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From: Maria Cruz [mcruz@local60funds.

com] Sent: Wednesday, December 01, 2010 6:35 AM To: HHS HealthInsurance (HHS) Subject: waiver Attachments: WAIVER-SEGAL.doc
Mr. Mayhew, please see below.
From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, November 30, 2010 9:57 AM To: 'healthinsurance@hhs.gov' Subject: FW: waiver

I have attached my email address and our mailing address, so that you can respond by either method.

Sincerely, Maria Cruz Local 60 Plan Administrator

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I Apologize for the inconvenience this has caused you and your staff.

file:///T|/...20Processing%20Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/waiver.htm[11/16/2011 4:00:14 PM]

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Mr. Mayhew, attached is an identical waiver application of the signed waiver application I mailed to you yesterday via UPS Next Day Air. Unfortunately the mailed copy does not contain our return address (I forgot to put it on letterhead). This morning I sent you another signed hard copy on letterhead via UPS Next Day Air.

From: Maria Cruz [mcruz@local60funds.com] Sent: Tuesday, November 30, 2010 9:57 AM To: HHS HealthInsurance (HHS) Subject: FW: waiver Attachments: WAIVER-SEGAL.doc
Mr. Mayhew, attached is an identical waiver application of the signed waiver application I mailed to you yesterday via UPS Next Day Air. Unfortunately the mailed copy does not contain our return address (I forgot to put it on letterhead). This morning I sent you another signed hard copy on letterhead via UPS Next Day Air. I have attached my email address and our mailing address, so that you can respond by either method. I Apologize for the inconvenience this has caused you and your staff.

Maria Cruz Local 60 Plan Administrator

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WPCH&H:000002

file:///T|/...ssing%20Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/FW%20waiver.htm[11/16/2011 4:00:15 PM]

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Sincerely,

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WPCH&H:000003

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WPCH&H:000004

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WPCH&H:000006

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Ex. 4

Westchester Putnam Counties Heavy & Highway Laborers Health & Welfare Fund, Local 60 Application for Waiver of the Annual Limits Requirement Attachment A

denied its application to waive the requirement that it raise its annual limit to $750,000, the following significant decrease in access to benefits and/or increase in costs paid by the participants will likely result. (1) Raising the annual limit to $750,000 will result in a Ex. 4 % increase in the cost of coverage under the per member per month).

(2) For fiscal 2012, the projected operating deficit is $Ex. 4

increasing the current annual limit to $750,000 would result in a projected annual deficit of $ Ex. 4 for fiscal 2011 and more than $ Ex. 4 million for fiscal 2012, with a corresponding draw down in reserves.

(3) The Fund is funded primarily through employer contributions that are set in collective bargaining agreements. For Plan Year 2011, due to the current collective bargaining agreements and other contributions. (4) To absorb the
Ex. 4

% cost increase that would result from raising the annual limit to $750,000, the

Fund would have reduce or eliminate certain benefits and/or increase participant costs. At this time, the Fund is considering a combination of some or all of the following: (a) Reduce or eliminate non-essential benefits; (b) Eliminate dental benefits entirely;

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(c) Increase the participants cost for the prescription drug benefit by increasing the brand copay from $Ex. to a 4
Ex. 4

(d) Increase the participants hospital copays from $Ex. 4 to $Ex. 4 ; and/or (e) Increase the participants medical copay from $Ex. to $Ex. 4 . 4

(5) Making the types of changes described in (4) above are likely to cause a significant portion of the covered population to delay or forgo medical treatment due to the increased costs.

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% coinsurance;

economic constraints on the contributing employers, it is not possible to obtain increased employer

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Funds health plan (the premium equivalent will be increased by $Ex. 4

. The additional costs associated with

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If the Westchester Putnam Counties Heavy & Highway Laborers Health and Welfare Fund (Fund) is

WPCH&H:000008

Pages 9 through 11 redacted for the following reasons: ---------------------------Ex. 4

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In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision. Thank you.

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WPCH&H:000010

file:///T|/.../West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Reqeust%20for%20info%2012.9.10.htm[11/16/2011 4:00:42 PM]

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Alexandra Botwinick Office of Oversight HHS/OCIIO

alexandra.botwinick@hhs.gov

From: Habit, Sandra (HHS/OCIIO) Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document. II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140? In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan. Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight

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file:///T|/...West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%2012.27.10.htm[11/16/2011 4:00:42 PM]

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Ms. Cruz, I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible. Thank you, Sandy From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

WPCH&H:000011

301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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WPCH&H:000012

file:///T|/...West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%2012.27.10.htm[11/16/2011 4:00:42 PM]

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From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz, I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.
WPCH&H:000013

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%2012.28.10.htm[11/16/2011 4:00:43 PM]

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Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

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From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Thanks, Sandy

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Thank you, Sandy

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

II. In addition, please provide the following information:

Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly
WPCH&H:000014

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%2012.28.10.htm[11/16/2011 4:00:43 PM]

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In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.

