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text-autospace:none;'><span style='font-family:"Calibri","sans-serif";color:black'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal><o:p>&nbsp;</o:p></p> <p class=MsoNormal style="margin-bottom: 0;"><a name="_MailOriginal"><img width=1 height=1 id="_x0000_i1025" src="http://r20.rs6.net/on.jsp?ca=1414dff0-c072-4c0f-810b-fe4852ad41ae&amp;a=1102316631277&amp;d=1121145004245&amp;r=3&amp;o=http://ui.constantcontact.com/images/p1x1.gif&amp;c=7a6b8750-3550-11e3-ad8b-d4ae529a824a&amp;ch=7bce99c0-3550-11e3-af4d-d4ae529a824a"><o:p></o:p></a></p> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;background:#817E51;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:0in 0in 0in 0in'> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=600 style='width:6.25in;mso-cellspacing:0in;mso-yfti-tbllook:1184'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width="100%" valign=top style='width:100.0%;padding:.75pt .75pt .75pt .75pt'><span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> <tr style='mso-yfti-irow:1'> <td valign=top style='background:#41535E;padding:.75pt .75pt .75pt .75pt'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in' id="content_LETTER.BLOCK1"> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width="100%" colspan=2 valign=top style='width:100.0%;background: white;padding:0in 0in 0in 0in'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:0in 0in 0in 0in'> <p class=MsoNormal><span style='mso-bookmark:_MailOriginal'><img width=657 height=130 id="_x0000_i1026" src="http://ih.constantcontact.com/fs087/1102316631277/img/15.jpg" vspace=5 alt="Wagner Header" name=ACCOUNT.IMAGE.15 border=0><o:p></o:p></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> <tr style='mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td width=160 valign=top style='width:120.0pt;background:white; padding:3.75pt 3.75pt 3.75pt 3.75pt'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in' id="content_LETTER.BLOCK2"> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width="100%" valign=top style='width:100.0%;padding:0in 0in 0in 0in'> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;background:#B2C4D0; border:solid black 1.0pt;mso-border-alt:solid black .75pt;mso-yfti-tbllook: 1184;mso-padding-alt:3.75pt 3.75pt 3.75pt 3.75pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td style='border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><a name=LETTER.BLOCK2></a><strong><span style='font-family:"Arial","sans-serif"; color:white'>The Wagner Law Group Description</span></strong></span><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size: 14.0pt;font-family:"Arial","sans-serif";color:#006E6D'>&nbsp;</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:14.0pt; font-family:"Arial","sans-serif";color:#006E6D'><o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> <tr style='mso-yfti-irow:1'> <td style='border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'><span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> <tr style='mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td style='border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'> <div> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA&nbsp;&amp;&nbsp;employee benefits, estate planning, employment, labor &amp; human resources&nbsp;practice.&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Established in 1996, The Wagner Law Group has&nbsp;22 attorneys engaged exclusively in employee benefits,</span></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt; font-family:"Arial","sans-serif";color:#5A879E'> </span></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt; font-family:"Arial","sans-serif";color:black'>estate planning and employment law.&nbsp;Six of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.</span></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt; font-family:"Arial","sans-serif";color:#5A879E'><o:p></o:p></span></span></p> </div> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <p align=center style='margin:0in; text-align: center; margin-top: 0; margin-bottom: .0001pt;'><span style='mso-bookmark:_MailOriginal'><span style='font-size:10.0pt;font-family:"Verdana","sans-serif"; color:#5A879E'>&nbsp;<o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <p class=MsoNormal style="margin-top: 0; margin-bottom: 0;"><span style='mso-bookmark:_MailOriginal'><a name=LETTER.BLOCK3></a><span style='display:none;mso-hide:all'><o:p>&nbsp;</o:p></span></span></p> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;background:#B2C4D0; border:solid black 1.0pt;mso-border-alt:solid black .75pt;mso-yfti-tbllook: 1184;mso-padding-alt:3.75pt 3.75pt 3.75pt 3.75pt' id="content_LETTER.BLOCK3"> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td style='border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:white'>Contact Info</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:white'><o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> <tr style='mso-yfti-irow:1'> <td style='border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>The Wagner Law Group</span></strong></span><span