
We are removing the overall lifetime limit as well as the lifetime limits on essential benefits
ATL PLUMBERS:000005
file:////co-adshare/.../Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Correspondence%2012.7.10.htm[11/02/2011 2:44:45 PM]
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I. In order to complete your application, please provide the following information for the application mentioned above:
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Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application:
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From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
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Lisa, please note the responses below. Please let me know if you need anything else. We want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted below, and would significantly decrease access to benefits for those currently covered under the plan. Donny Dowlen 800-831-4914
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· Was each plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions.
· When is the expiration date of the current collective bargaining agreement? August 1, 2013 For the plan listed above, please provide the current monthly premium rate and the projected monthly premium rates applicable to the plan if were to comply with the restricted annual benefits.
(b)(4) 1. The premium in 2011 is 2. The expected cost in 20 he absence of annual limits 3. The expected cost in 2011 to comply with annual limits is
Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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file:////co-adshare/.../Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Correspondence%2012.7.10.htm[11/02/2011 2:44:45 PM]
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(b)(4) (b)(4)
ATL PLUMBERS:000006
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 07, 2010 2:53 PM To: Donny Dowlen Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Annual Limit Waiver Application - Request for Additional Information
Thank you for the information, Donny. The following applications are now complete: 1. Atlanta Plumbers & Steamfitters Fringe Benefit Funds 2. South Central Laborers’ Health & Welfare Fund
4. Sheet Metal Workers Local No. 177 Health & Welfare Fund Thank you again, Lisa
The expiration of the collective bargaining agreement is April, 2012
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application: Sheet Metal Workers’ National Health Fund I. In order to complete your application, please provide the following information:
ATL PLUMBERS:000007
file:////co-adshare/...20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%2012.7.10.htm[11/02/2011 2:44:46 PM]
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From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
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Lisa, please note the responses below.
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From: Donny Dowlen [mailto:[email protected]] Sent: Monday, December 06, 2010 3:20 PM To: 'Keels, Lisa (HHS/OCIIO)' Cc: 'Habit, Sandra (HHS/OCIIO)'; 'Jere Brassell' Subject: RE: Annual Limit Waiver Application - Request for Additional Information
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From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 07, 2010 2:34 PM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO) Subject: FW: Annual Limit Waiver Application - Request for Additional Information
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3. Sheet Metal Workers’ National Health Fund
In the application, you state that a certain number of eligible employees are covered. Please provide the total n of individuals covered.
(b)(4)
The application states that the plan is comprehensive. Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
Based on our conversation last week, the plan would be considered a limited benefit plan
The plan above includes a lifetime limit. Please confirm that you are removing both overall lifetime limits as well as lifetime limits on essential health benefits in those plans.
We would be removing both the overall lifetime limit as well as the lifetime limits on essential health benefits
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions . · For each plan, what was the date of the last collective bargaining agreement pursuant to which each plan was designed? April, 2008
1. Expected premium in 2011 is (b)(4) 2. Expected cost in 2011 in th of annual limits 3. Expected cost in 2011 to comply with annual limits is
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Please provide the current monthly premium rates and the projected monthly premium rates applicable to the plan if the plan were to comply with the restricted annual benefits.
(b)(4) (b)(4)
Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
ATL PLUMBERS:000008
file:////co-adshare/...20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%2012.7.10.htm[11/02/2011 2:44:46 PM]
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Lisa, we want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted above, and would significantly decrease access to benefits for those currently covered under the plan. We trust that this responds adequately to your questions. If not, please let us know. Donny Dowlen 800-831-4914
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· Was the plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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file:////co-adshare/...20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%2012.7.10.htm[11/02/2011 2:44:46 PM]
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From: Donny Dowlen [[email protected]] Sent: Tuesday, December 07, 2010 2:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO); [email protected] Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Lisa, please note the responses below. Please let me know if you need anything else. We want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted below, and would significantly decrease access to benefits for those currently covered under the plan. Donny Dowlen 800-831-4914 From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Atlanta Plumbers & Steamfitters Fringe Benefit Funds
I. In order to complete your application, please provide the following information for the application mentioned above:
Please provide the total number of individuals covered –
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Based on our conversation last week, the plan would be considered a limited benefit plan
Please confirm that you are removing both overall lifetime limit as well as lifetime limits on essential health benefits.
