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Pages 7 through 10 redacted for the following reasons:- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4

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Pages 14 through 18 redacted for the following reasons:- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4

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//T|/...LOW/Applications%20with%20NO%2012600%20Response%20[YELLOW]/UABT/Acceptance%20Letter%209-24-2010.htm[08/01/2011 10:55:4

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Friday, September 24, 2010 4:45 PM

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

Attachments: OCIIO_Waiver_Acceptance_Letter.pdfear Applicant,

hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Actection 2711. HHS has reviewed your application and made its determination. Please see the attached letter

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

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

incerely,

Alexandra Botwinick

ffice of Oversight

HHS/OCIIO

[email protected]

UABT:000014
mailto:[email protected]:[email protected]


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//T|/...%20with%20NO%2012600%20Response%20[YELLOW]/UABT/Additional%20Information%20Requested%2010-5-2010.htm[08/01/2011 10:55

rom: Pham, Erica (HHS/OCIIO)ent: Tuesday, October 05, 2010 4:21 PM

To: 'Wainblat, Neal B.'ubject: RE: Waiver Application-United Food & Commercial Workers Union-Employer Health & Welfare Fund

Mr. Wainblat:

hank you for sending us the updated information following our requests. Wed like the salary information regarding the individ

ho are enrolled on the following plans:

3UT

5U

5L

1G

1J

1S

8U

2E

4I

4U

4L

5I

5R8M

7M

7R

8M

0R

0R

2R

2M

7M

9R

0M

3R

8R

1M

6C

pecifically, were interested in whether these are part-time or full-time workers, and the average salary of those individuals wh

re enrolled onto these plans. In addition, can you please confirm that the retiree plans listed in the application package do no

ave any current full-time employees?

ind Regards,

rica Pham

rom: Madry, Elaine G. [mailto:[email protected]] On Behalf OfWainblat, Neal B.ent: Wednesday, September 22, 2010 1:41 PMo: Pham, Erica (HHS/OCIIO)ubject: Waiver Application-United Food & Commercial Workers Union-Employer Health & Welfare Fund

Ms. Pham,

Response attached.

Regards

Neal Wainblat

UABT:000015


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//T|/...%20with%20NO%2012600%20Response%20[YELLOW]/UABT/Additional%20Information%20Requested%2010-5-2010.htm[08/01/2011 10:55

Neal B. Wainblat,Attorney At Law

-216-623-6132 direct


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//T|/...h%20NO%2012600%20Response%20[YELLOW]/UABT/Communication%20regarding%20more%20info%2010-18-2010.htm[08/01/2011 10:55

rom: Clare Marie Einsmann, Esq. [[email protected]]ent: Monday, October 18, 2010 6:57 PM

To: Andrews, Jane (HHS/OCIIO)Cc: Botwinick, Alexandra (HHS/OCIIO)

ubject: RE: Plans effective date clarification today.

ollow Up Flag: Follow uplag Status: Blue

Hi Jane

ve d Ben Mulkey, UABTs independent actuary, to get you his opinion on what the rates would increase he $ Tanimura & Antle benefit plan if it were forced to increase its annual limit to $750,000. I know that

will le to get back to you this evening so relax!

As for the Teixeira Farms $ Plan yes it is a $ annual maximum plan! If you look on page B2, you wee that it specifically refere e Plan Maximum .

And again, all the plans will show unlimited lifetime benefits as of 1/1/2011!

hanks for all your efforts on our behalf. And as soon as I receive word from our actuary, I will pass it along to yo

Clare.Clare Marie Einsmann, Esq.

xecutive Vice PresidentUnited Agribusiness League4 Corporate Parkrvine, CA 92606.510500.223.4590 or 949.975.1424ax: [email protected]

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 3:31 PMo: 'Clare Marie Einsmann, Esq.'c: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: Plans effective date clarification today.

please provide me with the actuarys estimate of what an annual limit of $ would increase rates by? There is annual limit on the tamura antil plan, but that type of annual limit and pe rease it is not provided on the actua

tter, and I will need that.