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Confirm whether the plan was created pursuant to the Taft-Hartley Act.

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In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

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Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

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disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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WPCH&H:000015

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%2012.28.10.htm[11/16/2011 4:00:43 PM]

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From: Maria Cruz [mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:39 AM To: Habit, Sandra (HHS/OCIIO) Subject: waiver information request
Ms Habit: I have just recd this email. The email on 12/9/2010 was not recd by Maria Cruz who is away on vacation and out of this country until 1/10/2011. I will review this request and answer promptly. I apologize for this problem. Thank you for your response I was getting worried and left several calls at the HHS office this morning. Pamn

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file:///T|/.../West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20(1)%2012.28.10.htm[11/16/2011 4:00:43 PM]

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From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office
From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document. II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

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Ms. Cruz, I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible. Thank you, Sandy From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

file:///T|/...%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20question%2012.28.10.htm[11/16/2011 4:00:43 PM]

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WPCH&H:000017

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan. Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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file:///T|/...%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20question%2012.28.10.htm[11/16/2011 4:00:43 PM]

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WPCH&H:000018

From: Habit, Sandra (HHS/OCIIO) Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

Thanks, Sandy

Ms. Cruz,

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

WPCH&H:000019

file:///T|/...est%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Spreadsheet%20assistance%2012.28.10.htm[11/16/2011 4:00:44 PM]

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

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From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

Confirm whether the plan was created pursuant to the Taft-Hartley Act.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.

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In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

file:///T|/...est%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Spreadsheet%20assistance%2012.28.10.htm[11/16/2011 4:00:44 PM]

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WPCH&H:000020

From: Pamn Mende [pmende@local60funds.com] Sent: Wednesday, December 29, 2010 10:59 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Sandra, Thank you so much. I have forwarded it on to Segal (our Consultants). I have the answer to three of your questions (total 4) but I need our Consultants to complete the first item you requested. Do you want the answers to the ones I have or do you prefer to wait for all? I presume the one I cant answer is the most important. Thank you for all your time and consideration, pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

Thanks, Sandy
From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
WPCH&H:000021

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%2012.29.10.htm[11/16/2011 4:00:44 PM]

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Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn

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From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks, Sandy

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Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers


From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may
WPCH&H:000022

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%2012.29.10.htm[11/16/2011 4:00:44 PM]

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From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

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add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%2012.29.10.htm[11/16/2011 4:00:44 PM]

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WPCH&H:000023

Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

From: Habit, Sandra (HHS/OCIIO) Sent: Wednesday, December 29, 2010 11:21 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, I am so glad you were able to obtain the spreadsheet and forward it on to your consultants. I would prefer to receive the spreadsheet all in one piece so I can wait until all the information is complete. Please let me know if you have any questions. Thanks, Sandy

I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:
WPCH&H:000024

file:///T|/...%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20response%2012.29.10.htm[11/16/2011 4:00:45 PM]

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From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks, Sandy

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

ra do .

Sandra, Thank you so much. I have forwarded it on to Segal (our Consultants). I have the answer to three of your questions (total 4) but I need our Consultants to complete the first item you requested. Do you want the answers to the ones I have or do you prefer to wait for all? I presume the one I cant answer is the most important. Thank you for all your time and consideration, pamn

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From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 10:59 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

Thanks, Sandy
From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete
WPCH&H:000025

file:///T|/...%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20response%2012.29.10.htm[11/16/2011 4:00:45 PM]

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Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

(i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

Confirm whether the plan was created pursuant to the Taft-Hartley Act.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.

file:///T|/...%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20response%2012.29.10.htm[11/16/2011 4:00:45 PM]

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In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

WPCH&H:000026

From: Pamn Mende [pmende@local60funds.com] Sent: Wednesday, December 29, 2010 11:41 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Will do, Thanks so much again, pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 11:21 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 10:59 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn
WPCH&H:000027

file:///T|/...Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Corresponse%20response%20(2)%2012.29.10.htm[11/16/2011 4:00:45 PM]

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Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks, Sandy

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Sandra, Thank you so much. I have forwarded it on to Segal (our Consultants). I have the answer to three of your questions (total 4) but I need our Consultants to complete the first item you requested. Do you want the answers to the ones I have or do you prefer to wait for all? I presume the one I cant answer is the most important. Thank you for all your time and consideration, pamn

ol o

ra do .