We are removing the overall lifetime limit as well as the lifetime limits on essential benefits
· Was each plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions.
· When is the expiration date of the current collective bargaining agreement?
ATL PLUMBERS:000010
file:////co-adshare/...amfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%20response%2012.7.10.htm[11/02/2011 2:44:46 PM]
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Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
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(b)(4)
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Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application:
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August 1, 2013 For the plan listed above, please provide the current monthly premium rate and the projected monthly premium rates applicable to the plan if t ere to comply with the restricted annual benefits.
1. The premium in 2011 is (b)(4) 2. The expected cost in 20 e absence of annual limits 3. The expected cost in 2011 to comply with annual limits is
(b)(4)
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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file:////co-adshare/...amfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%20response%2012.7.10.htm[11/02/2011 2:44:46 PM]
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ATL PLUMBERS:000011
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 07, 2010 12:04 PM To: Keels, Lisa (HHS/OCIIO); [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Hello again, Donny, Thank you for all your responses thus far. I have one more question for all the plans listed below (and the Mid South Carpenters Regional Council Health and Welfare Fund): · For each plan, what is the date on which the last collective bargaining agreement pursuant to which the plan was negotiated will expire? Thank you again, Lisa
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, November 23, 2010 5:15 PM To: '[email protected]' Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following applications: 1. Memphis Construction Benefit Fund 2. Atlanta Plumbers & Steamfitters Fringe Benefit Funds 3. South Central Laborers’ Health & Welfare Fund 4. Southeastern Pipetrades Health & Welfare Fund 5. Aerospace Contractors’ Trust 6. Southern Operators’ Health Fund 7. Sheet Metal Workers’ National Health Fund 8. Sheet Metal Workers Local No. 177 Health & Welfare Fund 9. Louisiana Electrical Health Fund I. In order to complete your applications, please provide the following information for all applications mentioned above: In each application, you state that a certain number of eligible employees are covered. For each plan, please provide the total number of individuals covered. Some applications state that the plans are comprehensive. Please confirm whether each plan listed above is a comprehensive or limited-benefit plan. Some of the plans above include lifetime limits. Please confirm that you are removing both overall lifetime limits as
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file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.7.10.htm[11/02/2011 2:44:46 PM]
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well as lifetime limits on essential health benefits in those plans.
· Was each plan listed above in existence prior to March 23 rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions? · For each plan, what was the date of the last collective bargaining agreement pursuant to which each plan was designed?
For each plan listed above, please provide the current monthly premium rates and the projected monthly premium rates applicable to the plan if the plan were to comply with the restricted annual benefits. In other words, we would like a chart that reflects the following information: 2010 January Premium (current level) 2011 January Premium (renewal) 2011 January Premium (if $750,000 annual limit was applied)
In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight
ATL PLUMBERS:000013
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.7.10.htm[11/02/2011 2:44:46 PM]
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II. Please provide additional information for the following plans: 1. Aerospace Contractors’ Trust: In your cover letter, you state that the annual limit is (b)(4) However, the schedule of benefits states that the annual limit is (b)(4) Please confirm which it is correct. 2. Sheet Metal Workers Local No. 177 Health & Welfare Fund: In your cover letter, you state that the plan has an annual maximum of (b)(4) However, the schedule of benefits does not seem to have an annual limit. Rather, it seems as though the schedule of benefits has an annual limit of (b)(4) for hospitalization benefits. Please clarify this information. III. I will be in touch separately about Mid South Carpenters Regional Council Health and Welfare Fund.
