Southeastern Pipetrades Health & Welfare - Redacted Bates HW
Assurant Redacted HW
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Transcript of Assurant Redacted HW
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Assurant Health markets products underwritten by Time Insurance Company, Union Security Insurance
September29,
2010
JamesMayhew
HealthandHumanServices
OfficeofConsumerInformationandInsurance
OfficeofOversight
Room737F04
200IndependenceAve.SW
WashingtonD.C. 20201
Re:Waiver
of
Application
of
Time
Insurance
Company
and
John
Alden
Life
Insurance
CompanysKeyMedandAssurantAffordableHealthAccessA,BandCProductsDearMr.Mayhew,
501WestMichigan
P.O.Box3050
Milwaukee,WI 532013050
T800.800.1212
www.assurant.com
Beginningin2008,webegansellingthelimitedbenefitplanstitledAssurantAffordableHealth
Access. In2007,webegansellingKeyMed. Theseplansprovidebenefitsforeverydaymedical
expensessuchasofficevisitsandprescriptiondrugs. Theseplansincludesomeoutpatientand
hospitalizationcoverage. Weseekawaiveroftheapplicationoftheimpositionoftherestricted
annuallimitsportionofPPACA. Therequestsaresetforthbelow:
HealthAccess
A
1. BenefitsunderHealthAccessA,whichisissuedwithnomedicalunderwriting 4officevisitsperyearatamaximumof visitforatotalofmaximumof
peryearforofficevisits
maximumperyearforprescriptiondrugs peryearforoutpatientxrayandlaboratoryservices peryearforsurgicalservices
2. Therearecurrently planswitheffectivedatesafter3/23/2010,whosenextplanyearbegins1/1/2011. WestoppedsellingthisplanonJune15,2010.
3. Theannuallimitsweseektomaintainarelistedabove. Thepremiumratesforthisproductvarybyage milycomposition. Aratechartisattached. Forexample,
a
single
person
aged
would
pay
in
the
monthly
premium.
For
a
husband
(age andwife children,themonthlypremiumis4. Compliancewiththeremovaloftheannualmaximumswouldresultinasignificant
increaseinpremiumspaidbyourinsureds. Theinc inpremiumnecessarytoaccountforremovalofjusttheannualmaximumsis Theadditio hewellnessbenefitsf productwillresultinapremiumincreaseof foranoverallincreaseof
Company and John Alden Life Insurance Company.
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5. AttestationofChiefExecutiveOfficerisattached.HealthAccessB
1. BenefitsunderHealthAccessB officevisitsperyearatamaximumof$ /visitforatotalofmaximumof$
peryearforofficevisits
peryearforprescriptiondrugs peryearforoutpatientservices
2
emergency
room
visits
per
year
at
a
maximum
of
/year
for
a
total
annual
maximumof ground, airambulancefor2tripsperyearforatotalannual
maximumof ground, air Upto dayforsickness, /dayforinjuryduetoinpatienthospitalization,
toamaximumof peryear
Surgicalservicespaidperaschedule, limitedto peryear2. Therearecurrently planswitheffectivedatesafter3/23/2010,whosenext
planyearbegins1/1/2011. WestoppedsellingthisplanSeptember15,2010.
3. Theannuallimitsweseektomaintainarelistedabove. Thepremiumratesforthisproductvarybyageandfamilycomposition. Aratechartisattached. For
example,asinglepe aged ,wouldpay inthemonthlypremium.usband
(age
)and
wife
with children,themonthlypremiumis
.
4. Compliancewiththeremovaloftheannualmaximumswouldresultinasignificantincreaseinpremiumspaidbyourinsureds. Theincreaseinpremium
necessarytoaccountforremovalofjusttheannualmaximumsis The
additionof ellnessbenefitsforthisproductwillresultinapremiumincreaseof ,foranoverallincreaseof .
