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Pages 3 through 19 redacted for the following reasons:- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
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Pages 29 through 34 redacted for the following reasons:- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
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RelStand:000014
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From: Botwinick, Alexandra (HHS/OCIIO)Sent: Friday, September 24, 2010 4:51 PMTo: '[email protected]'Subject: Waiver of the Annual Limits Requirements of the PHS Act Section 2711
Attachments: OCIIO_Waiver_Acceptance_Letter.pdfDear Applicant,
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
Section 2711. HHS has reviewed your application and made its determination. Please see the attached letter.
Please confirm receipt of this letter by replying to this e-mail with a copy to [email protected].
Please let me know if I can be of further assistance.
Sincerely,
Alexandra Botwinick
Office of Oversight
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From: Warren Cohen [[email protected]]Sent: Monday, September 27, 2010 11:27 AMTo: Botwinick, Alexandra (HHS/OCIIO)Cc: OCIIO OversightSubject: Re: Waiver of the Annual Limits Requirements of the PHS Act
Section 2711
Dear Ms. Botwinick,
By way of this Email I am confirming receipt of your letter.
Thank you very much,
Warren Cohen
Warren Cohen, FSA, MAAA, GBA, RHUSenior VP ActuarialReliance Standard Life Insurance Co.2001 Market St. Suite 1500
Philadelphia, PA 19103
Phone: 267-256-3626Fax: [email protected]
>>> "Botwinick, Alexandra (HHS/OCIIO)" 9/24/2010 4:50 PM >>>
Dear Applicant,
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section2711. HHS has reviewed your application and made its determination. Please see the attached letter.
Please confirm receipt of this letter by replying to this e-mail with a copy to [email protected].
Please let me know if I can be of further assistance.
Sincerely,
Alexandra Botwinick
Office of Oversight
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or entity to which it is addressed. If you are not the intended recipient, you are hereby notified that any disclosure,copying, distribution or the taking of any action in reliance of the contents of this information is strictly prohibited. Ifyou have received this electronic transmission in error, please immediately notify the sender by return e-mail anddelete this message from your computer or arrange for the return of any transmitted information.
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From: McCune, Julie (HHS/OCIIO)
Sent: Friday, January 14, 2011 9:20 AM
To: '[email protected]'
Subject: Application Question: Waiver of the Annual Limits Requirements
Good Morning Mr. Cohen,
Im in the process of entering Waiver Application information into our database. Your application contains a large table of
enrollment information that I am unable to copy and paste because it came as a hard copy. Could you provide me with an
electronic copy of your application, or if possible, a Total Enrollment figure including all dependents? The number I need is
Total Number of Individuals Covered by Policy (include all dependents covered).
Thank you very much.
Julie McCune
Office of Consumer Information and Insurance Oversight (OCIIO)
U.S. Department of Health and Human Services
Phone: 301-492-4196
Email:[email protected]
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From: Charles Denaro [[email protected]]
Sent: Friday, January 14, 2011 3:33 PM
To: McCune, Julie (HHS/OCIIO)
Subject: Re: Application Question: Waiver of the Annual Limits Requirements
Attachments: Waiver RSL Cases by Policy Year Date.XLS; Waiver RSL Cases by Policy Year Date_1.XLS; Waiver RSL-
Inforce Plans vs. HHS Plan 090810.XLS
Ms. McCune, not sure which file you wanted, so I am enclosing all three.
Charles DenaroVice President, Secretary& Deputy General Counsel
Reliance Standard Life Insurance Co.Phone: 267-256-3810Fax: 267-256-0650e-mail [email protected]
>>> "McCune, Julie (HHS/OCIIO)" 1/14/2011 9:19 AM >>>Good Morning Mr. Cohen,
Im in the process of entering Waiver Application information into our database. Your application contains a large table of
enrollment information that I am unable to copy and paste because it came as a hard copy. Could you provide me with an
electronic copy of your application, or if possible, a Total Enrollment figure including all dependents? The number I need is
Total Number of Individuals Covered by Policy (include all dependents covered).
Thank you very much.
