South Central UFCW - Redacted HWM

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//T|/...nd%20Employers%20Health%20and%20Welfare%20Trust/Waiver%20Application%20-%20South%20Central%20UFCW.htm[11/08/2011 10:35:4

rom: Gregory A. Storm [[email protected]]

ent: Thursday, January 06, 2011 1:07 PM

o: OCIIO Oversight

c: Bennett E. Choice

ubject: Waiver Application - South Central UFCW Unions and Employers Health and Welfare Trus

ttachments: Waiver Letter.pdf

ear Sir or Madam -

n behalf of the South Central United Food and Commercial Workers Unions and Employers Health and Welfare Trust (the "Pl

e attach a request for a waiver of the restricted annual benefit limit requirement with respect to the benefits described in the

ttachment.

or your information, the Plan's contact information is as follows:

outh Central United Food and Commercial Workers Unions and Employers Health and Welfare Trust

/o Dennis Nast, Administrative Manager

800 Phoenix Boulevard, Suite 310

tlanta, GA 30349

hone: 770-997-9910

mail: [email protected]

you have any questions regarding the waiver application, please contact the Plan's legal counsel, Ben Choice or the

ndersigned, at 414-298-1000.

reg Storm

Gregory A. Stormeinhart Boerner Van Deuren s.c.

000 North Water Street, Suite 1700 | Milwaukee, WI 53202

ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097

[email protected] | bio | vCard | reinhartlaw.com

ny advice expressed in this writing as to tax matters was neither written nor intended by the sender or Reinhart Boerner Van

euren s.c. to be used and cannot be used by any taxpayer for the purpose of avoiding tax penalties that may be imposed on

axpayer. If any such tax advice is made to any person or party other than to our client to whom the advice is directed and

tended, then the advice expressed is being delivered to support the promotion or marketing (by a person other than Reinhart

oerner Van Deuren s.c.) of the transaction or matter discussed or referenced. Each taxpayer should seek advice based on the

axpayer's particular circumstances from an independent tax advisor.

his e-mail and any attachments may contain privileged or confidential information. This e-mail is intended solely for the use of

dividual or entity to which it is addressed. If you are not the intended recipient of this e-mail, you are hereby notified that any

opying, distribution, dissemination or action taken in relation to the contents of this e-mail and any of its attachments is strictly

rohibited and may be unlawful. If you have received this e-mail in error, please notify the sender immediately and permanent

elete the original e-mail and destroy any copies or printouts of this e-mail as well as any attachments. To the extent

epresentations are made herein concerning matters of a client of the firm, be advised that such representations are not those o

he client and do not purport to bind them.

SC UFCW:000001
mailto:[email protected]:[email protected]://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://reinhartlaw.com/http://reinhartlaw.com/http://reinhartlaw.com/http://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormmailto:[email protected]:[email protected]


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//T|/...20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Request%20for%20info%202.2.11.htm[11/08/2011 10:35:4

rom: Andrews, Jane (HHS/OCIIO)ent: Wednesday, February 02, 2011 11:01 AM

To: '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)ubject: Application for annual limit waiver on behalf of SouthCentral UFCW

Mr. Storm I am in receipt of your application of a waiver for South Central. I have a few questions before I can complete you

pplication:

1) What is the expiration date of the referenced cba?

2) Is this a Taft-Hartley plan?3) The letter mentions that the Trustees can seek guidance from the Plan Consultant to provide proposed benefit changes

Since you have entered See Explanation in the column under decrease in access to benefits, but the explanation doe

not specify the decrease in benefits, could you be more specific? What decrease in access to benefits would the Fund

experience?

hanks.

SC UFCW:000010


11/65

//T|/...20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Request%20for%20info%20response%202.3.11.htm[11/08/2011 10:35

rom: Gregory A. Storm [[email protected]]ent: Thursday, February 03, 2011 3:36 PM

To: Andrews, Jane (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO)ubject: RE: Application for annual limit waiver on behalf of SouthCentral UFCW

Ms. Andrews -

hank you for your response. Our initial reply follows:

. The last CBA currently in effect will expire June 29, 2013.

. This plan is a multiemployer plan subject to the Taft-Hartley Act.

We have contacted the Plan's consultant to request more calculations regarding the potential benefit reductions. We will se

hem to you shortly.