5. AttestationofChiefExecutiveOfficerisattached.HealthAccessC
1. BenefitsunderHealthAccessC
4officevisitsperyearatamaximumof /visitforatotalofmaximumofperyearforofficevisits
peryearforprescriptiondrugs peryearforoutpatientservices emergencyroomvisitsperyearatamaximumof /yearforatotalannual
maximumof
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ground, /airambulancefor tripsperyearforatotalannualmaximumof ground, air
Upto /dayforsickness, /dayforinjuryduetoinpatienthospitalization,toamaximumof peryear
Surgicalservicespaidperaschedule, limitedto peryear2. Therearecurrently planswitheffectivedatesafter3/23/2010,whosenextplan
yearbegins1/1/2011. WestoppedsellingthisplanSeptember15,2010.
3. Theannuallimitsweseektomaintainarelistedabove. Thepremiumratesforthisproduct
vary
by
age
and
family
composition.
A
rate
chart
is
attached.
For
example,
asinglepersonaged wouldpay inthemonthlypremium. Fora
husband(age andwifewith children,themonthlypremiumis .4. Compliancewiththeremovaloftheannualmaximumswouldresultinasignificant
increaseinpremiumspaidbyourinsureds. Theincreaseinpremiumnecessaryto
accountforremovalofjusttheannualmaximumsis . Theaddit fthewellnessbenefitsforthisproductwillresultinapremiumincreaseof ,foran
overallincreaseof .
5. AttestationofChiefExecutiveOfficerisattached.KeyMed
1. BenefitsunderKeyMedThose
with
annual
maximums:
officevisitsperyearatamaximumof peryearforofficevisits peryearforprescriptiondrugs peryearforoutpatientservices emergencyroomvisitsperyearatamaximumof$ /yearforatotalannual
maximumof
ground, /airambulancefor tripsperyearforatotalannualmaximumof ground, air
Thosewithnoannualmaximums:
Surgicalservicespai dule,witha perconditionmaximum sickness, injuryperinpatienthospitalizationday,uptoa
maximumper
condition
2. Therearecurrently planswitheffectivedatesafter3/23/2010,whosenextplanyearbegins1/1/2011. WestoppedsellingthisplanJune15,2010.
3. Theannuallimitsweseektomaintainarelistedabove. Thepremiumratesforthisproductvarybyageandfamilycomposition. Aratechartisattached. Forexample,
asinglemaleaged whopurchasedthemostpopularplanwouldpay in
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themonthlypremium. Forahusband(age )andwifewith children,the
monthlypremiumforthatplanis
4. Compliancewiththeremovaloftheannualmaximumswouldresultinasignificantincreaseinpremiumspaidbyourinsureds. Theinc npremiumnecessarytoaccountforremovalofjusttheannualmaximumsis Theadditionofthewellnessbenefitsf productwillresultinapremiumincreaseof foranoverallincreaseof
5. AttestationofChiefExecutiveOfficerisattached.Werespectfullyrequestthatawaiverbegrantedassetforthabove. Pleasecontactmeifyou
havequestionsorrequireadditionalinformation. Thankyouforyourconsideration.
Sincerely,
JuliaM.Hix
VicePresident,RegulatoryCompliance
AssurantHealthComplianceOfficer
(T)(414)2997830
(F)(414)2996168
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Pages 6 through 7 redacted for the following reasons:- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemtion (b)(6)
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///co-adshare/...20Force/CCIIO%20Waivers%20-%20Torres/DFOI%20Processing%20Team/Desiree/Assurant%20Health/Waiver.htm[11/02/2011 10:35
rom: [email protected]: Wednesday, September 29, 2010 4:45 PM
To: HHS HealthInsurance (HHS)Cc: [email protected]; [email protected]; [email protected]: Waiver
Attachments: Waiver Application - Time Insurance Company and John Alden Life Insurance Company.pdflease find the attached letter for waiver of application of the restricted annual limit requirements which includes exhibit
ttachments, including the required attestation.
hank you,
licia Blake
enior Contract Compliance Analyst
ssurant Health
egal Department
414.299.8713
414.299.6168 This e-mail message and all attachments transmitted with it may contain legally privileged and/oronfidential information intended solely for the use of the addressee(s). If the reader of this message is not thentended recipient, you are hereby notified that any reading, dissemination, distribution, copying, forwarding or othse of this message or its attachments is strictly prohibited. If you have received this message in error, please notifyhe sender immediately and delete this message and all copies and backups thereof. Thank you.