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EE EE + Child (if applicable or other appropriate tier) EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier)
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[email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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ATL PLUMBERS:000014
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.7.10.htm[11/02/2011 2:44:46 PM]
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From: Donny Dowlen [[email protected]] Sent: Thursday, December 09, 2010 9:47 AM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO) Subject: FW: Annual Limit Waiver Applications - Request for Additional Information
Lisa, just so there is no misunderstanding, I want to document clarification concerning my responses to your question below regarding premium and cost information. In #1 we are providing the premium expected for 2011. In #2, we are providing the estimated plan cost if it does not have to comply with the $750,000 annual limit. In #3, we are providing the estimated plan cost if it has to comply with the $750,000 annual limit. I know you understand this, but we want to make sure that others who review this application have the same understanding. Thank you. Donny Dowlen
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application: Atlanta Plumbers & Steamfitters Fringe Benefit Funds
I. In order to complete your application, please provide the following information for the application mentioned above: Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
Based on our conversation last week, the plan would be considered a limited benefit plan
Please provide the total number of individuals covered –
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From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Please confirm that you are removing both overall lifetime limit as well as lifetime limits on essential health
ATL PLUMBERS:000015
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.9.10.htm[11/02/2011 2:44:47 PM]
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Lisa, please note the responses below. Please let me know if you need anything else. We want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted below, and would significantly decrease access to benefits for those currently covered under the plan. Donny Dowlen 800-831-4914
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From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 07, 2010 1:24 PM To: 'Keels, Lisa (HHS/OCIIO)' Cc: 'Habit, Sandra (HHS/OCIIO)'; '[email protected]' Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
benefits.
We are removing the overall lifetime limit as well as the lifetime limits on essential benefits
· Was each plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions.
· When is the expiration date of the current collective bargaining agreement? August 1, 2013
For the plan listed above, please provide the current monthly premium rate and the projected monthly premium rates applicable to the plan if t ere to comply with the restricted annual benefits.
Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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(b)(4) 1. The premium in 2011 is 2. The expected cost in 20 he absence of annual limits 3. The expected cost in 2011 to comply with annual limits is
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.9.10.htm[11/02/2011 2:44:47 PM]
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(b)(4) (b)(4)
ATL PLUMBERS:000016
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 14, 2010 3:09 PM To: Donny Dowlen Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver
Thank you, Donny. I hope you have a happy holiday season as well! All the best, Lisa
From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 14, 2010 1:00 PM To: Keels, Lisa (HHS/OCIIO) Cc: [email protected] Subject: Waiver
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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Lisa, I just received approval on eight of the applications that you were reviewing for our company. I just want to thank you for your assistance in this process. I know you guys are buried in applications and we just want to thank you for the prompt and courteous service you gave these applications. I hope you have a happy holiday season. Donny Dowlen
file:////co-adshare/.../Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/RE%20Waiver%2012.14.10.htm[11/02/2011 2:44:47 PM]
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ATL PLUMBERS:000017
From: Donny Dowlen [[email protected]] Sent: Tuesday, December 14, 2010 1:11 PM To: Botwinick, Alexandra (HHS/OCIIO) Subject: FW: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High Follow Up Flag: Follow up Flag Status: Red Attachments: Updated Jan 1 Approval Letter .pdf
Alexandra, I presume this waiver is for the Atlanta Plumbers and Steamfitters Fringe Benefit Funds. Please confirm this for us. Thank you. Donny Dowlen 800-831-4914 From: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, December 14, 2010 11:31 AM To: '[email protected]' Subject: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High
[email protected]
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Alexandra Botwinick Office of Oversight HHS/OCIIO
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Good Afternoon, Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Plumbers & Steamfitters Fringe Benefit Funds. HHS has reviewed your application and made its determination. Please see the attached letter. Please confirm receipt of this letter by replying to this e-mail. Please let me know if I can be of further assistance. Sincerely,
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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file:////co-adshare/...%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Confirmation%20of%20Approval%20lette%2012-14-2010.htm[11/02/2011 2:44:48 PM]
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ATL PLUMBERS:000018
From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 16, 2010 9:11 AM To: 'Donny Dowlen' Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver of the Annual Limits Requirements of PHS Act Section 2711
Mr. Dowlen, I apologize for the confusion. You are correct, the below waiver is for the Atlanta Plumbers and Steamfitters Fringe Benefit Funds. Please let me know if I can be of further assistance.