lso, I am not clear on what the Texeira Farms $ plan means. Is $ the annual limit? Please let me know.

enerally, I note that your annual plan maximums are followed by a lifetime limit. As you know lifetime limits are not permitteo please confirm that the lifetime limit language will not be included in future plan descriptions.

have completed my reviews and once I hear back on the tamura antil and Texiera Farms questions, I should be able to get yecision on your applications.

hanks.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

UABT:000017


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01-492-4122 (desk)

02-536-6779 (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: Clare Marie Einsmann, Esq. [mailto:[email protected]]ent: Monday, October 18, 2010 5:45 PMo: Andrews, Jane (HHS/OCIIO)c: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: Plans effective date clarification today.

ane

hank you so very much for your understanding. And I really appreciate your extra effort.



rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 2:16 PMo: '[email protected]'

c: Botwinick, Alexandra (HHS/OCIIO)ubject: Plans effective date clarification today.

lare thanks for speaking with me this afternoon. I appreciate the clarification around your application effective date. I chec

ith the person who did the original data intake (unpackaged the paper application) and she had scanned in your September 1over letter, so now I can see the application is for a January 1, 2011 effective date. Therefore, you dont need to send me the

eptember 15th letter. Unfortunately, when I received the paper binder for application review several weeks ago, the cover letas not on the binder, and there was nothing in the binder itself to indicate a January 1, 2011 effective date, so I went with theover page effective date for each plan, which range widely. Again, that is why our original letter indicated approval for Octobeffective dates as those are the only plans I had reviewed. However, as I indicated in our phone call, between your actuarys lith the percent increases for the varying annual limits for the plans, I dont foresee a problem in approving any of your plans,

hey all fall within that range.

n fact, I will stay late to review them, so I can confirm with you before the end of your day today.

gain, I appreciate the clarification today on the effective date for all of the plans as January 1, 2011. Be back with you soon.

hanks

ane Andrews

ane W. Andrews

CIIO

501 Wisconsin Ave

UABT:000018


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ethesda, MD 20814

01-492-4122 (desk)





rom: Clare Marie Einsmann, Esq. [mailto:[email protected]]ent: Monday, October 18, 2010 11:53 AMo: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: THIRD REQUEST FOR CONFIRMATION

Dear Ms. Botwinick

hank you so very much for changing the effective date of our plan waiver. We are most appreciative of this chans it now coincides with our plan year effective date.

have received the attachment which has the appropriate January effective date. And I thank you for your assistan



rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 8:52 AMo: 'Clare Marie Einsmann, Esq.'ubject: RE: THIRD REQUEST FOR CONFIRMATION

Ms. Einsmann,

hank you for your prompt response.

have changed your plans effective date in our file and have attached an approval for your January 1st

ffective date. Please confirm with me that you received this e-mail and the attachment.

incerely,

Alexandra Botwinick

ffice of Oversight

HHS/[email protected]

UABT:000019


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rom: Clare Marie Einsmann, Esq. [mailto:[email protected]]ent: Monday, October 18, 2010 11:14 AMo: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: THIRD REQUEST FOR CONFIRMATIONmportance: High

Dear Ms. Botwinick -

Yes, United Agricultural Benefit Trust did receive our notice of approval. (Im sorry I didnt get this response to yooner, I was unexpectedly out of the office for a couple of days.)

And please be advised that I did originally attempt to respond to the email address provided, however each time thaubmitted my response, I received an error message.

We would, however, like to request a change in the effective dates of the approval. Our plan year is January 1st. T

pproval is for October 1st. How should I go about requesting that the plan year be changed on our waiver approvao whom should this request be sent?

hank you for your assistance in this matter.



rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 7:15 AMo: '[email protected]'ubject: THIRD REQUEST FOR CONFIRMATIONmportance: High

ear Applicant,

an you please confirm that you received the approval letter for a waiver of the annual limits requirements of PHS Act Section

711 on September 24, 2010. Your cooperation is greatly appreciated.

