Horizon BCBS New Jersey - Redacted HWM

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Pages 4 through 68 redacted for the following reasons: --------------------------------------------------Exemption 4
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Please create a folder on the G drive for this applicant. They originally submitted to the wrong address (heathinsurance@hhs.gov).
Dear Ms. Kottenmeier,
If you have any questions, please do not hesitate to contact me. Thank you very much for your assistance .
Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
----- Forwarded by Jill Swyernovak/BCBSNJ on 12/22/2010 12:23 PM ----From: Jill Swyernovak/BCBSNJ To: heathinsurance@hhs.gov Cc: Colleen Brennan/BCBSNJ@BCBSNJ, Adam Young/BCBSNJ@BCBSNJ, Edward Mailander/BCBSNJ@BCBSNJ, Robert E Meehan/BCBSNJ@BCBSNJ, Peter Morey/BCBSNJ@BCBSNJ, Ellen.DeRosa@dobi.state.nj.us, neil.sullivan@dobi.state.nj.us
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Sincerely, Jill Swyer Novak
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In response to your request that Horizon Blue Cross Blue Shield of New Jersey resubmit its waiver filing directly to you, I have included the original email containing the filing (below). I have also attached the new filing form that you requested. This filing pertains to an individual product.
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From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Wednesday, December 22, 2010 1:26 PM To: Pham, Erica (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM; Edward_Mailander@horizonblue.com; Robert_E_Meehan@horizon-bcbsnj.com; Peter_Morey@horizonblue.com; Sandi_L_Kelly@horizon-bcbsnj.com; Kristen_A_Jarosz@horizon-bcbsnj.com Subject: Fw: Horizon Blue Cross Blue Shield of New Jersey Waiver Filing
file:///T|/...20New%20Jersey/FW%20Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Filing.htm[10/25/2011 12:45:17 PM]
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From: Pham, Erica (HHS/OCIIO) Sent: Wednesday, December 22, 2010 1:31 PM To: Gary, Lapreea (HHS/OCIIO) Subject: FW: Horizon Blue Cross Blue Shield of New Jersey Waiver Filing Attachments: Letter and Application.pdf; EXHIBIT 1 B&E Plus Plan Waiver Filing.doc; Exhibit 1A - B&E EPO Plan.doc; Exhibit 1B - IHC B&E Products 10-27-2010.xls; Exhibit 1C- Rate Information.xls; Exhibit 2 CEO Attestation.pdf; Copy of waiver_application_form.xls Follow Up Flag: Follow up Flag Status: Flagged
HBCBSNJ:000006
Date: 11/02/2010 05:12 PM Subject: Horizon Blue Cross Blue Shield of New Jersey Waiver Filing
Dear Mr. Mayhew: I am writing on behalf of Horizon Blue Cross Blue Shield of New Jersey to submit its application for a waiver from restricted annual limits on the dollar value of essential benefits for Horizon BCBSNJ's Basic and Essential EPO Plus plan. Please see the attached letter and application, supporting exhibits and. CEO attestation.
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This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000007
file:///T|/...20New%20Jersey/FW%20Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Filing.htm[10/25/2011 12:45:17 PM]
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Sincerely, Jill Swyer Novak, Esq.
ANNUAL LIMIT WAIVER APPLICATION 2010
Annual Limit Waiver Request Applicant Name Applicant ABC
Policy Name (use a new row for each Applicant (Plan/ Policy policy application) Situs) City Plan 1 Washington
Applicant (Plan/ Plan/ Policy Policy Effective Date Contact Situs) (mm/dd/yyyy) Name State DC 01/01/2011 Jane Doe
Street Address 100 ABC Drive
City Washington
State DC
Phone Number (including Email Zip Code area code) Address 1-800-ABC- abc@abchea 20201 1234 lthplan.com Limited Benefit
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Yes No
Total Number of Individuals Current Covered by Type of Plan Overall Policy Coverage Annual (include all Self(e.g., Limited Limit (in Benefit, HRA, Insured Individual or dependents dollars) Rx only, Other) (Yes/No) Group Policy covered) Group
Ex. 4
NJ
09/23/2010
Jill Swyer Novak
Three Penn Plaza East, PP 16F,
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Horizon Healthcare Services, Inc. d/b/a Horizon Blue Cross Blue Shield of New Jersey Basic & Essential EPO Plus
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Newark NJ jill_swyernov 1-973-466- ak@horizonb lue.com Limited Benefit 7421 Individual
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1105. The time required to complete this information collection is estimated to average ( 8 hours) or ( 240 minutes) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.
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PRA Disclosure Statement
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Ambulatory
Emergency
Hospitalization
Laboratory
Pediatric
Maternity/ Newborn
Mental Health/ Substance Abuse
Rehabilitative/ Devices
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Preventive/ Wellness Prescription
Current Essential Benefits Annual Limits (Annual Limit for Each Essential Benefit)
Office Visit Hospital Inpatient Emergency Room Rx Copays/Coinsurance Copay/Coinsurance Copay/Coinsurance Copay/Coninsurance
Coinsura Coinsura Copay (if Coinsuranc Copay (if nce (if Copay (if nce (if Copay (if Coinsuran ce (if applicabl applicabl applicabl applicabl applicabl e (if applicabl Plan applicable) e) e) e) e) e) applicable) e) Deductible
Ex. 4
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Total
Current Monthly Premium Rates or Premium Equivalent Rates (in dollars)*:
Projected Rate Increase that would result Renewal Monthly Premium Rates or from compliance with $750,000 Annual Limit Premium Equivalent Rates if Waiver Granted Restriction (in dollars) (Average Premium (in dollars)* by Individual)*
Employer Employee Individual/ Employee contribution contribution (if applicable) (if applicable) Tier*
Total
Employer Employee contribution contribution (if applicable) (if applicable)
Total
Employer Employee contribution contribution (if applicable) (if applicable)
Decrease in Access to Benefits that Projected Rate Increase would result that would result from from compliance with $750,000 compliance Annual Limit Restriction with $750,000 (in dollars)(Average Annual Limit Premium by Individual) Restriction (Difference of Column AT (describe and AQ divided by briefly in cell Column AQ) or in a
Plan Administr ator/ CEO of Health Insuranc e Issuer Name Jane Doe
Title of Individual Providing Attestation Plan Administrator
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William J. Marino
CEO
* When completing the columns requesting premium rate information, please express the premium rates as a composite rate (if premiums are a range based on years of service or age) and by tier (Employee, Employee + Spouse, Employee + Child, Family, etc.) as applicable. If you are an issuer, please provide the premium amount in the column titled, "Total" (Column AN, AQ and AT).
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HBCBSNJ:000010
From: Pham, Erica (HHS/OCIIO) Sent: Wednesday, December 22, 2010 3:14 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: 'Adam_Young@horizonblue.com'; 'Colleen_Brennan@Horizon-BCBSNJ.COM'; 'Edward_Mailander@horizonblue.com'; 'Robert_E_Meehan@horizon-bcbsnj.com'; 'Peter_Morey@horizonblue.com'; 'Sandi_L_Kelly@horizon-bcbsnj.com'; 'Kristen_A_Jarosz@horizon-bcbsnj.com' Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Waiver Filing
Dear Ms. Swyer Novak: HHS is in receipt of your application, We will review and process this application. We note that we did not receive your original application submitted on November 2 because it appears it was sent to an incorrect address, heathinsurance@hhs.gov rather than healthinsurance@hhs.gov. Thank you and happy holidays, Erica Erica Pham Division of Enforcement Office of Oversight OCIIO/HHS 301-492-4108 erica.pham@hhs.gov From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Wednesday, December 22, 2010 1:26 PM To: Pham, Erica (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM; Edward_Mailander@horizonblue.com; Robert_E_Meehan@horizon-bcbsnj.com; Peter_Morey@horizonblue.com; Sandi_L_Kelly@horizon-bcbsnj.com; Kristen_A_Jarosz@horizon-bcbsnj.com Subject: Fw: Horizon Blue Cross Blue Shield of New Jersey Waiver Filing
Dear Ms. Kottenmeier,
If you have any questions, please do not hesitate to contact me. Thank you very much for your assistance . Sincerely, Jill Swyer Novak
Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are
HBCBSNJ:000011
file:///T|/...ng%20Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%2012.22.10.htm[10/25/2011 12:45:17 PM]
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In response to your request that Horizon Blue Cross Blue Shield of New Jersey resubmit its waiver filing directly to you, I have included the original email containing the filing (below). I have also attached the new filing form that you requested. This filing pertains to an individual product.
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not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
----- Forwarded by Jill Swyernovak/BCBSNJ on 12/22/2010 12:23 PM ----From: Jill Swyernovak/BCBSNJ To: heathinsurance@hhs.gov Cc: Colleen Brennan/BCBSNJ@BCBSNJ, Adam Young/BCBSNJ@BCBSNJ, Edward Mailander/BCBSNJ@BCBSNJ, Robert E Meehan/BCBSNJ@BCBSNJ, Peter Morey/BCBSNJ@BCBSNJ, Ellen.DeRosa@dobi.state.nj.us, neil.sullivan@dobi.state.nj.us Date: 11/02/2010 05:12 PM Subject: Horizon Blue Cross Blue Shield of New Jersey Waiver Filing
Dear Mr. Mayhew: I am writing on behalf of Horizon Blue Cross Blue Shield of New Jersey to submit its application for a waiver from restricted annual limits on the dollar value of essential benefits for Horizon BCBSNJ's Basic and Essential EPO Plus plan. Please see the attached letter and application, supporting exhibits and. CEO attestation.
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This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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Sincerely, Jill Swyer Novak, Esq.
file:///T|/...ng%20Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%2012.22.10.htm[10/25/2011 12:45:17 PM]
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From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Tuesday, January 04, 2011 3:56 PM To: Pham, Erica (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM; Edward_Mailander@horizonblue.com; Robert_E_Meehan@horizon-bcbsnj.com; Peter_Morey@horizonblue.com; Sandi_L_Kelly@horizon-bcbsnj.com; Kristen_A_Jarosz@horizon-bcbsnj.com Subject: Horizon Blue Cross Blue Shield of New Jersey Waiver Application Attachments: New Jersey Waiver Letter.pdf
Dear Ms. Pham,
Ex. 4
Since the NJDOBI's filing has been approved, Horizon BCBSNJ looks forward to hearing shortly from HHS on its approval as well. Happy New Year and thank you very much for your assistance in this process. Sincerely,
HBCBSNJ:000013
file:///T|/...f%20New%20Jersey/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Application.htm[10/25/2011 12:45:18 PM]
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I would also like to bring to your attention the fact that HHS has approved the New Jersey Department of Banking and Insurance ("NJDOBI") application for a waiver of the annual limit restrictions on essential health benefits under Section 2711 of the Public Health Services Act (See attached letter below). The coverage that is the subject of the NJDOBI's filing is the underlying coverage supporting the rider in the Horizon BCBSNJ application. Horizon BCBSNJ's rider enhances the underlying NJDOBI coverage by providing increased benefits for members.
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I am writing to inform you that the data sheet that was submitted with the resubmission of the Horizon Blue Cross Blue Shield of New Jersey ("Horizon BCBSNJ") application for a waiver of the annual limit restrictions on essential benefits contains an incorrect number in the column labeled "Total Number of Individuals Cove Policy (include all depend overed)." The number should be members instead of listed.
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Jill Swyer Novak
Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000014
file:///T|/...f%20New%20Jersey/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Application.htm[10/25/2011 12:45:18 PM]
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HBCBSNJ:000015
HBCBSNJ:000016
From: Sent: To: Subject:
Hi Sandy,
Keels, Lisa (HHS/OCIIO) Monday, January 24, 2011 2:57 PM Habit, Sandra (HHS/OCIIO) FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
The email didnt go through. I will try again. Thanks!