Pamn, I am so glad you were able to obtain the spreadsheet and forward it on to your consultants. I would prefer to receive the spreadsheet all in one piece so I can wait until all the information is complete. Please let me know if you have any questions. Thanks, Sandy

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

Thanks, Sandy

Ms. Cruz,

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

WPCH&H:000028

file:///T|/...Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Corresponse%20response%20(2)%2012.29.10.htm[11/16/2011 4:00:45 PM]

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

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From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

Confirm whether the plan was created pursuant to the Taft-Hartley Act.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.

ol o

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In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

file:///T|/...Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Corresponse%20response%20(2)%2012.29.10.htm[11/16/2011 4:00:45 PM]

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WPCH&H:000029

From: Habit, Sandra (HHS/OCIIO) Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers Attachments: Waiver application form.xls
Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks, Sandy From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM
WPCH&H:000030

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Waiver%20sent%2012.29.10.htm[11/16/2011 4:00:46 PM]

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Thanks, Sandy

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Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

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Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

ra do .

I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn

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To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers


From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz, I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of
WPCH&H:000031

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Waiver%20sent%2012.29.10.htm[11/16/2011 4:00:46 PM]

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

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From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

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receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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WPCH&H:000032

file:///T|/.../Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Waiver%20sent%2012.29.10.htm[11/16/2011 4:00:46 PM]

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

From: Pamn Mende [pmende@local60funds.com] Sent: Wednesday, December 29, 2010 12:51 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Sandra, I just heard back from my Consultants/Actuaries. They have indicated the person who worked on our waiver is out on vacation. They are attempting to get another staff member to assist me. They want to know if you will grant us an extension until Tuesday, based on these factors. Pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 11:21 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks, Sandy From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it,
WPCH&H:000033

file:///T|/...0Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Extension%2012.29.10.htm[11/16/2011 4:00:46 PM]

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

et eC

Sandra, Thank you so much. I have forwarded it on to Segal (our Consultants). I have the answer to three of your questions (total 4) but I need our Consultants to complete the first item you requested. Do you want the answers to the ones I have or do you prefer to wait for all? I presume the one I cant answer is the most important. Thank you for all your time and consideration, pamn

ol o

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 10:59 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

ra do .

Pamn, I am so glad you were able to obtain the spreadsheet and forward it on to your consultants. I would prefer to receive the spreadsheet all in one piece so I can wait until all the information is complete. Please let me know if you have any questions. Thanks, Sandy

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pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Thanks, Sandy

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section
WPCH&H:000034

file:///T|/...0Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Extension%2012.29.10.htm[11/16/2011 4:00:46 PM]

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

pl

et eC

ol o

Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

ra do .

co m

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

2711 Importance: High

II. In addition, please provide the following information:

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan. Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

Co m

Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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ol o

ra do .

Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

file:///T|/...0Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Extension%2012.29.10.htm[11/16/2011 4:00:46 PM]

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

WPCH&H:000035

From: Habit, Sandra (HHS/OCIIO) Sent: Wednesday, December 29, 2010 1:12 PM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Pamn, That is fine. Sandy

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 11:21 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Sandra, Thank you so much. I have forwarded it on to Segal (our Consultants). I have the answer to three of your questions (total 4) but I need our Consultants to complete the first item you requested. Do you want the answers to the ones I have or do you prefer to wait for all? I presume the one I cant answer is the most important. Thank you for all your time and consideration, pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks,
WPCH&H:000036

file:///T|/.../West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Extension%20response%2012.29.10.htm[11/16/2011 4:00:47 PM]

Co m

pl

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 10:59 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

et eC

Pamn, I am so glad you were able to obtain the spreadsheet and forward it on to your consultants. I would prefer to receive the spreadsheet all in one piece so I can wait until all the information is complete. Please let me know if you have any questions. Thanks, Sandy

ol o

ra do .

Sandra, I just heard back from my Consultants/Actuaries. They have indicated the person who worked on our waiver is out on vacation. They are attempting to get another staff member to assist me. They want to know if you will grant us an extension until Tuesday, based on these factors. Pamn

co m

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 12:51 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Sandy From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions. Thanks, Sandy

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers


From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,
WPCH&H:000037

file:///T|/.../West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Extension%20response%2012.29.10.htm[11/16/2011 4:00:47 PM]

Co m

Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

pl

et eC

ol o

ra do .

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

co m

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

II. In addition, please provide the following information:

In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov


WPCH&H:000038

file:///T|/.../West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Extension%20response%2012.29.10.htm[11/16/2011 4:00:47 PM]

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Confirm whether the plan was created pursuant to the Taft-Hartley Act.

pl

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

et eC

Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

ol o

ra do .

Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

co m

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

Co m

pl

et eC

ol o

ra do .
WPCH&H:000039

file:///T|/.../West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Extension%20response%2012.29.10.htm[11/16/2011 4:00:47 PM]

co m

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, January 04, 2011 2:36 PM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Sandra, The Funds Benefit Consultants promised me a response to your request by Tuesday (today). This morning when I spoke to them they indicated based on vacations, holidays, etc, they were having problems, but assured me they would have this completed by this afternoon. I have not heard from them & I am leaving for the day. I am looking forward to receiving this information & forwarding it to you by tomorrow. Would that be satisfactory to you. I do apologize for all this mix up, since 12/9/10. I am sure glad and thankful that you followed up on 12/28/2010. Thank you once again for your consideration, Pamn Mende
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 1:12 PM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, I am so glad you were able to obtain the spreadsheet and forward it on to your consultants. I would prefer to receive the spreadsheet all in one piece so I can wait until all the information is complete. Please let me know if you have any questions. Thanks, Sandy From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 10:59 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Sandra, Thank you so much. I have forwarded it on to Segal (our Consultants). I have the answer to three of your questions (total 4) but I need our Consultants to complete the first item you requested. Do you want the answers to the ones I have or
WPCH&H:000040

file:///T|/...am/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%201.4.11.htm[11/16/2011 4:00:47 PM]

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 11:21 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

pl

et eC

Sandra, I just heard back from my Consultants/Actuaries. They have indicated the person who worked on our waiver is out on vacation. They are attempting to get another staff member to assist me. They want to know if you will grant us an extension until Tuesday, based on these factors. Pamn

ol o

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 12:51 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

ra do .

Pamn, That is fine. Sandy

co m

do you prefer to wait for all? I presume the one I cant answer is the most important. Thank you for all your time and consideration, pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

Thanks, Sandy

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

WPCH&H:000041

file:///T|/...am/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%201.4.11.htm[11/16/2011 4:00:47 PM]

Co m

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

pl

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

et eC

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

ol o

I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn

ra do .

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

co m

Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks, Sandy

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers


From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,

Thank you, Sandy

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is
WPCH&H:000042

file:///T|/...am/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%201.4.11.htm[11/16/2011 4:00:47 PM]

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pl

Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

et eC

ol o

ra do .

co m

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

Co m

pl

et eC

ol o

ra do .
WPCH&H:000043

file:///T|/...am/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%201.4.11.htm[11/16/2011 4:00:47 PM]

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From: Habit, Sandra (HHS/OCIIO) Sent: Tuesday, January 04, 2011 2:53 PM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Pamn, This will not be an issue. Thank you for the update, Sandy

Pamn, That is fine. Sandy

Sandra, I just heard back from my Consultants/Actuaries. They have indicated the person who worked on our waiver is out on vacation. They are attempting to get another staff member to assist me. They want to know if you will grant us an extension until Tuesday, based on these factors. Pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 11:21 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, I am so glad you were able to obtain the spreadsheet and forward it on to your consultants. I would prefer to receive the spreadsheet all in one piece so I can wait until all the information is complete. Please let me know if you have any questions.
WPCH&H:000044

file:///T|/...st%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20response%201.4.11.htm[11/16/2011 4:00:47 PM]

Co m

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 12:51 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

pl

et eC

ol o

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 1:12 PM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

ra do .

Sandra, The Funds Benefit Consultants promised me a response to your request by Tuesday (today). This morning when I spoke to them they indicated based on vacations, holidays, etc, they were having problems, but assured me they would have this completed by this afternoon. I have not heard from them & I am leaving for the day. I am looking forward to receiving this information & forwarding it to you by tomorrow. Would that be satisfactory to you. I do apologize for all this mix up, since 12/9/10. I am sure glad and thankful that you followed up on 12/28/2010. Thank you once again for your consideration, Pamn Mende

co m

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, January 04, 2011 2:36 PM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Thanks, Sandy From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, December 29, 2010 10:59 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Sandra, Thank you so much. I have forwarded it on to Segal (our Consultants). I have the answer to three of your questions (total 4) but I need our Consultants to complete the first item you requested. Do you want the answers to the ones I have or do you prefer to wait for all? I presume the one I cant answer is the most important. Thank you for all your time and consideration, pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, December 29, 2010 9:47 AM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

Thanks, Sandy

WPCH&H:000045

file:///T|/...st%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20response%201.4.11.htm[11/16/2011 4:00:47 PM]

Co m

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

pl

I tried to download it, my system wont allow it-security issues. I have forwarded your request to our benefit consultants to address the first requirement & they will hopefully be able to access this. Thank you for getting back to me so fast. I appreciate it, pamn

et eC

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Tuesday, December 28, 2010 1:05 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

ol o

Pamn, I am back in the office today and am attaching the spreadsheet. Let me know if you have any additional questions. Thanks, Sandy

ra do .

co m

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,

Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?
WPCH&H:000046

file:///T|/...st%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20response%201.4.11.htm[11/16/2011 4:00:47 PM]

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pl

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

et eC

Thank you, Sandy

ol o

I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

ra do .