Alexandra Botwinick

ffice of Oversight


UABT:000020


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//T|/...12600%20Response%20[YELLOW]/UABT/Clarification%20of%20change%20in%20effective%20date-approval%20letter.htm[08/01/2011 10:55

rom: Andrews, Jane (HHS/OCIIO)ent: Monday, October 18, 2010 5:16 PM

To: '[email protected]'Cc: Botwinick, Alexandra (HHS/OCIIO)

ubject: Plans effective date clarification today.

ollow Up Flag: Follow uplag Status: Bluelare thanks for speaking with me this afternoon. I appreciate the clarification around your application effective date. I chec

ith the person who did the original data intake (unpackaged the paper application) and she had scanned in your September 1

over letter, so now I can see the application is for a January 1, 2011 effective date. Therefore, you dont need to send me the

eptember 15th letter. Unfortunately, when I received the paper binder for application review several weeks ago, the cover let

as not on the binder, and there was nothing in the binder itself to indicate a January 1, 2011 effective date, so I went with the

over page effective date for each plan, which range widely. Again, that is why our original letter indicated approval for Octobe

ffective dates as those are the only plans I had reviewed. However, as I indicated in our phone call, between your actuarys l

ith the percent increases for the varying annual limits for the plans, I dont foresee a problem in approving any of your plans,




hanks

ane Andrews

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






Dear Ms. Botwinick




xecutive Vice PresidentUnited Agribusiness League4 Corporate Park

UABT:000021


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rvine, CA 92606.510500.223.4590 or 949.975.1424ax: [email protected]


Ms. Einsmann,




incerely,

Alexandra Botwinick

ffice of Oversight





And please be advised that I did originally attempt to respond to the email address provided, however each time tha

ubmitted my response, I received an error message.





xecutive Vice PresidentUABT:000022


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United Agribusiness League4 Corporate Parkrvine, CA 92606.510500.223.4590 or 949.975.1424ax: [email protected]

rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]

ent: Monday, October 18, 2010 7:15 AMo: '[email protected]'ubject: THIRD REQUEST FOR CONFIRMATIONmportance: High

ear Applicant,



Alexandra Botwinick

ffice of OversightHHS/OCIIO

[email protected]

UABT:000023


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To: 'Clare Marie Einsmann, Esq.'Cc: Botwinick, Alexandra (HHS/OCIIO)


ollow Up Flag: Follow uplag Status: Blueou are welcome.

uick question. Wherever the current plan summary descriptions state that there is a lifetime limit, that language will no longe

here for the January 1, 2011 effective date plans, right?

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)


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 governm

use only and must not be disseminated, distributed, or copied to persons not authorized to receive the informatioUnauthorized disclosure may result in prosecution to the full extent of the law.


ane



xecutive Vice PresidentUnited Agribusiness League4 Corporate Parkrvine, CA 92606.510500.223.4590 or 949.975.1424ax: 949.975.1573

[email protected]

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 2:16 PMo: '[email protected]'c: Botwinick, Alexandra (HHS/OCIIO)ubject: Plans effective date clarification today.




UABT:000024


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as not on the binder, and there was nothing in the binder itself to indicate a January 1, 2011 effective date, so I went with the

over page effective date for each plan, which range widely. Again, that is why our original letter indicated approval for Octobe

ffective dates as those are the only plans I had reviewed. However, as I indicated in our phone call, between your actuarys l

ith the percent increases for the varying annual limits for the plans, I dont foresee a problem in approving any of your plans,




hanks

ane Andrews

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






Dear Ms. Botwinick




xecutive Vice PresidentUnited Agribusiness League4 Corporate Park

rvine, CA 92606.510500.223.4590 or 949.975.1424ax: [email protected]


Ms. Einsmann,

UABT:000025


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incerely,

Alexandra Botwinick

ffice of Oversight










xecutive Vice President


rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 7:15 AMo: '[email protected]'ubject: THIRD REQUEST FOR CONFIRMATION

UABT:000026


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mportance: High

ear Applicant,



Alexandra Botwinick


[email protected]

