1199 SEIU LPN- Combined Redacted HW

7/27/2019 1199 SEIU LPN- Combined Redacted HW

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1199SEIU LPN:000001


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1199SEIU LPN:000002


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3. The annual limit and rates p p l i c ~ b l e . t o the plan:.Currently, t/jeFund has. a n ~ n n u a L m a x i n 1 l l t 1 1 presctiptibll \'irug be,nefitoO_pertamilY, 'lhepJan JS currentlyself-funded, so no insured premiutl1 rate,ls a V l : ' l i l ~ p l e . ThepresctlptiPn drug tate (apFticableqQsl) for the Plan wasapproximately per active memberper'year in 2009. fiarrioi.pants do notcontripute tpwatdtlles.e ~ n e f i t s ,

4. A briefdescription.of whycQrnpliancewith the interim final regulations wou.Jd result in a significantdecreaseinaccessJo benefits for lhosecurrently coveredbysuch l a n s o r ' p o l i c i e s , o r ~ g n i t l ~ ~ l l t i n c r c a s ein premiums a i d b y t h o s e c o v e r ~ ~ by$Ueh p'ansol' U ( t j ~ , :along with any ~ p p o r t i n g documentation:

The intt'lnt and pllrpose'(\f'lbe Fllnci is toptovide !$upplementat"healthand 'welfare benefits for employees and theiri ...... ' '. '. . . . . . . . . . . ....... ..' " . ." . . . . . . . . . ..... .fainilies povered under tlie City of New York's ..beilefit p r o g t < l f h s ~ The C i t y o f ~ w York is contractually bound

to p,ov+ funding for such l>enefiis, Current m p l o n r c Q O ! r i ~ . " , ! o f f 1.v


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1199SEIU LPN:000004


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er

//T|/...tions%20with%20NO%2012600%20Response%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/waiver.htm[07/25/2011 2:25:

rom: Sarah Burgos [[email protected]]ent: Thursday, October 28, 2010 12:10 PM

To: HHS HealthInsurance (HHS)ubject: waiver

Attachments: Request for Waiver-LPN.pdf

ttached please find a request for a waiver on behalf of the 1199SEIU Licensed Practical Nurses Welfare Fund.

arah Burgos on behalf of Fred Hagen, Chief Benefits Officer

199SEIU Benefit & Pension Fund

30 West 42nd St/31st Floor

ew York, NY 10036

646) 473-6953 (phone)

646) 473-6019 (fax)

[email protected]

>

--------------------------------------------------Note: The email address of this sender has changed. Please update your records accordingly.------------------------------------------------

efore printing this email, think about the environmental impact. Think Green. Act Green.

Health care information is personal and sensitive information. If such information is being emailed to you, it is afteppropriate authorization from the patient or under circumstances that do not require patient authorization. You, theecipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without additional paonsent or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality couldubject you to penalties described in federal and state law. If you have received this message in error, please notifymmediately and destroy the related message.

1199SEIU LPN:000005
mailto:[email protected]:[email protected]:[email protected]:[email protected]


6/39

//T|/...se%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Request%20for%20additional%20info%2011.15.10.htm[07/25/2011 2:25

rom: Andrews, Jane (HHS/OCIIO)ent: Monday, November 15, 2010 11:02 AM

To: '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)

ubject: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsam in receipt of your application for a waiver of annual limits for the 1199SEIU fund. I have a few questions:

What is the effective date o policy?When you write there is an prescription drug rate for 2009, what is that rate for 2010, the re rate for 2011, and whahe rate should the prescrip rugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?

hank you.

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.

1199SEIU LPN:000006


7/39

//T|/...OW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Reqeust%20for%20information%20correspondence%2011.17.10.htm[07/25/2011 2:25

rom: Sarah Burgos [[email protected]]ent: Wednesday, November 17, 2010 8:29 AM

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

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsood morning: We did receive your e-mail on Monday and are currently working on getting the information requested. Thank y

arah Burgos

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Wednesday, November 17, 2010 8:27 AMo: Andrews, Jane (HHS/OCIIO); Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

Ms. Burgos: I am writing to confirm your receipt of my e-mail from Monday. Thanks.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)





rom: Andrews, Jane (HHS/OCIIO)ent: Monday, November 15, 2010 11:02 AMo: '[email protected]'c: Habit, Sandra (HHS/OCIIO)ubject: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

am in receipt of your application for a waiver of annual limits for the 1199SEIU fund. I have a few questions:

What is the effective date o policy?When you write there is an prescription drug rate for 2009, what is that rate for 2010, the re rate for 2011, and whahe rate should the prescrip rugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?

hank you.

ane W. Andrews

CIIO

501 Wisconsin Aveethesda, MD 20814

01-492-4122 (desk)





1199SEIU LPN:000007


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//T|/...OW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Reqeust%20for%20information%20correspondence%2011.17.10.htm[07/25/2011 2:25

_____________________________________________________________________his email has been scanned by the MessageLabs Email Security System.



Health care information is personal and sensitive information. If such information is being emailed to you, it is afterppropriate authorization from the patient or under circumstances that do not require patient authorization. You, theecipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without additional patonsent or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality couldubject you to penalties described in federal and state law. If you have received this message in error, please notifymmediately and destroy the related message.

1199SEIU LPN:000008


9/39

//T|/...esponse%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Request%20for%20confirmation%2011.17.10.htm[07/25/2011 2:25

rom: Andrews, Jane (HHS/OCIIO)ent: Wednesday, November 17, 2010 8:27 AM

To: Andrews, Jane (HHS/OCIIO); '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsMs. Burgos: I am writing to confirm your receipt of my e-mail from Monday. Thanks.

ane W. Andrews

CIIO


01-492-4122 (desk)





rom: Andrews, Jane (HHS/OCIIO)

ent: Monday, November 15, 2010 11:02 AMo: '[email protected]'c: Habit, Sandra (HHS/OCIIO)ubject: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits


What is the effective date policy?When you write there is an prescription drug rate for 2009, what is that rate for 2010, the r rate for 2011, and whahe rate should the prescription drugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?

hank you.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)





1199SEIU LPN:000009


10/39

//T|/...OW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Request%20for%20additional%20info%20response%2011.19.10.htm[07/25/2011 2:25

rom: Sarah Burgos [[email protected]]ent: Friday, November 19, 2010 2:38 PM

To: Andrews, Jane (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO); Fred Hagen

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsood afternoon,

lease note our responses to your questions below. If you have any additional questions, please do not hesitate to contact me

arah Burgos on behalfof Fred Hagen199SEIU Benefit & Pension Fund30 West 42nd St/31st Floorew York, NY 10036

646) 473-6953 (phone)646) 473-6019 (fax)[email protected]

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, November 15, 2010 11:02 AM

o: Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits


What is the effective date o policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the re l rate for 2011, and whahe rate should the prescription drugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?

010 rate for prescription with current annual maximum is

011 rate for prescription with current annual maximum would be 011 rate for prescription with a $750,000 annual maximum is hank you.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






--------------------------------------------------

1199SEIU LPN:000010


11/39

//T|/...OW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Request%20for%20additional%20info%20response%2011.19.10.htm[07/25/2011 2:25

Note: The email address of this sender has changed. Please update your records accordingly.------------------------------------------------


Health care information is personal and sensitive information. If such information is being emailed to you, it is afterppropriate authorization from the patient or under circumstances that do not require patient authorization. You, the

ecipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without additional patonsent or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality couldubject you to penalties described in federal and state law. If you have received this message in error, please notifymmediately and destroy the related message.

1199SEIU LPN:000011


12/39

//T|/...%2012600%20Response%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Correspondence%2012.13.10.htm[07/25/2011 2:2

rom: Fred Hagen [[email protected]]ent: Monday, December 13, 2010 3:21 PM

To: Sarah Burgos; Andrews, Jane (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO)

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsMs. Andrews/Ms. Habit,

We just want to confirm that you did receive our response sent on November 19, 2010 to your inquiry for additional

nformation regarding our waiver application.

We look forward to hearing your response as soon as possible since this Plans effective date is January 1, 2011.

hank you for your consideration in this matter.

red Hagen

hief Benefits Officer

199SEIU Benefit Funds

46-473-6950

rom: Sarah Burgosent: Friday, November 19, 2010 2:38 PMo: Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO); Fred Hagenubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

ood afternoon,




rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, November 15, 2010 11:02 AMo: Sarah Burgosc: Habit, Sandra (HHS/OCIIO)

ubject: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits


What is the effective date policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the re rate for 2011, and whahe rate should the prescription drugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?