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

co m

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

Co m

pl

et eC

ol o

ra do .
WPCH&H:000047

file:///T|/...st%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%20response%201.4.11.htm[11/16/2011 4:00:47 PM]

co m

Co m

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et eC

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

ol o

ra do .
WPCH&H:000048

Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

file:///T|/...20Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Completion%201.5.11.htm[11/16/2011 4:00:48 PM]

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From: Habit, Sandra (HHS/OCIIO) Sent: Wednesday, January 05, 2011 3:15 PM To: 'Pamn Mende' Subject: Waiver Application - Westchester Putnam Counties January 5, 2011 Dear Pamn, Thank you for your information. Your application is now complete and you will receive a determination of your application within 30 days. Take care and if you have any questions, please feel free to contact me. Thank you, Sandy

From: Pamn Mende [pmende@local60funds.com] Sent: Wednesday, January 05, 2011 3:08 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties
Thank you once again, Pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, January 05, 2011 3:15 PM To: 'Pamn Mende' Subject: Waiver Application - Westchester Putnam Counties

Co m

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

pl

et eC

Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

ol o

ra do .

January 5, 2011 Dear Pamn, Thank you for your information. Your application is now complete and you will receive a determination of your application within 30 days. Take care and if you have any questions, please feel free to contact me. Thank you, Sandy

file:///T|/...e/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Completion%20response%201.5.11.htm[11/16/2011 4:00:48 PM]

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WPCH&H:000049

From: Habit, Sandra (HHS/OCIIO) Sent: Wednesday, January 05, 2011 12:40 PM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Pamn, Thank you for the information. I have one last question for you, do you know the date that the last collective bargaining agreement expires? Sandy From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, January 05, 2011 11:10 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende
WPCH&H:000050

file:///T|/...e/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%201.5.11.htm[11/16/2011 4:00:48 PM]

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Thanks, Sandy

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Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

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Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

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Sandra, as promised, attached is the spreadsheet and other information requested to continue in the processing of the Funds Waiver request. If possible, kindly copy me on your final determination OR if you need any additional information in order to process the Funds Waiver. Thanking you again for your patience throughout this process, Pamn

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Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers


From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz, I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
WPCH&H:000051

file:///T|/...e/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%201.5.11.htm[11/16/2011 4:00:48 PM]

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

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From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

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Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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WPCH&H:000052

file:///T|/...e/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%201.5.11.htm[11/16/2011 4:00:48 PM]

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

From: Pamn Mende [pmende@local60funds.com] Sent: Wednesday, January 05, 2011 1:23 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers
Sandra, I have a call into our Union Office & will let you know shortly. Pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, January 05, 2011 12:40 PM To: 'Pamn Mende' Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Wednesday, January 05, 2011 11:10 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

Thanks, Sandy
From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me?
WPCH&H:000053

file:///T|/...20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%20correspondence%201.5.11.htm[11/16/2011 4:00:49 PM]

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Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

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Sandra, as promised, attached is the spreadsheet and other information requested to continue in the processing of the Funds Waiver request. If possible, kindly copy me on your final determination OR if you need any additional information in order to process the Funds Waiver. Thanking you again for your patience throughout this process, Pamn

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Pamn, Thank you for the information. I have one last question for you, do you know the date that the last collective bargaining agreement expires? Sandy

Thank you, Pamn Mende Local 60 Benefits Fund Office

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers


From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,

Thank you, Sandy

II. In addition, please provide the following information: Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.
WPCH&H:000054

file:///T|/...20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%20correspondence%201.5.11.htm[11/16/2011 4:00:49 PM]

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

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From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

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I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

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Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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file:///T|/...20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%20correspondence%201.5.11.htm[11/16/2011 4:00:49 PM]

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WPCH&H:000055

From: Pamn Mende [pmende@local60funds.com] Sent: Wednesday, January 05, 2011 11:10 AM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers Attachments: HHS Response info.doc; 60 West Waiver application form.XLS; Westchester Local 60 WF Attachment A.DOC
Sandra, as promised, attached is the spreadsheet and other information requested to continue in the processing of the Funds Waiver request. If possible, kindly copy me on your final determination OR if you need any additional information in order to process the Funds Waiver. Thanking you again for your patience throughout this process, Pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Tuesday, December 28, 2010 1:01 PM To: Pamn Mende Subject: RE: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html

From: Pamn Mende [pmende@local60funds.com] Sent: Tuesday, December 28, 2010 11:57 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

From: Maria Cruz [mailto:mcruz@local60funds.com] Sent: Tuesday, December 28, 2010 11:35 AM To: Pamn Mende Subject: FW: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers


From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, December 27, 2010 11:55 AM To: 'mcruz@local60funds.com' Subject: Waiver Application - Westchester Putnam Counties Heavy and Highway Laborers

Ms. Cruz,
WPCH&H:000056

file:///T|/...hester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%20resposne%201.5.11.htm[11/16/2011 4:00:49 PM]

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Ms Habit, this email refers to an attachment of entire Annual Limits Requirements. I was unable to retrieve it off the website given. Can you send this attachment to me? Thank you, Pamn Mende Local 60 Benefits Fund Office

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Thanks, Sandy

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Click on Annual Limit Waiver Application Form (6th Bullet down) and you should be able to access the spreadsheet. Please let me know if you have any questions.

