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7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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REQUEST FOR LIMITED PLAN WAIVERPLAN NAME: SECURITY BENEFIT FUND OF THE UNIFORMED FIREFIGHTE.RS ASSOCIATION OFNEW YORK CITYPLAN TYPE: MUNICIPAL SUPPLEMENTAL HEALTH AND WELFARE 8ENEFlT FUNDPLAN YEAR FOR WHICH WAIVER IS REQUESTED' JULY 1, 2011 - JUNE 30, 2012BACKGROUND: The Plan is a health and welfare benefit plan established under the proviSions of anAgreement and Declaration of Trust between Its Trustees and the Uniformed Firefighters Associatton ofGreater New York, Local 94 IAF.F., AFL-CIO (the UFA). Participants are firefighters, fire marshals, marineengmeers, pilots, and uniformed wipers who are covered by collective bargaining agreements between theCity of New York and the UFA.Benefits The Plan provides preSCrIption drug, dental, optical, hearing aid. life insurance. supplementalhealth insurance, certain widows' benefits and other benefits to eligible participants and their covereddependents.Contributions - The Plan is funded by employer contributions and participants' COBRA contributions.Employer contributions are determined by collective bargaining agreements between the City of New Yorkand the UFA.
APPLICATION COMPONENTS:The terms of the plan or policy fOrln(s) for which a waiver is sought
SEE ATTACHED2. The number of individuals covered by 1I1e plan or policy form(s);
APROX1MATELY_EXCLUDING DEPENDENTS3. The annual l i m i t ( ~ ; ) and rates applicable to the plan or policy form(s),
THE PRESCRIPTION DRUG BENEF!T IS LIMITED TO f I I I PER FAMILY PERCALENDAR YEAR
4. A brief description Of why compliance with the regulations would result ill a significantdecrease in access to i)enefits for those current ly covered by the plan or policy. or a significantincrease in premiums paid by those covered by the plan or polley, along with any supportingdocumentation; and
PRESCRIPTION DRUG EXPENSES REPRESENT APPROXIMATELY_/a OFTOTAL FUND BENEFIT EXPENDITURE. AS SUCH, REMOVAL OF THE .A.NNUALBENEFIT CAP ON THE PHARMACY BENEFIT WILL NECESSITATE LARGE SCALEPLAN REDESIGN RESULTING IN COST INCREASES FOR MEMBERS, EITHER INTHE FORM OF INCREASED CO PAYS/COINSURANCE AND/OR REQUIRED MEMBERCONTRIBUTUIONS TOWARDS COVERAGE. GIVEN THAT THE FUND'S INCOME ISLIMITED TO FIXED DOLL.A,R CONTRIBUTIONS FROM THE CITY OF NEW YORK, ANDIS A SUBJECT OF COLLECTIVE BARGAINING, ELIMINATION OF THE BENEFIT CJ:\PON THE PHARMACY BENEFIT WILL HAVE AN ADVERSE IMPACT ON THE FUND'S
UFireA:000001
http:///reader/full/FIREFIGHTE.RShttp:///reader/full/FIREFIGHTE.RS7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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LONG-TERM ABILITY TO CONTINUE TO PROVIDE ITS MEMBERS WITH ACCESS TOPHARMACY BENEFITS AS WELL AS OTHER BENEFITS SUCH AS DENTAL, VISION,HEARING.
5. An attestation, signed by the plan administrator or clllef executive officer of the insurer,certifying thaI (i) the plan or policy was in force prior to September 23,2010, and (il) the applicationof restricted annual limits to the plan or policy would result in a significant decrease in access tobenefits for those currently covered by the plan or policy, or a significant increase in premiums paidby those covered by the plan or policy
I, THE UNDERSIGNED PLAN ADMINISTRATOR, CERTIFY THAT (i) THE PLANREFENCED IN THIS APPLICATION WAS IN FORCE PRIOR TO SEPTEMBER 23,2010.AND (ii) THAT THE APPLICATION OF RESTRICTED ANNUAL LIMITS TO THE PLANWOULD RESULT IN SIGNIFICANT DECREASE IN ACCESS TO BENEFITS FORTHOSE CURRENTLY COVERED BY THE PLAN. OR A SIGNIFICANT INCREASE IN::::1UM /J ~ R E D BY THE PLAN.Title: TFflJ ;;Uf..ff(.Date: -1J':> a I I ti __ ._._..__ .Phone 1 ~E-mail; Address: B ::n .R A UB ~ \.\ A N '1
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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//C|/...ty%20Benefit%20Fund%20of%20the%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/WAIVER.txt[08/15/2011 11:10:
rom: Carapella,Theresa [[email protected]]ent: Monday, November 22, 2010 2:25 PMo: HHS HealthInsurance (HHS)ubject: WAIVER
Attachments: B2_Health Book_Ch01_Security Benefits Fund_11-10.pdf;imited Plan Waiver..pdf
he attached booklet summarizes Welfare Benefits for Active and Retired Firefighters although the Waiver applicas specific to the Active Fund.
TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments to this message are intended for the
xclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intendeecipient, please notify us immediately by e-mail reply to sender or by telephone to Uniformed Firefighters Associat (212) 683-4832, and destroy all copies of this message and any attachments. Please note that any views or opiniresented in this email are solely those of the author and do not necessarily represent those of the Uniformedirefighters Association.inally, the recipient should check this email and any attachments for the presence of viruses. The company accepo liability for any damage caused by any virus transmitted by this email.
