ua local 13 - redacted bates hw
TRANSCRIPT
-
7/27/2019 UA Local 13 - Redacted Bates HW
1/39
UA L13:000001
-
7/27/2019 UA Local 13 - Redacted Bates HW
2/39
Pages 2 through 40 redacted for the following reasons:- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
UA L13:000002
-
7/27/2019 UA Local 13 - Redacted Bates HW
3/39
ANNUAL LIMIT WAIVER APPLICATION 2010
al
Waiverest
c ante
Policy Name
(use a newrow for each
policyapplication)
Applic ant
(Plan/ PolicySitus) City
Applic ant
(Plan/Policy
Situs)State
Plan/ Policy
Effective Date(mm/dd/yyyy)
ContactName
StreetAddress City State Zip Code
PhoneNumber
(includingarea code)
EmailAddress
Type of
Coverage(e.g., Limited
Benefit, HRA,Rx only, Other)
Self-
Insured(Yes/No)
Individual orGroup Policy
Total
Number ofIndividualsCovered by
Policy(include all
dependentscovered)
Current
Plan OverallAnnual
Limit (indollars)
Local 13mployers
roup
urance
Plan
Section VII of
ApplicantPlan entitled
"Reimbursem
ent of Medical
Expenses" Rochester NY 12/01/1975
Steve
Ostrander
1850 Mt.
Read Blvd Rochester NY 14615
1-800-224-
8544 x104
sostrander
@ualocal
13.org Other Yes Group
Disclosure Statement
rding to the Pape rwork Reduction Act of 1995, no person s are required to re spond to a collect ion of information unless it displays a vali d OMB control num ber. The valid OMB contro l number for this
mation collection is 0938-1105. The time required to complete this information collection is estimate d to average ( 8 hours) or ( 240 minutes) per response, including the time to review instructions,ch existing data resources, gather the data needed, and complete and review the information collec tion. If you have comments concerning the accuracy of the time estimate(s ) or suggestions foroving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.
UA L13:000003
mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
4/39
ANNUAL LIMIT WAIVER APPLICATION 2010
mbulat ory Emergency Hospit alization Laborat ory PediatricMaternity/Newborn
Mental Health/
SubstanceAbuse
Rehabilitative/Devices
Preventive/Wel ln es s Pr es cr ip ti on
PlanDeductible
Copay (if
applicable)
Coinsuranc
e (ifapplicable)
Copay (if
applicable)
Coinsurance (if
applicable)
Copay (if
applicable)
Coinsurance (if
applicable)
Copay (if
applicable)
C
a
*None *None *None *None *None *None *None *None *None *None *None *None *None *None *None *None *None
Current Essential Benefits Annual Limits (Annual Limit f or Each Essential Benefit)Rx
Copay/ConOffice Visit
Copays/CoinsuranceHospital Inpatient
Copay/CoinsuranceEmergency Room
Copay/Coinsurance
UA L13:000004
-
7/27/2019 UA Local 13 - Redacted Bates HW
5/39
ANNUAL LIMIT WAIVER APPLICATION 2010
idual/ Employee
Employee
contribution(if applicable)
Employer
contribution(i f ap pl ic ab le) To tal
Employee
contribution(if applicable)
Employer
contribution(i f ap pl ic ab le) To tal
Employee
contribution(if applicable)
Employer
contribution(if applicable)
Projected Rate Increasethat would result from
compliance with $750,000Annual L imit Restric tion
(in do llars)(Average
Premium by Individual)(Difference of Column AT
and AQ divided by
Access t oBenefits that
would resultfrom
compliancewith $750,000Annual L imit
Restriction(describe
briefly in cellor in a
PlanAdmini strator/ CEO
of HealthInsuranc
e IssuerName
Title of Individual
ProvidingAttest ation
Employee *None *None *None *None *None *None None
Steve
Ostrander Fund Manager
Current Monthly Premium Rates orPremium Equivalent Rates (in dollars)*:
Renewal Monthly Premium Rates orPremium Equivalent Rates if Waiver Granted
(in dollars)*
Projected Rate Increase that would result
from compliance with $750,000 Annual LimitRestriction (in d ollars) (Average Premium by
Individual)*
* When completing the columns requesting premium rate information, please express the premium rates as a composite rate (ifpremiums are a range based on years of service or age) and by tier (Employee, Employee + Spouse, Employee + Child, Family,etc.) as applicable. If you are an issuer, please provide the premium amount in the column titled, "Total" (Column AN, AQ and AT).
