UFCW Local 1459 - Redacted Bates HW

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//T|/...20-%20YELLOW/Applications%20with%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/waiver.htm[07/25/2011 5:01

rom: Joe Semo [[email protected]]ent: Thursday, October 14, 2010 10:24 AM

To: HHS HealthInsurance (HHS)ubject: waiver

Attachments: 92150 hhs sub.pdflease find attached the request for a waiver of the annual benefit limitation required by PHS Act section 2711 submitted on be

f the United Food and Commercial Workers Local 1459 and Contributing Employers Health and Welfare Fund.

hank you in advance for your prompt consideration of this request as changes would need to go into effect as ofanuary 1, 2011.

oseph Semo, Esq. AV Peer Review Rating in

EMO LAW GROUP Martindale-Hubbell

800 M Street, NWui t e 730S

WASHI NGTON, DC 20036irect Dial: 202 833 7366acsimile: 202 478 0919-mail:[email protected]://www.semolawgroup.com

rivileged and Confidential: The information contained in this e-mail message is intended only for the personal and confidential use ofntended recipient(s). This message may be an attorney-client communication and/or work product and as such is privileged and confidential axempt from disclosure. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipou are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this messastrictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original messag

I RCULAR 230 NOTI CE.

O ENSURE COMPLI ANCE WI TH REQUI REMENTS I MPOSED BY THE I RS, WE I NFORM YOU THAT ANY U. S. FEDERALAX ADVI CE CONTAI NED I N THI S COMMUNI CATI ON ( I NCLUDI NG ANY ATTACHMENTS) I S NOT I NTENDED OR WRI TO BE USED, AND CANNOT BE USED, FOR THE PURPOSE OF ( I ) AVOI DI NG PENALTI ES UNDER THE I NTERNALEVENUE CODE OR ( I I ) PROMOTI NG, MARKETI NG OR RECOMMENDI NG TO ANOTHER PARTY ANY TRANSACTI ON OR

MATTER ADDRESSED HEREI N.

UFCW L1459:000030
http://blocked:%3Amailto%[email protected]/http://www.semolawgroup.com/http://www.semolawgroup.com/http://blocked:%3Amailto%[email protected]/


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//T|/...ith%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/Approval%20Letter%20Sent%2011-5-2010.htm[07/25/2011 5:02:

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Friday, November 05, 2010 12:13 PM

To: '[email protected]'ubject: Waiver of the Annual Limits Requirements of PHS Act Section 2711

mportance: High

Attachments: Updated Jan 1 Approval Letter .pdf

Mr. Semo,

hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act

ection for UFCW Local 1459. HHS has reviewed your application and made its determination. Please see th

ttached letter.

lease confirm receipt of this letter by replying to this e-mail address with a copy to [email protected]

lease let me know if I can be of further assistance.

incerely,

Alexandra Botwinick

ffice of Oversight

HHS/[email protected]

UFCW L1459:000031
mailto:[email protected]:[email protected]


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//T|/...12600%20Response%20[YELLOW]/UFCW%20Local%201459/Confirmation%20of%20Approval%20Letter%2011-5-2010.htm[07/25/2011 5:02

rom: Joe Semo [[email protected]]ent: Friday, November 05, 2010 12:32 PM

To: Botwinick, Alexandra (HHS/OCIIO)Cc: OCIIO Oversightubject: RE: Waiver of the Annual Limits Requirements of PHS Act Section 2711eceipt acknowledged.


EMO LAW GROUP Martindale-Hubbell800 M Street, NWuite 730SASHINGTON, DC 20036

irect Dial: 202 833 7366

acsimile: 202 478 0919

-mail:[email protected]

ttp://www.semolawgroup.com

rivileged and Confidential: The information contained in this e-mail message is intended only for the personal and confidential use ofntended recipient(s). This message may be an attorney-client communication and/or work product and as such is privileged and confidential a

xempt from disclosure. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recip

ou are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this messa

strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message

IRCULAR 230 NOTICE.

