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7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 151
LDCWAI000001
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 251
LDCWAI000002
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 351
LDCWAI000003
7272019 Laundry Dryclean - Redacted HWM
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Pages 4 through 6 redacted for the following reasons- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
LDCWAI000004
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 551
T|20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20Additional20Information2012910htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 09 2010 409 PM
To mhirschamalgamatedlifecomCc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Wai
Application - Request for Additional Information
Attachments Waiver Application Formxlsx
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiatwill expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000005
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 114 PM
To Habit Sandra (HHSOCIIO)ubject FW Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding
ntent to lower annual limitYI ndash thanks Sandy
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]
ent Monday December 13 2010 1246 PMo Keels Lisa (HHSOCIIO)ubject RE Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lowernnual limit
orry I am in a Trustee meeting at that time How about 430 on Wednesday (I should be done by then) or Thursday afte
PM
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Monday December 13 2010 1154 AMo Hirsch Michaelc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lower annumit
ear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JDLDCWAI000006
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000007
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 251
LDCWAI000002
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 351
LDCWAI000003
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 451
Pages 4 through 6 redacted for the following reasons- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
LDCWAI000004
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 551
T|20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20Additional20Information2012910htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 09 2010 409 PM
To mhirschamalgamatedlifecomCc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Wai
Application - Request for Additional Information
Attachments Waiver Application Formxlsx
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiatwill expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000005
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 114 PM
To Habit Sandra (HHSOCIIO)ubject FW Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding
ntent to lower annual limitYI ndash thanks Sandy
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]
ent Monday December 13 2010 1246 PMo Keels Lisa (HHSOCIIO)ubject RE Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lowernnual limit
orry I am in a Trustee meeting at that time How about 430 on Wednesday (I should be done by then) or Thursday afte
PM
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Monday December 13 2010 1154 AMo Hirsch Michaelc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lower annumit
ear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JDLDCWAI000006
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000007
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 351
LDCWAI000003
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 451
Pages 4 through 6 redacted for the following reasons- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
LDCWAI000004
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 551
T|20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20Additional20Information2012910htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 09 2010 409 PM
To mhirschamalgamatedlifecomCc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Wai
Application - Request for Additional Information
Attachments Waiver Application Formxlsx
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiatwill expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000005
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 114 PM
To Habit Sandra (HHSOCIIO)ubject FW Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding
ntent to lower annual limitYI ndash thanks Sandy
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]
ent Monday December 13 2010 1246 PMo Keels Lisa (HHSOCIIO)ubject RE Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lowernnual limit
orry I am in a Trustee meeting at that time How about 430 on Wednesday (I should be done by then) or Thursday afte
PM
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Monday December 13 2010 1154 AMo Hirsch Michaelc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lower annumit
ear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JDLDCWAI000006
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000007
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
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xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
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httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 451
Pages 4 through 6 redacted for the following reasons- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
LDCWAI000004
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 551
T|20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20Additional20Information2012910htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 09 2010 409 PM
To mhirschamalgamatedlifecomCc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Wai
Application - Request for Additional Information
Attachments Waiver Application Formxlsx
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiatwill expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000005
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 114 PM
To Habit Sandra (HHSOCIIO)ubject FW Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding
ntent to lower annual limitYI ndash thanks Sandy
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]
ent Monday December 13 2010 1246 PMo Keels Lisa (HHSOCIIO)ubject RE Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lowernnual limit
orry I am in a Trustee meeting at that time How about 430 on Wednesday (I should be done by then) or Thursday afte
PM
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Monday December 13 2010 1154 AMo Hirsch Michaelc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lower annumit
ear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JDLDCWAI000006
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000007
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 551
T|20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20Additional20Information2012910htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 09 2010 409 PM
To mhirschamalgamatedlifecomCc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Wai
Application - Request for Additional Information
Attachments Waiver Application Formxlsx
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiatwill expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000005
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 114 PM