UFireA:000003
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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Pages 4 through 42 redacted for the following reasons:- - - - - - - - - - - - - - - - - - - - - - - - - - - -Exemption 4
UFireA:000004
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//C|/...ty/Uniformed%20Firefighters%20Association%20of%20New%20York%20Waiver%20Application%20Dec%209%202010.htm[08/15/2011 11:10
rom: Morales, Veronica (HHS/OCIIO)
ent: Thursday, December 09, 2010 3:02 PM
o: '[email protected]'
c: '[email protected]'; Sheer, Jennifer (HHS/OCIIO)
ubject: Uniformed Forefighters Association of New York, Waiver Application
ttachments: Waiver Application Form.xls
Dear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at:http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadshto this email address as an attachment. We will only be able to process spreadsheets that are fully comp(i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain tyour plan, please write None, and/or provide an explanation regarding why you are unable to completethat particular cell in a separate document.
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 10, 2010. Once thisnformation is received and the application is complete, it will be processed by the Department of Health and Hum
ervices (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 you.
Veronica W. Morales, J.D.U.S. Department of Health & Human ServicesOffice of Consumer Information & Insurance OversightOffice of Consumer Support
hone# (301) 492-4249mail: [email protected]
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distrib
or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
UFireA:000005
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.htmlmailto:[email protected]:[email protected]://www.hhs.gov/ociio/regulations/annual_limit_waivers.html7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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//C|/...Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Request%20for%20info%20resposne%2012.14.10.htm[08/15/2011 11:10
rom: Moultrie, Cam (HHS/OCIIO)ent: Tuesday, December 14, 2010 3:52 PM
To: Habit, Sandra (HHS/OCIIO)ubject: FW: Waiver Application for UFA Security Benefits Fund
Attachments: UFA waiver_application_form.xls
am Lynne Moultrieffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
301) 492-4174
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distribu
copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Carapella,Theresa [mailto:[email protected]]ent: Tuesday, December 14, 2010 2:54 PMo: Moultrie, Cam (HHS/OCIIO)ubject: FW: Waiver Application for UFA Security Benefits Fund
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completed
spreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why you
unable to complete that particular cell in a separate document.
SEE ATTACHED FOR COMPLETED SPREADSHEET
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140? YES, PLAN WAS IN EXISTENCE PRIOR TO MARCH
2010. PLAN IS ALSO IN COMPLIANCE WITH GRANDFATHERING PROVISIONS.
Confirm whether the plan was created pursuant to the Taft-Hartley Act. NO
lease let me know if you have questions or need anything further.
hank you.
heresa Carapella
enefits Administrator
niformed Firefighters Association
ecurity Benefit FundUFireA:000007
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//C|/...Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Request%20for%20info%20resposne%2012.14.10.htm[08/15/2011 11:10
212) 545-6960
TATEMENT OF CONFIDENTIALITY:The information contained in this electronic message and any attachments to this message are intended for the exclusive use addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify us immediately by e-mail reply to sender orephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Straub,Bob
ent: Monday, December 13, 2010 3:43 PMo: Carapella,Theresaubject: FW: Waiver Application for UFA Security Benefits Fund
rom: Moultrie, Cam (HHS/OCIIO) [mailto:[email protected]]ent: Monday, December 13, 2010 2:54 PMo: Straub,Bobc: Habit, Sandra (HHS/OCIIO)ubject: Waiver Application for UFA Security Benefits Fund
ear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act
PHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completed
spreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why youunable to complete that particular cell in a separate document.
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 15, 2010. Once th
nformation is received and the application is complete, it will be processed by the Department of Health and
uman Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision
within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the wai
ecision.
hank you.
UFireA:000008
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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//C|/...%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Additional%20info%20requested%2012.28.10.htm[08/15/2011 11:10
rom: Moultrie, Cam (HHS/OCIIO)ent: Tuesday, December 28, 2010 3:07 PM
To: Carapella,TheresaCc: Habit, Sandra (HHS/OCIIO)
ubject: RE: Waiver Application for UFA Security Benefits Fundlease provide a breakdown of individuals in each tier (column P).
hank you.
am Lynne Moultrie
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
301) 492-4174
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distribu
copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Carapella,Theresa [mailto:[email protected]]ent: Tuesday, December 14, 2010 2:54 PMo: Moultrie, Cam (HHS/OCIIO)ubject: FW: Waiver Application for UFA Security Benefits Fund
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why you
unable to complete that particular cell in a separate document.
SEE ATTACHED FOR COMPLETED SPREADSHEET
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140? YES, PLAN WAS IN EXISTENCE PRIOR TO MARCH
2010. PLAN IS ALSO IN COMPLIANCE WITH GRANDFATHERING PROVISIONS.
Confirm whether the plan was created pursuant to the Taft-Hartley Act. NO
lease let me know if you have questions or need anything further.
hank you.
heresa Carapella
UFireA:000010
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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//C|/...%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Additional%20info%20requested%2012.28.10.htm[08/15/2011 11:10
enefits Administrator
niformed Firefighters Association
ecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY:The information contained in this electronic message and any attachments to this message are intended for the exclusive use addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify us immediately by e-mail reply to sender orephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Straub,Bobent: Monday, December 13, 2010 3:43 PMo: Carapella,Theresaubject: FW: Waiver Application for UFA Security Benefits Fund
rom: Moultrie, Cam (HHS/OCIIO) [mailto:[email protected]]ent: Monday, December 13, 2010 2:54 PMo: Straub,Bobc: Habit, Sandra (HHS/OCIIO)ubject: Waiver Application for UFA Security Benefits Fund
ear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act
PHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completed
spreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why you
unable to complete that particular cell in a separate document.
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 15, 2010. Once th
nformation is received and the application is complete, it will be processed by the Department of Health and
uman Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision
within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the wai
ecision.