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Pamn, Unfortunately, I am working from home today and my home computer does not have the capability to access the spreadsheet. If you go to this website:

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I am resending an email that was sent to you on December 9, 2010. We have not heard back from you as of this point. Please complete the application and send back to me as soon as possible.

Thank you, Sandy

II. In addition, please provide the following information:

Confirm whether the plan was created pursuant to the Taft-Hartley Act. In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.
Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

WPCH&H:000057

file:///T|/...hester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%20resposne%201.5.11.htm[11/16/2011 4:00:49 PM]

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In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of nonessential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan.

et eC

Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140?

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Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information: I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

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From: Botwinick, Alexandra (HHS/OCIIO) Sent: Thursday, December 09, 2010 12:15 PM To: 'mcruz@local60funds.com' Subject: Westchester Putnam Counties Heavy and Highway Laborers Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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WPCH&H:000058

file:///T|/...hester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Request%20for%20info%20resposne%201.5.11.htm[11/16/2011 4:00:49 PM]

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Street Address City State 01/01/2011 Maria Cruz 140 Broadway Hawthorne 01/01/2011 Maria Cruz 140 Broadway Hawthorne

Applicant ID Annual Limit Waiver Request Number Applicant Name

Policy Name (use a new row for each policy application)

Applicant (Plan/ Applicant Policy (Plan/ Policy Situs) Situs) City State

Plan/ Policy Effective Contact Date (mm/dd/yyyy) Name

Phone Number (including area code) (xxx- Email Zip Code xxx-xxx) Address

Westchester Putnam Counties Heavy & Highway Laborers Health & Welfare Fund, Local 101130-008 60

Westchester Putnam Counties Heavy & Highway Laborers Health & Welfare Fund, Local 60

Hawthorne

NY

NY

10532

mcruz@lo 914 cal60fund 769-2440 s.com

Hawthorne

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Westchester Putnam Counties Heavy & Highway Laborers Health & Welfare Fund, Local 101130-008 60

Westchester Putnam Counties Heavy & Highway Laborers Health & Welfare Fund, Local 60

NY

NY

10532

mcruz@lo 914 cal60fund 769-2440 s.com

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WPCH&H:000059

Type of Coverage (e.g., Limited Benefit, HRA, Rx Selfonly, Other) Insured

Current Plan Annual Limit (in dollars)

Mental Health/ Rehabilit Preventiv Ambulato Emergen Hospitaliz Laborator Maternity/ Substanc ative/ e/ Prescripti ry cy ation y Pediatric Newborn e Abuse Devices Wellness on Plan Deductible
Ex. 4

Other

Yes

Group

Other

Yes

Group

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Total Number of Individual s Covered by Policy (include Individual all or Group dependent s covered) Policy

WPCH&H:000060

Coinsura Copay (if Copay (if nce (if applicable applicable applicable ) ) )

Coinsura nce (if Copay (if applicable applicable ) )

Coinsura nce (if Copay (if applicable applicable ) )

Coinsura nce (if applicable )


Ex. 4

Individual / Employee Employer Employee contributi contributi Tier* on on Total

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Employee Employer contributi contributi on on Total

Employee Employer contributi contributi on on Total


Ex. 4

Employee

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Employee + Family

WPCH&H:000061

Plan Administr ator/ CEO of Health Insurance Issuer Name


Ex. 4

Title of Individual Providing TaftAttestatio Hartley n Plan

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If Yes TaftHartley then Date Collective Bargaining Agreement Expires Complian ce with Grandfat her Regulatio Lead Date of n Reviewer Receipt Yes 03/31/2011 Yes S. Habit Yes 03/31/2011 Yes S. Habit

Projected Rate Increase that would result from compliance with $750,000 Annual Limit Restriction (in dollars)(Average Premium by Individual) Decrease in Access to Benefits that would result (Difference of Column from compliance with $750,000 Annual Limit AV and AS divided by Column AS) Restriction (describe briefly)

Factor 1 Factor 2 Factor 3 Factor 4 for for for for Decision Decision Decision Decision

Maria Cruz

Fund Manager

3: The change in premium in percentag 11/30/2010 e terms.