[email protected]
From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 14, 2010 1:11 PM To: Botwinick, Alexandra (HHS/OCIIO) Subject: FW: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High
Alexandra, I presume this waiver is for the Atlanta Plumbers and Steamfitters Fringe Benefit Funds. Please confirm this for us. Thank you. Donny Dowlen 800-831-4914 From: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, December 14, 2010 11:31 AM To: '[email protected]' Subject: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High
Good Afternoon, Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Plumbers & Steamfitters Fringe Benefit Funds. HHS has reviewed your application and made its determination. Please see the attached letter. Please confirm receipt of this letter by replying to this e-mail. Please let me know if I can be of further assistance. Sincerely,
Alexandra Botwinick Office of Oversight
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file:////co-adshare/...m/Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Confirmation%2012.16.10.htm[11/02/2011 2:44:48 PM]
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Alexandra Botwinick Office of Oversight HHS/OCIIO
HHS/OCIIO
[email protected]
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file:////co-adshare/...m/Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Confirmation%2012.16.10.htm[11/02/2011 2:44:48 PM]
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
From: Donny Dowlen [[email protected]] Sent: Tuesday, November 09, 2010 11:06 AM To: HHS HealthInsurance (HHS) Subject: Waiver Attachments: 119102.pdf
Enclosed is documentation for the Atlanta Plumbers and Steamfitters Health and Welfare Fund. Donny Dowlen Southern Benefit Administrators 2001 Caldwell Drive Goodlettsville, TN 37072
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file:////co-adshare/...Processing%20Team/Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Waiver.htm[11/02/2011 2:44:49 PM]
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
(b)(4)
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Pages 2 through 8 redacted for the following reasons: ---------------------------Exemption (b)(4)
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From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, November 23, 2010 5:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following applications: 1. Memphis Construction Benefit Fund 2. Atlanta Plumbers & Steamfitters Fringe Benefit Funds 3. South Central Laborers’ Health & Welfare Fund 4. Southeastern Pipetrades Health & Welfare Fund 5. Aerospace Contractors’ Trust 6. Southern Operators’ Health Fund 7. Sheet Metal Workers’ National Health Fund 8. Sheet Metal Workers Local No. 177 Health & Welfare Fund 9. Louisiana Electrical Health Fund I. In order to complete your applications, please provide the following information for all applications mentioned above: In each application, you state that a certain number of eligible employees are covered. For each plan, please provide the total number of individuals covered. Some applications state that the plans are comprehensive. Please confirm whether each plan listed above is a comprehensive or limited-benefit plan. Some of the plans above include lifetime limits. Please confirm that you are removing both overall lifetime limits as well as lifetime limits on essential health benefits in those plans.
For each plan listed above, please provide the current monthly premium rates and the projected monthly premium rates applicable to the plan if the plan were to comply with the restricted annual benefits. In other words, we would like a chart that reflects the following information: 2010 January Premium (current level) 2011 January Premium (renewal) 2011 January Premium (if $750,000 annual limit was applied)
EE EE + Child (if applicable or other appropriate tier)
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· Was each plan listed above in existence prior to March 23 rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions? · For each plan, what was the date of the last collective bargaining agreement pursuant to which each plan was designed?
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file:////co-adshare/...20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information.htm[11/02/2011 2:44:44 PM]
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EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier)
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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II. Please provide additional information for the following plans: 1. Aerospace Contractors’ Trust: In your cover letter, you state that the annual limit is (b)(4) . However, the schedule of benefits states that the annual limit is (b)(4) Please confirm which annual limit is correct. 2. Sheet Metal Workers Local No. 177 Health & Welfare Fund: In your cover letter, you state that the plan has an annual maximum of (b)(4) However, the schedule of benefits does not seem to have an annual limit. Rather, it seems as though the schedule of benefits has an annual limit of (b)(4) for hospitalization benefits. Please clarify this information. III. I will be in touch separately about Mid South Carpenters Regional Council Health and Welfare Fund.
file:////co-adshare/...20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information.htm[11/02/2011 2:44:44 PM]
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From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 07, 2010 2:25 PM To: Donny Dowlen Cc: Habit, Sandra (HHS/OCIIO); [email protected] Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Thanks, Donny. Lisa
From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 07, 2010 2:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO); [email protected] Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Atlanta Plumbers & Steamfitters Fringe Benefit Funds
Please provide the total number of individuals covered – 7,235 Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
Based on our conversation last week, the plan would be considered a limited benefit plan
Please confirm that you are removing both overall lifetime limit as well as lifetime limits on essential health benefits.