To Habit Sandra (HHSOCIIO)ubject FW Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding
ntent to lower annual limitYI ndash thanks Sandy
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]
ent Monday December 13 2010 1246 PMo Keels Lisa (HHSOCIIO)ubject RE Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lowernnual limit
orry I am in a Trustee meeting at that time How about 430 on Wednesday (I should be done by then) or Thursday afte
PM
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Monday December 13 2010 1154 AMo Hirsch Michaelc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lower annumit
ear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JDLDCWAI000006
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000007
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 114 PM
To Habit Sandra (HHSOCIIO)ubject FW Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding
ntent to lower annual limitYI ndash thanks Sandy
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]
ent Monday December 13 2010 1246 PMo Keels Lisa (HHSOCIIO)ubject RE Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lowernnual limit
orry I am in a Trustee meeting at that time How about 430 on Wednesday (I should be done by then) or Thursday afte
PM
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Monday December 13 2010 1154 AMo Hirsch Michaelc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding intent to lower annumit
ear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JDLDCWAI000006
7272019 Laundry Dryclean - Redacted HWM
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T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000007
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
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T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121310htm[12212011 1207
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000007
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121310htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Monday December 13 2010 1154 AM
To mhirschamalgamatedlifecomCc Mayhew James A (CMSCPC) Habit Sandra (HHSOCIIO)ubject Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United - call regarding inten
ower annual limitear Michael
We spoke last week about setting up a call regarding the trusteesrsquo intent to lower the annual limit on the Laundry Dryleaning Workers and Allied Industries Health Fund
spoke with my supervisor Jim Mayhew and he and I are able to call you at 1130am on Wednesday December 15th Ple
onfirm that this time works for you
hank you
sa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000008
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 951
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PM
To Keels Lisa (HHSOCIIO)Cc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Information
Attachments Waiver Application Formxlsxsa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
LDCWAI000009
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1051
T|undry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20response20121310htm[12212011 1207
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000010
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1151
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Policy Name
(use a new
row for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(Plan
Policy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
LaunsdryDry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
Main Plan
Family
Coverage Michael
333
Westchester 1-914-367-
mhirscham
algamatedlife
n e ewar rsc venue e ans com m
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1251
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
Current Essential Benefits Annual Li mits (Annual Limi t for Each Essential Benefit)
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1351
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Projected Rate Increase that would result
from compliance wit h $750000 Annual Limi t
Restrict ion (in dollars) (Average Premium
by Individual)
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)
Renewal Monthly Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)
Employee
mpoyee am y
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1451
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1551
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1651
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1751
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health Fynd
Workers
United
Main Plan
Individual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Main Plan
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
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xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
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he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
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n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
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rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
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T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
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rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1851
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 1951
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
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T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
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ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
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ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
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T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2051
ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver Request
App lic ant
Name
Policy Name
(use a newrow for each
policy
application)
Applicant
(Plan Policy
Situs) City
App lic ant
(PlanPolicy
Situs)
State
Plan Policy
Effective Date
(mmddyyyy)
Contact
Name
Street
Address City State Zip Code
PhoneNumber
(including
area code)
Address
C(e
Be
Rx o
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied Local 284
IndustryHealth Fynd
Workers
United
DivisonIndividual
Coverage
$ Newark NJ 01012011
Michael
Hirsch
333
Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirscham
algamatedlife
com Lim
Healthand
Welfare Plan
of the
Launsdry
Dry Cleaning
Workeres amp
Allied
Industry
Health FyndWorkers
United
Local 284
Divison
FamilyCoverage
$ Newark NJ 01012011
Michael
Hirsch
333Westchester
Avenue White Plains NY 10604
1-914-367-
4212
mhirschamalgamatedlife
com Lim
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2151
ANNUAL LIMIT WAIVER APPLICATION
Ambulatory Emergency Hosp italizat ion Laboratory Pediatric
Maternity
Newborn
Mental Health
Substance
Abuse
Rehabilitative
Devices
Preventive
Wellness
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2251
ANNUAL LIMIT WAIVER APPLICATION
ndividual Employee
Tier
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
contribution
Employer
contribution
Employee
Employee +Family
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2351
