Co m pl et eC ol o ra do .

co m

ANDERSON:000001

(b)(4)

pl

Co m

et eC
(b)(4)

ol o
(b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) (b)(4) ANDERSON:000002

ra do .

co m

(b)(4) (b)(4) (b)(4) (b)(4) (b)(4)

(b)(4)

(b)(4)

Co m

pl

et eC
(b)(4)

ol o
ANDERSON:000003

ra do .

(b)(4)

co m

Co m pl et eC ol o ra do . co m

ANDERSON:000004

Pages 5 through 23 redacted for the following reasons: ---------------------------Exemption (b)(4)

Co m

pl

et eC

ol o
ANDERSON:000005

ra do .

co m

Dear Applicant:

November 16, 2010

RE: Anderson Media Corporation

1. Effective date of policy. July 1, 2010 Prescription Other

3. Type of Plan: Limited Benefit Comprehensive

EE + Child (if applicable or other appropriate tier) EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier)

Not applicable

Co m

pl

Not applicable

et eC

4. (The premium amounts is the total cost to the employer and the employee) Bronze Plans Premium Premium Premium % increase if the (Current) (renewal Projected) (if $750,000 $750,000 was annual limit implemented was applied) EE (b)(4) (b)(4) (b)(4)

ol o

ra do .
HRA
(b)(4)

2. Indicate is this is a Group or Individual policy. Group policy

(b)(4)

5. Indicate if this plan has Grandfather Status. Yes, Grandfathered

co m
(b)(4)

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 Anderson Media Corporation Bronze Plans:

ANDERSON:000006

Please provide this information by 5:00 pm Thursday November 18, 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
ANDERSON:000007

ra do .

co m

Dear Applicant:

November 16, 2010

RE: Anderson Media Corporation

1. Effective date of policy. July 1, 2010 Prescription Other

3. Type of Plan: Limited Benefit Comprehensive

EE + Child (if applicable or other appropriate tier) EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier)

Not applicable

Co m

pl

Not applicable

et eC
(b)(4)

4. (The premium amounts is the total cost to the employer and the employee) Silver Plans Premium Premium Premium % increase if the (Current) (renewal Projected) (if $750,000 $750,000 was annual limit implemented was applied) EE (b)(4) (b)(4) (b)(4)

ol o

5. Indicate if this plan has Grandfather Status. Yes, Grandfathered

ra do .
HRA
(b)(4)

2. Indicate is this is a Group or Individual policy. Group policy

co m
(b)(4)

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 Anderson Media Corporation Silver Plans:

ANDERSON:000008

Please provide this information by 5:00 pm Thursday November 18, 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
ANDERSON:000009

ra do .

co m

Dear Applicant:

November 16, 2010

RE: Anderson Media Corporation

1. Effective date of policy.

3. Type of Plan: Limited Benefit Comprehensive

Prescription Other

EE + Child (if applicable or other appropriate tier) EE + Spouse (if applicable or other appropriate tier) Family (if applicable or other appropriate tier)

Co m

5. Indicate if this plan has Grandfather Status.

pl

et eC

EE

ol o

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

ra do .
HRA

2. Indicate is this is a Group or Individual policy.

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 Anderson Media Corporation:

ANDERSON:000010

Please provide this information by 5:00 pm Thursday November 18, 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
ANDERSON:000011

ra do .

co m

From: Donna Norris [norrisd@amerch.com] Sent: Monday, December 06, 2010 8:45 AM To: Botwinick, Alexandra (HHS/OCIIO) Cc: OCIIO Oversight Subject: Re: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Follow Up Flag: Follow up Flag Status: Red Good Morning,

On Mon, Dec 6, 2010 at 8:30 AM, Botwinick, Alexandra (HHS/OCIIO) <Alexandra.Botwinick@hhs.gov> wrote: Good Morning,

Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Anderson Media Corporation. 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
ANDERSON:000012

file:////co-adshare/...%20Processing%20Team/Desiree/Anderson%20Media%20Corporation/Confirmation%2012-6-2010.htm[10/27/2011 2:57:47 PM]

Co m

pl

et eC

ol o

ra do .

Sincerely, Donna Norris Corporate Benefit Manager

co m

Thank you for the favorable response to our applications for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Anderson Media Corporation's Bronze and Silver Medical plans.