We look forward to speaking with you soon. Please contact me with a request for any additional information.

reg Storm

Gregory A. Storm

einhart Boerner Van Deuren s.c.000 North Water Street, Suite 1700 | Milwaukee, WI 53202

ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097


rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]

ent: Wednesday, February 02, 2011 10:01 AMo: Gregory A. Stormc: Habit, Sandra (HHS/OCIIO)ubject: Application for annual limit waiver on behalf of SouthCentral UFCW


pplication:


2) Is this a Taft-Hartley plan?

3) The letter mentions that the Trustees can seek guidance from the Plan Consultant to provide proposed benefit changes

Since you have entered See Explanation in the column under decrease in access to benefits, but the explanation doe

not specify the decrease in benefits, could you be more specific? What decrease in access to benefits would the Fund

experience?

hanks.

SC UFCW:000011
mailto:[email protected]://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://reinhartlaw.com/http://reinhartlaw.com/http://reinhartlaw.com/http://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormmailto:[email protected]


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//T|/...Central%20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Correspondence%202.3.11.htm[11/08/2011 10:35

rom: Andrews, Jane (HHS/OCIIO)ent: Thursday, February 03, 2011 3:37 PM

To: 'Gregory A. Storm'Cc: Habit, Sandra (HHS/OCIIO); Scelzo, Kathleen (HHS/OCIIO)

ubject: RE: Application for annual limit waiver on behalf of SouthCentral UFCWam transitioning off annual limits waivers. Please contact Kathleen or Sandy who are ccd on this e-mail to complete your

pplication. Thanks.

ane W. Andrews

enter for Consumer Informationnd Insurance Oversight (CCIIO)

501 Wisconsin Ave

ethesda, MD 20814

01)492-4122 (Desk)

202)536-6779 (Blackberry)

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 governmuse only and must not be disseminated, distributed, or copied to persons not authorized to receive the informatio

Unauthorized disclosure may result in prosecution to the full extent of the law.

rom: Gregory A. Storm [mailto:[email protected]]ent: Thursday, February 03, 2011 3:36 PMo: Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO)ubject: RE: Application for annual limit waiver on behalf of SouthCentral UFCW

Ms. Andrews -

hank you for your response. Our initial reply follows:

. The last CBA currently in effect will expire June 29, 2013.

. This plan is a multiemployer plan subject to the Taft-Hartley Act.

We have contacted the Plan's consultant to request more calculations regarding the potential benefit reductions. We will se

hem to you shortly.

We look forward to speaking with you soon. Please contact me with a request for any additional information.

reg Storm



ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: [email protected] | bio | vCard | reinhartlaw.com

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, February 02, 2011 10:01 AM

SC UFCW:000012


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//T|/...Central%20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Correspondence%202.3.11.htm[11/08/2011 10:35

o: Gregory A. Stormc: Habit, Sandra (HHS/OCIIO)ubject: Application for annual limit waiver on behalf of SouthCentral UFCW


pplication:


2) Is this a Taft-Hartley plan?

3) The letter mentions that the Trustees can seek guidance from the Plan Consultant to provide proposed benefit changes

Since you have entered See Explanation in the column under decrease in access to benefits, but the explanation doenot specify the decrease in benefits, could you be more specific? What decrease in access to benefits would the Fund

experience?

hanks.

SC UFCW:000013


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//T|/.../South%20Central%20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Data%202.4.11.htm[11/08/2011 10:35

rom: Andrews, Jane (HHS/OCIIO)ent: Friday, February 04, 2011 1:05 PM

To: Scelzo, Kathleen (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO)ubject: Here is the Iron Workers and Greg Storm apps on spreadsheet in progress

Attachments: jwaapps2_3_2011.xls

SC UFCW:000014


15/65

Appl icant

ID

Number

Limit

Waiver

Request

Appl icant

Name

Name

(use a

new row

for each

policy

Appl icant

(Plan/

Policy

Situs)

City

Appl icant

(Plan/

Policy

Situs)

State

Policy

Effective

Date

(mm/dd/y

yyy)