Julie McCuneOffice of Consumer Information and Insurance Oversight (OCIIO)
U.S. Department of Health and Human Services
Phone: 301-492-4196
Email:[email protected]
CONFIDENTIALITY AND PROPRIETARY INFORMATION NOTICE: This email, including attachments, iscovered by the Electronic Communications Privacy Act (18 U.S.C. 2510-2521) and contains confidential informationbelonging to the sender which may be legally privileged. The information is intended only for the use of the individualor entity to which it is addressed. If you are not the intended recipient, you are hereby notified that any disclosure,copying, distribution or the taking of any action in reliance of the contents of this information is strictly prohibited. If
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D t bt i d b C l t C l d
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Employer Name
Policy Year
Beginning
On
Subscriber
Count
Dependent
Count
COMPANIONS OF A 10/01/2010
CONSOLIDATED 10/01/2010
DAVES DETAILING 10/01/2010
GRECO INVEST 10/01/2010
NORTH CENTRAL 10/01/2010
NU YALE CLEANER 10/01/2010
OPAA FOOD MANAG 10/01/2010
PREFERRED MEAL 10/01/2010
SENIOR CARE 10/01/2010 STEPPENWOLF 10/01/2010
AMERISTAFF 10/03/2010
ADMINISTRATIVE 11/01/2010
B AND B MAINT 11/01/2010
BURGER MAKER 11/01/2010
CHECKMATE 11/01/2010
DELTA CONNECTIO 11/01/2010
DICKERSON STAT 11/01/2010
DUVAL GARDENS 11/01/2010
FRESH IDEAS 11/01/2010
HCM INC 11/01/2010
HOLLIDAYSBURG 11/01/2010
INSTITUTE FOR N 11/01/2010
MATRIX CARE LLC 11/01/2010
MATTHEWS BUS CO 11/01/2010
SOUTHERN OIL 11/01/2010
TEXAS WESTERN 11/01/2010 TRAIL LAKE 11/01/2010
UNIFORM CITY 11/01/2010
VILLA CAMILLUS 11/01/2010
STROM AVIATION 11/29/2010
6TH & ISLAND IN 12/01/2010
AMERICAN LODG 12/01/2010
APW HOLDINGS 12/01/2010
BRIMSTONE WFG 12/01/2010
CHESTERFIELD 12/01/2010 CLARK OIL CO 12/01/2010
COLONIAL PLACE 12/01/2010
CREATIVE FAMILY 12/01/2010
EA ADVANTAGE 12/01/2010
ECLIPSE ADVANTA 12/01/2010
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MERIDIAN PROP 12/01/2010
MFPLACEMENT 12/01/2010
MI LIN WOOD 12/01/2010
MICKEY MART 12/01/2010 MOOSEHEAD SALOO 12/01/2010
OMEGA SOLUTIONS 12/01/2010
PROVIDENCE PAVI 12/01/2010
RHDD 12/01/2010
TECH SERV 12/01/2010
WSA GROUP 12/01/2010
XLC SERVICES 12/01/2010
CAREER LINK COMPANIES 12/13/2010
CLARKSON EYECARE INC 12/25/2010
ADVANCE NURSING 12/26/2010
CARISCH 12/26/2010
MANPOWER 12/27/2010
MANPOWER LANS 12/27/2010
MANPOWER W TENN 12/27/2010
MARVATEMP 12/27/2010
NURSESTAFFING 12/27/2010
REALTIME GROUP 12/27/2010 FLASH FOODS 12/31/2010
ABM J ANITORIAL 01/01/2011
ABM SECURITY 01/01/2011
ACADEMY HEALTH 01/01/2011
ACCURATE HOME 01/01/2011
ADVANCE MANAGE 01/01/2011
AGORA 01/01/2011
AMERICAN GAMING 01/01/2011
AMERICAN LASER 01/01/2011 AMERICAN SOLUT 01/01/2011