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Segarra Madeline [msegarraamalgamatedlifecom]Sent Tuesday December 14 2010 150 PMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants) Keels Lisa (HHSOCIIO) Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)
Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workersnited Waiver Application - Request for Additional Information
mportance High
Please use the following number for the conference call for Wednesday December 15th 430 PM
Tel 8888504523
Pass Code 559346
Michael please use your moderator number
Thank youLICO-Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michaelent Tuesday December 14 2010 122 PMo markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Segarra Madelineubject Fw Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applica
Request for Additional Information
an you all make this call at 430 tomorrow Please let me know ASAP and I will send out conference call
Michael
Michael Hirsch
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
LDCWAI000023
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T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
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httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2451
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Tuesday December 14 2010 1255 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Mayhew James A (CMSCPC) ltJamesMayhewcmshhsgovgtubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000024
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesConference20call20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regarding
why you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3
ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000025
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2651
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday December 14 2010 1256 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Mayhew James A (CMSCPC)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationhank you Michael
lso we will be able to call you tomorrow (Wednesday) at 430pm Please let me know which phone number we should u
est
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000026
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2751
T|-20Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121410htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual Limits
Requirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardime when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000027
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2851
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Thursday December 16 2010 249 PM
To Hirsch MichaelCc Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thomps
homas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United
Waiver Application - Request for Additional Informationear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
LDCWAI000028
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
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xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
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he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
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n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
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rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 2951
T|ound202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesRequest20for20info20121610htm[12212011 1207
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversightffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000029
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3051
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
rom Keels Lisa (HHSOCIIO)Sent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck onsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationhank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael Hirschxecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein Susan
SusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you againsa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
LDCWAI000030
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3151
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application
LDCWAI000031
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3251
T|202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesCorrespondence20121710htm[12212011 120
equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return thecompleted spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Servicesffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000032
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
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n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
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rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
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LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
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httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
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T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
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egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
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HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
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rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
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T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 322 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buckonsultants)
Cc Habit Sandra (HHSOCIIO)Subject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers
nited Waiver Application - Request for Additional Informationsa
am looking for an status update on the waiver application for the Workers United Laundry Dry Cleaning Workers and Alli
ndustries Health Fund
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Friday December 17 2010 951 AMo Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO)ubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hank you Michael
sa
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Thursday December 16 2010 928 PMo Keels Lisa (HHSOCIIO) markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)ubject Re Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
hat is correct please go forward with the $ annual limit We will go forward with an appeal for the $ Michael
Michael HirschLDCWAI000033
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xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
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T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
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httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
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n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
xecutive Vice President
malgamated Life
14-367-4212
mhirschamal
amatedlifecom
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 16 2010 0249 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO) ltSandraHabithhsgovgt Brossman Mark ltMarkBrossmansrzcomgt Bernstein SusanSusanBernsteinsrzcomgt French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