Contact

Name

Street

Address City State Zip

110105-

003

Iron

Workers

Local #

16 Health

Fund

110106-

003

Central

UFCW

Unions

and

Employer

s Health

and

Welfare

Trust Plan A Dallas TX ########

Greg

Storm

1000

North

WaterStreet,

Suite

1700 Milwaukee WI 5

110106-

003

South

Central

UFCW

Unions

and

Employers Health

and

Welfare

Trust Plan B Dallas TX ########

Greg

Storm

1000

NorthWater

Street,

Suite

1700 Milwaukee WI 5


16/65

Coverage

(e.g.,

Limited

Benefit,

HRA, Rx

Self-

Insured

Individual

or Group

Policy

Number

of

Individual

s

Covered

Current Plan

Annual L imit

(in dollars)

Ambulato

ry

Emergen

cy

Hospitali

zation

Laborator

y Pediatric

Limited

Benefit Yes Group

Limited

Benefit Yes Group


17/65

Preventiv

e/

Wellness

Prescripti

on

Plan

Deductibl

e

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Co

nc

ap

e)


18/65

Employer

contributi

on Total

Employee

contributi

on

Employer

contributi

on Total

Employee

contributi

on

Employer

contributi

on Total

Rate

Increase

that

would

result

in Access

to

Benefits

that

would

Ad

ato

of

Ins

e I

See

Explanatio

n G

See

Explanatio

n G


19/65

Taft-

Hartley

then Date

Collectiv

e

ce with

Grandfat

her

Regulatio

n

Lead

Reviewer

Date of

Receipt

Factor 1

fo r

Decision

Factor 2

for

Decision

Factor 3

for

Decision

Factor 4

for

Decision

Staff

Recomm

endation

for

Approval/

Comment

s

Da

Co

d

Ap

on

########

Yes

J .

Andrews ########

Yes

J .

Andrews ########


20/65

Date of

Waiver

Approval/

Disappro

val Letter

Sent Y/N

Date of

Letter

Confirma

tion of

Receipt

of

Approval

Access

File


21/65

Appl icant

ID

Number

Limit

Waiver

Request

Appl icant

Name

Name

(use a

new row

for each

policy

Appl icant

(Plan/

Policy

Situs)

City

Appl icant

(Plan/

Policy

Situs)

State

Policy

Effective

Date

(mm/dd/y

yyy)

Contact

Name

Street


110106-

003

Central

UFCW

Unions

and

Employer

s Health

and

Welfare

Trust Retirees Dallas TX ########

Greg

Storm

1000

North

Water

Street,

Suite

1700 Milwaukee WI 5

110105-

002

Unions &

Participat

ing

Employer

s Health

and

Welfare

Fund Plan J S Sparks MD ########

William

J ensen

4301

Garden

City Dr,

#201 Landover MD 2

110105-

002

Unions &

Participat

ing

Employer

s Health

andWelfare

Fund Plan JSS2 Sparks MD ########

William

J ensen

911Ridgebroo

k Road Landover MD 2


22/65

Coverage

(e.g.,

Limited

Benefit,

HRA, Rx

Self-

Insured

Individual

or Group

Policy

Number

of

Individual

s

Covered

Current Plan

Annual L imit

(in dollars)

Ambulato

ry

Emergen

cy

Hospitali

zation

Laborator

y Pediatric

Limited

Benefit Yes Group

Other Yes Group

Other Yes Group


23/65

Preventiv

e/

Wellness

Prescripti

on

Plan

Deductibl

e

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Co

nc

ap

e)


24/65

Employer

contributiEmployee

contributiEmployer

contributiEmployee

contributiEmployer

contributi

Rate

Increase

that

would

in Access

to

Benefits

that

would

Ad

ato

of

Ins

e I

See

Explanatio

n G

See

NOTES

TAB - C

B

Tr

See

NOTES

TAB - C

W

J


25/65

Taft-

Hartley

then Date

Collectiv

e

ce with

Grandfat

her

Regulatio

n

Lead

Reviewer

Date of

Receipt

Factor 1

fo r

Decision

Factor 2

for

Decision

Factor 3

for

Decision

Factor 4

for

Decision

Staff

Recomm

endation

for

Approval/

Comment

s

Da

Co

d

Ap

on

Yes

J .

Andrews ########

########

J .

Andrews ########

########

J .