_____________________________________________ From: System Administrator Sent: Monday, January 24, 2011 2:57 PM To: Keels, Lisa (HHS/OCIIO) Subject: Undeliverable: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information
Your message did not reach some or all of the intended recipients. Subject: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information Sent: 1/24/2011 2:57 PM The following recipient(s) cannot be reached:
'Jill_Swyernovak@Horizon-BCBSNJ.com' on 1/24/2011 2:57 PM None of your e-mail accounts could send to this recipient.
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HBCBSNJ:000017
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Lisa M. Keels, J.D. U.S. Department of Health & Human Services Office of Consumer Information and Insurance Oversight Office of Oversight lisa.keels@hhs.gov 301-492-4168
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From: Keels, Lisa (HHS/OCIIO) Sent: Monday, January 24, 2011 2:59 PM To: jill_swyernovak@horizonblue.com Cc: Habit, Sandra (HHS/OCIIO) Subject: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information Dear Ms. Swyer Novak: Thank you for your application for the Waiver of the Annual Limits Requirements of the Public Health Service Act (PHS Act) Section 2711. I left you a voicemail earlier this afternoon. We are processing your application and have a couple of questions about the waiver application spreadsheet you submitted. In order to complete your application, please provide the following information: 1. On the spreadsheet, enrollees are categorized under the following tiers: Individual, Employee + Spouse, Employee + Family, and Employee + Children. Since Horizon BCBSNJ is an individual policy, please confirm that, by Employee + Spouse, Employee + Family, and Employee + Children, you mean Individual + Spouse, Individual + Family, and Individual + Children. 2. The spreadsheet column entitle tal Number of Individuals Covered by Policy (include all dependent covered) contains the number Ex. 4 . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the seco arter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). 3. Please confirm whether the policy was in existence prior to March 23, 2010. If so, is the plan in compliance with grandfathering provisions, pursuant to 45 CFR 147.140? Please feel free to call me if you have any questions. I look forward to hearing from you soon. Thank you, Lisa
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file:///T|/.../Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Request%20for%20info%20(2)%20%201.24.11.htm[10/25/2011 12:45:28 PM]
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HBCBSNJ:000018
From: Keels, Lisa (HHS/OCIIO) Sent: Thursday, February 03, 2011 3:34 PM To: Jill_Swyernovak@Horizon-BCBSNJ.com Cc: Habit, Sandra (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Jill, I just wanted to let you know that your application is complete, and you should be hearing from HHS soon. Thank you, Lisa
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 2:02 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Thank you, Lisa. Regards, Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com
Thank you, Jill. I will let you know if we have additional questions. Best, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 1:33 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
HBCBSNJ:000019
file:///T|/...Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/completion%202.3.11.htm[10/25/2011 12:45:41 PM]
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From: To: Cc:
"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Colleen_Brennan@Horizon-BCBSNJ.COM" <Colleen_Brennan@HorizonBCBSNJ.COM>, "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> Date: 02/03/2011 01:43 PM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Dear Lisa, I am writing to submit an answer to your question which was as follows: The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependent covered) contains the number Ex. 4 . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the secon arter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sen ail to Ms. Pham corr Ex. 4 sheet by indicating that the total number of of individuals covered was members instead of Ex. 4 BCBSNJ does not maintain its data in terms of members per tier. Hori BSNJ maintains its d contracts per tier. Ex. 4 The Ex. 4 mem esents contracts which when broken down by tier is as follows: Sing Ex. 4 Two adults Adult/Child/ren Family _____________ _____ Ex. 4 Total contracts Obviously, the above represents The question is the number of m
Ex. 4
the data . Horizon terms of
members in the single category and in the Adult/Child/ren and Family c
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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Sincerely, Jill
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I hope this information is helpful. If I can be of further assistance, please contact me.
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file:///T|/...Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/completion%202.3.11.htm[10/25/2011 12:45:41 PM]
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members in the two adult category. ies.
HBCBSNJ:000020
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, February 15, 2011 3:41 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Kottenmeier, Erika (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Jill, Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application. Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd . Thank you, Lisa
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 4:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Lisa,
Regards, Jill
From: To: Cc: Date: Subject: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> 02/03/2011 03:33 PM RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon.
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file:///T|/...rizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%202.15.11.htm[10/25/2011 12:45:41 PM]
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HBCBSNJ:000021
Dear Jill, I just wanted to let you know that your application is complete, and you should be hearing from HHS soon. Thank you, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 2:02 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Thank you, Jill. I will let you know if we have additional questions.
Best, Lisa
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 1:33 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Lisa, I am writing to submit an answer to your question which was as follows:
HBCBSNJ:000022
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Thank you, Lisa. Regards, Jill
The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependent covered) contains the number Ex. 4 . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the seco arter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sen ail to Ms. Pham cor sheet by indicating that the total number of of individuals covered was Ex. 4 members instead of Ex. 4 BCBSNJ does not maintain its data in terms of members per tier. Hori SNJ maintains its d contracts per tier. The Ex. 4 mem esents Ex. 4 contracts which when broken down by tier is as follows: Ex. 4 Single Two adults Adult/Child/ren Family ______________ _____ Ex. 4 Total contracts the data Horizon terms of
I hope this information is helpful. If I can be of further assistance, please contact me. Sincerely, Jill
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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Obviously, the above represents Ex. 4 members in the single category and Ex. 4 members in the two adult category. The question is the number of members in the Adult/Child/ren and Family categories.
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HBCBSNJ:000023
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, February 15, 2011 4:06 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Kottenmeier, Erika (HHS/OCIIO) Subject: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information
Hello again, Jill, In addition to letting me know if you are available at 10:00am next Wednesday, February 23 rd , could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience. Thank you again, Lisa
Dear Lisa,
Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards, Jill
Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421