010 rate for prescription with current annual maximum is 011 rate for prescription with current annual maximum would be

011 rate for prescription with a $750,000 annual maximum is 1199SEIU LPN:000012


13/39


hank you.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)









1199SEIU LPN:000013


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//T|/...0[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Correspondence%20response%2012.13.10.htm[07/25/2011 2:25

rom: Andrews, Jane (HHS/OCIIO)Sent: Monday, December 13, 2010 3:43 PMo: '[email protected]'; '[email protected]'

Cc: Habit, Sandra (HHS/OCIIO)Subject: Re: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

am checking on the status

rom: Fred Hagen [mailto:[email protected]]ent: Monday, December 13, 2010 03:20 PM

o: Sarah Burgos ; Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

Ms. Andrews/Ms. Habit,





red Hagen



46-473-6950

rom: Sarah Burgosent: Friday, November 19, 2010 2:38 PMo: Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO); Fred Hagen

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

ood afternoon,



646) 473-6953 (phone)

646) 473-6019 (fax)[email protected]

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, November 15, 2010 11:02 AMo: Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits


1199SEIU LPN:000014


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//T|/...0[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Correspondence%20response%2012.13.10.htm[07/25/2011 2:25

What is the effective date o policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the r rate for 2011, and whahe rate should the prescription drugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?


011 rate for prescription with a $750,000 annual maximum is

hank you.

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

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.


--------------------------------------------------ote: The email address of this sender has changed. Please update your records accordingly.------------------------------------------------


ealth care information is personal and sensitive information. If such information is being emailed to yous after appropriate authorization from the patient or under circumstances that do not require patientuthorization. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Risclosure without additional patient consent or as permitted by law is prohibited. Unauthorized re-isclosure or failure to maintain confidentiality could subject you to penalties described in federal and sta

aw. If you have received this message in error, please notify us immediately and destroy the relatedmessage.

1199SEIU LPN:000015


16/39

//T|/...e%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Corr%20response%20(2)%2012.13.10.htm[07/25/2011 2:2

rom: Fred Hagen [[email protected]]Sent: Monday, December 13, 2010 3:50 PMo: Andrews, Jane (HHS/OCIIO); Sarah Burgos

Cc: Habit, Sandra (HHS/OCIIO)Subject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

hanks so much.

rom: Andrews, Jane (HHS/OCIIO) [mailto:[email protected]]ent: Monday, December 13, 2010 3:43 PMo: Fred Hagen; Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: Re: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits


rom: Fred Hagen [mailto:[email protected]]ent: Monday, December 13, 2010 03:20 PMo: Sarah Burgos ; Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits






red Hagen

hief Benefits Officer199SEIU Benefit Funds

46-473-6950


ood afternoon,




1199SEIU LPN:000016


17/39




What is the effective date o policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the re rate for 2011, and whahe rate should the prescrip rugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?

010 rate for prescription with current annual maximum is

011 rate for prescription with current annual maximum w e011 rate for prescription with a $750,000 annual maximum is

hank you.

ane W. Andrews

CIIO


01-492-4122 (desk)










--------------------------------------------------1199SEIU LPN:000017


18/39


ote: The email address of this sender has changed. Please update your records accordingly.------------------------------------------------


ealth care information is personal and sensitive information. If such information is being emailed to yous after appropriate authorization from the patient or under circumstances that do not require patient

uthorization. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Risclosure without additional patient consent or as permitted by law is prohibited. Unauthorized re-isclosure or failure to maintain confidentiality could subject you to penalties described in federal and sta

aw. If you have received this message in error, please notify us immediately and destroy the relatedmessage.

1199SEIU LPN:000018


19/39

//T|/...NO%2012600%20Response%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Clarification%2012.14.10.htm[07/25/2011 2:2

rom: Andrews, Jane (HHS/OCIIO)ent: Tuesday, December 14, 2010 9:57 AM

To: Habit, Sandra (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitshis is one that should have been on approval list but feel of radar screen. We are trying to get Gary and Jim to approve toda

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 2081401-492-4122 (desk)





rom: Habit, Sandra (HHS/OCIIO)ent: Monday, December 13, 2010 4:04 PM

o: Andrews, Jane (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

ane,

m really confused by this. I think that 1199 SEIU and 1199 SEIU LPNs are the same because Sara Burgos and Fred Hagen n both sets of emails. 1199 SEIU has been approved but 1199 SEIU LPN has not been approved and on the master spreadsonly says may be a duplicate of 125. Let me know how you would like me to proceed with this.andy

rom: Andrews, Jane (HHS/OCIIO)ent: Monday, December 13, 2010 3:56 PM

o: Habit, Sandra (HHS/OCIIO)ubject: Fw: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsmportance: High

think these LPNs are on a new or recent approval list so Erica may know.