Andrews ########


26/65

Date of

Waiver

Approval/

Disappro

val Letter

Sent Y/N

Date of

Letter

Confirma

tion of

Receipt

of

Approval

Access

File


27/65

Appl icant

ID

Number

Limit

Waiver

Request

Appl icant

Name

Name

(use a

new row

for each

policy

Appl icant

(Plan/

Policy

Situs)

City

Appl icant

(Plan/

Policy

Situs)

State

Policy

Effective

Date

(mm/dd/y

yyy)

Contact

Name

Street


110105-

002

Unions &

Participat

ing

Employer

s Health

and

Welfare

Fund Plan Y FT Sparks MD ########

William

J ensen

4301

Garden

City Dr,

#201 Landover MD 2

110105-

002

Unions &

Participat

ing

Employer

s Health

and

Welfare

Fund

Plan Y PT

EE Sparks MD ########

William

J ensen

4301

Garden

City Dr,

#201 Landover MD 2

110105-002

Unions &

Participat

ing

Employer

s Health

and

Welfare

FundPlan Y PT

Family Sparks MD ########WilliamJ ensen

4301

Garden

City Dr,#201 Landover MD 2


28/65

Coverage

(e.g.,

Limited

Benefit,

HRA, Rx

Self-

Insured

Individual

or Group

Policy

Number

of

Individual

s

Covered

Current Plan

Annual L imit

(in dollars)

Ambulato

ry

Emergen

cy

Hospitali

zation

Laborator

y Pediatric

Other Yes Group

Other Yes Group

Other Yes Group


29/65

Preventiv

e/

Wellness

Prescripti

on

Plan

Deductibl

e

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Co

nc

ap

e)


30/65

Employer

contributi

on Total

Employee

contributi

on

Employer

contributi

on Total

Employee

contributi

on

Employer

contributi

on Total

Rate

Increase

that

would

result

in Access

to

Benefits

that

would

Ad

ato

of

Ins

e I

See

NOTES

TAB - C

B

Tr

SeeNOTES

TAB - C

B

Tr

See

NOTES

TAB - C

BTr


31/65

Taft-

Hartley

then Date

Collectiv

e

ce with

Grandfat

her

Regulatio

n

Lead

Reviewer

Date of

Receipt

Factor 1

fo r

Decision

Factor 2

for

Decision

Factor 3

for

Decision

Factor 4

for

Decision

Staff

Recomm

endation

for

Approval/

Comment

s

Da

Co

d

Ap

on

########

J .

Andrews ########

########

J .

Andrews ########

########J .Andrews ########


32/65

Date of

Waiver

Approval/

Disappro

val Letter

Sent Y/N

Date of

Letter

Confirma

tion of

Receipt

of

Approval

Access

File


33/65

Appl icant

ID

Number

Limit

Waiver

Request

Appl icant

Name

Name

(use a

new row

for each

policy

Appl icant

(Plan/

Policy

Situs)

City

Appl icant

(Plan/

Policy

Situs)

State

Policy

Effective

Date

(mm/dd/y

yyy)

Contact

Name

Street


110105-

002

UFCW

Unions &

Participat

ing

Employer

s Health

and

Welfare

Fund

Plan Y20

FT Sparks MD ########

William

J ensen

4301

Garden

City Dr,

#201 Landover MD 2

110105-

002

UFCW

Unions &

Participat

ing

Employer

s Health

and

Welfare

Fund

Plan Y20

PT Sparks MD ########

William

J ensen

4301

Garden

City Dr,

#201 Landover MD 2

110105-

002

Unions &

Participat

ing

Employer

s Healthand

Welfare

Fund Plan Z PT Sparks MD ########

William

J ensen

4301Garden

City Dr,

#201 Landover MD 2


34/65

Coverage

(e.g.,

Limited

Benefit,

HRA, Rx

Self-

Insured

Individual

or Group

Policy

Number

of

Individual

s

Covered

Current Plan

Annual L imit

(in dollars)

Ambulato

ry

Emergen

cy

Hospitali

zation

Laborator

y Pediatric

Other Yes Group

Other Yes Group

Other Yes Group


35/65

Preventiv

e/

Wellness

Prescripti

on

Plan

Deductibl

e

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Coinsura

nce (if

applicabl

e)

Copay (if

applicabl

e)

Co

nc

ap

e)


36/65

Employer

contributi

on Total

Employee

contributi

on

Employer

contributi

on Total

Employee

contributi

on

Employer

contributi

on Total

Rate

Increase

that

would

result

in Access

to

Benefits

that

would

Ad

ato

of

Ins

e I

See

NOTES

TAB - C

B

Tr

See

NOTES

TAB - C

B

Tr

See

NOTES

TAB - C

B

Tr


37/65

Taft-

Hartley

then Date

Collectiv

e

ce with

Grandfat

her

Regulatio

n

Lead

Reviewer

Date of

Receipt

Factor 1

fo r

Decision

Factor 2

for

Decision

Factor 3

for

Decision

Factor 4

for

Decision

Staff

Recomm

endation

for

Approval/

Comment

s

Da

Co

d

Ap

on

########

J .