HBCBSNJ:000024
file:///T|/...20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%20Follow-Up%202.15.11.htm[10/25/2011 12:45:42 PM]
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Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd . Thank you, Lisa
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Dear Jill, Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application.
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973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
From: To: Cc:
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HBCBSNJ:000025
Best, Lisa
I am writing to submit an answer to your question which was as follows:
Sincerely, Jill
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this
HBCBSNJ:000026
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Obviously, the above represents Ex. 4 The question is the number of m
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On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sent an email to Ms. Pham cor sheet by indicating that the total number of of individuals covered was Ex. 4 members instead of Ex. 4 BCBSNJ does not maintain its data in terms of members per tier. Hori BSNJ maintains its d cont r tier. The Ex. 4 mem sents Ex. 4 contracts which when broken down by tier is as follows: Ex. 4 Sing Two adults Adult/Child/ren Family _____________ _____ Total Ex. 4 contracts members in the single category and Ex. 4 in the Adult/Child/ren and Family c
ra do .
The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependent covered) contains the number Ex. 4 However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the second quarter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). the data . Horizon terms of
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Dear Lisa,
message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000027
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From: Keels, Lisa (HHS/OCIIO) Sent: Wednesday, February 16, 2011 4:33 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Adam_Young@horizonblue.com; Kottenmeier, Erika (HHS/OCIIO) Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Follow Up Flag: Follow up Flag Status: Flagged
Hello Lisa.
Wednesday, February 23, 2011 at 10 am is fine. As alternative dates and times, I would like to suggest Thursday, February 24, 2011 at 11 am and Friday, February 25, 2011 at 10 am. Regards, Jill
From: To: Cc: Date: Subject: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/15/2011 04:06 PM FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Wednesday, February 16, 2011 4:30 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
file:///T|/...Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%20about%20call%202.16.11.htm[10/25/2011 12:45:42 PM]
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Thank you, Jill. I will work on scheduling the call and will confirm with you as soon as possible. All the best, Lisa
HBCBSNJ:000028
Hello again, Jill, In addition to letting me know if you are available at 10:00am next Wednesday, February 23 rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience. Thank you again, Lisa From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, February 15, 2011 3:41 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Kottenmeier, Erika (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Lisa,
Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards, Jill
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Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd. Thank you, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 4:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Dear Jill, Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application.
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HBCBSNJ:000029
Dear Jill,
I just wanted to let you know that your application is complete, and you should be hearing from HHS soon.
From: To: Cc: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Colleen_Brennan@Horizon-BCBSNJ.COM" <Colleen_Brennan@HorizonBCBSNJ.COM>, "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> Date: 02/03/2011 01:43 PM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Thank you, Jill. I will let you know if we have additional questions. Best, Lisa
HBCBSNJ:000030
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Thank you, Lisa
Dear Lisa, I am writing to submit an answer to your question which was as follows: The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependents covered) contains the number Ex. 4 . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the seco arter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sen ail to Ms. Pham correcting the data Ex. 4 sheet by indicating that the total number of of individuals covered was members instead of Ex. 4 Horizon BCBSNJ does not maintain its data in terms of members per tier. Hori BSNJ maintains its d terms of contracts per tier. The Ex. 4 members represents Ex. 4 contracts which when broken down by tier is as follows: Sing Ex. 4 Two adults Adult/Child/ren Family _____________ _____ Ex. 4 Total contracts Obviously, the above represents The question is the number of m
Ex. 4
members in the single category and Ex. 4 in the Adult/Child/ren and Family c
ol o
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
HBCBSNJ:000031
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members in the two adult category. es.
============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000032
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From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Wednesday, February 16, 2011 4:35 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Follow Up Flag: Follow up Flag Status: Flagged
Thank you very much, Lisa.
Thank you, Jill. I will work on scheduling the call and will confirm with you as soon as possible. All the best, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Wednesday, February 16, 2011 4:30 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Hello Lisa. Wednesday, February 23, 2011 at 10 am is fine. As alternative dates and times, I would like to suggest Thursday, February 24, 2011 at 11 am and Friday, February 25, 2011 at 10 am. Regards, Jill
HBCBSNJ:000033
file:///T|/...ue%20Shield%20of%20New%20Jersey/Correspondence%20about%20scheduling%20a%20call%202.16.11.htm[10/25/2011 12:45:43 PM]
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From: To: Cc: Date: Subject:
"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/16/2011 04:33 PM RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
Thank you again, Lisa
Dear Jill,