APOGEE NY 01/01/2011
APOGEE RETAIL 01/01/2011
ATLANTA J OURNAL 01/01/2011
AXCESS FINANCIA 01/01/2011
B & B MAINT 01/01/2011
BAYWOOD HOTELS 01/01/2011
BENETTON USA 01/01/2011
BOYS & GIRLS CL 01/01/2011
CCLS 01/01/2011
CERTIFIED RESEA 01/01/2011
CHILDCARE NETWO 01/01/2011
CONESTOGA VIEW 01/01/2011
COX OHIO 01/01/2011
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FUTURE KEYS 01/01/2011
GAGE RESTAURANT 01/01/2011
GIACALONE 01/01/2011
GMR MARKETING 01/01/2011 GOLDEN OIL CO 01/01/2011
GOURMET TO GO 01/01/2011
HARDAGE GROUP 01/01/2011
HEALTHHELP LLC 01/01/2011
HUMAN CAPITAL 01/01/2011
IDS 01/01/2011
INDECON 01/01/2011
K & S CAFETERIA 01/01/2011
KELLEY WILLIAMS 01/01/2011
KWIK CHEK 01/01/2011
MAINSCAPE INC 01/01/2011
MILLERS ALE HOU 01/01/2011
MMI HOTEL GROUP 01/01/2011
MOBILE MODULAR 01/01/2011
NEWCOMB OIL CO 01/01/2011
OAO TECHNOLOGY 01/01/2011
OLD TOWN SCHOOL 01/01/2011 PACKARD COMPANI 01/01/2011
PIEDMONT AIR 01/01/2011
PLANT PERFORM 01/01/2011
QUALITY ASSOCIA 01/01/2011
QUARTERDECK 01/01/2011
RICHARD OIL 01/01/2011
ROBERT GOFF 01/01/2011
SATCOM MARKET 01/01/2011
SCHAEFER TEMP 01/01/2011 SHANER 01/01/2011
SIGNAL METAL 01/01/2011
SILVERLEAF CLUB 01/01/2011
SMITH & KEENE 01/01/2011
SULIK LINESTAFF 01/01/2011
SYNOVATE INC 01/01/2011
TEXAS FACILITIE 01/01/2011
THE CARIOCA CO 01/01/2011
THE CHILDRENS 01/01/2011
TIM HORTONS 01/01/2011
TITAN HOSP 01/01/2011
TITAN MEDICAL 01/01/2011
TOWN OF BRECKEN 01/01/2011
UNIDINE 01/01/2011
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CHICAGO RESTAUR 01/27/2011
CALIFORNIA MARK 02/01/2011
FISHLIPS 02/01/2011
MANAGEMENT CLEA 02/01/2011 MARKET BASKET 02/01/2011
MARSHALL MANOR 02/01/2011
MIC BURGER KING 02/01/2011
MID SOUTH WAFF 02/01/2011
NCO 02/01/2011
PENSACOLA CARE 02/01/2011
SILVER DINER 02/01/2011
SOURCE POINTE 02/01/2011
STAR FUEL 02/01/2011
SUNSHINE RESTAU 02/01/2011
SWITCHCRAFT INC 02/01/2011
TJ M PROPERTY 02/01/2011
TOWER HOSPITALI 02/01/2011
BOS TEMPORARIES 02/07/2011
SPHERION 02/07/2011
DANCING PIGS 02/24/2011
ADVANTIS HEALTH 02/26/2011 ALLGAUERS GROUP 03/01/2011
CLARK CONSTRUC 03/01/2011
COCONUTS ON THE 03/01/2011
COLUMBIA HOTEL 03/01/2011
EAGLE USA INC 03/01/2011
ETW ENTERPRISES 03/01/2011
HUMAN RESOURCE 03/01/2011
LONGWOOD 03/01/2011
M AND Y CARE 03/01/2011 MBA POULTRY 03/01/2011
METRO PRO 03/01/2011
MUSIC CHOICE 03/01/2011
NATIONAL PETRO 03/01/2011
PAPER SOURCE 03/01/2011
SAFETY HARBOR 03/01/2011
SIWEL CONSULT 03/01/2011
SONIC HEALTH 03/01/2011
SPRINGFIELD RES 03/01/2011
SYNERGY 03/01/2011
SYR 03/01/2011
TEN THOUSAND WAVES 03/01/2011
YALE ENFORCE 03/01/2011
FULENWIDER ENT 03/02/2011
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CENTRAL VAN 04/01/2011
CENTURION POULT 04/01/2011
CHARMING 04/01/2011
