From: Aliakbar Esfahani [Aesfahani@odonoghuelaw.

com] Sent: Tuesday, October 12, 2010 3:40 PM To: HHS HealthInsurance (HHS) Subject: waiver

Document obtained by CompleteColorado.com

Attachments: So CA Pipe Trades - Waiver Application.pdf; So CA Pipe Trades - Waiver Application - Attachment 3.pdf; So CA Pipe Trades - Waiver Application - Attachment 2.pdf; So CA Pipe Trades - Waiver Application Attachment 1.pdf
To whom it may concern: This firm is counsel to the Southern California Pipe Trades Trust Fund (Fund). Pursuant to OCIIO Sub-Regulatory Guidance 2010-1, please find attached the Funds application and supporting materials for waiver of the restricted annual dollar limit set forth under PPACA. This waiver is for the plan year that begins on January 1, 2011. If you have any questions, please do not hesitate to contact the undersigned. Thank you, Aliakbar Esfahani, Esq. ODonoghue & ODonoghue, LLP 4748 Wisconsin Ave, NW Washington, DC 20016 (202) 274-2414 - Direct (202) 362-0041 - Main (202) 362-2640 - Fax

Co m

pl

Confidentiality Notice and Disclaimer: This e-mail is from a law firm. It may be protected by the attorney-client privilege or as attorney work-product. If you received the message by error, please notify the sender that you received it by replying to this e-mail and then delete it from you computer. Unless specifically stated otherwise in the body of the message, the content of the message is not to be construed as establishing an attorney-client relationship, if one does not otherwise exist, or as a consent to conduct business by any electronic medium.

et eC

IRS Circular 230 Disclosure: To comply with recent IRS rules, we are informing you that this communication, if it contains advice about federal taxes, is not intended or written to be used, and it cannot be used, for (1) the purpose of avoiding penalties that may be imposed under federal tax law; or (2) promoting, marketing, or recommending to another party any tax related matter addressed herein. Under these IRS rules, a taxpayer may rely on professional advice to avoid federal tax penalties only if that advice is reflected in a comprehensive tax opinion that conforms to stringent requirements under federal law.

ol o

ra do .

file:///T|/...pplications%20with%20NO%2012600%20Response%20[YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/waiver.htm[08/08/2011 4:59:18 PM]

co m

S CA Pipe:000001

Document obtained by CompleteColorado.com

et eC
Ex. 4

ol o

ra do .
Ex. 4 Ex. 4

co m Co m pl
Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4

S CA Pipe:000002

Document obtained by CompleteColorado.com

Co m

pl

et eC

ol o
Ex. 4 Ex. 4

ra do .
S CA Pipe:000003

co m

Document obtained by CompleteColorado.com

Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4 Ex. 4

Ex. 4

Ex. 4

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000004

co m

Document obtained by CompleteColorado.com

Pages 5 through 73 redacted for the following reasons: ---------------------------Exemption 4

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000005

co m

Document obtained by CompleteColorado.com

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000006

co m

From: Scelzo, Kathleen (HHS/OCIIO) Sent: Monday, November 01, 2010 1:44 PM To: 'aesfahani@odonoghue.com' Cc: Habit, Sandra (HHS/OCIIO) Subject: Southern California Pipe Trade's Waiver Application Importance: High

Document obtained by CompleteColorado.com

Attachments: Southern California Pipe Trade Waiver Application Questions.doc

Co m

pl

et eC

ol o

ra do .

Alia Kbar Esfahani, I left a message for you this afternoon alerting you about an e-mail you would receive from me concerning Southern California Pipe Trades. application for Annual Limits Requirements of the PHS Act Section 2711. Attached above is the document that needs to be completed in order to finalize the application process. Many thanks for your assistance with this document . Kathleen M. Scelzo, RN, MSN Rules Compliance Division Office of Insurance Oversight Office of Consumer Information and Insurance Oversight (OCIIO) Department of Health and Human Services 7501 Wisconsin Avenue Bethesda, MD 301-492-4121

file:///T|/...esponse%20[YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/Request%20for%20Additional%20Info%2011.1.10.htm[08/08/2011 4:59:25 PM]

co m

S CA Pipe:000007

Document obtained by CompleteColorado.com

Dear Applicant:

November 1, 2010

RE: Southern California Pipe Trades

EE

Co m

EE + Child (if applicable or other appropriate tier) EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier) 2. In Ex. 4

pl

et eC
tion in premium for the three level of participants?

ol o

ra do .