Andrews ########

########

J .

Andrews ########

########

J .

Andrews ########


38/65

Date of

Waiver

Approval/

Disappro

val Letter

Sent Y/N

Date of

Letter

Confirma

tion of

Receipt

of

Approval

Access

File


39/65

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SC UFCW:000040


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SC UFCW:000041


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//T|/...0UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Additional%20info%20(2)%202.8.11.htm[11/08/2011 10:35

rom: Gloria N. Sarmiento [[email protected]] on behalf of Gregory A. Storm [[email protected]: Tuesday, February 08, 2011 5:27 PM

To: Habit, Sandra (HHS/OCIIO)Cc: Scelzo, Kathleen (HHS/OCIIO)ubject: South Central UFCW Unions and Employers Health and Welfare Trust

Attachments: Corr to S. Habit 2.8.11.pdf; Waiver Letter.pdf; 5659273_1.XLS.XLSandra -

ere it is again with the corresponding attachments.



ffice: 414-298-8147 | Fax: 414-298-8097


SC UFCW:000043


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//T|/...%20Central%20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Completion%202.9.11.htm[11/08/2011 10:35

rom: Habit, Sandra (HHS/OCIIO)ent: Wednesday, February 09, 2011 11:32 AM

To: 'Gregory A. Storm'ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trust

Dear Gregory,hank you for your information.

Your application is now complete and you will receive a determination of your application within 30 days. Take cnd if you have any questions, please feel free to contact me.

hank you,andy

rom: Gloria N. Sarmiento [mailto:[email protected]] On Behalf OfGregory A. Storment: Tuesday, February 08, 2011 5:27 PMo: Habit, Sandra (HHS/OCIIO)c: Scelzo, Kathleen (HHS/OCIIO)ubject: South Central UFCW Unions and Employers Health and Welfare Trust

andra -




ffice: 414-298-8147 | Fax: 414-298-8097


SC UFCW:000044


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//T|/...h%20Central%20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Approval%202.17.11.htm[11/08/2011 10:35

rom: Habit, Sandra (HHS/OCIIO)ent: Thursday, February 17, 2011 1:36 PM

To: 'Gregory A. Storm'ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trust

mportance: High

Attachments: March 2011 Approval.pdf

ear Gregory,

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

ection for South Central UFCW Unions and Employers Health and Welfare Trust. HHS has reviewed your

pplication and made its determination. Please see the attached letter. The letter applies to the following

lans:

Plan A

Plan B

Retirees

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

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

incerely,andy


andra -




ffice: 414-298-8147 | Fax: 414-298-8097


SC UFCW:000045


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//T|/...h%20Central%20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Approval%202.17.11.htm[11/08/2011 10:35

SC UFCW:000046


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//T|/...al%20UFCW%20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Approval%20receipt%202.17.11.htm[11/08/2011 10:35

rom: Gregory A. Storm [[email protected]]ent: Thursday, February 17, 2011 2:07 PM

To: Habit, Sandra (HHS/OCIIO)ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustear Ms. Habit -

his email confirms our receipt of the approval letter. Thank you for your correspondence and your prompt review of our

pplication.

reg Storm

rom: Habit, Sandra (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, February 17, 2011 12:36 PMo: Gregory A. Stormubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustmportance: High

ear Gregory,




lans:

Plan A

Plan B

Retirees



incerely,

andy


andra -


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ffice: 414-298-8147 | Fax: 414-298-8097


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rom: Gregory A. Storm [[email protected]]ent: Tuesday, March 01, 2011 5:32 PM

To: Habit, Sandra (HHS/OCIIO); Scelzo, Kathleen (HHS/OCIIO)ubject: FW: South Central UFCW Unions and Employers Health and Welfare Trust

mportance: High

Attachments: March 2011 Approval.pdfandy -

had one follow up question on this client and its approved waiver.