ear Michael
hank you for speaking with us yesterday As we discussed please confirm that you would like HHS to move forward with
our waiver application based on the current $ annual limit
lease feel free to contact me if you have any further questions
hank you again
sa
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified th
ny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messagnd any attachment(s) from your system
rom Hirsch Michael [mailtoMHIRSCHamalgamatedlifecom]ent Monday December 13 2010 652 PMo Keels Lisa (HHSOCIIO)c Habit Sandra (HHSOCIIO) Brossman Mark Bernstein Susan French Darren (Buck Consultants) Thompson Thomas Gubject RE Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Applicatequest for Additional Information
sa
ere is the annual limits spreadsheet for the Workers United Laundry Dry Cleaning Workers and Allied Industries Health
und Workers United Waiver Application
LDCWAI000034
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3551
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
he current collective bargaining agreements expire on November 30 2012
you need any other information please call me on my cell 917-612-3822
lso please let me know if we can have the call on Wednesday after 430 or Thursday after 1PM
hank you
Michael Hirsch
NOTICE
his e-mail message is intended only for the named recipient(s) above It may contain confidential information thatrivileged or that constitutes attorney work product If you are not the intended recipient you are hereby notified thny dissemination distribution or copying of this e-mail and any attachment(s) is strictly prohibited If you haveeceived this e-mail in error please immediately notify the sender by replying to this e-mail and delete the messag
nd any attachment(s) from your system
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov]ent Thursday December 09 2010 409 PMo Hirsch Michaelc Habit Sandra (HHSOCIIO)ubject Workers United Laundry Dry Cleaning Workers and Allied Industries Health Fund Workers United Waiver Application equest for Additional Information
Dear Michael
hank you for speaking with me earlier today and for your application for the Waiver of the Annual LimitsRequirements of the Public Health Service Act (PHS Act) Section 2711 As we discussed I will email you regardi
me when we can set up a call to discuss the trusteesrsquo intent to lower the annual limit on the plan
Also as we discussed in order to expedite your application please provide the following information
I Please complete the entire annual limits spreadsheet which is attached to this email Please return the
completed spreadsheet to this email address as an attachment We will only be able to process spreadshthat are fully complete (ie every cell should contain the information requested) If a cell on thespreadsheet does not pertain to your plan please write ldquoNonerdquo andor provide an explanation regardingwhy you are unable to complete that particular cell in a separate document
II In addition please provide the following information
middot What is the date on which the last collective bargaining agreement pursuant to which the plan was negotiat
will expire
LDCWAI000035
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n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
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rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3651
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion2011811htm[12212011 120
n order to complete your application please provide this information by 500 pm December 10 2010 Once thisnformation is received and the application is complete it will be processed by the Department of Health and Humervices (HHS) As stated in our September 3 2010 Sub-Regulatory Guidance HHS will issue a decision within 3ays of receiving a complete application You will receive an e-mail from HHS notifying you of the waiver decisi
hank youisa
sa M Keels JD
S Department of Health amp Human Services
ffice of Consumer Information and Insurance Oversight
ffice of Oversight
sakeelshhsgov
01-492-4168
LDCWAI000036
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3751
T|0Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20response2011811htm[12212011 1207
rom Keels Lisa (HHSOCIIO)ent Tuesday January 18 2011 339 PM
To Hirsch Michael markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants)Cc Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund
Workers United Waiver of the Annual Limits Requirements 12-29-2010
mportance High
Attachments Updated Jan 1 Approval Letter pdf Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
LDCWAI000037
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3851
LDCWAI000038
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 3951
LDCWAI000039
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4051
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
rom Hirsch Michael [MHIRSCHamalgamatedlifecom]Sent Tuesday January 18 2011 550 PMo Keels Lisa (HHSOCIIO)
Cc markbrossmansrzcom SusanBernsteinsrzcom French Darren (Buck Consultants) Habit SandHHSOCIIO) Botwinick Alexandra (HHSOCIIO)Subject Re Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health FuWorkers United Waiver of the Annual Limits Requirements 12-29-2010We acknowledge receipt of the waiver approval for the Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United
Michael Hirsch
ent from my iPad
On Jan 18 2011 at 338 PM Keels Lisa (HHSOCIIO) ltLisaKeelshhsgovgt wrote
Michael
Thank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning
Workers amp Allied Industry Health Fund Workers United was approved You should have received the emailbelow on December 29 2010 along with the approval letter (which is also attached to this email) attached
Please confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
Thank you again
Lisa
NOTICE
This e-mail message is intended only for the named recipient(s) above It may containconfidential information that is privileged or that constitutes attorney work product If you are
not the intended recipient you are hereby notified that any dissemination distribution orcopying of this e-mail and any attachment(s) is strictly prohibited If you have received this e-
mail in error please immediately notify the sender by replying to this e-mail and delete themessage and any attachment(s) from your system
From Botwinick Alexandra (HHSOCIIO)Sent Wednesday December 29 2010 152 PMTo mhirschamalgamatedlifecomSubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund WorkersUnited Waiver of the Annual Limits Requirements 12-29-2010Importance High
Good Afternoon
LDCWAI000040
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4151
T|2Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesApproval20receipt2011811htm[12212011 120
Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the
PHS Act Section 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied
Industry Health Fund Workers United 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
Please let me know if I can be of further assistance
Sincerely
Alexandra Botwinick
Office of Oversight
HHSOCIIO
alexandrabotwinickhhsgov
ltUpdated Jan 1 Approval Letter pdfgt