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Monday, December 13, 2010 03:53 PMo: Andrews, Jane (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

checked the folder. You have correspondence from them on the 19th which is what they asked. Its 1199SEIU Licensed Pract

urses.

Alexandra Botwinick

ffice of Oversight

HHS/OCIIO

301) [email protected]

1199SEIU LPN:000019
mailto:[email protected]:[email protected]


20/39


rom: Andrews, Jane (HHS/OCIIO)ent: Monday, December 13, 2010 3:53 PMo: Botwinick, Alexandra (HHS/OCIIO)ubject: Re: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

oo hArd for me to recall. I will ask Sandy to see if she can track this one down.

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Monday, December 13, 2010 03:51 PMo: Andrews, Jane (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

November 5th

t is published on the public list as1199SEIU Greater New York Benefit Fund. Is that a different app?

Alexandra Botwinick

ffice of OversightHHS/OCIIO


rom: Andrews, Jane (HHS/OCIIO)ent: Monday, December 13, 2010 3:49 PMo: Botwinick, Alexandra (HHS/OCIIO)ubject: Re: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

ovember 5 or December5?

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Monday, December 13, 2010 03:45 PMo: Andrews, Jane (HHS/OCIIO)c: Pham, Erica (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

ane I have that Lisa Keels did their application and they received and confirmed receipt of a waiver on November 5th. The co-mail was [email protected]. Is this another application from them?

Alexandra Botwinick

ffice of Oversight

HHS/OCIIO


1199SEIU LPN:000020
mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]


21/39


rom: Andrews, Jane (HHS/OCIIO)ent: Monday, December 13, 2010 3:43 PMo: Botwinick, Alexandra (HHS/OCIIO); Pham, Erica (HHS/OCIIO)ubject: Fw: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

nce I am out of office would you mind checking on this ones' status? Thanks







red Hagen



46-473-6950


ood afternoon,



646) 473-6953 (phone)646) 473-6019 (fax)

[email protected]



1199SEIU LPN:000021


22/39


What is the effective date o policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the re rate for 2011, and whahe rate should the prescrip drugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?



hank you.

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

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.





1199SEIU LPN:000022


23/39

//T|/...0Response%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Correspondence%20response%2012.14.10.htm[07/25/2011 2:25

rom: Fred Hagen [[email protected]]ent: Tuesday, December 14, 2010 4:57 PM

To: Andrews, Jane (HHS/OCIIO); Sarah BurgosCc: Habit, Sandra (HHS/OCIIO)

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitshanks so much for your attention to this matter.

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

ent: Tuesday, December 14, 2010 4:56 PMo: Fred Hagen; Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

red and Sarah I just left a voice mail for Sarah indicating that you should be getting an approval letter of your waiver applicaor 1199SEIU LPN Fund.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)





rom: Fred Hagen [mailto:[email protected]]ent: Tuesday, December 14, 2010 11:07 AMo: Andrews, Jane (HHS/OCIIO); Sarah Burgosc: Habit, Sandra (HHS/OCIIO)

ubject: Re: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

hank you for your prompt reply. We are looking forward to your response.red Hagenhief Benefits Officer199 SEIU Benefit and Pension Fund46-473-6950 Office46-473-6019 Fax

rom: Andrews, Jane (HHS/OCIIO)o: Fred Hagen; Sarah Burgos

c: Habit, Sandra (HHS/OCIIO)ent: Tue Dec 14 10:47:30 2010ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

Mr. Hagen and Ms. Burgos.

need to apologize for the delay in getting you a response. You are correct that we last corresponded on November 19th. Iompleted my review on November 23, but for some reason, when I sent it forward for second level review, this application goropped from the approval committee list. I suspect it is due to having received two applications from 1199 one of which waspproved November 5, but I am not sure. In any case, I will ensure that this application gets in front of the committee today soan communicate back to you with a final determination by COB.

gain, my apologies.