O ENSURE COMPLIANCE WITH REQUIREMENTS IMPOSED BY THE IRS, WE INFORM YOU THAT ANY U.S. FEDERALAX ADVICE CONTAINED IN THIS COMMUNICATION (INCLUDING ANY ATTACHMENTS) IS NOT INTENDED OR WRITO BE USED, AND CANNOT BE USED, FOR THE PURPOSE OF (I) AVOIDING PENALTIES UNDER THE INTERNALEVENUE CODE OR (II) PROMOTING, MARKETING OR RECOMMENDING TO ANOTHER PARTY ANY TRANSACTION ORATTER ADDRESSED HEREIN.

rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]ent: Friday, November 05, 2010 12:13 PMo: Joe Semoubject: Waiver of the Annual Limits Requirements of PHS Act Section 2711mportance: High

Mr. Semo,

hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act

ection for UFCW Local 1459. HHS has reviewed your application and made its determination. Please see th

ttached letter.

lease confirm receipt of this letter by replying to this e-mail address with a copy to [email protected]

lease let me know if I can be of further assistance.

incerely,

Alexandra Botwinick

ffice of Oversight

HHS/[email protected]

UFCW L1459:000032
http://blocked:%3Amailto%[email protected]/http://www.semolawgroup.com/mailto:[email protected]:[email protected]://www.semolawgroup.com/http://blocked:%3Amailto%[email protected]/


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//T|/...-%20YELLOW/Applications%20with%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/WAIVER.txt[07/25/2011 5:02

rom: Joseph Semo [[email protected]]ent: Monday, November 15, 2010 5:51 PMo: HHS HealthInsurance (HHS)

Cc: joesemoubject: WAIVER

Attachments: ufcw 1459 hhs.pdf

lease find attached the waiver application submitted on behalf of UFCW Local 1459 and Contributing EmployersHealth & Welfare Fund for its Plan B of benefits.

oseph Semo, Esq.EMO LAW GROUP800 M Street, NWuite 730 S

Washington, DC 20036

02 833 7366

UFCW L1459:000034


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//T|/...0NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/UFCW%20Local%201459%20Annual%20Waiver.htm[07/25/2011 5:02

rom: Scelzo, Kathleen (HHS/OCIIO)ent: Tuesday, November 23, 2010 10:39 AM

To: '[email protected]'; '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)ubject: UFCW Local 1459 Annual Waiver

Attachments: UFCW Local 1459 Waiver Application Questions.docoe Semo,

left a message for you this morning alerting you about an e-mail you would receive from me concerning UFCW Local 1459

pplication for Annual Limits Requirements of the PHS Act Section 2711. Attached above is the document that needs to be

ompleted in order to finalize the application process.

Many thanks for your assistance with this document.

athleen M. Scelzo, RN, MSN

ules Compliance Division

ffice of Insurance Oversight

ffice of Consumer Information and Insurance Oversight (OCIIO)

epartment of Health and Human Services

501 Wisconsin Avenue

ethesda, MD01-492-4121

UFCW L1459:000035


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November 16, 2010

Dear Applicant:

RE: United Food and Commercial Workers Local 1459

Thank you for your application for the Waiver of the Annual Limits Requirements of

the PHS Act Section 2711. In order to complete your application, please provide the

following information about United Food and Commercial Workers Local 1459

1. Effective date of next renewal2. (The premium amounts is the total cost to the employer and the employee)

Premium(Current)

Premium(renewal)

Premium(if $750,000

annual limitwas applied)

% increase if the$750,000 was

implemented

EE

EE + Child (ifapplicable orother appropriatetier)

EE + Spouse (ifapplicable or

other appropriatetier)

Family (ifapplicable orother appropriatetier)

UFCW L1459:000036


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3. Indicate if this is an Individual or Group policy.4. Type of Plan:

Limited Benefit Prescription HRA

Comprehensive Other

5. Indicate if this plan has Grandfather Status.

Please provide this information by 5:00 pm Friday November 26, 2010. We look

forward to receiving your completed application. Thank you.