Thank you, Lisa
Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application. Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd.
HBCBSNJ:000034
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In addition to letting me know if you are available at 10:00am next Wednesday, February 23 rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience.
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Hello again, Jill,
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Dear Lisa, Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards, Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com
I just wanted to let you know that your application is complete, and you should be hearing from HHS soon. Thank you, Lisa
Thank you, Lisa. Regards, Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421
HBCBSNJ:000035
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Dear Jill,
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"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> 02/03/2011 03:33 PM RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
Dear Lisa,
The spreadsheet column entitle tal Number of Individuals Covered by Policy (include all dependent Ex. 4 covered) contains the number . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the secon arter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sent an email to Ms. Pham corr sheet by indicating that the total number of of individuals covered was Ex. 4 members instead of Ex. 4 BCBSNJ does not maintain its data in terms of members per tier. Hori BSNJ maintains its d cont er tier. The Ex. 4 mem sents Ex. 4 contracts which when broken down by tier is as follows: Ex. 4 Sing Two adults Adult/Child/ren Family the data Horizon terms of
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I am writing to submit an answer to your question which was as follows:
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HBCBSNJ:000036
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_____________ Ex. 4 Total
_______ contracts members in the single category and Ex. 4 in the Adult/Child/ren and Family c members in the two adult category. ies.
============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
Co m
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000037
From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Wednesday, February 16, 2011 4:30 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Follow Up Flag: Follow up Flag Status: Flagged
Hello Lisa.
Wednesday, February 23, 2011 at 10 am is fine. As alternative dates and times, I would like to suggest Thursday, February 24, 2011 at 11 am and Friday, February 25, 2011 at 10 am.
Hello again, Jill,
In addition to letting me know if you are available at 10:00am next Wednesday, February 23 rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience. Thank you again, Lisa From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, February 15, 2011 3:41 PM
HBCBSNJ:000038
file:///T|/...%20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%20response%202.16.11.htm[10/25/2011 12:45:44 PM]
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"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/15/2011 04:06 PM FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Regards, Jill
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To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Kottenmeier, Erika (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Jill, Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application. Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd. Thank you, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 4:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Lisa, Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards, Jill
Co m
"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> 02/03/2011 03:33 PM RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Dear Jill,
HBCBSNJ:000039
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Thank you, Lisa
From: To: Cc:
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Dear Lisa, I am writing to submit an answer to your question which was as follows:
HBCBSNJ:000040
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The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependent covered) contains the number Ex. 4 . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the second quarter. Please confirm the number of enrollees under each tier of coverage (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey se ail to Ms. Pham correcting the data sheet by indicating that the total number of of individuals covered was Ex. 4 members instead of Ex. 4 Horizon BCBSNJ does not maintain its data in terms of members per tier. Hori BSNJ maintains its d terms of cont r tier. TheEx. 4 members represents Ex. 4 contracts which when broken down by tier is as follows: Sin Ex. 4 Two adults Adult/Child/ren Family _____________ _____ Ex. 4 Total contracts Obviously, the above represents Ex. 4 The question is the number of members in the single category and Ex. 4 in the Adult/Child/ren and Family c
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HBCBSNJ:000041
From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Thursday, February 17, 2011 10:56 AM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Follow Up Flag: Follow up Flag Status: Flagged
Hi Lisa. Would it be possible to provide me with an agenda for the call? We would like to be able to have the appropriate people on the call to respond to your questions. Thanks very much for your help. Jill
Hello Lisa.
HBCBSNJ:000042
file:///T|/...lue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Question%20re%20Call%20Agenda%202.17.11.htm[10/25/2011 12:45:44 PM]
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Hello again, Jill,
In addition to letting me know if you are available at 10:00am next Wednesday, February 23 rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience. Thank you again, Lisa
Dear Jill,
Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application.
Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd.
Thank you, Lisa
HBCBSNJ:000043
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"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/15/2011 04:06 PM FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Dear Lisa, Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards, Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com
et eC Co m pl
Dear Jill,
I just wanted to let you know that your application is complete, and you should be hearing from HHS soon. Thank you, Lisa
Thank you, Lisa. Regards,

HBCBSNJ:000044
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Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
Best, Lisa
Dear Lisa,
I am writing to submit an answer to your question which was as follows: The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependents covered) contains the number Ex. 4 . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the seco arter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sen ail to Ms. Pham corr sheet by indicating that the total number of of individuals covered was Ex. 4 members instead of Ex. 4 BCBSNJ does not maintain its data in terms of members per tier. Horizon BCBSNJ maintains its d contracts per tier. The Ex. 4 members represents Ex. 4 contracts which when broken down by tier is as follows: the data . Horizon terms of
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HBCBSNJ:000045
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Single Ex. 4 Two adults Adult/Child/ren Family _____________ Total Ex. 4
_____ contracts members in the single category and Ex. 4 in the Adult/Child/ren and Family c members in the two adult category. ies.
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HBCBSNJ:000046
Sincerely, Jill
From: Keels, Lisa (HHS/OCIIO) Sent: Thursday, February 17, 2011 12:32 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Adam_Young@horizonblue.com; Kottenmeier, Erika (HHS/OCIIO) Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Follow Up Flag: Follow up Flag Status: Flagged
From: To: Cc: Date: Subject: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/16/2011 04:33 PM RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 17, 2011 10:56 AM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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I would also like to confirm that the call has been scheduled for next Wednesday, February 23 rd , at 10:00am. Please feel free to let me know if you have any other questions. Thank you again, Lisa
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Hi Jill, Leadership asked to schedule the call to discuss the sale of individual policies after September 23, 2010.
HBCBSNJ:000047
Hello Lisa.
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Hello again, Jill,
In addition to letting me know if you are available at 10:00am next Wednesday, February 23 rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones
HBCBSNJ:000048
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earliest convenience.
Dear Jill,

Thank you, Lisa Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd.
Dear Lisa,
Regards, Jill

HBCBSNJ:000049
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Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon.
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From: To: Cc:
Thank you, Jill. I will let you know if we have additional questions. Best, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com]
HBCBSNJ:000050
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Sent: Thursday, February 03, 2011 1:33 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Dear Lisa, I am writing to submit an answer to your question which was as follows: The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependent covered) contains the number Ex. 4 However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the seco rter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sent an email to Ms. Pham correcting the data sheet by indicating that the total number of of individuals covered was Ex. 4 members instead of Ex. 4 Horizon BCBSNJ does not maintain its data in terms of members per tier. Hori BSNJ maintains its data in terms of cont er tier. The Ex. 4 members represents Ex. 4 contracts which when broken down by tier is as follows: Ex. 4 Sing Two adults Adult/Child/ren Family _____________ _____ Ex. 4 Total contracts Obviously, the above represents Ex. 4 The question is the number of m members in the single category and Ex. 4 in the Adult/Child/ren and Family c
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This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ==============================================================================
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This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Tuesday, February 22, 2011 4:51 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Follow Up Flag: Follow up Flag Status: Completed
I would also like to confirm that the call has been scheduled for next Wednesday, February 23 rd, at 10:00am. Please feel free to let me know if you have any other questions. Thank you again, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 17, 2011 10:56 AM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
HBCBSNJ:000053
file:///T|/...ss%20Blue%20Shield%20of%20New%20Jersey/Correspondence%20re%20Call-In%20Number%202.22.11.htm[10/25/2011 12:45:46 PM]
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Hi Jill, Leadership asked to schedule the call to discuss the sale of individual policies after September 23, 2010.
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Hi Lisa. I hope you had a nice weekend. What is your telephone number for the meeting tomorrow at 10am? Thank you. Jill