UFireA:000011
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//C|/...%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Additional%20info%20requested%2012.28.10.htm[08/15/2011 11:10
hank you.
am Lynne Moultrie
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
301) 492-4174
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
This information has not been publicly disclosed and may be pr ivileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copie
persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments tohis message are intended for the exclusive use of the addressee(s) and mayontain confidential or privileged information. If you are not the intendedecipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4832, and destroyll copies of this message and any attachments. Please note that any views orpinions presented in this email are solely those of the author and do notecessarily represent those of the Uniformed Firefighters Association.inally, the recipient should check this email and any attachments for theresence of viruses. The company accepts no liability for any damage caused byny virus transmitted by this email.
UFireA:000012
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//C|/...20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Reqeust%20for%20info%20response%201.6.11.htm[08/15/2011 11:10
rom: Carapella,Theresa [[email protected]]ent: Thursday, January 06, 2011 12:56 PM
To: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Waiver Application for UFA Security Benefits Fundam:
elow is the information requested
Contracts Members
ngle
amily
OTAL
hank you.
heresa Carapella
enefits Administrator
niformed Firefighters Associationecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY:The information contained in this electronic message and any attachments to this message are intended for the exclusive use addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify us immediately by e-mail reply to sender orephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Moultrie, Cam (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, December 28, 2010 3:07 PM
o: Carapella,Theresac: Habit, Sandra (HHS/OCIIO)ubject: RE: Waiver Application for UFA Security Benefits Fund
lease provide a breakdown of individuals in each tier (column P).
hank you.
am Lynne Moultrie
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
301) 492-4174
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
This information has not been publicly disclosed and may be pr ivileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copie
UFireA:000013
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//C|/...20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Reqeust%20for%20info%20response%201.6.11.htm[08/15/2011 11:10
persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Carapella,Theresa [mailto:[email protected]]
ent: Tuesday, December 14, 2010 2:54 PM
o: Moultrie, Cam (HHS/OCIIO)
ubject: FW: Waiver Application for UFA Security Benefits Fund
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completed
spreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why you
unable to complete that particular cell in a separate document.
SEE ATTACHED FOR COMPLETED SPREADSHEET
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140? YES, PLAN WAS IN EXISTENCE PRIOR TO MARCH
2010. PLAN IS ALSO IN COMPLIANCE WITH GRANDFATHERING PROVISIONS.
Confirm whether the plan was created pursuant to the Taft-Hartley Act. NO
lease let me know if you have questions or need anything further.
hank you.
heresa Carapellaenefits Administrator
niformed Firefighters Association
ecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachments to this mesre intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If yore not the intended recipient, please notify us immediately by e-mail reply to sender or by telephone to Uniformedirefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Straub,Bob
ent: Monday, December 13, 2010 3:43 PM
o: Carapella,Theresa
ubject: FW: Waiver Application for UFA Security Benefits Fund
UFireA:000014
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//C|/...20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Reqeust%20for%20info%20response%201.6.11.htm[08/15/2011 11:10
rom: Moultrie, Cam (HHS/OCIIO) [mailto:[email protected]]
ent: Monday, December 13, 2010 2:54 PM
o: Straub,Bob
c: Habit, Sandra (HHS/OCIIO)
ubject: Waiver Application for UFA Security Benefits Fund
ear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act
PHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completed
spreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why you
unable to complete that particular cell in a separate document.
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 15, 2010. Once th
nformation is received and the application is complete, it will be processed by the Department of Health and
uman Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision
within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the wai
ecision.
hank you.
am Lynne Moultrie
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
301) 492-4174
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
This information has not been publicly disclosed and may be pr ivileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copie
persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
UFireA:000015
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//C|/...20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Reqeust%20for%20info%20response%201.6.11.htm[08/15/2011 11:10
TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments tohis message are intended for the exclusive use of the addressee(s) and mayontain confidential or privileged information. If you are not the intendedecipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4832, and destroyll copies of this message and any attachments. Please note that any views orpinions presented in this email are solely those of the author and do notecessarily represent those of the Uniformed Firefighters Association.
inally, the recipient should check this email and any attachments for theresence of viruses. The company accepts no liability for any damage caused byny virus transmitted by this email.TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments tohis message are intended for the exclusive use of the addressee(s) and mayontain confidential or privileged information. If you are not the intendedecipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4832, and destroyll copies of this message and any attachments. Please note that any views orpinions presented in this email are solely those of the author and do notecessarily represent those of the Uniformed Firefighters Association.inally, the recipient should check this email and any attachments for theresence of viruses. The company accepts no liability for any damage caused byny virus transmitted by this email.
UFireA:000016
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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
(mm/dd/yyyy)
Contact
Name
Street
Address City State Zip Code
Phone
Number
(including
area code)
Address
C
(e.
Be
Rx o
Security
Benefit Fund
of the
Uniformed
Firefighters
Association
of New York
City
Security
Benefit Fund
of the
Uniformed
Firefighters
Association of
New York City New York NY 07/01/2011
Robert
Straub
204 East
23rd Street New York NY 10010
212-545-
6975
bstraub@ufa
nyc.org
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name Ambulatory Emergency Hospitalization Laboratory Pediatric
Maternity/
Newborn
Mental Health/
Substance
Abuse
Rehabilitative/
Devices
Pre
We
Current Essential Benefits Annual Limits (Annual Limi t for Each Essential Benefit)
Security
Benefit Fund
of the
Uniformed
Firefighters
Association
of New York
City
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ANNUAL LIMIT WAIVER APPLICATION
Annual
Limit Waiver
Request
App lic ant
Name
Coinsuran
ce (if
applicable)
Individual/ Employee
Tier*
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Employer
contribution
(if applicable) Total
Employee
contribution
(if applicable)
Em
con
(if ap
Projected Rate Inc
from compliance wit
Restriction (in doll
by In
Current Monthly Premium Rates or
Premium Equivalent Rates (in dol lars)*:
x
ninsurance
Renewal Monthl y Premium Rates or
Premium Equivalent Rates if Waiver Granted
(in dollars)*
Security
Benefit Fund
of the
Uniformed
Firefighters
Association
of New York
City n/a Individual
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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rom: Carapella,Theresa [[email protected]]ent: Monday, January 10, 2011 9:32 AM
To: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)Cc: Straub,Bob; Eustace, John; Spollen,Jim
ubject: RE: Waiver Application for UFA Security Benefits Fund
rom: Carapella,Theresaent: Thursday, January 06, 2011 12:56 PMo: 'Moultrie, Cam (HHS/OCIIO)'; '[email protected]'
ubject: RE: Waiver Application for UFA Security Benefits Fund
am:
elow is the information requested
Contracts Members
ngle
amily
OTAL
hank you.