Sincerely,

Kathleen M. Scelzo, RN, MSN

Rules Compliance DivisionOffice of Insurance Oversight

Office of Consumer Information and Insurance Oversight (OCIIO)

Department of Health and Human Services

301-492-4121

UFCW L1459:000037


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//T|/...0%20Response%20[YELLOW]/UFCW%20Local%201459/Request%20for%20additional%20info%20response%2011.23.10.htm[07/25/2011 5:02

rom: Joe Semo [[email protected]]ent: Tuesday, November 23, 2010 12:26 PM

To: Scelzo, Kathleen (HHS/OCIIO); '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)ubject: RE: UFCW Local 1459 Annual Waiverear Ms. Scelzo,

will complete the form when I return to Washington later today. However, it does not appear particularly applicable to this wa

equest. The Plan B prescription drug benefit which appears to be the only coverage within the scope of the essential health

enefit requirement (other coverage includes dental, vision, disability and life offered under separate arrangements) is a selfunded benefit, administered under a contract with a pharmacy manager. Accordingly, there is no contract renewal in the sens

n insured coverage.

he employees covered under Plan B obtain such coverage as a result of the contributions their employer is required to pa

to und based upon the collective bargaining agreement. All coverage is provided based upon the employer contributions

ubject to any co-pays that the particular benefit might require.

his is a grandfathered plan, as the attestation provided confirms.



800 M Street, NWuite 730SASHINGTON, DC 20036

irect Dial: 202 833 7366

acsimile: 202 478 0919




xempt from disclosure. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipou are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this messa


IRCULAR 230 NOTICE.


rom: Scelzo, Kathleen (HHS/OCIIO) [mailto:[email protected]]

ent: Tuesday, November 23, 2010 10:39 AMo: Joe Semo; '[email protected]'c: Habit, Sandra (HHS/OCIIO)ubject: UFCW Local 1459 Annual Waiver

oe Semo,





UFCW L1459:000038


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//T|/...0%20Response%20[YELLOW]/UFCW%20Local%201459/Request%20for%20additional%20info%20response%2011.23.10.htm[07/25/2011 5:02







ethesda, MD

01-492-4121

UFCW L1459:000039


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//T|/...lications%20with%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/Correspondence%2011.26.10.htm[07/25/2011 5:02

rom: Scelzo, Kathleen (HHS/OCIIO)ent: Friday, November 26, 2010 11:55 AM

To: 'Joe Semo'Cc: Habit, Sandra (HHS/OCIIO)ubject: RE: UFCW Local 1459 Annual Waiveroe,

hanks for the information and look forward to the completed form when you return. I hope that you had a good Thanksgiving!


ules Compliance Divisionffice of Insurance Oversight




ethesda, MD

01-492-4121

rom: Joe Semo [mailto:[email protected]]ent: Tuesday, November 23, 2010 12:26 PMo: Scelzo, Kathleen (HHS/OCIIO); '[email protected]'c: Habit, Sandra (HHS/OCIIO)ubject: RE: UFCW Local 1459 Annual Waiver

ear Ms. Scelzo,



enefit requirement (other coverage includes dental, vision, disability and life offered under separate arrangements) is a self

unded benefit, administered under a contract with a pharmacy manager. Accordingly, there is no contract renewal in the sens

n insured coverage.

he employees covered under Plan B obtain such coverage as a result of the contributions their employer is required to p

to the Fund based upon the collective bargaining agreement. All coverage is provided based upon the employer contributions






irect Dial: 202 833 7366

acsimile: 202 478 0919-mail:[email protected]






IRCULAR 230 NOTICE.

UFCW L1459:000040


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//T|/...lications%20with%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/Correspondence%2011.26.10.htm[07/25/2011 5:02


rom: Scelzo, Kathleen (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, November 23, 2010 10:39 AMo: Joe Semo; '[email protected]'c: Habit, Sandra (HHS/OCIIO)

ubject: UFCW Local 1459 Annual Waiver

oe Semo,








ffice of Consumer Information and Insurance Oversight (OCIIO)epartment of Health and Human Services


ethesda, MD

01-492-4121

UFCW L1459:000041


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//T|/...W/Applications%20with%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/Question%2012.29.10.htm[07/25/2011 5:02

rom: Joe Semo [[email protected]]ent: Wednesday, December 29, 2010 12:38 PM

To: Scelzo, Kathleen (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO)ubject: RE: UFCW Local 1459 Annual Waiveras a decision been made with respect to this Plan B group?