From: To: Cc: Date: Subject: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/16/2011 04:33 PM RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
Thank you, Jill. I will work on scheduling the call and will confirm with you as soon as possible.
All the best, Lisa
Hello Lisa.
Jill Swyer Novak Assistant General Counsel
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From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Wednesday, February 16, 2011 4:30 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
Hello again, Jill,
Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application. Please let me know if you would be available for a call at 10:00am next Wednesday, February 23 rd. Thank you, Lisa
Dear Lisa,
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Dear Jill,
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In addition to letting me know if you are available at 10:00am next Wednesday, February 23 rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience.
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Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards, Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system.
Dear Jill,
HBCBSNJ:000056
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Thank you, Lisa
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Dear Lisa,
I am writing to submit an answer to your question which was as follows: The spreadsheet column entitle tal Number of Individuals Covered by Policy (include all dependent Ex. 4 covered) contains the number . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the seco arter. Please confirm the number of enrollees under each tier of cov (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sent an email to Ms. Pham correcting the data sheet by indicating that the total number of of individuals covered was Ex. 4 members instead ofEx. 4 Horizon BCBSNJ does not maintain its data in terms of members per tier. Hori SNJ maintains its d erms of cont r tier. The Ex. 4 members represents Ex. 4 contracts which when broken down by tier is as follows: Sing Ex. 4 Two adults Adult/Child/ren Family
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_____________ Total Ex. 4
_______ contracts members in the single category and Ex. 4 in the Adult/Child/ren and Family c members in the two adult category. ies.
Obviously, the above represents Ex. 4 The question is the number of
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This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by email if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000058
From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, February 22, 2011 10:34 PM To: Jill_Swyernovak@Horizon-BCBSNJ.com Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information Follow Up Flag: Follow up Flag Status: Flagged Hi Jill, Thank you for your email - I hope you had a nice weekend as well. If you don't mind, we will call you (our numbers are unpredictable depending on what room we are in). Should we call you at 973-466-7421?
From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@HorizonBCBSNJ.com> Cc: "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> Date: 02/17/2011 12:32 PM Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
HBCBSNJ:000059
file:///T|/...orizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Response%20re%20Call-In%20Number%202.22.11.txt[10/25/2011 12:45:46 PM]
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This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system.
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Hi Lisa. I hope you had a nice weekend. What is your telephone number for the meeting tomorrow at 10am? Thank you. Jill
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Thank you again, Lisa ________________________________________ From: Jill_Swyernovak@Horizon-BCBSNJ.com [Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Tuesday, February 22, 2011 4:51 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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________________________________
Hi Jill, Leadership asked to schedule the call to discuss the sale of individual policies after September 23, 2010. I would also like to confirm that the call has been scheduled for next Wednesday, February 23rd, at 10:00am. Please feel free to let me know if you have any other questions. Thank you again, Lisa
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@HorizonBCBSNJ.com> Cc: "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> Date: 02/16/2011 04:33 PM Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual
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From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@HorizonBCBSNJ.com] Sent: Thursday, February 17, 2011 10:56 AM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Limits Waiver Application - Request for Additional Information
________________________________
Thank you, Jill. I will work on scheduling the call and will confirm with you as soon as possible. All the best, Lisa
Hello Lisa.
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@HorizonBCBSNJ.com> Cc: "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> Date: 02/15/2011 04:06 PM Subject: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
HBCBSNJ:000061
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From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@HorizonBCBSNJ.com] Sent: Wednesday, February 16, 2011 4:30 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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________________________________
Hello again, Jill, In addition to letting me know if you are available at 10:00am next Wednesday, February 23rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience. Thank you again, Lisa
Dear Jill,
Please let me know if you would be available for a call at 10:00am next Wednesday, February 23rd.
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@HorizonBCBSNJ.com] Sent: Thursday, February 03, 2011 4:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information Dear Lisa, Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards, Jill
HBCBSNJ:000062
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Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@HorizonBCBSNJ.com> Cc: "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> Date: 02/03/2011 03:33 PM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
________________________________
Dear Jill,
Thank you, Lisa
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@HorizonBCBSNJ.com] Sent: Thursday, February 03, 2011 2:02 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information Thank you, Lisa. Regards, Jill Jill Swyer Novak
HBCBSNJ:000063
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Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@HorizonBCBSNJ.com> Cc: "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Colleen_Brennan@Horizon-BCBSNJ.COM" <Colleen_Brennan@Horizon-BCBSNJ.COM>, "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> Date: 02/03/2011 01:43 PM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
________________________________
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@HorizonBCBSNJ.com] Sent: Thursday, February 03, 2011 1:33 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information Dear Lisa, I am writing to submit an answer to your question which was as follows: The spreadsheet column entitled Total Number of Individuals Covered by Policy (include all dependents covered) contains the numberEx. 4 However,
HBCBSNJ:000064
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the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the end of the second quarter. Please confirm the numb nrollees under each tier of coverage (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sent an email to Ms. Pham correcting the data sheet by indicating that the total number of of individuals covered was Ex. 4 members instead of Ex. 4 Horizon BCBSNJ does not maintain its data in f members per tier. Horizon BCBSNJ maintains its data in terms of co per tier. The Ex. 4 members represents Ex. 4 contracts which when broken down by tier is as s: Ex. 4 Single Two adults Adult/Child/ren Family _____________ _____ Ex. 4 Total contracts Obviously, the above represents 31, 986 members in the single category and 2,780 members in the two adult category. The question is the number of members in the Adult/Child/ren and Family categories. I hope this information is helpful. If I can be of further assistance, please contact me. Sincerely, Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you
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are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
HBCBSNJ:000066
From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Wednesday, February 23, 2011 8:33 AM To: Keels, Lisa (HHS/OCIIO) Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Follow Up Flag: Follow up Flag Status: Flagged
Hi Jill,
Thank you again, Lisa ________________________________________ From: Jill_Swyernovak@Horizon-BCBSNJ.com [Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Tuesday, February 22, 2011 4:51 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Hi Lisa. I hope you had a nice weekend. What is your telephone number for the meeting tomorrow at 10am? Thank you. Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have
HBCBSNJ:000067
file:///T|/...Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Confirming%20Call-In%20Number%202.23.11.htm[10/25/2011 12:45:47 PM]