UA L13:000005
-
7/27/2019 UA Local 13 - Redacted Bates HW
6/39
UA L13:000006
-
7/27/2019 UA Local 13 - Redacted Bates HW
7/39
UA L13:000007
-
7/27/2019 UA Local 13 - Redacted Bates HW
8/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2015%202010.htm[08/02/2011 10:53:
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Wednesday, December 15, 2010 9:19 AM
o: '[email protected]'
c: Sheer, Jennifer (HHS/OCIIO)
ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
ttachments: Waiver Application Form.xls
ollow Up Flag: Follow up
ag Status: Completed
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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 withgrandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000008
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
9/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2016%202010.htm[08/02/2011 10:53
rom: Tricia Marciano [[email protected]]
ent: Thursday, December 16, 2010 3:26 PM
o: Sheer, Jennifer (HHS/OCIIO)
c: Steve Ostrander; TobinLaw
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ttachments: Waiver Application Form.xlsx; WaiverResponse.docx
ollow Up Flag: Follow up
ag Status: Completed
ennifer,
hank you for getting back to me in a timely fashion. Attached is the spreadsheet along with our response to the section
he spreadsheet where we indicated none. This document outlines how our plan works. Steve Ostrander (Fund
Manager), our Legal Counsel and myself met this morning to go over this information. When you return to the office, ple
ve me a call to discuss the information. I will not be in the office tomorrow, but will return on Monday, December 20th
hank you.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, December 16, 2010 11:13 AMo: Tricia Marciano
c: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something weddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete thpreadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]ent: Thursday, December 16, 2010 11:04 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
UA L13:000009
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected]:[email protected]:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
10/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2016%202010.htm[08/02/2011 10:53
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AMo: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]
ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
UA L13:000010
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
11/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2016%202010.htm[08/02/2011 10:53
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000011
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
12/39
UA LOCAL 13 & EMPLOYERS GROUP INSURANCE PLAN
Response to Fields Indicated as *None
Hourly contributions from Contractors per Collective Bargaining Agreement are
deposited into each participants Hour Bank. Any contributions in excess of the required
amount for their individual selected insurance coverage (the cost of one years worth of
Health Care coverage) under the plan provisions can be used for reimbursement of the
participants out of pocket medical expenses.
The amount in each participants hour bank will vary for each participant based upon
their hours worked and their Medical/Dental coverage selection.
Work in the construction industry is cyclical. The average amount available for
reimbursement in a participants hour bank is $ . Therefore, it is not feasible that wecan comply with the $750,000 Annual Limit Res n based upon our plan design.
UA L13:000012
-
7/27/2019 UA Local 13 - Redacted Bates HW
13/39
//C|/...bers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20(Please%20Call)%20Dec%2016%202010.htm[08/02/2011 10:53
rom: Tricia Marciano [[email protected]]
ent: Thursday, December 16, 2010 11:04 AM
o: Sheer, Jennifer (HHS/OCIIO)
c: Steve Ostrander
ubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ttachments: Waiver Application Form.xls
ollow Up Flag: Follow Up
ag Status: Completed
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AMo: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]
ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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.
UA L13:000013
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
14/39
//C|/...bers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20(Please%20Call)%20Dec%2016%202010.htm[08/02/2011 10:53
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000014
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
15/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2016%202010.htm[08/02/2011 10:52
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Thursday, December 16, 2010 11:13 AM
o: Tricia Marciano
c: Steve Ostrander
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ollow Up Flag: Follow up
ag Status: Completed
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something weddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete thpreadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]ent: Thursday, December 16, 2010 11:04 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AMo: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)
UA L13:000015
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
16/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2016%202010.htm[08/02/2011 10:52
ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000016
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
17/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:51
rom: Steve Ostrander [[email protected]]
ent: Tuesday, December 21, 2010 5:00 PM
o: Sheer, Jennifer (HHS/OCIIO)
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ollow Up Flag: Follow up
ag Status: Completed
ennifer,
ricia has the day off today, and she is in possession of all the paperwork. I am unable to answer the first question regardi
he $ , but I can answer the second question. The $ is the annual cost of our policy per participant at the fam
evel. The cost in premium is close to $ per month. Each participant is required to maintain a one year premium bala
n their hour bank before any reimbursements can be requested. We had an instance in the past where a participant drain
is hour bank to $0.00 and was subsequently laid off. He did not have any contributions coming in for his health care and r
ut of coverage within 3 months. He then was still unemployed and unable to self pay his premium, and was termed from
ealth plan. He was offered COBRA, but could not pay for that either on $ per week unemployment. We have since
nstituted this one year policy to prevent this situation from ever arising again. Hope that helps, and I will have Tricia conta
ou tomorrow morning.