Office of Oversight HHS/OCIIO

alexandra.botwinick@hhs.gov

Co m

pl

et eC

********************************************************************* The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material including attached files, from any computer. *******************************************************************************

ol o

ra do .

-Donna Norris Anderson Merchandisers 727-771-6391 727-785-9082 fax

file:////co-adshare/...%20Processing%20Team/Desiree/Anderson%20Media%20Corporation/Confirmation%2012-6-2010.htm[10/27/2011 2:57:47 PM]

co m
ANDERSON:000013

Co m pl et eC ol o ra do . co m

ANDERSON:000014

Co m pl et eC ol o ra do . co m

ANDERSON:000015

From: Scelzo, Kathleen (HHS/OCIIO) Sent: Friday, November 19, 2010 8:04 AM To: Habit, Sandra (HHS/OCIIO) Subject: FW: Anderson Media Corporation Waiver Application Attachments: Anderson Media Corporation Waiver Application Questions- Silver Plans.docx; Anderson Media Corporation Waiver Application Questions- Bronze Plans.docx
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

From: Donna Norris [mailto:norrisd@amerch.com] Sent: Wednesday, November 17, 2010 11:10 AM To: Scelzo, Kathleen (HHS/OCIIO) Subject: Re: Anderson Media Corporation Waiver Application

Ms. Scelzo:

Please find attached the requested information for Anderson Media Corporation's Limited Waiver Application. We look forward to receiving your final determination and trust we have presented everything necessary to support a favorable response to our application. Please do not hesitate to contact me should you require anything additional. Best regards, Donna Norris norrisd@amerch.com 727-771-6391 727-785-9082 fax

********************************************************************* The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material including attached files, from any computer. ******************************************************************************* On Tue, Nov 16, 2010 at 11:24 AM, Scelzo, Kathleen (HHS/OCIIO) <Kathleen.Scelzo@hhs.gov> wrote:

Donna Norris Thanks for talking with me yesterday afternoon about your Limited Waiver Application. Attached above is the document that needs to be completed in order to finalize the application process concerning Anderson Media Corporation application for Annual Limits Requirements of the PHS Act Section 2711.
ANDERSON:000016

file:////co-adshare/...eam/Desiree/Anderson%20Media%20Corporation/reqeust%20for%20additional%20info%20response%2011.19.10.htm[10/27/2011 2:57:48 PM]

Co m

pl

et eC

ol o

ra do .

co m

 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

Co m

pl

et eC

ol o
ANDERSON:000017

file:////co-adshare/...eam/Desiree/Anderson%20Media%20Corporation/reqeust%20for%20additional%20info%20response%2011.19.10.htm[10/27/2011 2:57:48 PM]

ra do .

co m

From: Scelzo, Kathleen (HHS/OCIIO) Sent: Tuesday, November 16, 2010 11:25 AM To: 'norrisd@amerch.com' Cc: Habit, Sandra (HHS/OCIIO) Subject: Anderson Media Corporation Waiver Application Importance: High Attachments: Anderson Media Corporation Waiver Application Questions.doc
Donna Norris Thanks for talking with me yesterday afternoon about your Limited Waiver Application. Attached above is the document that needs to be completed in order to finalize the application process concerning Anderson Media Corporation application for Annual Limits Requirements of the PHS Act Section 2711. 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

Co m

pl

et eC

ol o
ANDERSON:000018

file:////co-adshare/...cessing%20Team/Desiree/Anderson%20Media%20Corporation/Request%20for%20additional%20info%2011.16.10.htm[10/27/2011 2:57:48 PM]

ra do .

co m

From: Botwinick, Alexandra (HHS/OCIIO) Sent: Monday, December 06, 2010 8:31 AM To: 'norrisd@amerch.com' Subject: Waiver of the Annual Limits Requirements of PHS Act Section 2711 Importance: High Attachments: July 1 .pdf Good Morning, Thank you for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Anderson Media Corporation. 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,

et eC pl

alexandra.botwinick@hhs.gov

Co m

ol o

ANDERSON:000019

Alexandra Botwinick Office of Oversight HHS/OCIIO

file:////co-adshare/...%20Processing%20Team/Desiree/Anderson%20Media%20Corporation/Approval%20Letter%20Sent%2012-6-2010.htm[10/27/2011 2:57:49 PM]

ra do .

co m