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Should we call you at 973-466-7421?
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Thank you for your email - I hope you had a nice weekend as well. If you don't mind, we will call you (our numbers are unpredictable depending on what room we are in).
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From: To: Date: Subject:
"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> 02/22/2011 10:34 PM RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Hi Lisa. Please call us at 973-466-4424. Thank you.
received this e-mail by mistake and delete this e-mail from your system. From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> Cc: "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> Date: 02/17/2011 12:32 PM Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information ________________________________
Hi Jill, Leadership asked to schedule the call to discuss the sale of individual policies after September 23, 2010. I would also like to confirm that the call has been scheduled for next Wednesday, February 23rd, at 10:00am. Please feel free to let me know if you have any other questions. Thank you again, Lisa
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 17, 2011 10:56 AM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Hi Lisa. Would it be possible to provide me with an agenda for the call? We would like to be able to have the appropriate people on the call to respond to your questions. Thanks very much for your help. Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com
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Thank you, Jill. I will work on scheduling the call and will confirm with you as soon as possible. All the best, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Wednesday, February 16, 2011 4:30 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application HBCBSNJ:000068
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From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> Cc: "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> Date: 02/16/2011 04:33 PM Subject: RE: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Request for Additional Information Hello Lisa. Wednesday, February 23, 2011 at 10 am is fine. As alternative dates and times, I would like to suggest Thursday, February 24, 2011 at 11 am and Friday, February 25, 2011 at 10 am. Regards, Jill
________________________________
Hello again, Jill,
Dear Jill,
Our leadership would like to schedule a call with you to discuss Horizon Blue Cross Blue Shield of New Jerseys annual limits waiver application. Please let me know if you would be available for a call at 10:00am next Wednesday, February 23rd. Thank you, Lisa
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 4:24 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Dear Lisa, Thank you very much for the information. I appreciate your help. I will look forward to hearing from you soon. Regards,
HBCBSNJ:000069
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From: Keels, Lisa (HHS/OCIIO) Sent: Tuesday, February 15, 2011 3:41 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Kottenmeier, Erika (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information
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In addition to letting me know if you are available at 10:00am next Wednesday, February 23rd, could you also please let me know your availability for two additional dates/times? Scheduling changes often arise, and we would like to be able to schedule this call at everyones earliest convenience.
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From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> Cc: "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> Date: 02/15/2011 04:06 PM Subject: FW: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
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Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> Cc: "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> Date: 02/03/2011 03:33 PM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
________________________________
Dear Jill,
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. From: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> To: "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> Cc: "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Colleen_Brennan@HorizonBCBSNJ.COM" <Colleen_Brennan@Horizon-BCBSNJ.COM>, "Habit, Sandra (HHS/OCIIO)" <Sandra.Habit@hhs.gov> Date: 02/03/2011 01:43 PM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application - Request for Additional Information
________________________________
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From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 2:02 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information
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HBCBSNJ:000070
Thank you, Jill. I will let you know if we have additional questions. Best, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Thursday, February 03, 2011 1:33 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com; Colleen_Brennan@Horizon-BCBSNJ.COM Subject: RE: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Request for Additional Information Dear Lisa, I am writing to submit an answer to your question which was as follows: The spreadsheet column entitled Total Nu of Individuals Covered by Policy (include all dependents covered tains the number Ex. 4 . However, the application letter states that the B&E Plus Plan had Ex. 4 enrollees at the of the second quarter. Please confirm the number of enrollees under tier of coverage (i.e., Individual, Employee + Child, etc.). On January 4, 2011, Horizon Blue Cross Blue Shield of New Jersey sent an email to Ms. Pham ecting the data she indicating that the total number of of individuals covered was Ex. 4, Ex. 4 Ex. 4 members instead of . Horizon BCBSNJ does not maintain its data in terms of members r izon BCBSNJ m in data in terms of contracts per tier. Ex. 4 The Ex. 4 member contracts which when broken down by tier is as follows: Sing Ex. 4 Two adults Adult/Child/ren Family _________________ Total Ex. 4 contracts
This message contains confidential attorney/client privileged information and is intended only for the individual(s) named. If you are not the named addressee, you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this
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Obviously, the above represents Ex. 4 two adult category. The questio categories.
members in the single category and Ex. 4 e number of members in the Adult/Chi
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members in the n and Family
HBCBSNJ:000071
message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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From: Keels, Lisa (HHS/OCIIO) Sent: Friday, February 25, 2011 10:37 AM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Kottenmeier, Erika (HHS/OCIIO) Subject: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Follow Up Flag: Follow up Flag Status: Flagged
Hi Jill, I just wanted to keep you posted about the status of Horizon BCBS of New Jerseys waiver application for the riders to the B&E Plan (i.e., the B&E Plus Plan). We are still waiting to hear from leadership, so the decision may have to wait until next week. I will keep you updated as soon as I have more information. Thank you for your patience. All the best, Lisa
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Lisa M. Keels, J.D. U.S. Department of Health & Human Services Center for Consumer Information and Insurance Oversight Division of Oversight lisa.keels@hhs.gov 301-492-4168
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From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Friday, February 25, 2011 10:59 AM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Follow Up Flag: Follow up Flag Status: Flagged
Hi Lisa. Thank you very much for the information. We will look forward to hearing favorably from you soon. Regards, Jill Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421 973 - 466 - 7759 email: jill_swyernovak@horizonblue.com
"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/25/2011 10:37 AM Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
Hi Jill, I just wanted to keep you posted about the status of Horizon BCBS of New Jerseys waiver application for the riders to the B&E Plan (i.e., the B&E Plus Plan). We are still waiting to hear from leadership, so the decision may have to wait until next week. I will keep you updated as soon as I have more information. Thank you for your patience. All the best, Lisa Lisa M. Keels, J.D. U.S. Department of Health & Human Services
HBCBSNJ:000074
file:///T|/...%20Cross%20Blue%20Shield%20of%20New%20Jersey/Response%20to%20Status%20Update%202.25.11.htm[10/25/2011 12:45:48 PM]
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Center for Consumer Information and Insurance Oversight Division of Oversight lisa.keels@hhs.gov 301-492-4168 ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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file:///T|/...%20Cross%20Blue%20Shield%20of%20New%20Jersey/Response%20to%20Status%20Update%202.25.11.htm[10/25/2011 12:45:48 PM]
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Horizon Blue Cross Blue Shield of New Jersey, ID # 101222-003 Name of Reviewer
L. Keels
Date and Time