Maria Cruz

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Fund Manager

3: The change in premium in percentag 11/30/2010 e terms.

WPCH&H:000062

Final Decision Date of Decision Date Waiver

Approval/ Disappro val Letter Date of Sent Y/N Letter

Confirmat ion of Receipt of Access Approval File

Approve

01/05/2011

Approve

01/05/2011

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WPCH&H:000063

OCIIO Staff Recomm endation for Approval/ Date of Disappro Comment Completed val s Application
Ex. 4

Please see responses in RED below: (The completed spreadsheet is attached) Dear Applicant: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. In order to expedite your application, please provide the following information:

II.

In addition, please provide the following information:

Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140? Yes & Yes In your application, your plan(s) or policy(ies) provide a lifetime limit. Pursuant to Section 2711 of the PHS Act, you may not have any lifetime limit on your plan as of September 23, 2010, except in the case of non-essential benefits that are permitted under Federal or State law. Plans that previously had a lifetime limit may add an annual limit not less than the lifetime limit without affecting the grandfather status of the plan. Please confirm whether this lifetime limit will be eliminated from your plan. Yes Confirm whether the plan was created pursuant to the Taft-Hartley Act. Yes

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In order to complete your application, please provide this information as soon as possible. Once this information is received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). As stated in our September 3, 2010 SubRegulatory Guidance, HHS will issue a decision within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decision.

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I.

Please complete the entire annual limits spreadsheet, [attached to the email] [and available at: http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an explanation regarding why you are unable to complete that particular cell in a separate document.

WPCH&H:000064

From: Habit, Sandra (HHS/OCIIO) Sent: Thursday, February 03, 2011 2:46 PM To: Kottenmeier, Erika (HHS/OCIIO) Subject: Westchester Putnam Attachments: Updated spreadsheet 2.3.11.xls
Updated spreadsheet. Thanks! Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

file:///T|/...est%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/spreadsheet%20to%20erika%202.3.11.htm[11/16/2011 4:00:59 PM]

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WPCH&H:000065

From: Habit, Sandra (HHS/OCIIO) Sent: Thursday, February 03, 2011 1:12 PM To: Kottenmeier, Erika (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties

Hi Erika, I am forwarding this to you because I never heard back from Erica regarding this applicant. They have an over 12% rate increase and I recommended an approval. Do I need to wait until next Wednesday to put this in front of Gary again? Thanks, Sandy

January 5, 2011 Dear Pamn, Thank you for your information. Your application is now complete and you will receive a determination of your application within 30 days. Take care and if you have any questions, please feel free to contact me. Thank you, Sandy

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, January 05, 2011 3:15 PM To: 'Pamn Mende' Subject: Waiver Application - Westchester Putnam Counties

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Hi Sandra, I dont know if you recall, but the last time you forwarded an email to Maria Cruz for more information needed, it was not received, so Im just checking with you to see if a determination on our waiver has been made and she was notified. If so, can you kindly copy me on that email. Thank you for your time & consideration, Pamn

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From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Monday, January 31, 2011 1:18 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties

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Hi Ladies, I sent this for leadership review on 1/5/11 for approval and they still havent heard a response. Do you have a status update for them by any chance? Thanks, Sandy

file:///T|/...est%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Status%20update%20check%202.3.11.htm[11/16/2011 4:00:59 PM]

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From: Habit, Sandra (HHS/OCIIO) Sent: Tuesday, February 01, 2011 10:01 AM To: Pham, Erica (HHS/OCIIO); Botwinick, Alexandra (HHS/OCIIO) Subject: FW: Waiver Application - Westchester Putnam Counties

WPCH&H:000066

Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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WPCH&H:000067

file:///T|/...est%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Status%20update%20check%202.3.11.htm[11/16/2011 4:00:59 PM]

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From: Pamn Mende [pmende@local60funds.com] Sent: Monday, February 07, 2011 1:35 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver status
Oh thank you. Pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Monday, February 07, 2011 12:16 PM To: 'Pamn Mende' Cc: 'mcruz@local60funds.com' Subject: RE: Waiver status

Pamn, I apologize for the delay. You should receive a response this week via email. Thank you for you patience, Sandy From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Monday, February 07, 2011 11:18 AM To: Habit, Sandra (HHS/OCIIO) Cc: mcruz@local60funds.com Subject: Waiver status

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Sandra, I really hate to bother you, but I emailed you last Monday and didnt hear back from you. Do you have a status on our Waiver application? Thank you, Pamn Mende Local 60 Health & Welfare Fund 914-769-2440

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file:///T|/...am/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Correspondence%202.7.11.htm[11/16/2011 4:00:59 PM]