heresa Carapella
enefits Administrator
niformed Firefighters Association
ecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY:The information contained in this electronic message and any attachments to this message are intended for the exclusive use addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify us immediately by e-mail reply to sender orephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Moultrie, Cam (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, December 28, 2010 3:07 PMo: Carapella,Theresac: Habit, Sandra (HHS/OCIIO)ubject: RE: Waiver Application for UFA Security Benefits Fund
lease provide a breakdown of individuals in each tier (column P).
hank you.
am Lynne Moultrie
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
301) 492-4174
UFireA:000020
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
This information has not been publicly disclosed and may be pr ivileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copie
persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Carapella,Theresa [mailto:[email protected]]
ent: Tuesday, December 14, 2010 2:54 PM
o: Moultrie, Cam (HHS/OCIIO)
ubject: FW: Waiver Application for UFA Security Benefits Fund
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completed
spreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why you
unable to complete that particular cell in a separate document.SEE ATTACHED FOR COMPLETED SPREADSHEET
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140? YES, PLAN WAS IN EXISTENCE PRIOR TO MARCH
2010. PLAN IS ALSO IN COMPLIANCE WITH GRANDFATHERING PROVISIONS.
Confirm whether the plan was created pursuant to the Taft-Hartley Act. NO
lease let me know if you have questions or need anything further.
hank you.
heresa Carapella
enefits Administrator
niformed Firefighters Association
ecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachments to this mesre intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If yore not the intended recipient, please notify us immediately by e-mail reply to sender or by telephone to Uniformedirefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Straub,Bob
ent: Monday, December 13, 2010 3:43 PMUFireA:000021
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o: Carapella,Theresa
ubject: FW: Waiver Application for UFA Security Benefits Fund
rom: Moultrie, Cam (HHS/OCIIO) [mailto:[email protected]]
ent: Monday, December 13, 2010 2:54 PM
o: Straub,Bobc: Habit, Sandra (HHS/OCIIO)
ubject: Waiver Application for UFA Security Benefits Fund
ear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act
PHS Act) Section 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html. Please return the completedspreadsheet to this email address as an attachment. We will only be able to process spreadsheets tha
are fully complete (i.e., every cell should contain the information requested). If a cell on the spreadsh
does not pertain to your plan, please write None, and/or provide an explanation regarding why you
unable to complete that particular cell in a separate document.
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 15, 2010. Once th
nformation is received and the application is complete, it will be processed by the Department of Health and
uman Services (HHS). As stated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision
within 30 days of receiving a complete application. You will receive an e-mail from HHS notifying you of the wai
ecision.
hank you.
am Lynne Moultrie
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
301) 492-4174
UFireA:000022
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
This information has not been publicly disclosed and may be pr ivileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copie
persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments tohis message are intended for the exclusive use of the addressee(s) and mayontain confidential or privileged information. If you are not the intendedecipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4832, and destroyll copies of this message and any attachments. Please note that any views orpinions presented in this email are solely those of the author and do notecessarily represent those of the Uniformed Firefighters Association.inally, the recipient should check this email and any attachments for theresence of viruses. The company accepts no liability for any damage caused byny virus transmitted by this email.TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments tohis message are intended for the exclusive use of the addressee(s) and mayontain confidential or privileged information. If you are not the intended
ecipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4832, and destroyll copies of this message and any attachments. Please note that any views orpinions presented in this email are solely those of the author and do notecessarily represent those of the Uniformed Firefighters Association.inally, the recipient should check this email and any attachments for theresence of viruses. The company accepts no liability for any damage caused byny virus transmitted by this email.
UFireA:000023
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//C|/...und%20of%20the%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Correspondence%201.11.11.htm[08/15/2011 11:10
rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 11, 2011 11:39 AM
To: '[email protected]'Cc: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO); Morales, Veronica (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Applicationi Theresa
have checked with my colleagues and we did receive your spreadsheet and the supplemental information submitted on J
, 2011 (the number of individuals in each tier). At this time, we do not require additional information; however, furthernformation may be requested during the processing of your application.
omeone from this office should be in touch with you next week.
ood luck with the snowstorm.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight.S. Department of Health and Human Services
01-492-4487
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)ent: Monday, January 10, 2011 4:27 PMo: '[email protected]'c: '[email protected]'ubject: Uniformed Firefighters Association of New York, Waiver Application
ello
n Dec. 9, 2010, my colleague Veronica Morales sent you the email below (please see below my signature for the original
message). We have not yet received a reply regarding this information request. Without your reply, we are unable to proc
our application for an annual limit waiver. Please provide the requested information by 5pm Tuesday, January 11, 2011.
lease feel free to email or call me if you have any questions.
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance OversightUFireA:000024
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.S. Department of Health and Human Services
01-492-4487
ORINGAL MESSAGE]
rom: Morales, Veronica (HHS/OCIIO)
ent: Thursday, December 09, 2010 3:02 PM
o: '[email protected]'
c: '[email protected]'; Sheer, Jennifer (HHS/OCIIO)
ubject: Uniformed Forefighters Association of New York, Waiver Application
ttachments: Waiver Application Form.xls
ear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act
ection 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at:http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadshto this email address as an attachment. We will only be able to process spreadsheets that are fully comp(i.e., every cell should contain the information requested). If a cell on the spreadsheet does not pertain tyour plan, please write None, and/or provide an explanation regarding why you are unable to completethat particular cell in a separate document.