irect Dial: 202 833 7366

acsimile: 202 478 0919







IRCULAR 230 NOTICE.


rom: Scelzo, Kathleen (HHS/OCIIO) [mailto:[email protected]]ent: Friday, November 26, 2010 11:55 AMo: Joe Semoc: Habit, Sandra (HHS/OCIIO)

ubject: RE: UFCW Local 1459 Annual Waiver

oe,

hanks for the information and look forward to the completed form when you return. I hope that you had a good Thanksgiving!







ethesda, MD

01-492-4121

rom: Joe Semo [mailto:[email protected]]ent: Tuesday, November 23, 2010 12:26 PMo: Scelzo, Kathleen (HHS/OCIIO); '[email protected]'c: Habit, Sandra (HHS/OCIIO)ubject: RE: UFCW Local 1459 Annual Waiver

ear Ms. Scelzo,



UFCW L1459:000042


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enefit requirement (other coverage includes dental, vision, disability and life offered under separate arrangements) is a self

unded benefit, administered under a contract with a pharmacy manager. Accordingly, there is no contract renewal in the sens

n insured coverage.

he employees covered under Plan B obtain such coverage as a result of the contributions their employer is required to p

to und based upon the collective bargaining agreement. All coverage is provided based upon the employer contributions






irect Dial: 202 833 7366

acsimile: 202 478 0919







IRCULAR 230 NOTICE.


rom: Scelzo, Kathleen (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, November 23, 2010 10:39 AMo: Joe Semo; '[email protected]'c: Habit, Sandra (HHS/OCIIO)ubject: UFCW Local 1459 Annual Waiver

oe Semo,











ethesda, MD

01-492-4121

UFCW L1459:000043


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UFCW L1459:000044


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//T|/...W/Applications%20with%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/Approval%201.11.11.htm[07/25/2011 5:02:

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Tuesday, January 11, 2011 10:18 AM

To: '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)ubject: UFCW Local 1459 Plan B Approval Letter 1-11-2011

mportance: High

Attachments: Updated Jan 1 Approval Letter .pdfMr. Semo,

apologize for the delay. Thank you for submitting an application for a Waiver of the Annual Limits

Requirements of the PHS Act Section 2711 for UFCW Local 1459 Plan B.HHS has reviewed your applicationnd made its determination. Please see the attached letter.

Please confirm receipt of this letter by replying to this e-mail.

Please let me know if I can be of further assistance.

incerely,

Alexandra Botwinick

ffice of Oversight

HHS/OCIIO

301) [email protected]

UFCW L1459:000045
mailto:[email protected]:[email protected]


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//T|/...ns%20with%20NO%2012600%20Response%20[YELLOW]/UFCW%20Local%201459/Approval%20plan%20B%201.11.11.htm[07/25/2011 5:02

rom: Joe Semo [[email protected]]ent: Tuesday, January 11, 2011 11:40 AM

To: Botwinick, Alexandra (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO)ubject: RE: UFCW Local 1459 Plan B Approval Letter 1-11-2011his acknowledges receipt.

hank you.




irect Dial: 202 833 7366

acsimile: 202 478 0919




xempt from disclosure. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipou are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this messa


IRCULAR 230 NOTICE.


rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, January 11, 2011 10:18 AMo: Joe Semoc: Habit, Sandra (HHS/OCIIO)ubject: UFCW Local 1459 Plan B Approval Letter 1-11-2011mportance: High

Mr. Semo,

apologize for the delay. Thank you for submitting an application for a Waiver of the Annual Limits

Requirements of the PHS Act Section 2711 for UFCW Local 1459 Plan B.HHS has reviewed your applicationnd made its determination. Please see the attached letter.

Please confirm receipt of this letter by replying to this e-mail.

Please let me know if I can be of further assistance.

incerely,

Alexandra Botwinick

ffice of Oversight

HHS/OCIIO

301) [email protected]

UFCW L1459:000046
http://blocked:%3Amailto%[email protected]/http://www.semolawgroup.com/mailto:[email protected]:[email protected]://www.semolawgroup.com/http://blocked:%3Amailto%[email protected]/


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Documents

UFCW Local 1459 - Redacted Bates HW