UABT:000027


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To: 'Clare Marie Einsmann, Esq.'Cc: Botwinick, Alexandra (HHS/OCIIO)


ollow Up Flag: Follow uplag Status: Blue

please provide me with the actuarys estimate of what an annual limit of $ would increase rates by? There is annual limit on the tamura antil plan, but that type of annual limit and percent increase it is not provided on the actua





hanks.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






ane


Clare.Clare Marie Einsmann, Esq.xecutive Vice President


UABT:000028


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as not on the binder, and there was nothing in the binder itself to indicate a January 1, 2011 effective date, so I went with theover page effective date for each plan, which range widely. Again, that is why our original letter indicated approval for Octobeffective dates as those are the only plans I had reviewed. However, as I indicated in our phone call, between your actuarys lith the percent increases for the varying annual limits for the plans, I dont foresee a problem in approving any of your plans,




hanks

ane Andrews

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






Dear Ms. Botwinick





UABT:000029


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[email protected]


Ms. Einsmann,




incerely,

Alexandra Botwinick

ffice of Oversight



mportance: High








xecutive Vice PresidentUnited Agribusiness League4 Corporate Parkrvine, CA 92606.5105

UABT:000030


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00.223.4590 or 949.975.1424ax: [email protected]


ear Applicant,

an you please confirm that you received the approval letter for a waiver of the annual limits requirements of PHS Act Section711 on September 24, 2010. Your cooperation is greatly appreciated.

Alexandra Botwinick

ffice of Oversight


UABT:000031


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//T|/...20with%20NO%2012600%20Response%20[YELLOW]/UABT/Updated%20Approval%20Letter%20Sent%2010-18-2010.htm[08/01/2011 10:55:4

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Monday, October 18, 2010 11:52 AM

To: 'Clare Marie Einsmann, Esq.'ubject: RE: THIRD REQUEST FOR CONFIRMATION

Attachments: Updated Jan 1 Approval Letter .pdf

Ms. Einsmann,




incerely,

Alexandra Botwinick


[email protected]






pproval is for October 1st. How should I go about requesting that the plan year be changed on our waiver approva

o whom should this request be sent?




UABT:000032


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ear Applicant,



Alexandra Botwinick

ffice of Oversight


UABT:000033


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//T|/...0%20Response%20[YELLOW]/UABT/CONFIRMATION%20of%20receipt%20of%20approval%20letter%2010-18-2010.htm[08/01/2011 10:55:

rom: Clare Marie Einsmann, Esq. [[email protected]]ent: Monday, October 18, 2010 11:14 AM

To: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: THIRD REQUEST FOR CONFIRMATION

mportance: HighDear Ms. Botwinick -









ear Applicant,



Alexandra Botwinick

ffice of Oversight


UABT:000034


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//T|/...nse%20[YELLOW]/UABT/Second%20Request%20For%20Confirmation%20of%20Receipt%20of%20Approval%20Letter.htm[08/01/2011 10:55

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Friday, October 15, 2010 1:43 PM

To: '[email protected]'ubject: Second Request For Confirmation of Receipt of Approval Letter

mportance: High

ood Afternoon,

he e-mail you received containing the Approved Waiver of the Annual Limits Requirements of PHS Actection 2711 instructed you to confirm receipt of the e-mail and attached Approval Letter. Please e-mail ba

o confirm receipt as soon as possible.

incerely,

Alexandra Botwinick

ffice of Oversight


UABT:000035


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//T|/...th%20NO%2012600%20Response%20[YELLOW]/UABT/RE%20THIRD%20REQUEST%20FOR%20CONFIRMATION.htm[08/01/2011 10:55

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Monday, October 18, 2010 11:52 AM

To: 'Clare Marie Einsmann, Esq.'ubject: RE: THIRD REQUEST FOR CONFIRMATION

Attachments: Updated Jan 1 Approval Letter .pdf

Ms. Einsmann,




incerely,

Alexandra Botwinick


[email protected]






pproval is for October 1st. How should I go about requesting that the plan year be changed on our waiver approva

o whom should this request be sent?