1/24/2011, 2:15pm
Action
Called Jill Swyer Novak and left voicemail regarding questions about application (emailed these questions at 3:00pm 1/24/2011).
L. Keels
1/31/2011, 10:55am
L. Keels
2/23/2011, 10:00am
L. Keels
2/25/2011, 4:05pm
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L. Keels
1/25/2011, 2:40pm
Called Jill Swyer Novak and left follow-up voicemail regarding questions about application. Called Jill Swyer Novak and left follow-up voicemail regarding questions about application (Jill responded at 2:16pm on 1/31/2011). G. Cohen, E. Kottenmeier, and I called Jill Swyer Novak and colleagues to discuss the riders involved in Horizon BCBSNJs B&E Plus plan. Called Jill Swyer Novak and left a voicemail message to inform her that the application was approved and that a letter and email are forthcoming.
HBCBSNJ:000076
HBCBSNJ:000077
From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Monday, March 07, 2011 2:31 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Follow Up Flag: Follow up Flag Status: Flagged
Hi Jill, Thank you for your email - I hope you had a nice weekend as well. Please expect to receive the approval letter this week. Please feel free to contact me if you have any other questions. Thank you again, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Monday, March 07, 2011 2:22 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
Hi Lisa. I hope you had a nice weekend.

HBCBSNJ:000078
file:///T|/...ue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Status%20Check%20Correspondence%203.7.11.htm[10/25/2011 12:45:59 PM]
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"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 03/07/2011 02:26 PM RE: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
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Thanks very much, Lisa. I appreciate your help. Regards, Jill
We have not received the approval letter yet. Can you please tell me when we can expect it? Thanks very much for your help. Regards, Jill
From: To: Cc: Date: Subject: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/25/2011 10:37 AM Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
I just wanted to keep you posted about the status of Horizon BCBS of New Jerseys waiver application for the riders to the B&E Plan (i.e., the B&E Plus Plan). We are still waiting to hear from leadership, so the decision may have to wait until next week. I will keep you updated as soon as I have more information.
Thank you for your patience.
All the best, Lisa
============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the
HBCBSNJ:000079
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Hi Jill,
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intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000080
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From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Monday, March 07, 2011 2:22 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Follow Up Flag: Follow up Flag Status: Flagged Hi Lisa. I hope you had a nice weekend. We have not received the approval letter yet. Can you please tell me when we can expect it? Thanks very much for your help. Regards, Jill
Hi Jill, I just wanted to keep you posted about the status of Horizon BCBS of New Jerseys waiver application for the riders to the B&E Plan (i.e., the B&E Plus Plan). We are still waiting to hear from leadership, so the decision may have to wait until next week. I will keep you updated as soon as I have more information. Thank you for your patience. All the best, Lisa Lisa M. Keels, J.D.
HBCBSNJ:000081
file:///T|/...0Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Status%20Check%20re%20Letter%203.7.11.htm[10/25/2011 12:46:00 PM]
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U.S. Department of Health & Human Services Center for Consumer Information and Insurance Oversight Division of Oversight lisa.keels@hhs.gov 301-492-4168 ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000082
file:///T|/...0Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Status%20Check%20re%20Letter%203.7.11.htm[10/25/2011 12:46:00 PM]
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From: Keels, Lisa (HHS/OCIIO) Sent: Monday, March 07, 2011 4:05 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Subject: RE: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Follow Up Flag: Follow up Flag Status: Flagged
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Monday, March 07, 2011 2:31 PM To: Keels, Lisa (HHS/OCIIO) Subject: RE: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
Thanks very much, Lisa. I appreciate your help. Regards, Jill
"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Adam_Young@horizonblue.com" <Adam_Young@horizonblue.com>, "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 03/07/2011 02:26 PM RE: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
Hi Jill, Thank you for your email - I hope you had a nice weekend as well. Please expect to receive the approval letter this week. Please feel free to contact me if you have any other questions.
HBCBSNJ:000083
file:///T|/...e%20Cross%20Blue%20Shield%20of%20New%20Jersey/Status%20Check%20Response%20(2)%203.7.11.htm[10/25/2011 12:46:00 PM]
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Hi Jill, Good news I just received the signed letter. I will send you the official approval email and letter momentarily. Thanks again, Lisa
Thank you again, Lisa From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Monday, March 07, 2011 2:22 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
Hi Lisa. I hope you had a nice weekend. We have not received the approval letter yet. Can you please tell me when we can expect it? Thanks very much for your help. Regards, Jill
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Hi Jill,
I just wanted to keep you posted about the status of Horizon BCBS of New Jerseys waiver application for the riders to the B&E Plan (i.e., the B&E Plus Plan). We are still waiting to hear from leadership, so the decision may have to wait until next week. I will keep you updated as soon as I have more information.
Thank you for your patience.
All the best, Lisa
Lisa M. Keels, J.D. U.S. Department of Health & Human Services Center for Consumer Information and Insurance Oversight
HBCBSNJ:000084
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Division of Oversight lisa.keels@hhs.gov 301-492-4168
============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ============================================================================== ============================================================================== This message and any attachments are solely for the intended recipient. If you are not the intended recipient, disclosure, copying, use, or distribution of the information included in this message is prohibited -- please immediately and permanently delete this message. ==============================================================================
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HBCBSNJ:000085
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From: Keels, Lisa (HHS/OCIIO) Sent: Monday, March 07, 2011 2:26 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Cc: Adam_Young@horizonblue.com; Kottenmeier, Erika (HHS/OCIIO) Subject: RE: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application Follow Up Flag: Follow up Flag Status: Flagged
Hi Jill, Thank you for your email - I hope you had a nice weekend as well. Please expect to receive the approval letter this week. Please feel free to contact me if you have any other questions. Thank you again, Lisa
From: Jill_Swyernovak@Horizon-BCBSNJ.com [mailto:Jill_Swyernovak@Horizon-BCBSNJ.com] Sent: Monday, March 07, 2011 2:22 PM To: Keels, Lisa (HHS/OCIIO) Cc: Adam_Young@horizonblue.com Subject: Re: Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
Hi Lisa. I hope you had a nice weekend. We have not received the approval letter yet. Can you please tell me when we can expect it? Thanks very much for your help. Regards, Jill
From: To: Cc: Date: Subject: "Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> "Kottenmeier, Erika (HHS/OCIIO)" <Erika.Kottenmeier@hhs.gov> 02/25/2011 10:37 AM Status Update re: Horizon Blue Cross Blue Shield of New Jersey Annual Limits Waiver Application
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file:///T|/...%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Status%20Check%20Response%203.7.11.htm[10/25/2011 12:46:01 PM]
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Hi Jill, I just wanted to keep you posted about the status of Horizon BCBS of New Jerseys waiver application for the riders to the B&E Plan (i.e., the B&E Plus Plan). We are still waiting to hear from leadership, so the decision may have to wait until next week. I will keep you updated as soon as I have more information. Thank you for your patience. All the best, Lisa Lisa M. Keels, J.D. U.S. Department of Health & Human Services Center for Consumer Information and Insurance Oversight Division of Oversight lisa.keels@hhs.gov 301-492-4168
file:///T|/...%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Status%20Check%20Response%203.7.11.htm[10/25/2011 12:46:01 PM]
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From: Keels, Lisa (HHS/OCIIO) Sent: Monday, March 07, 2011 4:09 PM To: 'Jill_Swyernovak@Horizon-BCBSNJ.com' Subject: Horizon BCBS NJ B&E EPO Plus Plan - Waiver of the Annual Limits Requirements of PHS Act Section 2711 Attachments: Horizon BCBS Approval .pdf Follow Up Flag: Follow up Flag Status: Flagged
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Dear Jill: Thank you for speaking with us last week and for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Horizon Blue Cross Blue Shield of New Jerseys Basic and Essential EPO Plus Plan (the B&E EPO Plus Plan). HHS has reviewed your application and made its determination. Please see the attached letter. Your application states that the B&E EPO Plus Plan uses the State of New Jerseys . . . Basic and Essential Health Care Services Plan (B&E Plan) as its underlying framework. The B&E EPO Plus plan, which is in the form of a rider, adds benefits to the B&E plan such as prescription drug, home health care, durable medical equipment, hospice and diabetes care. Per our phone conversation last week, this application is approved on the basis that coverage for the rider is contingent upon coverage for New Jerseys state-mandated B&E Plan. We also confirm that the B&E EPO Plus Plan was in place prior to September 23, 2010 under the approval of the New Jersey Department of Insurance. In addition, we confirm that this approval applies only to this particular rider. Please confirm receipt of this letter by replying to this e-mail. Please let me know if I can be of further assistance. Thank you again, Lisa
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file:///T|/...0Processing%20Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Approval%203.7.11.htm[10/25/2011 12:46:01 PM]
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HBCBSNJ:000090
From: Jill_Swyernovak@Horizon-BCBSNJ.com Sent: Monday, March 07, 2011 5:04 PM To: Keels, Lisa (HHS/OCIIO) Subject: Re: Horizon BCBS NJ B&E EPO Plus Plan - Waiver of the Annual Limits Requirements of PHS Act Section 2711 Attachments: Horizon BCBS Approval .pdf Follow Up Flag: Follow up Flag Status: Completed
Thank you very much for all of your help, Lisa. Regards, Jill
Dear Jill: Thank you for speaking with us last week and for submitting an application for a Waiver of the Annual Limits Requirements of the PHS Act Section 2711 for Horizon Blue Cross Blue Shield of New Jerseys Basic and Essential EPO Plus Plan (the B&E EPO Plus Plan). HHS has reviewed your application and made its determination. Please see the attached letter. Your application states that the B&E EPO Plus Plan uses the State of New Jerseys . . . Basic and Essential Health Care Services Plan (B&E Plan) as its underlying framework. The B&E EPO Plus plan, which is in the form of a rider, adds benefits to the B&E plan such as prescription drug, home health care, durable medical equipment, hospice and diabetes care. Per our phone conversation last week, this application is approved on the basis that coverage for the rider is contingent upon coverage for New Jerseys state-mandated B&E Plan. We also confirm that the B&E EPO Plus Plan was in place prior to September 23, 2010 under the approval of the New Jersey Department of Insurance. In addition, we confirm that this approval applies only to this particular rider.
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From: To: Date: Subject:
"Keels, Lisa (HHS/OCIIO)" <Lisa.Keels@hhs.gov> "Jill_Swyernovak@Horizon-BCBSNJ.com" <Jill_Swyernovak@Horizon-BCBSNJ.com> 03/07/2011 04:10 PM Horizon BCBS NJ B&E EPO Plus Plan - Waiver of the Annual Limits Requirements of PHS Act Section 2711
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Please confirm receipt of this letter by replying to this e-mail. Please let me know if I can be of further assistance. Thank you again, Lisa
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Horizon BCBS New Jersey - Redacted HWM