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///co-adshare/...ers%20-%20Torres/DFOI%20Processing%20Team/Desiree/Assurant%20Health/Additional%20Info%2010.19.10.htm[11/02/2011 10:35
rom: Andrews, Jane (HHS/OCIIO)ent: Tuesday, October 19, 2010 11:25 AM
To: '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)
ubject: Regarding Assurant's application for annual limit waiversMs. Hix: I am currently reviewing your application for annual limit waivers for your four products. I have several questions:
looks as if these are fully insured products for groups, is that correct? If this is not correct, please let me know what market
hese policies are for, e.g. individual market.
lso, it looks as if the effective dates for all products is 1/1/11. Is that correct?inally, woul u to give us the premiums that underlie the percent increases? For example, you have notedercents like etc, but can you tell us what current premium that is based on and future premium amount if
ad to compl annual limit? Is that an average premium across all age and genders?hanks and feel free to contact me with questions.
ane W. Andrews
CIIO
501 Wisconsin Ave
ethesda, MD 20814
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.
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///co-adshare/...20Torres/DFOI%20Processing%20Team/Desiree/Assurant%20Health/Additional%20Info%20Resp%2010.19.10.htm[11/02/2011 10:35:4
rom: [email protected]: Tuesday, October 19, 2010 12:34 PM
To: Andrews, Jane (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO)
ubject: Re: Regarding Assurant's application for annual limit waiversane and Sandra,
will have a response back to you shortly. Julie
ulia Hix-Royer
ice President Assurant Regulatory Compliance
nd Assurant Health Compliance Officer
01 West Michigan
Milwaukee, WI 53201-3050
4142997830
4142996168
f you want to be really good at something, its going to involve relentlessly pushing past your comfort zone, along with frustrati
truggle, setbacks and failures."-Tony Schwartz -
om: "Andrews, Jane (HHS/OCIIO)" o: "'[email protected]'" c: "Habit, Sandra (HHS/OCIIO)" ate: 10/19/2010 10:25 AMubject: Regarding Assurant's application for annual limit waivers
Ms. Hix: I am currently reviewing your application for annual limit waivers for your four products. I have several questions:
looks as if these are fully insured products for groups, is that correct? If this is not correct, please let me know what market
hese policies are for, e.g. individual market.lso, it looks as if the effective dates for all products is 1/1/11. Is that correct? inally, woul u to give us the premiums that underlie the percent increases? For example, you have noteercents like
etc, but can you tell us what current premium that is based on and future premium amount if
ad to compl annual limit? Is that an average premium across all age and genders?hanks and feel free to contact me with questions.
ane W. AndrewsCIIO501 Wisconsin Aveethesda, MD 2081401-492-4122 (desk)02-536-6779 (Blackberry)
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///co-adshare/...20Torres/DFOI%20Processing%20Team/Desiree/Assurant%20Health/Additional%20Info%20Resp%2010.19.10.htm[11/02/2011 10:35:4
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.
his e-mail message and all attachments transmitted with it may contain legally privileged and/or confidentialnformation intended solely for the use of the addressee(s). If the reader of this message is not the intended recipienou are hereby notified that any reading, dissemination, distribution, copying, forwarding or other use of this messar its attachments is strictly prohibited. If you have received this message in error, please notify the sendermmediately and delete this message and all copies and backups thereof. Thank you.