egards,
teve
Steve Ostranderund Manager
A Local 13 Benefits Office
850 Mt. Read Blvd.
ochester, NY 14615
hone: 585-338-2310 ext.104
ax: 585-544-3993
oll free: 1-800-224-8544
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, December 21, 2010 4:21 PMo: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ello
have two quick questions regarding your spreadsheet. In column Q (Current Plan Overall Annual Limit), you entered $
this the maximum amount that an individual could accumulate in his/her hour bank for reimbursable medical expenses?
econd, in column AB, you list the plan deductible as $ what plan are you referring to (Im not clear on what this
umber means in relationship to the hour bank).
hank you in advance for the clarification.
UA L13:000017
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
18/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:51
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [mailto:[email protected]]ent: Thursday, December 16, 2010 3:26 PMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostrander; TobinLawubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
hank you for getting back to me in a timely fashion. Attached is the spreadsheet along with our response to the section
he spreadsheet where we indicated none. This document outlines how our plan works. Steve Ostrander (Fund
Manager), our Legal Counsel and myself met this morning to go over this information. When you return to the office, ple
ve me a call to discuss the information. I will not be in the office tomorrow, but will return on Monday, December 20th
hank you.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, December 16, 2010 11:13 AMo: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something weddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete thpreadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]
UA L13:000018
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected]:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
19/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:51
ent: Thursday, December 16, 2010 11:04 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
nsurance & Pension SpecialistA Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AMo: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.UA L13:000019
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
20/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:51
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
UA L13:000020
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
21/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2017%202010.htm[08/02/2011 10:52
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Friday, December 17, 2010 9:12 AM
o: 'Tricia Marciano'
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ollow Up Flag: Follow up
ag Status: Completed
ello Tricia
hank you for your understanding. I will call you Monday morning to discuss your application. Have a good weekend.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
rom: Tricia Marciano [mailto:[email protected]]ent: Thursday, December 16, 2010 3:26 PMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostrander; TobinLawubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
hank you for getting back to me in a timely fashion. Attached is the spreadsheet along with our response to the section
he spreadsheet where we indicated none. This document outlines how our plan works. Steve Ostrander (Fund
Manager), our Legal Counsel and myself met this morning to go over this information. When you return to the office, ple
ve me a call to discuss the information. I will not be in the office tomorrow, but will return on Monday, December 20th
hank you.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, December 16, 2010 11:13 AMo: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something we
UA L13:000021
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
22/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2017%202010.htm[08/02/2011 10:52
ddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete thpreadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]ent: Thursday, December 16, 2010 11:04 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AM
o: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto complete that particular cell in a separate document.
UA L13:000022
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
23/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2017%202010.htm[08/02/2011 10:52
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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once this
nformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000023
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
24/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:52
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Tuesday, December 21, 2010 4:21 PM
o: 'Tricia Marciano'
c: Steve Ostrander
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ollow Up Flag: Follow up
ag Status: Completed
ello
have two quick questions regarding your spreadsheet. In column Q (Current Plan Overall Annual Limit), you entered $
this the maximum amount that an individual could accumulate in his/her hour bank for reimbursable medical expenses?
econd, in column AB, you list the plan deductible as $ what plan are you referring to (Im not clear on what this
umber means in relationship to the hour bank).
hank you in advance for the clarification.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [mailto:[email protected]]ent: Thursday, December 16, 2010 3:26 PM
o: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostrander; TobinLawubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
hank you for getting back to me in a timely fashion. Attached is the spreadsheet along with our response to the section
he spreadsheet where we indicated none. This document outlines how our plan works. Steve Ostrander (Fund
Manager), our Legal Counsel and myself met this morning to go over this information. When you return to the office, ple
ve me a call to discuss the information. I will not be in the office tomorrow, but will return on Monday, December 20th
hank you.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]
UA L13:000024
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
25/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:52
ent: Thursday, December 16, 2010 11:13 AMo: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something weddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete thpreadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]
ent: Thursday, December 16, 2010 11:04 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AMo: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
UA L13:000025
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
26/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:52
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000026
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
27/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:52
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Wednesday, December 22, 2010 9:59 AM
o: 'Steve Ostrander'
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ollow Up Flag: Follow up
ag Status: Completed
i Steve
hank you for this information, this does help to clarify things. I will keep an eye out for Tricias response.