1. (The premium amounts is the total cost to the employer and the employee) Premium Premium Premium % increase if the (current level) (renewal) (if $750,000 $750,000 was annual limit was implemented applied)

co m

Thank you for your application for the Waiver of the Annual Limits Requirements of the PHS Act Section 2711. In order to complete your application, please provide the following information about the Southern California Pipe Trades:

S CA Pipe:000008

Document obtained by CompleteColorado.com

Please provide this information by 5:00 pm, November 3, 2010. We look forward to receiving your completed application. Thank you. Sincerely, Kathleen M. Scelzo, RN, MSN Rules Compliance Division Office of Insurance Oversight Office of Consumer Information and Insurance Oversight (OCIIO) Department of Health and Human Services 301-492-4121

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000009

co m

From: Aliakbar Esfahani [Aesfahani@odonoghuelaw.com] Sent: Tuesday, November 02, 2010 10:30 AM To: Scelzo, Kathleen (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO); Frank Martorana Subject: RE: Southern California Pipe Trade's Waiver Application

Document obtained by CompleteColorado.com

Attachments: SCPT H&W - OCIIO Waiver Program - Supplemental submission re premium rates.pdf
Ms. Scelzo, It was a pleasure speaking with you yesterday. Per our conversation, please find attached our responses to your inquiries. If you have any additional questions, please do not hesitate to contact us. Thank you, -Aliakbar Esfahani

Co m

Alia Kbar Esfahani, I left a message for you this afternoon alerting you about an e-mail you would receive from me concerning Southern California Pipe Trades. application for Annual Limits Requirements of the PHS Act Section 2711. Attached above is the document that needs to be completed in order to finalize the application process. Many thanks for your assistance with this document . Kathleen M. Scelzo, RN, MSN Rules Compliance Division Office of Insurance Oversight Office of Consumer Information and Insurance Oversight (OCIIO) Department of Health and Human Services 7501 Wisconsin Avenue Bethesda, MD 301-492-4121

pl

et eC

ol o

ra do .
S CA Pipe:000010

From: Scelzo, Kathleen (HHS/OCIIO) [mailto:Kathleen.Scelzo@hhs.gov] Sent: Monday, November 01, 2010 1:46 PM To: Aliakbar Esfahani Cc: Habit, Sandra (HHS/OCIIO) Subject: FW: Southern California Pipe Trade's Waiver Application Importance: High

file:///T|/...YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/Request%20for%20Additional%20Info%20Response%2011.2.10.htm[08/08/2011 4:59:59 PM]

co m

Document obtained by CompleteColorado.com

EE + Child (if applicable or other appropriate tier) EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier) *Pleasen contributingemployerscontributeanegotiatedamountaccordingtothenumber ofhoursworkedforeachparticipant.Theratesindicatedinthetableabove reflectCOBRArates,whichareapproximatelypremiumequivalentrates.

Co m

pl

et eC

ol o

ra do .

DearApplicant: RE:SouthernCaliforniaPipeTrades ThankyouforyourapplicationfortheWaiveroftheAnnualLimitsRequirementsof thePHSActSection2711.Inordertocompleteyourapplication,pleaseprovidethe followinginformationabouttheSouthernCaliforniaPipeTrades: SCPTHEALTH&WELFAREFUNDRESPONSE:Seebelow 1. (Thepremiumamountsisthetotalcosttotheemployerandtheemployee) % increase if Premium Premium Premium the $750,000 (current level) (renewal) 2011 (if $750,000 annual limit was was rate without implemented applied) -$750K PPACA annual, no adult child Ex. 4 EE

November1,2010

co m

S CA Pipe:000011

Document obtained by CompleteColorado.com

2. Indicateifthereanyvariationinpremiumforthethreelevelofparticipants? SCPTHEALTH&WELFAREFUNDRESPONSE:No,therearenovariations inpremiumsbetweenthethreelevelsofmaximumlimitsontotallifetime benefits. Ex. 4 Pleaseprovidethisinformationby5:00pm,November3,2010.Welookforwardto receivingyourcompletedapplication.Thankyou. Sincerely, KathleenM.Scelzo,RN,MSN RulesComplianceDivision OfficeofInsuranceOversight OfficeofConsumerInformationandInsuranceOversight(OCIIO) DepartmentofHealthandHumanServices 3014924121
202353_1.DOC

Co m

pl

et eC

ol o

ra do .

co m

S CA Pipe:000012

From: Scelzo, Kathleen (HHS/OCIIO) Sent: Tuesday, November 02, 2010 10:44 AM To: 'Aliakbar Esfahani' Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Southern California Pipe Trade's Waiver Application
Mr. Esfahani, Thanks for the quick response! Kathleen M. Scelzo, RN, MSN Rules Compliance Division Office of Insurance Oversight Office of Consumer Information and Insurance Oversight (OCIIO) Department of Health and Human Services 7501 Wisconsin Avenue Bethesda, MD 301-492-4121

Document obtained by CompleteColorado.com

From: Aliakbar Esfahani [mailto:Aesfahani@odonoghuelaw.com] Sent: Tuesday, November 02, 2010 10:30 AM To: Scelzo, Kathleen (HHS/OCIIO) Cc: Habit, Sandra (HHS/OCIIO); Frank Martorana Subject: RE: Southern California Pipe Trade's Waiver Application