II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 10, 2010. Once this informa
received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). A
tated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complet
pplication. You will receive an e-mail from HHS notifying you of the waiver decision.
hank you.
Veronica W. Morales, J.D.U.S. Department of Health & Human ServicesOffice of Consumer Information & Insurance OversightOffice of Consumer Support
hone# (301) 492-4249mail: [email protected]
UFireA:000025
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.htmlmailto:[email protected]:[email protected]://www.hhs.gov/ociio/regulations/annual_limit_waivers.html7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
26/64
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
UFireA:000026
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//C|/...it%20Fund%20of%20the%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Question%201.11.11.htm[08/15/2011 11:10
rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 11, 2011 8:20 AM
To: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: Uniformed Firefighters Association of NYCi
ust wanted to check on who is handling this application. Veronica Morales had this in her set of waivers, and she passed
me when she left on annual leave. I was told that there was no response from this organization. I have since spoken with
heresa Carapella, who said she has been in contact with you two regarding her application. Could you please let me knowhis should be on your to do list or mine? Theyre hoping to hear if the application is complete or a request for more info
efore the storm hits this evening (since they are anticipating not being in the office tomorrow due to weather conditions
ke to get back to them with that much today, since the confusion on our end has led to some worries on their side. Pleas
me know how to proceed (and if you reply to Theresa about the application status, can you CC me?).
hanks.
en
--------------------------------ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
UFireA:000027
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//C|/...%20of%20the%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Additional%20info%201.18.11.htm[08/15/2011 11:10:
rom: Moultrie, Cam (HHS/OCIIO)ent: Tuesday, January 18, 2011 10:54 AM
To: Sheer, Jennifer (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of NYCbelieve Veronica was handling this application. I had received a redundant copy of the application and turned it back ove
eronica.
am Lynne Moultrie
ffice of Consumer Information and Insurance Oversight.S. Department of Health and Human Services
301) 492-4174
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distribut
copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 11, 2011 8:20 AMo: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: Uniformed Firefighters Association of NYC
i
ust wanted to check on who is handling this application. Veronica Morales had this in her set of waivers, and she passed
me when she left on annual leave. I was told that there was no response from this organization. I have since spoken with
heresa Carapella, who said she has been in contact with you two regarding her application. Could you please let me knowhis should be on your to do list or mine? Theyre hoping to hear if the application is complete or a request for more info
efore the storm hits this evening (since they are anticipating not being in the office tomorrow due to weather conditions
ke to get back to them with that much today, since the confusion on our end has led to some worries on their side. Pleas
me know how to proceed (and if you reply to Theresa about the application status, can you CC me?).
hanks.
en
--------------------------------ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
UFireA:000028
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
UFireA:000029
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//C|/...0the%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Additional%20info%20needed%201.18.11.txt[08/15/2011 11:10
rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 18, 2011 11:08 AMo: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of NYC
Ok, then I guess it's in my pile now. Sandra, it looks like you saved the relevant emails/materials onto the G-drive; ave any questions, I hope you won't mind if I email you (since from what I can tell this applicant sent everything ou and Cam). Thanks.
en---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
[email protected]_______________________________________rom: Moultrie, Cam (HHS/OCIIO)ent: Tuesday, January 18, 2011 10:53 AM
o: Sheer, Jennifer (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of NYC
believe Veronica was handling this application. I had received a redundant copy of the application and turned it bver to Veronica.
Cam Lynne MoultrieOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services301) [email protected]
NFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:his information has not been publicly disclosed and may be privileged and confidential. It is for internal governmse only and must not be disseminated, distributed, or copied to persons not authorized to receive the information.
Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 11, 2011 8:20 AM
o: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: Uniformed Firefighters Association of NYC
Hi
just wanted to check on who is handling this application. Veronica Morales had this in her set of waivers, and sheassed it to me when she left on annual leave. I was told that there was no response from this organization. I have spoken with Theresa Carapella, who said she has been in contact with you two regarding her application. Could yolease let me know if this should be on your to do list or mine? Theyre hoping to hear if the application is complerequest for more info before the storm hits this evening (since they are anticipating not being in the office tomorrue to weather conditions). Id like to get back to them with that much today, since the confusion on our end has le
UFireA:000030
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ome worries on their side. Please let me know how to proceed (and if you reply to Theresa about the applicationtatus, can you CC me?).
hanks.
en
---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
NFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal governm
se only and must not be disseminated, distributed, or copied to persons not authorized to receive the information.Unauthorized disclosure may result in prosecution to the full extent of the law.
UFireA:000031
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//C|/...20Assoc%20of%20New%20York%20City/Follow%20up%20to%20Additional%20info%20needed%20Jan%2018%202011.txt[08/15/2011 11:10:
rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 18, 2011 11:08 AMo: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of NYC
Ok, then I guess it's in my pile now. Sandra, it looks like you saved theelevant emails/materials onto the G-drive; if I have any questions, I hopeou won't mind if I email you (since from what I can tell this applicant sent
verything to you and Cam). Thanks.
en---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department ofHealth and Human Services
[email protected]_______________________________________
rom: Moultrie, Cam (HHS/OCIIO)ent: Tuesday, January 18, 2011 10:53 AMo: Sheer, Jennifer (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of NYC
believe Veronica was handling this application. I had received a redundantopy of the application and turned it back over to Veronica.