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WPCH&H:000068

From: Pamn Mende [pmende@local60funds.com] Sent: Monday, February 07, 2011 11:18 AM To: Habit, Sandra (HHS/OCIIO) Cc: mcruz@local60funds.com Subject: Waiver status
Sandra, I really hate to bother you, but I emailed you last Monday and didnt hear back from you. Do you have a status on our Waiver application? Thank you, Pamn Mende Local 60 Health & Welfare Fund 914-769-2440

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WPCH&H:000069

file:///T|/...m/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Waiver%20status%202.7.11.htm[11/16/2011 4:01:00 PM]

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From: Habit, Sandra (HHS/OCIIO) Sent: Monday, February 07, 2011 12:16 PM To: 'Pamn Mende' Cc: 'mcruz@local60funds.com' Subject: RE: Waiver status

Pamn, I apologize for the delay. You should receive a response this week via email. Thank you for you patience, Sandy

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Sandra, I really hate to bother you, but I emailed you last Monday and didnt hear back from you. Do you have a status on our Waiver application? Thank you, Pamn Mende Local 60 Health & Welfare Fund 914-769-2440

file:///T|/...t%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Waiver%20status%20response%202.7.11.htm[11/16/2011 4:01:00 PM]

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From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Monday, February 07, 2011 11:18 AM To: Habit, Sandra (HHS/OCIIO) Cc: mcruz@local60funds.com Subject: Waiver status

WPCH&H:000070

From: Habit, Sandra (HHS/OCIIO) Sent: Wednesday, February 09, 2011 1:35 PM To: 'Pamn Mende' Cc: 'mcruz@local60funds.com' Subject: RE: Waiver Application - Westchester Putnam Counties Attachments: Jan 1 Approval.pdf Dear Pamn,

January 5, 2011 Dear Pamn, Thank you for your information. Your application is now complete and you will receive a determination of your application within 30 days. Take care and if you have any questions, please feel free to contact me. Thank you, Sandy
Sandy Habit

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From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, January 05, 2011 3:15 PM To: 'Pamn Mende' Subject: Waiver Application - Westchester Putnam Counties

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Hi Sandra, I dont know if you recall, but the last time you forwarded an email to Maria Cruz for more information needed, it was not received, so Im just checking with you to see if a determination on our waiver has been made and she was notified. If so, can you kindly copy me on that email. Thank you for your time & consideration, Pamn

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From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Monday, January 31, 2011 1:18 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties

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Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section for Westchester Putnam Counties. 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 address. Please let me know if I can be of further assistance. Sincerely, Sandy

file:///T|/...%20Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Approval%202.9.11.htm[11/16/2011 4:01:00 PM]

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WPCH&H:000071

Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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WPCH&H:000072

file:///T|/...%20Team/Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Approval%202.9.11.htm[11/16/2011 4:01:00 PM]

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WPCH&H:000073

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WPCH&H:000074

From: Pamn Mende [pmende@local60funds.com] Sent: Wednesday, February 09, 2011 2:01 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties
Email received, Thank you, Pamn
From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, February 09, 2011 1:35 PM To: 'Pamn Mende' Cc: 'mcruz@local60funds.com' Subject: RE: Waiver Application - Westchester Putnam Counties

From: Pamn Mende [mailto:pmende@local60funds.com] Sent: Monday, January 31, 2011 1:18 PM To: Habit, Sandra (HHS/OCIIO) Subject: RE: Waiver Application - Westchester Putnam Counties

From: Habit, Sandra (HHS/OCIIO) [mailto:Sandra.Habit@hhs.gov] Sent: Wednesday, January 05, 2011 3:15 PM To: 'Pamn Mende' Subject: Waiver Application - Westchester Putnam Counties

January 5, 2011 Dear Pamn, Thank you for your information. Your application is now complete and you will receive a determination of your application within 30 days. Take care and if you have any questions, please feel free to contact me.
WPCH&H:000075

file:///T|/...Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Approval%20receipt%202.9.11.htm[11/16/2011 4:01:00 PM]

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Hi Sandra, I dont know if you recall, but the last time you forwarded an email to Maria Cruz for more information needed, it was not received, so Im just checking with you to see if a determination on our waiver has been made and she was notified. If so, can you kindly copy me on that email. Thank you for your time & consideration, Pamn

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Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section for Westchester Putnam Counties. 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 address. Please let me know if I can be of further assistance. Sincerely, Sandy

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Dear Pamn,

Thank you, Sandy

Sandy Habit Department of Health and Human Services Office of Consumer Information and Insurance Oversight 301-492-4175 Sandra.Habit@hhs.gov

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full extent of the law.

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WPCH&H:000076

file:///T|/...Mike/West%20Chester%20Putnam%20Counties%20Heavy%20&%20Highway%20Laborers/Approval%20receipt%202.9.11.htm[11/16/2011 4:01:00 PM]

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