1199SEIU LPN:000023


24/39


ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)





rom: Fred Hagen [mailto:[email protected]]ent: Monday, December 13, 2010 3:50 PMo: Andrews, Jane (HHS/OCIIO); Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

hanks so much.



rom: Fred Hagen [mailto:[email protected]]ent: Monday, December 13, 2010 03:20 PMo: Sarah Burgos ; Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO)

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits






red Hagen



46-473-6950


1199SEIU LPN:000024


25/39


ood afternoon,






What is the effective date policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the renewal rate for 2011, and whahe rate should the prescription drugs annual limit be required to come up to $750,000? I see a 250% increase, but what are ctual dollars beneath that increase?



hank you.

ane W. AndrewsCIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)








1199SEIU LPN:000025


26/39








--------------------------------------------------



Health care information is personal and sensitive information. If such information is being emailed to you, it is afterppropriate authorization from the patient or under circumstances that do not require patient authorization. You, theecipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without additional patonsent or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality couldubject you to penalties described in federal and state law. If you have received this message in error, please notify

mmediately and destroy the related message.




1199SEIU LPN:000026


27/39



1199SEIU LPN:000027


28/39


rom: Andrews, Jane (HHS/OCIIO)ent: Tuesday, December 14, 2010 10:48 AM

To: 'Fred Hagen'; 'Sarah Burgos'Cc: Habit, Sandra (HHS/OCIIO)

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsMr. Hagen and Ms. Burgos.

need to apologize for the delay in getting you a response. You are correct that we last corresponded on November 19th. Iompleted my review on November 23, but for some reason, when I sent it forward for second level review, this application go

ropped from the approval committee list. I suspect it is due to having received two applications from 1199 one of which waspproved November 5, but I am not sure. In any case, I will ensure that this application gets in front of the committee today soan communicate back to you with a final determination by COB.

gain, my apologies.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)






hanks so much.



rom: Fred Hagen [mailto:[email protected]]

ent: Monday, December 13, 2010 03:20 PMo: Sarah Burgos ; Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO)ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits




We look forward to hearing your response as soon as possible since this Plans effective date is January 1, 2011.1199SEIU LPN:000028


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red Hagen



46-473-6950


ood afternoon,


arah Burgos on behalfof Fred Hagen

199SEIU Benefit & Pension Fund30 West 42nd St/31st Floorew York, NY 10036




What is the effective date o policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the re rate for 2011, and whahe rate should the prescrip rugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?

010 rate for prescription with current annual maximum is 011 rate for prescription with current annual maximum would be 011 rate for prescription with a $750,000 annual maximum is

hank you.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)



1199SEIU LPN:000029


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--------------------------------------------------



Health care information is personal and sensitive information. If such information is being emailed to you, it is afterppropriate authorization from the patient or under circumstances that do not require patient authorization. You, theecipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without additional patonsent or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality could

ubject you to penalties described in federal and state law. If you have received this message in error, please notifymmediately and destroy the related message.





1199SEIU LPN:000030


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//T|/...ELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Letter%20for%20approval%20correspondence%2012.14.10.htm[07/25/2011 2:25:

rom: Andrews, Jane (HHS/OCIIO)ent: Tuesday, December 14, 2010 4:56 PM

To: 'Fred Hagen'; 'Sarah Burgos'Cc: Habit, Sandra (HHS/OCIIO)

ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limitsred and Sarah I just left a voice mail for Sarah indicating that you should be getting an approval letter of your waiver applica

or 1199SEIU LPN Fund.

ane W. Andrews

CIIO501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)





rom: Fred Hagen [mailto:[email protected]]ent: Tuesday, December 14, 2010 11:07 AMo: Andrews, Jane (HHS/OCIIO); Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: Re: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

hank you for your prompt reply. We are looking forward to your response.red Hagenhief Benefits Officer199 SEIU Benefit and Pension Fund46-473-6950 Office46-473-6019 Fax

rom: Andrews, Jane (HHS/OCIIO)o: Fred Hagen; Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ent: Tue Dec 14 10:47:30 2010ubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

Mr. Hagen and Ms. Burgos.