Alia Kbar Esfahani, I left a message for you this afternoon alerting you about an e-mail you would receive from me concerning Southern California Pipe Trades. application for Annual Limits Requirements of the PHS Act Section 2711. Attached above is the document that needs to be completed in order to finalize the application process. Many thanks for your assistance with this document . Kathleen M. Scelzo, RN, MSN Rules Compliance Division Office of Insurance Oversight Office of Consumer Information and Insurance Oversight (OCIIO) Department of Health and Human Services 7501 Wisconsin Avenue
S CA Pipe:000013

file:///T|/...20NO%2012600%20Response%20[YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/Correspondence%2011.2.10.htm[08/08/2011 5:00:00 PM]

Co m

From: Scelzo, Kathleen (HHS/OCIIO) [mailto:Kathleen.Scelzo@hhs.gov] Sent: Monday, November 01, 2010 1:46 PM To: Aliakbar Esfahani Cc: Habit, Sandra (HHS/OCIIO) Subject: FW: Southern California Pipe Trade's Waiver Application Importance: High

pl

et eC

Ms. Scelzo, It was a pleasure speaking with you yesterday. Per our conversation, please find attached our responses to your inquiries. If you have any additional questions, please do not hesitate to contact us. Thank you, -Aliakbar Esfahani

ol o

ra do .

co m

Bethesda, MD 301-492-4121

Document obtained by CompleteColorado.com

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000014

file:///T|/...20NO%2012600%20Response%20[YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/Correspondence%2011.2.10.htm[08/08/2011 5:00:00 PM]

co m

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Tuesday, November 23, 2010 8:25 AM To: 'Aesfahani@odonoghuelaw.com' Subject: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High Attachments: Updated Jan 1 Approval Letter .pdf Good Morning, Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section for Southern CA Pipe Trade Fund Plan. 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 address with a copy to OCIIOOversight@hhs.gov. Please let me know if I can be of further assistance. Sincerely

Document obtained by CompleteColorado.com

alexandra.botwinick@hhs.gov

et eC Co m pl

ol o

Alexandra Botwinick Office of Oversight HHS/OCIIO

ra do .

file:///T|/...0%20Response%20[YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/Approval%20Letter%20Sent%2011-23-2010.htm[08/08/2011 5:00:01 PM]

co m

S CA Pipe:000015

Document obtained by CompleteColorado.com

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000016

co m

Document obtained by CompleteColorado.com

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000017

co m

From: Aliakbar Esfahani [Aesfahani@odonoghuelaw.com] Sent: Tuesday, November 23, 2010 9:22 AM To: Botwinick, Alexandra (HHS/OCIIO) Cc: OCIIO Oversight; Frank Martorana Subject: RE: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Follow Up Flag: Follow up Flag Status: Red
Ms. Botwinick, My name is Aliakbar Esfahani, and I am an associate at the law firm of ODonoghue & ODonoghue, LLP. This firm is counsel to the Southern California Pipe Trades Trust Fund (Fund). We are in receipt of your letter indicating the Fund has been approved for waiver of the PPACA restricted annual limits requirement for the 2011 Plan Year. Thank you very much. Also, please note that as of November 29, 2010, I will no longer be affiliated with ODonoghue & ODonoghue. All future correspondences concerning the Fund should be sent to Francis J. Martorana, who is the lead counsel for the Fund. His email address is fmartorana@odonoghuelaw.com. Sincerely, Aliakbar Esfahani ODonoghue & ODonoghue, LLP (202) 362-0041
From: Botwinick, Alexandra (HHS/OCIIO) [mailto:Alexandra.Botwinick@hhs.gov] Sent: Tuesday, November 23, 2010 8:25 AM To: Aliakbar Esfahani Subject: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High

Document obtained by CompleteColorado.com

Good Morning, Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section for Southern CA Pipe Trade Fund Plan. 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 address with a copy to OCIIOOversight@hhs.gov. Please let me know if I can be of further assistance. Sincerely

Alexandra Botwinick Office of Oversight HHS/OCIIO

alexandra.botwinick@hhs.gov

Co m

pl

et eC

ol o

ra do .

file:///T|/...Response%20[YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/Confirmation%20of%20Approval%2011-29-2010.htm[08/08/2011 5:00:01 PM]

co m

S CA Pipe:000018

Document obtained by CompleteColorado.com

Co m

pl

et eC

ol o

ra do .
S CA Pipe:000019

file:///T|/...Response%20[YELLOW]/Southern%20CA%20Pipe%20Trades%20Fund/Confirmation%20of%20Approval%2011-29-2010.htm[08/08/2011 5:00:01 PM]

co m