We are removing the overall lifetime limit as well as the lifetime limits on essential benefits
ATL PLUMBERS:000005
file:////co-adshare/.../Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Correspondence%2012.7.10.htm[11/02/2011 2:44:45 PM]
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I. In order to complete your application, please provide the following information for the application mentioned above:
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Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application:
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From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
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Lisa, please note the responses below. Please let me know if you need anything else. We want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted below, and would significantly decrease access to benefits for those currently covered under the plan. Donny Dowlen 800-831-4914
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· Was each plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions.
· When is the expiration date of the current collective bargaining agreement? August 1, 2013 For the plan listed above, please provide the current monthly premium rate and the projected monthly premium rates applicable to the plan if were to comply with the restricted annual benefits.
(b)(4) 1. The premium in 2011 is 2. The expected cost in 20 he absence of annual limits 3. The expected cost in 2011 to comply with annual limits is
Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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file:////co-adshare/.../Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Correspondence%2012.7.10.htm[11/02/2011 2:44:45 PM]
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ATL PLUMBERS:000006
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 07, 2010 2:53 PM To: Donny Dowlen Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Annual Limit Waiver Application - Request for Additional Information
Thank you for the information, Donny. The following applications are now complete: 1. Atlanta Plumbers & Steamfitters Fringe Benefit Funds 2. South Central Laborers’ Health & Welfare Fund
4. Sheet Metal Workers Local No. 177 Health & Welfare Fund Thank you again, Lisa
The expiration of the collective bargaining agreement is April, 2012
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application: Sheet Metal Workers’ National Health Fund I. In order to complete your application, please provide the following information:
ATL PLUMBERS:000007
file:////co-adshare/...20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%2012.7.10.htm[11/02/2011 2:44:46 PM]
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From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
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Lisa, please note the responses below.
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From: Donny Dowlen [mailto:[email protected]] Sent: Monday, December 06, 2010 3:20 PM To: 'Keels, Lisa (HHS/OCIIO)' Cc: 'Habit, Sandra (HHS/OCIIO)'; 'Jere Brassell' Subject: RE: Annual Limit Waiver Application - Request for Additional Information
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From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 07, 2010 2:34 PM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO) Subject: FW: Annual Limit Waiver Application - Request for Additional Information
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3. Sheet Metal Workers’ National Health Fund
In the application, you state that a certain number of eligible employees are covered. Please provide the total n of individuals covered.
(b)(4)
The application states that the plan is comprehensive. Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
Based on our conversation last week, the plan would be considered a limited benefit plan
The plan above includes a lifetime limit. Please confirm that you are removing both overall lifetime limits as well as lifetime limits on essential health benefits in those plans.
We would be removing both the overall lifetime limit as well as the lifetime limits on essential health benefits
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions . · For each plan, what was the date of the last collective bargaining agreement pursuant to which each plan was designed? April, 2008
1. Expected premium in 2011 is (b)(4) 2. Expected cost in 2011 in th of annual limits 3. Expected cost in 2011 to comply with annual limits is
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Please provide the current monthly premium rates and the projected monthly premium rates applicable to the plan if the plan were to comply with the restricted annual benefits.