When we prepared the waiver application, the Plan imposed an annual limit on dental benefits of $ for Plan A and $ folan B. Subsequently, the annual limits on dental benefits were increased to $ for Plan A and $ for Plan B. Howev

he waiver was approved based on the lower limit numbers. We are in the process of preparing the notices to send to allarticipants, and we were wondering how we should document this change in benefit limits for dental benefits. As of now, we roposing that we will complete the waiver form using the numbers approved by HHS in the waiver, but then we would attachnother page behind the waiver notice to acknowledge that plan benefits had actually increased.

s a side note, we know that dental benefits are considered essential for pediatric care, but it is unclear whether dental benefitre considered essential for adults. Our experience indicates that most consultants, attorneys, etc. are concluding that dental

enefits are nonessential for adults.

We would appreciate hearing your thoughts at your earliest convenience, as the Plan Office would like to send the notice as sos possible. Thanks in advance for your assistance. If you have any questions or need any additional information, please do nesitate to contact me.

reg Storm



ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097



ear Gregory,




lans:

Plan A

SC UFCW:000051


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Plan B

Retirees



incerely,

andy

rom: Gloria N. Sarmiento [mailto:[email protected]] On Behalf OfGregory A. Storment: Tuesday, February 08, 2011 5:27 PMo: Habit, Sandra (HHS/OCIIO)

c: Scelzo, Kathleen (HHS/OCIIO)ubject: South Central UFCW Unions and Employers Health and Welfare Trust

andra -




ffice: 414-298-8147 | Fax: 414-298-8097


SC UFCW:000052


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rom: Habit, Sandra (HHS/OCIIO)ent: Wednesday, March 02, 2011 5:30 PM

To: 'Gregory A. Storm'ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustreg,

n response to your questions, it will be fine that you send out a notice to all participants with the HHS approved dental benefitith the attached document that the dental benefits have been increased. Additionally, as long as a determination is made in g

aith and the law is consistently applied we will accept the adult dental benefit as non-essential.

hank you,andy

rom: Gregory A. Storm [mailto:[email protected]]ent: Tuesday, March 01, 2011 5:32 PMo: Habit, Sandra (HHS/OCIIO); Scelzo, Kathleen (HHS/OCIIO)ubject: FW: South Central UFCW Unions and Employers Health and Welfare Trustmportance: High

andy -


When we prepared the waiver application, the Plan imposed an annual limit on dental benefits of $ r Plan A and $ folan B. Subsequently, the annual limits on dental benefits were increased to $ for Plan A and $ for Plan B. Howev


s a side note, we know that dental benefits are considered essential for pediatric care, but it is unclear whether dental benefit

re considered essential for adults. Our experience indicates that most consultants, attorneys, etc. are concluding that dentalenefits are nonessential for adults.


reg Storm



ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097


rom: Habit, Sandra (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, February 17, 2011 12:36 PMo: Gregory A. Storm

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ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustmportance: High

ear Gregory,




lans:

Plan A

Plan B

Retirees



incerely,

andy

rom: Gloria N. Sarmiento [mailto:[email protected]] On Behalf OfGregory A. Storm

ent: Tuesday, February 08, 2011 5:27 PMo: Habit, Sandra (HHS/OCIIO)c: Scelzo, Kathleen (HHS/OCIIO)ubject: South Central UFCW Unions and Employers Health and Welfare Trust

andra -




ffice: 414-298-8147 | Fax: 414-298-8097


SC UFCW:000054


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//T|/...20Unions%20and%20Employers%20Health%20and%20Welfare%20Trust/Question%20correspondence%20(2)%203.2.11.htm[11/08/2011 10:35:

rom: Lorden, Susie (HHS/OCIIO)ent: Wednesday, March 02, 2011 5:16 PM

To: Habit, Sandra (HHS/OCIIO); Kottenmeier, Erika (HHS/OCIIO)ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustounds good to me. I am researching the dental issue now, before I talk to Jim about how to handle my dental plan applic

who has pediatric dependents.

rom: Habit, Sandra (HHS/OCIIO)

ent: Wednesday, March 02, 2011 5:03 PMo: Kottenmeier, Erika (HHS/OCIIO); Lorden, Susie (HHS/OCIIO)ubject: FW: South Central UFCW Unions and Employers Health and Welfare Trustmportance: High

i Ladies,

received the below question and I am pretty sure I know the answer but just wanted to run it by you both to see if you haddditional information you wanted to add

would say that sending the notices with the HHS approved dental benefits with the attached notice that the benefits had beencreased is acceptable. Also, they are correct in that dental benefits are considered essential for pediatric care but not essent

or adults.