UABT:000036


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//T|/...th%20NO%2012600%20Response%20[YELLOW]/UABT/RE%20THIRD%20REQUEST%20FOR%20CONFIRMATION.htm[08/01/2011 10:55



ear Applicant,



Alexandra Botwinick

ffice of Oversight


UABT:000037


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//T|/...sponse%20[YELLOW]/UABT/Confirmation%20of%20Receipt%20of%20Updated%20Approval%20Letter%2010-18-2010.htm[08/01/2011 10:55

rom: Clare Marie Einsmann, Esq. [[email protected]]ent: Monday, October 18, 2010 11:53 AM

To: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: THIRD REQUEST FOR CONFIRMATION

Dear Ms. Botwinick






Ms. Einsmann,




incerely,

Alexandra Botwinick

ffice of Oversight

HHS/OCIIO

[email protected]


Dear Ms. Botwinick -UABT:000038


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//T|/...sponse%20[YELLOW]/UABT/Confirmation%20of%20Receipt%20of%20Updated%20Approval%20Letter%2010-18-2010.htm[08/01/2011 10:55




pproval is for October 1

st

. How should I go about requesting that the plan year be changed on our waiver approvao whom should this request be sent?






ear Applicant,


Alexandra Botwinick

ffice of Oversight


UABT:000039


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//T|/...20NO%2012600%20Response%20[YELLOW]/UABT/2nd%20Request%20Addtional%20Info%20Response%2010.19.10.htm[08/01/2011 10:55:5

rom: Andrews, Jane (HHS/OCIIO)ent: Tuesday, October 19, 2010 7:20 PM

To: 'Clare Marie Einsmann, Esq.'Cc: Botwinick, Alexandra (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)

ubject: RE: Plans effective date clarification today.ur e-mails literally crossed in the mail. I will review this and get back to you tomorrow. Thanks.

ane W. Andrews

CIIO

501 Wisconsin Aveethesda, MD 20814

01-492-4122 (desk)





rom: Clare Marie Einsmann, Esq. [mailto:[email protected]]

ent: Tuesday, October 19, 2010 7:15 PMo: Andrews, Jane (HHS/OCIIO)c: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: Plans effective date clarification today.

Dear Jane

Attached is the letter from United Agricultural Benefit Trusts ABTs) consulting actuary stating that the anticipncrease for the Tanimura & Antle Mexican Panel Plan will be % if it were required to increase the annual maximo $750,000. This number is comparatively lower than our oth cost trends because all the medical benefits for thi

lan are rendered in Mexico where medical costs average 1/3rd of the costs of those in the United States. (So it canactored that the trend would be significantly greater if applied to U.S. medical rates maybe %.)

he Tanimura & Antle Mexican Panel Plan is a very unique benefit plan design. Their seasonal growing operationlong the California/Ariz d Mexican border s a seasonal plan and is active October through May each yehere are approximately farm laborers and dependents whose only health benefits are those that they rec

rom United Agricultural it Trusts contract doctor panel in the towns and cities along the border of Mexic

animura & Antles workforce is low income farm laborers. They are documented workers but many of the workeeside in Mexico and cross the border each day to work in the agricultural fields and return to Mexico each eveningecause they are working for a U.S. firm, they are not eligible for the Mexican socialized medical program. The o

medical care they could receive if the Tanimura & Antle plan were discontinued would be Medicaid.

Despite the fact that benefits are provided in Mexico, the Tanimura & Antle Mexican Plan is a comprehensive majomedical benefit plan providing hospital, physician, diagnostic testing, prescription medication, etc. The physicians ospitals are vetted and excellent quality. And most important, the participants are pleased with their health benefi

he plan is priced at a rate which the Tanimura & Antle can afford rates which enable the employer to provide thmployees health benefits at no cost sharing. And the employer knows that these employees cannot afford to sharhe cost of benefits. And if the employer were to cease providing benefits the employee would not be able to obtaiealth benefits independently.

n discussions with our employer it would appear that Tanimura & Antle may not be able to afford to continue to oenefits if the cost increases even %. There is little profit margin in the wholesale production agriculture. It is

UABT:000040


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irtually impossible for an agricultural producer to increase costs and pass them along to the consumer. If the cost ead lettuce increases, the consumer will bypass a salad with dinner and opt for broccoli or zucchini.