ASSURANT:000010
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///co-adshare/...rs%20-%20Torres/DFOI%20Processing%20Team/Desiree/Assurant%20Health/Approval%20Sent%2010-26-2010.htm[11/02/2011 10:35
rom: Botwinick, Alexandra (HHS/OCIIO)ent: Tuesday, October 26, 2010 3:06 PM
To: '[email protected]'
mportance: High
Attachments: Updated Jan 1 Approval Letter .pdf
Ms. Blake,
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection for Assurant Health. HHS has reviewed your application and made its determination. Please see the
ttached letter.
lease confirm receipt of this letter by replying to this e-mail address with a copy to [email protected]
lease let me know if I can be of further assistance.
incerely,
Alexandra Botwinick
ffice of Oversight
HHS/OCIIO
ASSURANT:000011
mailto:[email protected]:[email protected] -
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///co-adshare/...20Processing%20Team/Desiree/Assurant%20Health/Correspondence%20to%20waiver%20questions%2010.21.10.htm[11/02/2011 10:35
rom: Andrews, Jane (HHS/OCIIO)ent: Thursday, October 21, 2010 12:30 PM
To: '[email protected]'Cc: '[email protected]'; Habit, Sandra (HHS/OCIIO)
ubject: RE: Assurant Health - Response to Waiver Questionsreceived your information. Thank you. I see you have expressed these in an annual premium; however, we could take these
nnual premiums and divide by 12 to get the monthly premium, so I think this is all we need. Thanks again.
ane W. Andrews
CIIO501 Wisconsin Ave
ethesda, MD 20814
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: [email protected] [mailto:[email protected]]ent: Thursday, October 21, 2010 11:58 AMo: Andrews, Jane (HHS/OCIIO)c: [email protected]; Habit, Sandra (HHS/OCIIO)ubject: Assurant Health - Response to Waiver Questions
Ms. Andrews:
n follow up to our call this morning and to your October 19, 2010 email, please see the additional information below in respons
our questions regarding our waiver requests.
Product Type - The waiver requests are for plans sold in the individual market.
. Effective Dates - All of these plans were issued prior to September 23, 2010. The next plan year will begin on January 1, 20
hich would be the effective date of the waiver.
Premiums - The premiums underlying the percent increases are detailed below. These are average premiums for all plans
hich would receive the waiver.
Current % Futureroduct Premium Increase Premiumealth Access A
ealth Access B
ealth Access C
eyMed
hank you for taking time to discuss our request. Please contact me with any additional questions.
incerely,
osh Dauenior Counsel
ssurant Health
414) 299-8790
ASSURANT:000012
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///co-adshare/...20Processing%20Team/Desiree/Assurant%20Health/Correspondence%20to%20waiver%20questions%2010.21.10.htm[11/02/2011 10:35
his e-mail is intended solely for the person or entity to which it is addressed and may contain confidential and/or privileged
formation. Any review, dissemination, copying, printing or other use of this e-mail by persons or entities other than the
ddressees is prohibited. If you have received this e-mail in error, please contact the sender immediately and delete the mate
om any computer. This e-mail message and all attachments transmitted with it may contain legally privileged and/oronfidential information intended solely for the use of the addressee(s). If the reader of this message is not thentended recipient, you are hereby notified that any reading, dissemination, distribution, copying, forwarding or othse of this message or its attachments is strictly prohibited. If you have received this message in error, please notifyhe sender immediately and delete this message and all copies and backups thereof. Thank you.
ASSURANT:000013
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///co-adshare/...OI%20Processing%20Team/Desiree/Assurant%20Health/Response%20to%20Waiver%20Questions%2010.21.10.htm[11/02/2011 10:35:
rom: [email protected]: Thursday, October 21, 2010 11:58 AM
To: Andrews, Jane (HHS/OCIIO)Cc: [email protected]; Habit, Sandra (HHS/OCIIO)ubject: Assurant Health - Response to Waiver Questions
Ms. Andrews:
n follow up to our call this morning and to your October 19, 2010 email, please see the additional information below in respons
our questions regarding our waiver requests.
Product Type - The waiver requests are for plans sold in the individual market.
. Effective Dates - All of these plans were issued prior to September 23, 2010. The next plan year will begin on January 1, 20
hich would be the effective date of the waiver.
Premiums - The premiums underlying the percent increases are detailed below. These are average premiums for all plans
hich would receive the waiver.