hanks,andy


andy -


When we prepared the waiver application, the Plan imposed an annual limit on al benefits of $ for Plan A and $ folan B. Subsequently, the annual limits on dental benefits were increased to $ for Plan A and $ for Plan B. Howev


s a side note, we know that dental benefits are considered essential for pediatric care, but it is unclear whether dental benefitre considered essential for adults. Our experience indicates that most consultants, attorneys, etc. are concluding that dentalenefits are nonessential for adults.


reg Storm



ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097


SC UFCW:000055


56/65


rom: Habit, Sandra (HHS/OCIIO) [mailto:[email protected]]ent: Thursday, February 17, 2011 12:36 PM

o: Gregory A. Stormubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustmportance: High

ear Gregory,




lans:

Plan A

Plan B

Retirees



incerely,

andy

rom: Gloria N. Sarmiento [mailto:[email protected]] On Behalf OfGregory A. Storment: Tuesday, February 08, 2011 5:27 PMo: Habit, Sandra (HHS/OCIIO)

c: Scelzo, Kathleen (HHS/OCIIO)ubject: South Central UFCW Unions and Employers Health and Welfare Trust

andra -




ffice: 414-298-8147 | Fax: 414-298-8097


SC UFCW:000056


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rom: Kottenmeier, Erika (HHS/OCIIO)ent: Wednesday, March 02, 2011 5:24 PM

To: Lorden, Susie (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustagree that your response is fine. We have been treating pediatric dental benefits as essential and adult benefits as non-essenor gray areas like that (adult dental) we will accept their good-faith determination, so you can tell him that as long as aetermination is made in good faith and the law is consistently applied (i.e., no lifetime limits on an essential benefit if they are oing to apply restricted annual limits!), we will accept the adult dental benefit as non-essential, but that HHS has not officially

made a determination.

ou dont have to get specific about the legal aspect if you dont want to: Greg Storm is a lawyer (I believe) so he can work it mself. Good-faith determination is sufficient.

rom: Lorden, Susie (HHS/OCIIO)ent: Wednesday, March 02, 2011 5:16 PMo: Habit, Sandra (HHS/OCIIO); Kottenmeier, Erika (HHS/OCIIO)ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trust

ounds good to me. I am researching the dental issue now, before I talk to Jim about how to handle my dental plan applic

who has pediatric dependents.

rom: Habit, Sandra (HHS/OCIIO)ent: Wednesday, March 02, 2011 5:03 PMo: Kottenmeier, Erika (HHS/OCIIO); Lorden, Susie (HHS/OCIIO)ubject: FW: South Central UFCW Unions and Employers Health and Welfare Trustmportance: High

i Ladies,

received the below question and I am pretty sure I know the answer but just wanted to run it by you both to see if you haddditional information you wanted to add

would say that sending the notices with the HHS approved dental benefits with the attached notice that the benefits had been

creased is acceptable. Also, they are correct in that dental benefits are considered essential for pediatric care but not essentor adults.

hanks,andy


andy -


When we prepared the waiver application, the Plan imposed an annual limit on dental benefits of $ for Plan A and $ folan B. Subsequently, the annual limits on dental benefits were increased to $ for Plan A and $ for Plan B. Howev


SC UFCW:000058


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reg Storm



ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097



ear Gregory,




lans:

Plan A

Plan B

Retirees



incerely,

andy

SC UFCW:000059


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andra -




ffice: 414-298-8147 | Fax: 414-298-8097


SC UFCW:000060


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rom: Gregory A. Storm [[email protected]]ent: Thursday, March 03, 2011 12:14 PM

To: Habit, Sandra (HHS/OCIIO)ubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustandy -

hanks so much for this helpful and prompt response. We really appreciate it.

reg

rom: Habit, Sandra (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, March 02, 2011 4:30 PMo: Gregory A. Stormubject: RE: South Central UFCW Unions and Employers Health and Welfare Trust

reg,

n response to your questions, it will be fine that you send out a notice to all participants with the HHS approved dental benefitith the attached document that the dental benefits have been increased. Additionally, as long as a determination is made in g

aith and the law is consistently applied we will accept the adult dental benefit as non-essential.