Cam Lynne MoultrieOffice of Consumer Information and Insurance Oversight U.S. Department ofHealth and Human Services
301) [email protected]
NFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:his information has not been publicly disclosed and may be privileged andonfidential. It is for internal government use only and must not beisseminated, distributed, or copied to persons not authorized to receive the
nformation. Unauthorized disclosure may result in prosecution to the fullxtent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 11, 2011 8:20 AMo: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: Uniformed Firefighters Association of NYC
Hi
just wanted to check on who is handling this application. Veronica Morales
UFireA:000032
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rom: Scelzo, Kathleen (HHS/OCIIO)ent: Tuesday, January 25, 2011 12:09 PM
To: Habit, Sandra (HHS/OCIIO)ubject: FW: Uniformed Firefighters Association of New York, Waiver Application
athleen M. Scelzo, RN, MSN
ules Compliance Division
ffice of Insurance Oversight
ffice of Consumer Information and Insurance Oversight (OCIIO)epartment of Health and Human Services
501 Wisconsin Avenue
ethesda, MD
01-492-4121
rom: Moultrie, Cam (HHS/OCIIO)ent: Monday, January 24, 2011 2:55 PMo: Scelzo, Kathleen (HHS/OCIIO)ubject: FW: Uniformed Firefighters Association of New York, Waiver Application
forgot to send this to you. This is the conversation regarding the firefighter application that was discussed today.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distribu
copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Carapella,Theresa [mailto:[email protected]]ent: Monday, January 24, 2011 9:24 AM
o: Sheer, Jennifer (HHS/OCIIO)c: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Application
ood Morning Jennifer:
have not heard anything with regard to the status of the Waiver Application. Please advise.
hank you.
heresa Carapella
enefits Administrator
niformed Firefighters Association
ecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY:The information contained in this electronic message and any attachments to this message are intended for the exclusive use addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify us immediately by e-mail reply to sender orephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, January 11, 2011 11:39 AM
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o: Carapella,Theresac: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO); Morales, Veronica (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Application
i Theresa
have checked with my colleagues and we did receive your spreadsheet and the supplemental information submitted on J
, 2011 (the number of individuals in each tier). At this time, we do not require additional information; however, further
nformation may be requested during the processing of your application.
omeone from this office should be in touch with you next week.
ood luck with the snowstorm.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Monday, January 10, 2011 4:27 PM
o: '[email protected]'
c: '[email protected]'
ubject: Uniformed Firefighters Association of New York, Waiver Application
ello
n Dec. 9, 2010, my colleague Veronica Morales sent you the email below (please see below my signature for the original
message). We have not yet received a reply regarding this information request. Without your reply, we are unable to procour application for an annual limit waiver. Please provide the requested information by 5pm Tuesday, January 11, 2011.
lease feel free to email or call me if you have any questions.
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
UFireA:000035
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.S. Department of Health and Human Services
01-492-4487
ORINGAL MESSAGE]
rom: Morales, Veronica (HHS/OCIIO)
ent: Thursday, December 09, 2010 3:02 PM
o: '[email protected]'
c: '[email protected]'; Sheer, Jennifer (HHS/OCIIO)
ubject: Uniformed Forefighters Association of New York, Waiver Application
ttachments: Waiver Application Form.xls
ear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act
ection 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email ad
as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the
information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or 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:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 10, 2010. Once this informa
received and the application is complete, it will be processed by the Department of Health and Human Services (HHS). A
tated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complet
pplication. You will receive an e-mail from HHS notifying you of the waiver decision.
hank you.
Veronica W. Morales, J.D.U.S. Department of Health & Human ServicesOffice of Consumer Information & Insurance OversightOffice of Consumer Support
hone# (301) 492-4249mail: [email protected]
UFireA:000036
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.htmlmailto:[email protected]:[email protected]://www.hhs.gov/ociio/regulations/annual_limit_waivers.html7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
37/64
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments tohis message are intended for the exclusive use of the addressee(s) and mayontain confidential or privileged information. If you are not the intendedecipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4832, and destroyll copies of this message and any attachments. Please note that any views orpinions presented in this email are solely those of the author and do notecessarily represent those of the Uniformed Firefighters Association.inally, the recipient should check this email and any attachments for theresence of viruses. The company accepts no liability for any damage caused byny virus transmitted by this email.
UFireA:000037
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rom: Carapella,Theresa [[email protected]]ent: Monday, January 24, 2011 9:24 AM
To: Sheer, Jennifer (HHS/OCIIO)Cc: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)
ubject: RE: Uniformed Firefighters Association of New York, Waiver Applicationood Morning Jennifer:
have not heard anything with regard to the status of the Waiver Application. Please advise.
hank you.
heresa Carapella
enefits Administrator
niformed Firefighters Association
ecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY:The information contained in this electronic message and any attachments to this message are intended for the exclusive use addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify us immediately by e-mail reply to sender orephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and any attachments.
rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, January 11, 2011 11:39 AMo: Carapella,Theresac: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO); Morales, Veronica (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Application
i Theresa
have checked with my colleagues and we did receive your spreadsheet and the supplemental information submitted on J
, 2011 (the number of individuals in each tier). At this time, we do not require additional information; however, furthernformation may be requested during the processing of your application.
omeone from this office should be in touch with you next week.
ood luck with the snowstorm.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight.S. Department of Health and Human Services
01-492-4487
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
UFireA:000038
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
39/64
//C|/...und%20of%20the%20Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Status%20check%201.24.11.htm[08/15/2011 11:10
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)
ent: Monday, January 10, 2011 4:27 PM
o: '[email protected]'
c: '[email protected]'
ubject: Uniformed Firefighters Association of New York, Waiver Application
ello
n Dec. 9, 2010, my colleague Veronica Morales sent you the email below (please see below my signature for the original
message). We have not yet received a reply regarding this information request. Without your reply, we are unable to proc
our application for an annual limit waiver. Please provide the requested information by 5pm Tuesday, January 11, 2011.
lease feel free to email or call me if you have any questions.
hank you.
