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//T|/...I%20Processing%20Team/Mike/Progressive%20Logistics%20Services/Request%20for%20additional%20info%2011.4.10.htm[11/07/2011 10:23:3

rom: Scelzo, Kathleen (HHS/OCIIO)ent: Thursday, November 04, 2010 12:44 PM

To: '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)ubject: Progressive Logistic Services Waiver Application

Attachments: Progressive Logistic Services Waiver Application Questions.dochad Kapfhamer,

hanks for talking with me yesterday about Progressive Logistics Services application for Annual Limits Requirements of the P

ct Section 2711 for their various plans. Attached above is the document that needs to be completed in order to finalize the

pplication 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 Avenueethesda, MD

01-492-4121

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November 4, 2010

Dear Applicant:

RE: Progressive Logistic Services:

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 the Progressive Logistic Services Plan:

1. Indicate if there are essential benefit limits and the amount for the followingcategories :

Ambulatory: $Emergency (ER): $

Hospitalization: $Laboratory: $Pediatric: $

Maternity: $Mental Health/Substance Abuse: $

Rehabiliative: $Preventive: $Prescription (RX): $

2. Indicate if there are any deductibles for the plan and the amount.3. Indicate if the plan is fully-insured plan or a self-insured plan.4. Type of Plan:

Limited Benefit Prescription HRA

Comprehensive Other

5. If there are any copay/coinsurance for the plan for the following categoriesand the amount for the following:

Office Visit Inpatient ER Prescription

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6. (The premium amounts is the total cost to the employer and the employee)Premium(current level)

Premium(renewal)

Premium(if $750,000annual limit was

applied)

% increase if the$750,000 wasimplemented

EE

EE + Child (ifapplicable orother appropriatetier)

EE + Spouse (ifapplicable orother appropriate

tier)Family (ifapplicable orother appropriatetier)

Please provide this information by 5:00 pm, Monday November 8, 2010. We look

forward to receiving your completed application. Thank you.

Sincerely,

Kathleen M. Scelzo, RN, MSN

Rules Compliance Division

Office of Insurance Oversight

Office of Consumer Information and Insurance Oversight (OCIIO)

Department of Health and Human Services

301-492-4121

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//T|/...es/DFOI%20Processing%20Team/Mike/Progressive%20Logistics%20Services/Approval%20letter%20sent%2011-30-2010.htm[11/07/2011 10:24

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Tuesday, November 30, 2010 8:45 AM

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

mportance: High

Attachments: Updated Jan 1 Approval Letter .pdf

ood Morning,

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

ection for Progressive Logistics Services. HHS has reviewed your application and made its determinatio

lease see the attached 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]

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mailto:[email protected]:[email protected]


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