(b)(4) (b)(4)
Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
ATL PLUMBERS:000008
file:////co-adshare/...20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%2012.7.10.htm[11/02/2011 2:44:46 PM]
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Lisa, we want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted above, and would significantly decrease access to benefits for those currently covered under the plan. We trust that this responds adequately to your questions. If not, please let us know. Donny Dowlen 800-831-4914
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· Was the plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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file:////co-adshare/...20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%2012.7.10.htm[11/02/2011 2:44:46 PM]
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From: Donny Dowlen [[email protected]] Sent: Tuesday, December 07, 2010 2:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO); [email protected] Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Lisa, please note the responses below. Please let me know if you need anything else. We want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted below, and would significantly decrease access to benefits for those currently covered under the plan. Donny Dowlen 800-831-4914 From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Atlanta Plumbers & Steamfitters Fringe Benefit Funds
I. In order to complete your application, please provide the following information for the application mentioned above:
Please provide the total number of individuals covered –
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Based on our conversation last week, the plan would be considered a limited benefit plan
Please confirm that you are removing both overall lifetime limit as well as lifetime limits on essential health benefits.
We are removing the overall lifetime limit as well as the lifetime limits on essential benefits
· Was each plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions.
· When is the expiration date of the current collective bargaining agreement?
ATL PLUMBERS:000010
file:////co-adshare/...amfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%20response%2012.7.10.htm[11/02/2011 2:44:46 PM]
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Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
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Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application:
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August 1, 2013 For the plan listed above, please provide the current monthly premium rate and the projected monthly premium rates applicable to the plan if t ere to comply with the restricted annual benefits.
1. The premium in 2011 is (b)(4) 2. The expected cost in 20 e absence of annual limits 3. The expected cost in 2011 to comply with annual limits is
(b)(4)
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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file:////co-adshare/...amfitters%20Fringe%20Benefit%20Funds/Request%20for%20Additional%20Information%20response%2012.7.10.htm[11/02/2011 2:44:46 PM]
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ATL PLUMBERS:000011
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 07, 2010 12:04 PM To: Keels, Lisa (HHS/OCIIO); [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
Hello again, Donny, Thank you for all your responses thus far. I have one more question for all the plans listed below (and the Mid South Carpenters Regional Council Health and Welfare Fund): · For each plan, what is the date on which the last collective bargaining agreement pursuant to which the plan was negotiated will expire? Thank you again, Lisa
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, November 23, 2010 5:15 PM To: '[email protected]' Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following applications: 1. Memphis Construction Benefit Fund 2. Atlanta Plumbers & Steamfitters Fringe Benefit Funds 3. South Central Laborers’ Health & Welfare Fund 4. Southeastern Pipetrades Health & Welfare Fund 5. Aerospace Contractors’ Trust 6. Southern Operators’ Health Fund 7. Sheet Metal Workers’ National Health Fund 8. Sheet Metal Workers Local No. 177 Health & Welfare Fund 9. Louisiana Electrical Health Fund I. In order to complete your applications, please provide the following information for all applications mentioned above: In each application, you state that a certain number of eligible employees are covered. For each plan, please provide the total number of individuals covered. Some applications state that the plans are comprehensive. Please confirm whether each plan listed above is a comprehensive or limited-benefit plan. Some of the plans above include lifetime limits. Please confirm that you are removing both overall lifetime limits as
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file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.7.10.htm[11/02/2011 2:44:46 PM]
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ATL PLUMBERS:000012
well as lifetime limits on essential health benefits in those plans.
· Was each plan listed above in existence prior to March 23 rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions? · For each plan, what was the date of the last collective bargaining agreement pursuant to which each plan was designed?
For each plan listed above, please provide the current monthly premium rates and the projected monthly premium rates applicable to the plan if the plan were to comply with the restricted annual benefits. In other words, we would like a chart that reflects the following information: 2010 January Premium (current level) 2011 January Premium (renewal) 2011 January Premium (if $750,000 annual limit was applied)
In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight
ATL PLUMBERS:000013
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.7.10.htm[11/02/2011 2:44:46 PM]
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II. Please provide additional information for the following plans: 1. Aerospace Contractors’ Trust: In your cover letter, you state that the annual limit is (b)(4) However, the schedule of benefits states that the annual limit is (b)(4) Please confirm which it is correct. 2. Sheet Metal Workers Local No. 177 Health & Welfare Fund: In your cover letter, you state that the plan has an annual maximum of (b)(4) However, the schedule of benefits does not seem to have an annual limit. Rather, it seems as though the schedule of benefits has an annual limit of (b)(4) for hospitalization benefits. Please clarify this information. III. I will be in touch separately about Mid South Carpenters Regional Council Health and Welfare Fund.