--------------------------------
ennifer L. O. Sheer
ffice of Consumer Support
ffice of Consumer Information and Insurance Oversight
.S. Department of Health and Human Services
01-492-4487
ORINGAL MESSAGE]
rom: Morales, Veronica (HHS/OCIIO)
ent: Thursday, December 09, 2010 3:02 PM
o: '[email protected]'
c: '[email protected]'; Sheer, Jennifer (HHS/OCIIO)
ubject: Uniformed Forefighters Association of New York, Waiver Application
ttachments: Waiver Application Form.xls
ear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act
ection 2711. In order to expedite your application, please provide the following information:
I. Please complete the entire annual limits spreadsheet, [attached to the email] [and available at:
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to this email ad
as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cell should contain the
information requested). If a cell on the spreadsheet does not pertain to your plan, please write None, and/or provide an
explanation regarding why you are unable to complete that particular cell in a separate document.
UFireA:000039
http://www.hhs.gov/ociio/regulations/annual_limit_waivers.htmlhttp://www.hhs.gov/ociio/regulations/annual_limit_waivers.html7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
40/64
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II. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance with
grandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 pm, December 10, 2010. Once this informareceived and the application is complete, it will be processed by the Department of Health and Human Services (HHS). A
tated in our September 3, 2010 Sub-Regulatory Guidance, HHS will issue a decision within 30 days of receiving a complet
pplication. You will receive an e-mail from HHS notifying you of the waiver decision.
hank you.
Veronica W. Morales, J.D.U.S. Department of Health & Human ServicesOffice of Consumer Information & Insurance Oversight
Office of Consumer Supporthone# (301) 492-4249mail: [email protected]
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must n
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecu
to the full extent of the law.
TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments tohis message are intended for the exclusive use of the addressee(s) and mayontain confidential or privileged information. If you are not the intendedecipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4832, and destroyll copies of this message and any attachments. Please note that any views orpinions presented in this email are solely those of the author and do notecessarily represent those of the Uniformed Firefighters Association.inally, the recipient should check this email and any attachments for theresence of viruses. The company accepts no liability for any damage caused byny virus transmitted by this email.
UFireA:000040
mailto:[email protected]:[email protected]7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
41/64
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rom: Habit, Sandra (HHS/OCIIO)ent: Tuesday, January 25, 2011 2:51 PM
To: '[email protected]'ubject: Uniformed Firefighters Association of NYanuary 25, 2011
Dear Ms. Carapella,hank you for your information.
Your application is now complete and you will receive a determination of your application within 30 days. Take c
nd if you have any questions, please feel free to contact me.hank you,andy
andy Habit
epartment of Health and Human Services
ffice of Consumer Information and Insurance Oversight
01-492-4175
NFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly
sclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distribu
r copied to persons not authorized to receive the information. Unauthorized disclosures may result in prosecution to the full e
f the law.
UFireA:000041
mailto:[email protected]:[email protected]7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
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rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 25, 2011 7:27 AMo: Pham, Erica (HHS/OCIIO); McCune, Julie (HHS/OCIIO); Habit, Sandra
HHS/OCIIO)ubject: FW: Uniformed Firefighters Association of New York, Waiver
Application
Hello
his was one of the waivers I returned to Jane late last week (when we turned back over the waiver work). It lookshe information is on the G drive, but I did not have a chance to review it at all. Could someone please follow up wheresa?
hanks.
en---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
[email protected]_______________________________________rom: Carapella,Theresa [[email protected]]ent: Monday, January 24, 2011 9:24 AMo: Sheer, Jennifer (HHS/OCIIO)
Cc: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Application
Good Morning Jennifer:
have not heard anything with regard to the status of the Waiver Application. Please advise.
hank you.
heresa Carapellaenefits Administrator
Uniformed Firefighters Associationecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachmeno this message are intended for the exclusive use of the addressee(s) and may contain confidential or privilegednformation. If you are not the intended recipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and anyttachments.
_______________________________rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, January 11, 2011 11:39 AMo: Carapella,Theresa
UFireA:000042
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Cc: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO); Morales, Veronica (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Application
Hi Theresa
have checked with my colleagues and we did receive your spreadsheet and the supplemental information submittn Jan. 6, 2011 (the number of individuals in each tier). At this time, we do not require additional information;owever, further information may be requested during the processing of your application.
omeone from this office should be in touch with you next week.
Good luck with the snowstorm.
---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
NFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal governmse only and must not be disseminated, distributed, or copied to persons not authorized to receive the information.
Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)ent: Monday, January 10, 2011 4:27 PMo: '[email protected]'
Cc: '[email protected]'ubject: Uniformed Firefighters Association of New York, Waiver Application
Hello
On Dec. 9, 2010, my colleague Veronica Morales sent you the email below (please see below my signature for theriginal message). We have not yet received a reply regarding this information request. Without your reply, we arenable to process your application for an annual limit waiver. Please provide the requested information by 5pmuesday, January 11, 2011. Please feel free to email or call me if you have any questions.
hank you.
---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
ORINGAL MESSAGE]UFireA:000043
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rom: Morales, Veronica (HHS/OCIIO)ent: Thursday, December 09, 2010 3:02 PMo: '[email protected]'
Cc: '[email protected]'; Sheer, Jennifer (HHS/OCIIO)ubject: Uniformed Forefighters Association of New York, Waiver Application
Attachments: Waiver Application Form.xls
Dear Mr. Straub:
hank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service ActPHS Act) Section 2711. In order to expedite your application, please provide the following information:
Please complete the entire annual limits spreadsheet, [attached to the email] [and available at:ttp://www.hhs.gov/ociio/regulations/annual_limit_waivers.html]. Please return the completed spreadsheet to thismail address as an attachment. We will only be able to process spreadsheets that are fully complete (i.e., every cehould contain the information requested). If a cell on the spreadsheet does not pertain to your plan, please writeNone, and/or provide an explanation regarding why you are unable to complete that particular cell in a separateocument.