CHASE SOURCE LP 04/01/2011 CONRAD CONSTR 04/01/2011
DC OIL COMPANY 04/01/2011
DELUXE 04/01/2011
DEMONTROND 04/01/2011
DIAMOND GAS 04/01/2011
DISABILITY SERV 04/01/2011
EVER READY OIL 04/01/2011
EXQUISITA 04/01/2011
FRESH CHOICE 04/01/2011
FRONTIER MGMT 04/01/2011
GUARDIAN HOME 04/01/2011
HAMPTON GOLF 04/01/2011
KINETICOM INC 04/01/2011
LIFE SPAN 04/01/2011
MARKETING 04/01/2011
MERIT CONSTRUCT 04/01/2011
MILES KIMBALL 04/01/2011 NEOMONDE BAKING 04/01/2011
PK USA INC 04/01/2011
PROFESSIONAL CO 04/01/2011
PROSOURCE MGMT 04/01/2011
REAL CHOW BABY 04/01/2011
SANDHU MGMT 04/01/2011
SAVVI FORMAL 04/01/2011
TCIM SRVCS FT 04/01/2011
ZEMPLEO INC 04/01/2011 TCIM SRVCS PT 04/03/2011
CPE 04/04/2011
LSG FOOD SERVICES INC 04/28/2011
AHI SUPPLY LP 05/01/2011
AUGUSTA GARDENS 05/01/2011
BARRI REMIT 05/01/2011
BLUE RIDGE RES 05/01/2011
CASS 05/01/2011
CAUDILL SEED 05/01/2011
CENTRAL OIL 05/01/2011
CHESTNUT REST 05/01/2011
CULINARY SERV 05/01/2011
DAVENCORP MGMT 05/01/2011
DFG INC 05/01/2011
y p
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LEVINES DEPT 05/01/2011
MRG MANAGEMENT 05/01/2011
PAYNE AUTO 05/01/2011
PERSONNEL OUTSO 05/01/2011 RAMSELL DINING 05/01/2011
ROYAL CONCRETE 05/01/2011
ST OLAF 05/01/2011
TACO BILL 05/01/2011
UNITED STAFFING 05/01/2011
WELLCARE HOME 05/01/2011
ERG LLC 05/02/2011
WOODLAND GROUP 05/05/2011
ROYAL PET 05/08/2011
AM REST LLC 05/30/2011
EAGLE INDUSTRY 05/30/2011
AAA PAINTING 06/01/2011
ANDERSON FOREST 06/01/2011
ANGEL HEARTS 06/01/2011
APOTHECARY 06/01/2011
ARCH CHEMICALS 06/01/2011
ASI 06/01/2011 BETHLEHEM HOME 06/01/2011
COCKTAIL LANES 06/01/2011
EZ MART STORES 06/01/2011
FAMOUS RECIPE 06/01/2011
FELLOWSHIP 06/01/2011
FIDELITY 06/01/2011
GOODWILLHOUSTON 06/01/2011
HEALTHCARE LLC 06/01/2011
HIGH PROFILE 06/01/2011 INFINITI RESOUR 06/01/2011
INTEGRATED AIR 06/01/2011
LAKEWOOD SR LIV 06/01/2011
MMC GROUP 06/01/2011
NEWPORT 06/01/2011
NURSEFINDERS 06/01/2011
OLD DOMINION 06/01/2011
OZARK WAFFLES 06/01/2011
PRIMECARE 06/01/2011
PROSOURCE 06/01/2011
QUEST DISCOVERY 06/01/2011
RECOVER HEALTH 06/01/2011
SERVICEMASTER 06/01/2011
SOUTHEASTERN 06/01/2011
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HOME NURSING AGY 06/26/2011
12 OAKS SENIOR 07/01/2011
ALPHA CARE 07/01/2011
AMERICAN MAILER 07/01/2011 BEAED LP 07/01/2011
BIAGGIS 07/01/2011
BONFIRE 07/01/2011
BONWORTH 07/01/2011
BUFFALO 07/01/2011
BULGARI CORP 07/01/2011
C SQUARED INC 07/01/2011
CONWAY STORES 07/01/2011
DARQUE TAN 07/01/2011
DIE CUTS 07/01/2011
DUNKIN DONUTS 07/01/2011
ELITE PROF 07/01/2011
FEHR FOODS 07/01/2011
FPK SECURITY 07/01/2011
GENERAL SECUR 07/01/2011
GOODWILL INDUST 07/01/2011
HANDS OF HEART 07/01/2011 HARRIS MCBURNEY 07/01/2011
HARVARD 07/01/2011
HEART TO HEART 07/01/2011
HEARTLAND RESTA 07/01/2011