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Steve Ostrander [mailto:[email protected]]ent: Tuesday, December 21, 2010 5:00 PMo: Sheer, Jennifer (HHS/OCIIO)ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
ricia has the day off today, and she is in possession of all the paperwork. I am unable to answer the first question regardihe $ but I can answer the second question. The $ is the annual cost of our policy per participant at the fam
evel. The cost in premium is close to $ per month. Each participant is required to maintain a one year premium bala
n their hour bank before any reimbursements can be requested. We had an instance in the past where a participant drain
is hour bank to $0.00 and was subsequently laid off. He did not have any contributions coming in for his health care and r
ut of coverage within 3 months. He then was still unemployed and unable to self pay his premium, and was termed from
ealth plan. He was offered COBRA, but could not pay for that either on $ per week unemployment. We have since
nstituted this one year policy to prevent this situation from ever arising again. Hope that helps, and I will have Tricia conta
ou tomorrow morning.
egards,
teve
Steve Ostranderund Manager
A Local 13 Benefits Office
850 Mt. Read Blvd.
ochester, NY 14615
hone: 585-338-2310 ext.104
ax: 585-544-3993
UA L13:000027
mailto:[email protected]:[mailto:[email protected]]mailto:[email protected]:[email protected]:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
28/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:52
oll free: 1-800-224-8544
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, December 21, 2010 4:21 PMo: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ello
have two quick questions regarding your spreadsheet. In column Q (Current Plan Overall Annual Limit), you entered $
this the maximum amount that an individual could accumulate in his/her hour bank for reimbursable medical expenses?
econd, in column AB, you list the plan deductible as $ what plan are you referring to (Im not clear on what this
umber means in relationship to the hour bank).
hank you in advance for the clarification.
--------------------------------ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [mailto:[email protected]]ent: Thursday, December 16, 2010 3:26 PM
o: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostrander; TobinLawubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
hank you for getting back to me in a timely fashion. Attached is the spreadsheet along with our response to the section
he spreadsheet where we indicated none. This document outlines how our plan works. Steve Ostrander (Fund
Manager), our Legal Counsel and myself met this morning to go over this information. When you return to the office, ple
ve me a call to discuss the information. I will not be in the office tomorrow, but will return on Monday, December 20th
hank you.
ricia Marcianonsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, December 16, 2010 11:13 AM
UA L13:000028
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected]:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
29/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:52
o: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something weddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete thpreadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]ent: Thursday, December 16, 2010 11:04 AM
o: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AMo: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
UA L13:000029
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
30/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2021%202010.htm[08/02/2011 10:52
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000030
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
31/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:51
rom: Tricia Marciano [[email protected]]
ent: Wednesday, December 22, 2010 11:59 AM
o: Sheer, Jennifer (HHS/OCIIO)
c: Steve Ostrander
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ollow Up Flag: Follow up
ag Status: Completed
ennifer,
eres the clarification on your two questions below:
Column Q, $ . That is the most that one particular participant currently has in their hour bank available for
medical reimbursement after their one years worth of insurance has been held in reserve.
Column AB, $ That is the current cost of one years health insurance.
hope this information is helpful and please do not hesitate to call me if you need additional clarification. Have a wonder
oliday.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, December 21, 2010 4:21 PM
o: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ello
have two quick questions regarding your spreadsheet. In column Q (Current Plan Overall Annual Limit), you entered $
this the maximum amount that an individual could accumulate in his/her hour bank for reimbursable medical expenses?
econd, in column AB, you list the plan deductible as $ what plan are you referring to (Im not clear on what this
umber means in relationship to the hour bank).
hank you in advance for the clarification.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000031
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected]:[email protected]:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
32/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:51
rom: Tricia Marciano [mailto:[email protected]]ent: Thursday, December 16, 2010 3:26 PMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostrander; TobinLawubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
hank you for getting back to me in a timely fashion. Attached is the spreadsheet along with our response to the section
he spreadsheet where we indicated none. This document outlines how our plan works. Steve Ostrander (FundManager), our Legal Counsel and myself met this morning to go over this information. When you return to the office, ple
ve me a call to discuss the information. I will not be in the office tomorrow, but will return on Monday, December 20th
hank you.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, December 16, 2010 11:13 AMo: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something we
ddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete thpreadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]ent: Thursday, December 16, 2010 11:04 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marciano
UA L13:000032
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected]:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
33/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:51
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostrander
ent: Thursday, December 16, 2010 10:16 AMo: Tricia Marcianoubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto 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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Humervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
UA L13:000033
mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]] -
7/27/2019 UA Local 13 - Redacted Bates HW
34/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:51
01-492-4487
UA L13:000034
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
35/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:52
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Wednesday, December 22, 2010 12:03 PM
o: 'Tricia Marciano'
c: Steve Ostrander
ubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ollow Up Flag: Follow up
ag Status: Completed
i Tricia
hank you very much for this clarification.