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Ex. 4 Ex. 4 Ex. 4

Ex. 4 Ex. 4 Ex. 4

Pages 4 through 68 redacted for the following reasons: --------------------------------------------------Exemption 4

Dear Ms. Kottenmeier,

Sincerely, Jill Swyer Novak

file:///T|/...20New%20Jersey/FW%20Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Filing.htm[10/25/2011 12:45:17 PM]

file:///T|/...20New%20Jersey/FW%20Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Filing.htm[10/25/2011 12:45:17 PM]

Sincerely, Jill Swyer Novak, Esq.

ANNUAL LIMIT WAIVER APPLICATION 2010

Annual Limit Waiver Request Applicant Name Applicant ABC

Street Address 100 ABC Drive

Jill Swyer Novak

Three Penn Plaza East, PP 16F,

PRA Disclosure Statement

ANNUAL LIMIT WAIVER APPLICATION 2010

Mental Health/ Substance Abuse

ANNUAL LIMIT WAIVER APPLICATION 2010

Current Monthly Premium Rates or Premium Equivalent Rates (in dollars)*:

Employer Employee contribution contribution (if applicable) (if applicable)

Employer Employee contribution contribution (if applicable) (if applicable)

Title of Individual Providing Attestation Plan Administrator

Dear Ms. Kottenmeier,

file:///T|/...ng%20Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%2012.22.10.htm[10/25/2011 12:45:17 PM]

Sincerely, Jill Swyer Novak, Esq.

file:///T|/...ng%20Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%2012.22.10.htm[10/25/2011 12:45:17 PM]

Dear Ms. Pham,

file:///T|/...f%20New%20Jersey/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Application.htm[10/25/2011 12:45:18 PM]

Jill Swyer Novak

file:///T|/...f%20New%20Jersey/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey%20Waiver%20Application.htm[10/25/2011 12:45:18 PM]

From: Sent: To: Subject:

The email didnt go through. I will try again. Thanks!

file:///T|/.../Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Request%20for%20info%20(2)%20%201.24.11.htm[10/25/2011 12:45:28 PM]

file:///T|/...Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/completion%202.3.11.htm[10/25/2011 12:45:41 PM]

From: To: Cc:

the data . Horizon terms of

members in the single category and in the Adult/Child/ren and Family c

file:///T|/...Team/Mike/Horizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/completion%202.3.11.htm[10/25/2011 12:45:41 PM]

members in the two adult category. ies.

file:///T|/...rizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%202.15.11.htm[10/25/2011 12:45:41 PM]

file:///T|/...rizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%202.15.11.htm[10/25/2011 12:45:41 PM]

From: To: Cc:

Thank you, Lisa. Regards, Jill

file:///T|/...rizon%20Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%202.15.11.htm[10/25/2011 12:45:41 PM]

Jill Swyer Novak Assistant General Counsel 973 - 466 - 7421

file:///T|/...20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%20Follow-Up%202.15.11.htm[10/25/2011 12:45:42 PM]

Thank you, Lisa. Regards, Jill

From: To: Cc:

file:///T|/...20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%20Follow-Up%202.15.11.htm[10/25/2011 12:45:42 PM]

I am writing to submit an answer to your question which was as follows:

file:///T|/...20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%20Follow-Up%202.15.11.htm[10/25/2011 12:45:42 PM]

Obviously, the above represents Ex. 4 The question is the number of m

members in the two adult category. ies.

file:///T|/...20Cross%20Blue%20Shield%20of%20New%20Jersey/Scheduling%20a%20Call%20Follow-Up%202.15.11.htm[10/25/2011 12:45:42 PM]

file:///T|/...Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%20about%20call%202.16.11.htm[10/25/2011 12:45:42 PM]

file:///T|/...Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%20about%20call%202.16.11.htm[10/25/2011 12:45:42 PM]

file:///T|/...Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%20about%20call%202.16.11.htm[10/25/2011 12:45:42 PM]

Thank you, Lisa

file:///T|/...Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%20about%20call%202.16.11.htm[10/25/2011 12:45:42 PM]

members in the two adult category. es.

file:///T|/...Blue%20Cross%20Blue%20Shield%20of%20New%20Jersey/Correspondence%20about%20call%202.16.11.htm[10/25/2011 12:45:42 PM]

file:///T|/...ue%20Shield%20of%20New%20Jersey/Correspondence%20about%20scheduling%20a%20call%202.16.11.htm[10/25/2011 12:45:43 PM]

From: To: Cc: Date: Subject:

Thank you again, Lisa