hank you,andy


andy -


When we prepared the waiver application, the Plan imposed an annual limit on al benefits of $ for Plan A and $ folan B. Subsequently, the annual limits on dental benefits were increased to $ for Plan A and $ for Plan B. Howev




reg Storm



ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097

SC UFCW:000061


62/65



rom: Habit, Sandra (HHS/OCIIO) [mailto:[email protected]]

ent: Thursday, February 17, 2011 12:36 PMo: Gregory A. Stormubject: RE: South Central UFCW Unions and Employers Health and Welfare Trustmportance: High

ear Gregory,




lans:

Plan A

Plan B

Retirees



incerely,

andy

rom: Gloria N. Sarmiento [mailto:[email protected]] On Behalf OfGregory A. Storment: Tuesday, February 08, 2011 5:27 PM

o: Habit, Sandra (HHS/OCIIO)c: Scelzo, Kathleen (HHS/OCIIO)ubject: South Central UFCW Unions and Employers Health and Welfare Trust

andra -




ffice: 414-298-8147 | Fax: 414-298-8097

[email protected] | bio | vCard | reinhartlaw.comSC UFCW:000062
mailto:[email protected]://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://reinhartlaw.com/http://reinhartlaw.com/mailto:[email protected]://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://reinhartlaw.com/http://reinhartlaw.com/http://reinhartlaw.com/http://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormmailto:[email protected]://reinhartlaw.com/http://www.reinhartlaw.com/People/Pages/vcard.aspx?who=gstormhttp://www.reinhartlaw.com/People/Pages/bioredir.aspx?who=gstormmailto:[email protected]


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//T|/...and%20Employers%20Health%20and%20Welfare%20Trust/Timing%20of%20Waiver%20Notice%20Question%203.11.11.htm[11/08/2011 10:35

rom: Gregory A. Storm [[email protected]]ent: Friday, March 11, 2011 4:10 PM

To: Habit, Sandra (HHS/OCIIO)ubject: South Central UFCW - Timing of Waiver Noticei Sandy -

s you might remember, we have corresponded regarding the waiver applications for a few different plans. I have a follow up

uestion for one of those plans, the South Central UFCW plan, and I was wondering if you could assist.

he South Central plan has a plan year of March 1 to February 28. The waiver guidance requires plans that have plan yearseginning on or after February 1, 2011 to include the required waiver notice in educational materials, enrollment materials and

ocuments explaining plan benefits (such as an SPD). Our recollection is that other informal guidance stated that plans with pl

ears after February 1, 2011 (like South Central) should also send out the waiver notice within 60 days of receiving approval o

aiver. Can you please confirm our understanding?

hanks again for your ongoing assistance.

reg Storm


000 North Water Street, Suite 1700 | Milwaukee, WI 53202ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097


SC UFCW:000064


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rom: Habit, Sandra (HHS/OCIIO)ent: Monday, March 14, 2011 12:19 PM

To: 'Gregory A. Storm'ubject: RE: South Central UFCW - Timing of Waiver Noticei Greg,

ou are correct. The waiver notice should be sent out within 60 days of receiving approval of the waiver.

hank you,

andy

rom: Gregory A. Storm [mailto:[email protected]]ent: Friday, March 11, 2011 4:10 PMo: Habit, Sandra (HHS/OCIIO)ubject: South Central UFCW - Timing of Waiver Notice

i Sandy -

s you might remember, we have corresponded regarding the waiver applications for a few different plans. I have a follow up

uestion for one of those plans, the South Central UFCW plan, and I was wondering if you could assist.

he South Central plan has a plan year of March 1 to February 28. The waiver guidance requires plans that have plan years

eginning on or after February 1, 2011 to include the required waiver notice in educational materials, enrollment materials and

ocuments explaining plan benefits (such as an SPD). Our recollection is that other informal guidance stated that plans with pl

ears after February 1, 2011 (like South Central) should also send out the waiver notice within 60 days of receiving approval o

aiver. Can you please confirm our understanding?

hanks again for your ongoing assistance.

reg Storm


000 North Water Street, Suite 1700 | Milwaukee, WI 53202ffice: 414-298-8147 | Cell: 414-588-2448 | Fax: 414-298-8097


South Central UFCW - Redacted HWM

Documents