LDCWAI000041
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4251
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 432 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Flagged
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
LDCWAI000042
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4351
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP
19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PM
o mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
LDCWAI000043
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4451
T|Round202Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up2021611htm[12212011 1207
HHSOCIIOexandrabotwinickhhsgov
S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you============================================================================= S Tr easur y Ci r cul ar 230 Not i ce Any U S f eder al t ax advi ce i ncl uded i n t hi sommuni cat i on was not i nt ended or wr i t t en t o be used and cannot be used f or t heur pose of avoi di ng U S f eder al t ax penal t i es
OTI CE
hi s e- mai l message i s i nt ended onl y f or t he named r eci pi ent ( s) above I t mayont ai n conf i dent i al i nf or mat i on t hat i s pr i vi l eged or t hat const i t ut es at t or ney
wor k pr oduct I f you ar e not t he i nt ended r eci pi ent you ar e her eby not i f i ed t hatny di ssemi nat i on di st r i but i on or copyi ng of t hi s e- mai l and any at t achment ( s) i st r i ctl y pr ohi bi t ed I f you have r ecei ved t hi s e- mai l i n er r or pl ease i mmedi at el yot i f y t he sender by repl yi ng t o t hi s e- mai l and del ete the message and anyt t achment ( s) f r om your syst em Thank you=============================================================================
LDCWAI000044
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4551
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 455 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ollow Up Flag Follow up
lag Status Completed
ello Melissa
es this answer holds true for any multiemployer group health plan with a waiver as long as the new employer is under t
ame CBA
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 432 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
sa
hank you so much for your quick response I meant to pose the question about any multiemployer group health plan with a
aiver not specifically the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Can you please conf
hat your answer holds true for any plan that has obtained a waiver
est
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Wednesday February 16 2011 400 PMo Jacoby Melissaubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
LDCWAI000045
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4651
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Wa
f the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
LDCWAI000046
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4751
T|Laundry20Dry20Cleaning20Workes20amp20Allied20IndustriesQuestion20follow-up20response2021611htm[12212011 1207
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000047
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4851
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
rom Keels Lisa (HHSOCIIO)
ent Wednesday February 16 2011 400 PM
o Jacoby Melissa
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
Melissa
hank you for your question I can confirm that the waiver permits a new employer to join the waived plan as long as the
mployer is under the same collective bargaining agreement
lease let me know if you have any other questions
ll the best
sa
rom Jacoby Melissa [mailtoMelissaJacobysrzcom] ent Wednesday February 16 2011 227 PMo Keels Lisa (HHSOCIIO)ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)
c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
LDCWAI000048
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 4951
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20Re20Adding20Employer20Response2021611htm[12212011 1207
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for theurpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
LDCWAI000049
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5051
T|0Cleaning20Workes20amp20Allied20IndustriesQuestion20re20Adding20Employer20to20Plan2021611htm[12212011 1207
rom Jacoby Melissa [MelissaJacobysrzcom]
ent Wednesday February 16 2011 227 PM
o Keels Lisa (HHSOCIIO)
ubject RE Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Healt
Fund Workers United Waiver of the Annual Limits Requirements 12-29-2010
ttachments Updated Jan 1 Approval Letter pdf
ollow Up Flag Follow up
lag Status Flagged
Ms Keels
an you please confirm that the approval of the waiver application described below permits a new employer to join the waived
an I have attached a copy of the approval letter for your reference
egards
Melissa
Melissa Jacoby ssociate 127562163
melissajacobysrzcom
chulte Roth amp Zabel LLP 19 Third Avenue New York New York 10022 127562000 | 2125935955 fax
rom Keels Lisa (HHSOCIIO) [mailtoLisaKeelshhsgov] ent Tuesday January 18 2011 339 PMo Hirsch Michael Brossman Mark Bernstein Susan French Darren (Buck Consultants)c Habit Sandra (HHSOCIIO) Botwinick Alexandra (HHSOCIIO)ubject FW Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waf the Annual Limits Requirements 12-29-2010mportance High
Michael
hank you for your email The waiver application for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Alli
ndustry Health Fund Workers United was approved You should have received the email below on December 29 2010 a
with the approval letter (which is also attached to this email) attached
lease confirm receipt of this approval letter by emailing Alexandra Botwinick at alexandrabotwinickhhsgov
hank you again
sa
rom Botwinick Alexandra (HHSOCIIO)ent Wednesday December 29 2010 152 PMo mhirschamalgamatedlifecomubject Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fund Workers United Waiver he Annual Limits Requirements 12-29-2010mportance High
ood Afternoon
LDCWAI000050
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
7272019 Laundry Dryclean - Redacted HWM
httpslidepdfcomreaderfulllaundry-dryclean-redacted-hwm 5151
hank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act
ection 2711 for Health and Welfare Plan of the Laundry Dry Cleaning Workers amp Allied Industry Health Fu
Workers United HHS has reviewed your application and made its determination Please see the attached let
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
HHSOCIIOexandrabotwinickhhsgov
S Treasury Circular 230 Notice Any US federal tax advice included in thisommunication was not intended or written to be used and cannot be used for the
urpose of avoiding US federal tax penalties
OTICE
his e-mail message is intended only for the named recipient(s) above It mayontain confidential information that is privileged or that constitutes attorneyork product If you are not the intended recipient you are hereby notified thatny dissemination distribution or copying of this e-mail and any attachment(s) istrictly prohibited If you have received this e-mail in error please immediatelyotify the sender by replying to this e-mail and delete the message and anyttachment(s) from your system Thank you=============================================================================