Current % Futureroduct Premium Increase Premiumealth Access A
ealth Access B
ealth Access C
eyMed
hank you for taking time to discuss our request. Please contact me with any additional questions.
incerely,
osh Dauenior Counsel
ssurant Health
414) 299-8790
his e-mail is intended solely for the person or entity to which it is addressed and may contain confidential and/or privileged
formation. Any review, dissemination, copying, printing or other use of this e-mail by persons or entities other than the
ddressees is prohibited. If you have received this e-mail in error, please contact the sender immediately and delete the mate
om any computer. This e-mail message and all attachments transmitted with it may contain legally privileged and/oronfidential information intended solely for the use of the addressee(s). If the reader of this message is not thentended recipient, you are hereby notified that any reading, dissemination, distribution, copying, forwarding or othse of this message or its attachments is strictly prohibited. If you have received this message in error, please notifyhe sender immediately and delete this message and all copies and backups thereof. Thank you.
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///co-adshare/...onal%20Oct%208th%20app%20confirming%20approval%20for%20oct%2029th%20app%20only%2010-27-2010.htm[11/02/2011 10:35
rom: [email protected]: Wednesday, October 27, 2010 9:14 AM
To: Botwinick, Alexandra (HHS/OCIIO)Cc: OCIIO Oversight
ubject: Re:
ollow Up Flag: Follow uplag Status: Red
Attachments: 9.29.2010 Waiver Application - Time Insurance Company and John Alden Life InsuranceCompany.pdf; 10.8.2010 Waiver Application - RightStart and SaveRight.pdfMs. Botwinick,
received the approval letter for the Waiver of the Annual Limits Requirements you sent yesterday afternoon.
We submitted separate applications for different products. One application was submitted September 29th and additional
formation, as requested, was submitted to Jane Andrews on October 21st. The second application was submitted October 8t
opies of both initial applications are attached below for your reference. Can you please indicate which application was approve
hank you,
licia Blake
enior Contract Compliance Analyst
ssurant Health
egal Department
414.299.8713
414.299.6168
om: "Botwinick, Alexandra (HHS/OCIIO)" o: "'[email protected]'" ate: 10/26/2010 02:06 PMubject:
Ms. Blake,
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Actection for Assurant Health. HHS has reviewed your application and made its determination. Please see the
ttached letter.
lease confirm receipt of this letter by replying to this e-mail address with a copy to [email protected]
lease let me know if I can be of further assistance.
incerely,
ASSURANT:000015
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///co-adshare/...onal%20Oct%208th%20app%20confirming%20approval%20for%20oct%2029th%20app%20only%2010-27-2010.htm[11/02/2011 10:35
Alexandra Botwinick
ffice of Oversight
HHS/OCIIO
attachment "Updated Jan 1 Approval Letter .pdf" deleted by Alicia Blake/HEALTH/ASSURANT/US]his e-mail message and all attachments transmitted with it may contain legally privileged and/or confidential
nformation intended solely for the use of the addressee(s). If the reader of this message is not the intended recipienou are hereby notified that any reading, dissemination, distribution, copying, forwarding or other use of this messar its attachments is strictly prohibited. If you have received this message in error, please notify the sendermmediately and delete this message and all copies and backups thereof. Thank you.
ASSURANT:000016
mailto:[email protected]:[email protected] -
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///co-adshare/...aivers%20-%20Torres/DFOI%20Processing%20Team/Desiree/Assurant%20Health/Corresponsdence%2010.27.10.htm[11/02/2011 10:35
rom: Andrews, Jane (HHS/OCIIO)ent: Wednesday, October 27, 2010 11:15 AM
To: '[email protected]'Cc: Habit, Sandra (HHS/OCIIO); Botwinick, Alexandra (HHS/OCIIO)
ubject: Your other, October 8th waiver application
We dont seem to have a record of your October 8th waiver application, but we will get it in the queue now.
ane W. Andrews
CIIO
501 Wisconsin Ave
ethesda, MD 20814
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.
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