I. In addition, please provide the following information:
Confirm whether the plan was in existence prior to March 23, 2010. If so, is the plan in compliance withrandfathering provisions, pursuant to 45 CFR 147.140?
Confirm whether the plan was created pursuant to the Taft-Hartley Act.
n order to complete your application, please provide this information by 5:00 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 you.
Veronica W. Morales, J.D.
U.S. Department of Health & Human Services
Office of Consumer Information & Insurance Oversight
Office of Consumer Support
hone# (301) 492-4249
mail: [email protected]
UFireA:000044
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NFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal governmse only and must not be disseminated, distributed, or copied to persons not authorized to receive the information.
Unauthorized disclosure may result in prosecution to the full extent of the law.
TATEMENT OF CONFIDENTIALITY
he information contained in this electronic message and any attachments to this message are intended for thexclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intendeecipient, please notify us immediately by e-mail reply to sender or by telephone to Uniformed Firefighters Associat (212) 683-4832, and destroy all copies of this message and any attachments. Please note that any views or opiniresented in this email are solely those of the author and do not necessarily represent those of the Uniformedirefighters Association.inally, the recipient should check this email and any attachments for the presence of viruses. The company accep
o liability for any damage caused by any virus transmitted by this email.
UFireA:000045
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46/64
//C|/...0Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Status%20update%20response%20(1)%201.25.11.txt[08/15/2011 11:10:
rom: Habit, Sandra (HHS/OCIIO)ent: Tuesday, January 25, 2011 9:26 AMo: Sheer, Jennifer (HHS/OCIIO); Pham, Erica (HHS/OCIIO); McCune, Julie
HHS/OCIIO)Cc: Moultrie, Cam (HHS/OCIIO); Scelzo, Kathleen (HHS/OCIIO)
ubject: RE: Uniformed Firefighters Association of New York, WaiverApplication
en,
t looks like Kathleen has it but I will take the application from her so I can take care of it today. I will check the Grive to see where Veronica and Cam left off and contact Theresa with any additional questions I have.
hanks,andy
----Original Message-----rom: Sheer, Jennifer (HHS/OCIIO)ent: Tuesday, January 25, 2011 7:27 AMo: Pham, Erica (HHS/OCIIO); McCune, Julie (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)
ubject: FW: Uniformed Firefighters Association of New York, Waiver Application
Hello
his was one of the waivers I returned to Jane late last week (when we turned back over the waiver work). It lookshe information is on the G drive, but I did not have a chance to review it at all. Could someone please follow up wheresa?
hanks.
en
---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
[email protected]_______________________________________rom: Carapella,Theresa [[email protected]]ent: Monday, January 24, 2011 9:24 AMo: Sheer, Jennifer (HHS/OCIIO)
Cc: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Application
Good Morning Jennifer:
have not heard anything with regard to the status of the Waiver Application. Please advise.
hank you.
heresa Carapellaenefits Administrator
UFireA:000046
7/27/2019 Uniformed Firefighters Assn - Redacted - Bates HW
47/64
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Uniformed Firefighters Associationecurity Benefit Fund
212) 545-6960
TATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachmeno this message are intended for the exclusive use of the addressee(s) and may contain confidential or privilegednformation. If you are not the intended recipient, please notify us immediately by e-mail reply to sender or byelephone to Uniformed Firefighters Association at (212) 683-4723, and destroy all copies of this message and any
ttachments.
_______________________________rom: Sheer, Jennifer (HHS/OCIIO) [mailto:[email protected]]ent: Tuesday, January 11, 2011 11:39 AMo: Carapella,Theresa
Cc: Moultrie, Cam (HHS/OCIIO); Habit, Sandra (HHS/OCIIO); Morales, Veronica (HHS/OCIIO)ubject: RE: Uniformed Firefighters Association of New York, Waiver Application
Hi Theresa
have checked with my colleagues and we did receive your spreadsheet and the supplemental information submittn Jan. 6, 2011 (the number of individuals in each tier). At this time, we do not require additional information;owever, further information may be requested during the processing of your application.
omeone from this office should be in touch with you next week.
Good luck with the snowstorm.
---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
NFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW:
his information has not been publicly disclosed and may be privileged and confidential. It is for internal governmse only and must not be disseminated, distributed, or copied to persons not authorized to receive the information.
Unauthorized disclosure may result in prosecution to the full extent of the law.
rom: Sheer, Jennifer (HHS/OCIIO)ent: Monday, January 10, 2011 4:27 PMo: '[email protected]'
Cc: '[email protected]'ubject: Uniformed Firefighters Association of New York, Waiver Application
Hello
On Dec. 9, 2010, my colleague Veronica Morales sent you the email below (please see below my signature for theriginal message). We have not yet received a reply regarding this information request. Without your reply, we are
UFireA:000047
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48/64
//C|/...0Uniformed%20Firefighters%20Assoc%20of%20New%20York%20City/Status%20update%20response%20(1)%201.25.11.txt[08/15/2011 11:10:
nable to process your application for an annual limit waiver. Please provide the requested information by 5pmuesday, January 11, 2011. Please feel free to email or call me if you have any questions.
hank you.
---------------------------------ennifer L. O. Sheer
Office of Consumer SupportOffice of Consumer Information and Insurance Oversight U.S. Department of Health and Human Services
ORINGAL MESSAGE]
rom: Morales, Veronica (HHS/OCIIO)ent: Thursday, December 09, 2010 3:02 PMo: '[email protected]'
Cc: '[email protected]'; Sheer, Jennifer (HHS/OCIIO)
u