As I have indicated, UABT relied on our notice of September 24, 2010 notice from Steve Larsen, Director of theOffice of oversight and notified all of our participating employers, including Tanimura & Antle, that UABT receivewaiver of the annual limits for all of its plans, including the Tanimura & Antle plan. I now ask that Tanimura & A

ontinue to be included in the waiver granted UABT on September 24th as amended on October 18th.

hank you for your consideration and efforts on our behalf. And if you have any questions, please let me know.

Very truly yours,



[email protected]

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 4:07 PMo: '[email protected]'c: Botwinick, Alexandra (HHS/OCIIO)ubject: Re: Plans effective date clarification today.

hat's helpful. I will look for your e-mail tomorrow regarding Tanamura and Antle. Have a good evening.


Hi Jane

ve d Ben Mulkey, UABTs independent actuary, to get you his opinion on what the rates would increase he $ Tanimura & Antle benefit plan if it were forced to increase its annual limit to $750,000. I know that

will not be able to get back to you this evening so relax!

As for the Teixeira Farms $ Plan yes it is a $ nual maximum plan! If you look on page B2, you wee that it specifically refere e Plan Maximum at $ .




xecutive Vice PresidentUnited Agribusiness League

UABT:000041


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4 Corporate Parkrvine, CA 92606.510500.223.4590 or 949.975.1424ax: [email protected]

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 3:31 PM

o: 'Clare Marie Einsmann, Esq.'c: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: Plans effective date clarification today.

please provide me with the actuarys estimate of what an annual limit of $ would increase rates by? There is annual limit on the tamura antil plan, but that type of annual limit and percent increase it is not provided on the actua





hanks.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






ane



xecutive Vice PresidentUnited Agribusiness League4 Corporate Parkrvine, CA 92606.510500.223.4590 or 949.975.1424

UABT:000042


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ax: [email protected]








hanks

ane Andrews

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






Dear Ms. Botwinick





UABT:000043


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Ms. Einsmann,




incerely,

Alexandra Botwinick

ffice of Oversight










UABT:000044


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ear Applicant,


Alexandra Botwinick

ffice of Oversight


UABT:000045


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rom: Andrews, Jane (HHS/OCIIO)ent: Tuesday, October 19, 2010 7:18 PM

To: 'Clare Marie Einsmann, Esq.'Cc: Habit, Sandra (HHS/OCIIO); Botwinick, Alexandra (HHS/OCIIO)

ubject: RE: Plans effective date clarification today.lare just checking back to see if you were able to get the information on what percent increase in rates for the $250,000 an

mits plan. Thanks

ane W. Andrews

CIIO501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






Hi Jane

ve d Ben Mulkey, UABTs independent actuary, to get you his opinion on what the ould increase he $ Tanimura & Antle benefit plan if it were forced to increase its annual limit to $ I know that


As for the Teixeira Farms $ Plan yes it is a $ nual maximum plan! If you look on page B2, you wee that it specifically refere e Plan Maximum .







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an you please provide me with the actuarys estimate of what an annual limit of $ would increase rates by? There is annual limit on the tamura antil plan, but that type of annual limit and per rease it is not provided on the actua





hanks.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






ane







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hanks

ane Andrews

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






Dear Ms. Botwinick







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Ms. Einsmann,




incerely,

Alexandra Botwinick

ffice of Oversight











rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]ent: Monday, October 18, 2010 7:15 AM

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o: '[email protected]'ubject: THIRD REQUEST FOR CONFIRMATIONmportance: High

ear Applicant,


Alexandra Botwinick

ffice of Oversight


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rom: Andrews, Jane (HHS/OCIIO)ent: Tuesday, October 19, 2010 7:53 AM

To: Botwinick, Alexandra (HHS/OCIIO)Cc: Pham, Erica (HHS/OCIIO); Andrews, Jane (HHS/OCIIO)

ubject: UABT data for inputting

ollow Up Flag: Follow uplag Status: Bluehese are all self-insured, group plans.