HIGHGATE SENIOR 07/01/2011
HOULIHAN SMITH 07/01/2011
J ACOBS NEVADA 07/01/2011
KELLY & PICERNE 07/01/2011
KPW MGMT 07/01/2011 MARICOPA 07/01/2011
METRO REST 07/01/2011
MONCHINO MGMT 07/01/2011
MOTIR SERVICES 07/01/2011
N R HAMM 07/01/2011
OSS SERVICES 07/01/2011
OZARK SCHOOL 07/01/2011
REK EXPRESS 07/01/2011
ROKA AKOR 07/01/2011
ROUCK PLUMBING 07/01/2011
RUCKERS 07/01/2011
SHELBY RESIDENT 07/01/2011
SOLEIL 07/01/2011
STONE OAK CARE 07/01/2011
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COVENANT DOVE 08/01/2011
CRAVE IND 08/01/2011
CRAVE MEI 08/01/2011
CYNRAY INC 08/01/2011 DOROTHY LANE 08/01/2011
FLEMING CONSTRU 08/01/2011
FLOOR AND DECOR 08/01/2011
HITZ MEMORIAL 08/01/2011
HUGHES AGENCY 08/01/2011
J ACINTO MEDICAL 08/01/2011
J ENSEN 08/01/2011
J OHN WESLEY 08/01/2011
LENA LIVING 08/01/2011
LOEFFEL STEEL 08/01/2011
MANOR CARE 08/01/2011
MCMO MGMT LLC 08/01/2011
MERCHANTS 08/01/2011
OB SPORTS GOLF 08/01/2011
PORT CITY BAKE 08/01/2011
PROF EMPLOYMENT 08/01/2011
RUTHS HOSP 08/01/2011 SEACREST SERV 08/01/2011
SERVICESTAFFING 08/01/2011
SERVMASTER SERV 08/01/2011
SPECIALTY REST 08/01/2011
ST ANTHONYS NUR 08/01/2011
SUN HOSPITALITY 08/01/2011
SUNNYBROOK 08/01/2011
SW GA OIL CO 08/01/2011
VICTORY HOME 08/01/2011 VILLAGE LANDSCA 08/01/2011
WINCO LLC 08/01/2011
CAROLINA REST 08/02/2011
UNIV MEN HEALTH 08/06/2011
WAYTODOUGH 08/07/2011
BOJ ANGLES HC 08/08/2011
BOJ ANGLES SL 08/08/2011
SRI TECHNOLOGIES INC 08/22/2011
ADVANTAGE NUR 08/28/2011
MANPOWERALTOONA 08/29/2011
4 STAFFING INC 09/01/2011
ACME OYSTER 09/01/2011
ADVANTAGE AIDS 09/01/2011
BURNS J ANITOR 09/01/2011
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GALI MANAGERS 09/01/2011
GENESH INC 09/01/2011
GLEN IVY 09/01/2011
GM LAKEVILLE 09/01/2011 J UNEJ A 09/01/2011
LECHAPERON 09/01/2011
LIBERTY HOUSE 09/01/2011
LUNCHTIME 09/01/2011
NEXTAFF 09/01/2011
PARTS UNLIMITED 09/01/2011
PI RESTAURANT 09/01/2011
PRINCETON PLACE 09/01/2011
RE SERVICES 09/01/2011
RHG GROUP INC 09/01/2011
SAFER FOUNDATIO 09/01/2011
SOUTHWEST FLORI 09/01/2011
SPECTRUM RET 09/01/2011
SPEEDLINE ATHLE 09/01/2011
TRINITY PROP 09/01/2011
TYONEK 09/01/2011
US SUGAR CORP 09/01/2011 VILLA ENTERPRIS 09/01/2011
MARKETPLACE 09/08/2011
ACCESSIBLE SPAC 09/12/2011
INTERIM MORRIS 09/17/2011
INTERIM TRIAD 09/17/2011
KANN ENTERPRISE 09/18/2011
J OHN Q HAMMONS 10/01/2011
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RSL WAIVER APPLICATION - In force Plans vs. HHS Plan
Series Plans
Weekly
Rates
$750KAnnual
Limit Plan
Weekly
Rate
Rate Increase %
to a $750K Max
Basic Med 1
Basic Med 2
Basic Med 3
Basic Med 4
Basic Med 5 Basic Med 6
Basic Med 7
Basic Med 8
Ultra 9
Ultra 10
Ultra 11 Ultra 12
Notes: 1) Rates are Ee Only:
2) The $750K Plan assumes
3)
RelStand:000031