need to apologize for the delay in getting you a response. You are correct that we last corresponded on November 19th. Iompleted my review on November 23, but for some reason, when I sent it forward for second level review, this application goropped from the approval committee list. I suspect it is due to having received two applications from 1199 one of which waspproved November 5, but I am not sure. In any case, I will ensure that this application gets in front of the committee today so

an communicate back to you with a final determination by COB.

gain, my apologies.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)


1199SEIU LPN:000031


32/39






hanks so much.









red Hagen



46-473-6950

rom: Sarah Burgosent: Friday, November 19, 2010 2:38 PM

o: Andrews, Jane (HHS/OCIIO)c: Habit, Sandra (HHS/OCIIO); Fred Hagenubject: RE: Application on behalf of Fred Hagen, for a 1199SEIU fund waiver request of annual limits

ood afternoon,


arah Burgos on behalfof Fred Hagen199SEIU Benefit & Pension Fund30 West 42nd St/31st Floor

1199SEIU LPN:000032


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ew York, NY 10036646) 473-6953 (phone)646) 473-6019 (fax)[email protected]



What is the effective date o policy? January 1, 2011When you write there is an prescription drug rate for 2009, what is that rate for 2010, the renewal rate for 2011, and whahe rate should the prescrip drugs annual limit be required to come up to $750,000? I see a increase, but what are ctual dollars beneath that increase?



hank you.

ane W. Andrews

CIIO

501 Wisconsin Ave

ethesda, MD 20814

01-492-4122 (desk)









1199SEIU LPN:000033


34/39






_____________________________________________________________________

his email has been scanned by the MessageLabs Email Security System.




1199SEIU LPN:000034


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//T|/...20NO%2012600%20Response%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Approval%2012.21.10.htm[07/25/2011 2:25

rom: Botwinick, Alexandra (HHS/OCIIO)ent: Tuesday, December 21, 2010 9:33 AM

To: '[email protected]'Cc: Habit, Sandra (HHS/OCIIO)ubject: 1199SEIU Licensed Practical Nurses Welfare Fund Approval Letter for a Waiver of the Annual Limits

Requirements 12-21-2010

mportance: High

Attachments: Updated Jan 1 Approval Letter .pdf

ood Afternoon,

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

ection 2711 for 1199SEIU Licensed Practical Nurses Welfare Fund. HHS has reviewed your application

nd made its determination. Please see the attached letter.

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

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

incerely,

Alexandra Botwinick

ffice of Oversight

HHS/[email protected]

1199SEIU LPN:000035


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//T|/...600%20Response%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Approval%20received%2012.28.10.htm[07/25/2011 2:25

rom: Sarah Burgos [[email protected]]ent: Tuesday, December 28, 2010 8:51 AM

To: Botwinick, Alexandra (HHS/OCIIO)Cc: Habit, Sandra (HHS/OCIIO)ubject: RE: 1199SEIU Licensed Practical Nurses Welfare Fund Approval Letter for a Waiver of the Annual Limi

Requirements 12-21-2010orry for the delay in response. I was out of the office. Letter received. Thank you.

rom: Botwinick, Alexandra (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, December 21, 2010 9:33 AMo: Sarah Burgosc: Habit, Sandra (HHS/OCIIO)ubject: 1199SEIU Licensed Practical Nurses Welfare Fund Approval Letter for a Waiver of the Annual Limits Requirements 12-010mportance: High

ood Afternoon,

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

ection 2711 for 1199SEIU Licensed Practical Nurses Welfare Fund. HHS has reviewed your application

nd made its determination. Please see the attached letter.

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

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

incerely,

Alexandra Botwinick

ffice of OversightHHS/[email protected]




Health care information is personal and sensitive information. If such information is being emailed to you, it is afterppropriate authorization from the patient or under circumstances that do not require patient authorization. You, theecipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without additional pat

1199SEIU LPN:000036


37/39

//T|/...600%20Response%20[YELLOW]/1199%20SEIU%20Licensed%20Practical%20Nurses/Approval%20received%2012.28.10.htm[07/25/2011 2:25

onsent or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality couldubject you to penalties described in federal and state law. If you have received this message in error, please notifymmediately and destroy the related message.

1199SEIU LPN:000037


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1199SEIU LPN:000038


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Documents

1199 SEIU LPN- Combined Redacted HW