appy holidays.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [mailto:[email protected]]ent: Wednesday, December 22, 2010 11:59 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eres the clarification on your two questions below:
Column Q, $ . That is the most that one particular participant currently has in their hour bank available for
medical reimbursement after their one years worth of insurance has been held in reserve.
Column AB, $ . That is the current cost of one years health insurance.
hope this information is helpful and please do not hesitate to call me if you need additional clarification. Have a wonder
oliday.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, December 21, 2010 4:21 PMo: Tricia Marciano
UA L13:000035
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
36/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:52
c: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ello
have two quick questions regarding your spreadsheet. In column Q (Current Plan Overall Annual Limit), you entered $
this the maximum amount that an individual could accumulate in his/her hour bank for reimbursable medical expenses?
econd, in column AB, you list the plan deductible as $ what plan are you referring to (Im not clear on what this
umber means in relationship to the hour bank).
hank you in advance for the clarification.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [mailto:[email protected]]ent: Thursday, December 16, 2010 3:26 PMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostrander; TobinLawubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
hank you for getting back to me in a timely fashion. Attached is the spreadsheet along with our response to the section
he spreadsheet where we indicated none. This document outlines how our plan works. Steve Ostrander (Fund
Manager), our Legal Counsel and myself met this morning to go over this information. When you return to the office, pleve me a call to discuss the information. I will not be in the office tomorrow, but will return on Monday, December 20th
hank you.
ricia Marciano
nsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, December 16, 2010 11:13 AMo: Tricia Marcianoc: Steve Ostranderubject: RE: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ood morning
am unfortunately on sick leave today, and will not be able to return your call until I return to the office. If this is something weddress via e-mail, please let me know. If it does require a phone call, please know that you can have extra time to complete th
UA L13:000036
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
37/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:52
preadsheet and that I will return your call when I return to the office. I thank you for your understanding.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
rom: Tricia Marciano [[email protected]]ent: Thursday, December 16, 2010 11:04 AMo: Sheer, Jennifer (HHS/OCIIO)c: Steve Ostranderubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application (Please Call)
ennifer,
eft you a Voice Mail message regarding the waiver application. Please call me when you get a moment today. Thank yo
ricia Marcianonsurance & Pension Specialist
A Local 13
850 Mt. Read Blvd.
ochester, NY 14615
hone (585) 338-2310 x106
ax (585) 544-3993
rom: Steve Ostranderent: Thursday, December 16, 2010 10:16 AMo: Tricia Marciano
ubject: FW: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, December 15, 2010 9:19 AMo: Steve Ostranderc: Sheer, Jennifer (HHS/OCIIO)ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
Dear Mr. Ostrander:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, attached to this email. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets that arfully complete (i.e., every cell should contain the information requested). If a cell on the spreadsheet donot pertain to your plan, please write None, and/or provide an explanation regarding why you are unabto complete that particular cell in a separate document.
II. In addition, please provide the following information:UA L13:000037
mailto:[email protected]:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[mailto:[email protected]]mailto:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
38/39
//C|/...ocal%2013%20Plumbers%20and%20Pipefitters%20Annual%20Limit%20Waiver%20Application%20Dec%2022%202010.htm[08/02/2011 10:52
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.
n order to complete your application, please provide this information by 5:00 pm, December 16, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Hum
ervices (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 3ays of receiving a complete application. You will receive an e-mail from HHS notifying you of the waiver decisi
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UA L13:000038
mailto:[email protected]:[email protected] -
7/27/2019 UA Local 13 - Redacted Bates HW
39/39
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Wednesday, December 22, 2010 12:14 PM
o: 'Tricia Marciano'; Steve Ostrander
ubject: UA Local 13 Plumbers and Pipefitters Annual Limit Waiver Application
ollow Up Flag: Follow up
ag Status: Completed
Dear Applicant:
hank you for your information. Your application is now complete and you should receive a determination of yourpplication within 30 days.
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
mailto:[email protected]:[email protected]