nnual plan 10, individuals, AL w ady approvednnual plan 25, individuals, AL $ , % easennual Plan 30, ndividuals, AL about a % increasennual plan 50, individuals, AL $ % in sennual Plan 75, individuals, AL $ % increasennual Plan 100 individuals, A % increase(already approved)nnual Plan 125, individuals L

Medical Expense benefits, plan 1, ndividuals, $ AL, increaseMedical Expense Benefit an 2, indi , $ AL, % increaseMajor Medical A83 n, individua , % increaseMajor Medical B83, individuals, AL % increase

Major Medical , individual % increaseield 96 P individuals, AL , % increaselan 25A, individuals, AL % increaselan 30A, vidu % increaseroduce p , AL , s onversion pla , , , % increasertichoke and Veg , individuals, AL , % increasertichoke and Veg Trust Plan III, ndividuals, AL , % increasearthbound Farms Mexican P individu AL cre oothill Packing Plan 50/152, individuals, individuals, AL, % increaseiji Brothers Inc. and Seaview, individual individuals, AL about % increaseE Farms Seasonal Plan, individuals, A % increase

Mann Packi lan 60, ind , AL b % increase

ro 1 Plan, individuals, AL , % i selata 1 Plan individuals, AL out % increase

anamura and Antle Mexican Plan To Be Determined

aylor Farms Pacific Inc. Plan, individuals, AL , % increase

eixeira Farms, To be Determined

hanks

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)



This information has not been publicly disclosed and may be privileged and confidential. It is for internal governm

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//T|/...LLOW/Applications%20with%20NO%2012600%20Response%20[YELLOW]/UABT/Requested%20Info%2010-19-2010.htm[08/01/2011 10:55:5

use only and must not be disseminated, distributed, or copied to persons not authorized to receive the informatioUnauthorized disclosure may result in prosecution to the full extent of the law.

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rom: Andrews, Jane (HHS/OCIIO)ent: Wednesday, October 20, 2010 4:08 PM

To: 'Clare Marie Einsmann, Esq.'Cc: Botwinick, Alexandra (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)

ubject: RE: Plans effective date clarification today.lare we did a review of your e-mail letter below dated 10/19/2010 as well as your actuarys letter and can approve the Tanim Antle plan to be included in UABTs waiver approval letter dated October 18, 2010. Therefore, all plans included in your application dated

eptember 15, 2010 are considered to be approved for a waiver of annual limits for a one-year period as indicated in the October 18, 2010

pproval letter.

hanks and let me know if you have questions.

ane

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)





rom: Clare Marie Einsmann, Esq. [mailto:[email protected]]ent: Tuesday, October 19, 2010 7:15 PMo: Andrews, Jane (HHS/OCIIO)c: Botwinick, Alexandra (HHS/OCIIO)ubject: RE: Plans effective date clarification today.

Dear Jane

Attached is the letter from United Agricultural Benefit Trusts ABTs) consulting actuary stating that the anticipncrease for the Tanimura & Antle Mexican Panel Plan will be % if it were required to increase the annual maximo $750,000. This number is comparatively lower than our oth cost trends because all the medical benefits for thi

lan are rendered in Mexico where medical costs average 1/3rd of the costs of those in the United States. (So it canactored that the trend would be significantly greater if applied to U.S. medical rates maybe %.)

he Tanimura & Antle Mexican Panel Plan is a very unique benefit plan design. Their seasonal growing operationlong the California/Ariz nd Mexican border. s a seasonal plan and is active October through May each yehere are approximately farm laborers and dependents whose only health benefits are those that they rec

rom United Agricultural fit Trusts contract doctor panel in the towns and cities along the border of Mexic

animura & Antles workforce is low income farm laborers. They are documented workers but many of the workeeside in Mexico and cross the border each day to work in the agricultural fields and return to Mexico each eveningecause they are working for a U.S. firm, they are not eligible for the Mexican socialized medical program. The o

medical care they could receive if the Tanimura & Antle plan were discontinued would be Medicaid.