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EE EE + Child (if applicable or other appropriate tier) EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier)
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[email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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ATL PLUMBERS:000014
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.7.10.htm[11/02/2011 2:44:46 PM]
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From: Donny Dowlen [[email protected]] Sent: Thursday, December 09, 2010 9:47 AM To: Keels, Lisa (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO) Subject: FW: Annual Limit Waiver Applications - Request for Additional Information
Lisa, just so there is no misunderstanding, I want to document clarification concerning my responses to your question below regarding premium and cost information. In #1 we are providing the premium expected for 2011. In #2, we are providing the estimated plan cost if it does not have to comply with the $750,000 annual limit. In #3, we are providing the estimated plan cost if it has to comply with the $750,000 annual limit. I know you understand this, but we want to make sure that others who review this application have the same understanding. Thank you. Donny Dowlen
Dear Mr. Dowlen: Thank you for your applications for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. This email is a request for additional information for the following application: Atlanta Plumbers & Steamfitters Fringe Benefit Funds
I. In order to complete your application, please provide the following information for the application mentioned above: Please confirm whether the plan listed above is a comprehensive or limited-benefit plan.
Based on our conversation last week, the plan would be considered a limited benefit plan
Please provide the total number of individuals covered –
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From: Keels, Lisa (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, November 23, 2010 4:15 PM To: [email protected] Cc: Habit, Sandra (HHS/OCIIO) Subject: Annual Limit Waiver Applications - Request for Additional Information
Please confirm that you are removing both overall lifetime limit as well as lifetime limits on essential health
ATL PLUMBERS:000015
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.9.10.htm[11/02/2011 2:44:47 PM]
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Lisa, please note the responses below. Please let me know if you need anything else. We want to emphasize that complying with annual limits would significantly increase the cost to the plan participants as noted below, and would significantly decrease access to benefits for those currently covered under the plan. Donny Dowlen 800-831-4914
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From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 07, 2010 1:24 PM To: 'Keels, Lisa (HHS/OCIIO)' Cc: 'Habit, Sandra (HHS/OCIIO)'; '[email protected]' Subject: RE: Annual Limit Waiver Applications - Request for Additional Information
benefits.
We are removing the overall lifetime limit as well as the lifetime limits on essential benefits
· Was each plan listed above in existence prior to March 23rd, 2010? If so, have the trustees elected to comply with the grandfathering provisions?
The plan was in existence prior to March 23, 2010 and the trustees have elected to comply with the grandfathering provisions.
· When is the expiration date of the current collective bargaining agreement? August 1, 2013
For the plan listed above, please provide the current monthly premium rate and the projected monthly premium rates applicable to the plan if t ere to comply with the restricted annual benefits.
Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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In order to complete your applications, please provide this information as soon as possible. We look forward to receiving your completed applications. Thank you, Lisa Keels Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight [email protected] 301-492-4168 P.S. Please note that I will be out of the office for the rest of this week, but I will be available via email tomorrow (Wednesday) morning.
