Tuesday, October 17, 2017 at 1:57:03 PM Eastern Daylight Time

Subject: Public comments on waiver application
Date: Monday, September 25, 2017 at 8:53:04 AM Eastern Daylight Time

From: 
To: 
Priority: High

Hello-and-

On Friday, we received the attached comments on waiver application. You?ll see that two of them raise
the issue of assessment applying to self-funded plans that purchase stop loss coverage. The commenters
argue ERISA may pre-empt the state from imposing an assessment on such plans and that the assessment
will create burden on small- and mid- size employers.

We don?t necessarily see this issue as a barrier to approving the application today. However, we?d like to get
the state?s response to the concerns raised by these commenters. Can you send along a brief response 
Please feel free to reach out at the number below if you would like to discuss.

Best,

Center for Consumer Information and Insurance Oversight

Centers for Medicare and Medicaid Services

U.S. Department of Health and Human Services



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