Despite the fact that benefits are provided in Mexico, the Tanimura & Antle Mexican Plan is a comprehensive majomedical benefit plan providing hospital, physician, diagnostic testing, prescription medication, etc. The physicians ospitals are vetted and excellent quality. And most important, the participants are pleased with their health benefi

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he plan is priced at a rate which the Tanimura & Antle can afford rates which enable the employer to provide thmployees health benefits at no cost sharing. And the employer knows that these employees cannot afford to sharhe cost of benefits. And if the employer were to cease providing benefits the employee would not be able to obtaiealth benefits independently.

n discussions with our employer would appear that Tanimura & Antle may not be able to afford to continue to oenefits if the cost increases even %. There is little profit margin in the wholesale production agriculture. It isirtually impossible for an agricul ral producer to increase costs and pass them along to the consumer. If the costead lettuce increases, the consumer will bypass a salad with dinner and opt for broccoli or zucchini.

As I have indicated, UABT relied on our notice of September 24, 2010 notice from Steve Larsen, Director of theOffice of oversight and notified all of our participating employers, including Tanimura & Antle, that UABT receivewaiver of the annual limits for all of its plans, including the Tanimura & Antle plan. I now ask that Tanimura & A

ontinue to be included in the waiver granted UABT on September 24th as amended on October 18th.

hank you for your consideration and efforts on our behalf. And if you have any questions, please let me know.

Very truly yours,



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

ent: Monday, October 18, 2010 4:07 PMo: '[email protected]'c: Botwinick, Alexandra (HHS/OCIIO)ubject: Re: Plans effective date clarification today.

hat's helpful. I will look for your e-mail tomorrow regarding Tanamura and Antle. Have a good evening.


Hi Jane

ve contacted Ben Mulkey, UABTs independent actuary, to get you his opinion on what the rates would increase he $ Tanimura & Antle benefit plan if it were forced to increase its annual limit to $750,000. I know that


As for the Teixeira Farms $ Plan yes it is a $ annual maximum plan! If you look on page B2, you wee that it specifically refere e Plan Maximum a .


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please provide me with the actuarys estimate of what an annual limit of $ would increase rates by? There is

annual limit on the tamura antil plan, but that type of annual limit and per ease it is not provided on the actua I will need that.




hanks.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






ane


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as not on the binder, and there was nothing in the binder itself to indicate a January 1, 2011 effective date, so I went with theover page effective date for each plan, which range widely. Again, that is why our original letter indicated approval for Octobeffective dates as those are the only plans I had reviewed. However, as I indicated in our phone call, between your actuarys lith the percent increases for the varying annual limits for the plans, I dont foresee a problem in approving any of your plans,




hanks

ane Andrews

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






Dear Ms. Botwinick


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Ms. Einsmann,




incerely,

Alexandra Botwinick

ffice of Oversight



mportance: High




We would, however, like to request a change in the effective dates of the approval. Our plan year is January 1st. TUABT:000057


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xecutive Vice President



ear Applicant,


Alexandra Botwinick

ffice of Oversight


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//T|/...ith%20NO%2012600%20Response%20[YELLOW]/UABT/Resp%20Correspondence%20regarding%20plan%20inclusion.htm[08/01/2011 10:55:5

rom: Clare Marie Einsmann, Esq. [[email protected]]ent: Wednesday, October 20, 2010 4:57 PM

To: Andrews, Jane (HHS/OCIIO)Cc: Botwinick, Alexandra (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)

ubject: RE: Plans effective date clarification today.ane

hank you so much for your efforts at getting all of the UABT plans approved for the plan year of January 2011.

really appreciate your cooperation and understanding of our benefit programs.



rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, October 20, 2010 1:08 PMo: 'Clare Marie Einsmann, Esq.'c: Botwinick, Alexandra (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Plans effective date clarification today.

lare we did a review of your e-mail letter below dated 10/19/2010 as well as your actuarys letter and can approve the Tanim Antle plan to be included in UABTs waiver approval letter dated October 18, 2010. Therefore, all plans included in your application dated

eptember 15, 2010 are considered to be approved for a waiver of annual limits for a one-year period as indicated in the October 18, 2010

pproval letter.

hanks and let me know if you have questions.

ane

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)


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