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(b)(4) 1. The premium in 2011 is 2. The expected cost in 20 he absence of annual limits 3. The expected cost in 2011 to comply with annual limits is
file:////co-adshare/.../Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Request%20for%20info%2012.9.10.htm[11/02/2011 2:44:47 PM]
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(b)(4) (b)(4)
ATL PLUMBERS:000016
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, December 14, 2010 3:09 PM To: Donny Dowlen Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver
Thank you, Donny. I hope you have a happy holiday season as well! All the best, Lisa
From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 14, 2010 1:00 PM To: Keels, Lisa (HHS/OCIIO) Cc: [email protected] Subject: Waiver
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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Lisa, I just received approval on eight of the applications that you were reviewing for our company. I just want to thank you for your assistance in this process. I know you guys are buried in applications and we just want to thank you for the prompt and courteous service you gave these applications. I hope you have a happy holiday season. Donny Dowlen
file:////co-adshare/.../Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/RE%20Waiver%2012.14.10.htm[11/02/2011 2:44:47 PM]
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ATL PLUMBERS:000017
From: Donny Dowlen [[email protected]] Sent: Tuesday, December 14, 2010 1:11 PM To: Botwinick, Alexandra (HHS/OCIIO) Subject: FW: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High Follow Up Flag: Follow up Flag Status: Red Attachments: Updated Jan 1 Approval Letter .pdf
Alexandra, I presume this waiver is for the Atlanta Plumbers and Steamfitters Fringe Benefit Funds. Please confirm this for us. Thank you. Donny Dowlen 800-831-4914 From: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, December 14, 2010 11:31 AM To: '[email protected]' Subject: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High
[email protected]
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Alexandra Botwinick Office of Oversight HHS/OCIIO
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Good Afternoon, Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Plumbers & Steamfitters Fringe Benefit Funds. HHS has reviewed your application and made its determination. Please see the attached letter. Please confirm receipt of this letter by replying to this e-mail. Please let me know if I can be of further assistance. Sincerely,
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
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file:////co-adshare/...%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Confirmation%20of%20Approval%20lette%2012-14-2010.htm[11/02/2011 2:44:48 PM]
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ATL PLUMBERS:000018
From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 16, 2010 9:11 AM To: 'Donny Dowlen' Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver of the Annual Limits Requirements of PHS Act Section 2711
Mr. Dowlen, I apologize for the confusion. You are correct, the below waiver is for the Atlanta Plumbers and Steamfitters Fringe Benefit Funds. Please let me know if I can be of further assistance.
[email protected]
From: Donny Dowlen [mailto:[email protected]] Sent: Tuesday, December 14, 2010 1:11 PM To: Botwinick, Alexandra (HHS/OCIIO) Subject: FW: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High
Alexandra, I presume this waiver is for the Atlanta Plumbers and Steamfitters Fringe Benefit Funds. Please confirm this for us. Thank you. Donny Dowlen 800-831-4914 From: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]] Sent: Tuesday, December 14, 2010 11:31 AM To: '[email protected]' Subject: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High
Good Afternoon, Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Plumbers & Steamfitters Fringe Benefit Funds. HHS has reviewed your application and made its determination. Please see the attached letter. Please confirm receipt of this letter by replying to this e-mail. Please let me know if I can be of further assistance. Sincerely,
Alexandra Botwinick Office of Oversight
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ATL PLUMBERS:000019
file:////co-adshare/...m/Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Confirmation%2012.16.10.htm[11/02/2011 2:44:48 PM]
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Alexandra Botwinick Office of Oversight HHS/OCIIO
HHS/OCIIO
[email protected]
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ATL PLUMBERS:000020
file:////co-adshare/...m/Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Confirmation%2012.16.10.htm[11/02/2011 2:44:48 PM]
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
From: Donny Dowlen [[email protected]] Sent: Tuesday, November 09, 2010 11:06 AM To: HHS HealthInsurance (HHS) Subject: Waiver Attachments: 119102.pdf
Enclosed is documentation for the Atlanta Plumbers and Steamfitters Health and Welfare Fund. Donny Dowlen Southern Benefit Administrators 2001 Caldwell Drive Goodlettsville, TN 37072
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ATL PLUMBERS:000021
file:////co-adshare/...Processing%20Team/Desiree/Atlanta%20Plumbers%20&%20Steamfitters%20Fringe%20Benefit%20Funds/Waiver.htm[11/02/2011 2:44:49 PM]
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Privacy and Confidentiality Notice: This message is being sent via secure SSL encryption to protect the privacy of our clients and to ensure compliance with HIPAA regulations. Furthermore, this message (including any attached or embedded documents) is intended for the exclusive and confidential use of the individual or entity to which it has been addressed, and unless otherwise expressly indicated, is confidential and privileged information of Southern Benefit Administrators, Inc. Any dissemination, distribution or copying of the enclosed material is prohibited. If you receive this transmission in error, please notify us immediately by e-mail at [email protected], and delete the original message. Your cooperation is appreciated.