style='mso-bookmark: _MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif"; color:black'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt; font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;&nbsp;Integrity | Excellence</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Massachusetts Office&nbsp;</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Tel: (617) 357-5200&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Fax: (617) 357-5250&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>99 Summer Street&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>13th Floor<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Boston, MA 02110<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <br> <strong><span style='font-family:"Arial","sans-serif"'>Palm Beach</span></strong>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Tel: (561) 293-3590<br> Fax: (561) 293-3591<br> 7108 Fairway Drive<br> Suite 125<br> Palm Beach Gardens, FL 33418<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;<strong><span style='font-family:"Arial","sans-serif"'>&nbsp;</span></strong>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Tampa</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt; font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Tel: (813) 603-2959<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Fax: (813) 603-2961<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>101 East Kennedy Boulevard<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Suite 2140<br> Tampa, FL&nbsp; 33602&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>San Francisco</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Tel: (415) 625-0002<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Fax: (415) 358-8300<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>315 Montgomery Street<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Suite 904<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>San Francisco, CA 94104<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>St. Louis</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Tel: (314) 236-0065<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>Fax: (314) 236-5743<br> 100 South 4th Street, Suite 550<br> St. Louis, MO&nbsp; 63102&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif"; color:#8595A3'>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'></span><a href="http://r20.rs6.net/tn.jsp?f=001MfQJsy5nEI_f9Q7_puZ-n4iJYtKoEnNw5yk_Qgad35VsgpXZ8238RexkAdTqD8BWE63k7JGydzwhu5Xt3mP5zaz8InBSf8pzsHsUGecVmNT3xbH2sHT8PGh53Y1YlqT2MhOgtW_CAy4qIJkK6scVErzXGk56wKrl4USEY4VDSHUKA3L3KYJ4igb-03EnwmVIrUsVtAvQodtrwo_UgiuuzEbGv4FHZxsLcCMiITu9IY0HnplCM05yZdR4wGoCLdd0TFY2_ezmpJ6FdDxaqfFb07VQZ8JeP9dSe0tluzgPPat7i1rkcYQ4omoz9fvPNR4Q4BA0LNxsHjeo328Loo8o2fIIzcThOhHP&amp;c=EDofUyaZwwl6ja1kIgkB_IvIairMd4jyeB7GrbftCgmnvVUDws_T8A==&amp;ch=ZCTJQtmkgAcEkZTcIp6HpzAQxMRkXRgGg6Kr-fHkAnSGJ6UE1oO2FA==" target="_blank" track=on shape=rect linktype=link alt="http://wagnerlawgroup.com/?utm_source=+Health+and+Welfare+Law+Alert+5%2F21%2F15&amp;utm_campaign=State+%26+Fed&amp;utm_medium=email"><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt; font-family:"Arial","sans-serif"'>www.wagnerlawgroup.com</span></span><span style='mso-bookmark:_MailOriginal'></span></a><span style='mso-bookmark: _MailOriginal'><span style='font-size:8.0pt;color:#8595A3'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;color:#8595A3'>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:8.0pt;font-family:"Arial","sans-serif";color:black'>&nbsp;<o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> <tr style='mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td style='border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:10.0pt;font-family:"Verdana","sans-serif"; color:#5A879E'>&nbsp;<o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> <td width=440 valign=top style='width:330.0pt;background:white; padding:3.75pt 5.25pt 3.75pt 3.75pt'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width="100%" valign=top style='width:100.0%;padding:0in 0in 0in 0in'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;background:#B6BFC9; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow: yes;height:.75pt'> <td style='padding:0in 0in 0in 0in;height:.75pt'><span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <p class=MsoNormal style="margin-top: 0; margin-bottom: 0;"><span style='mso-bookmark:_MailOriginal'><span style='display:none;mso-hide:all'><o:p>&nbsp;</o:p></span></span></p> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:3.75pt 3.75pt 3.75pt 3.75pt' id="content_LETTER.BLOCK5"> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow: yes'> <td style='padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p align=right style='margin:0in;margin-bottom:.0001pt;text-align: right'><span style='mso-bookmark:_MailOriginal'><span style='font-size:11.0pt;color:black'>May 21, 2015<o:p></o:p></span></span></p> <p align=right style='margin:0in;margin-bottom:.0001pt;text-align: right'><span style='mso-bookmark:_MailOriginal'><span style='font-size:11.0pt;color:black'>&nbsp;<o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:18.0pt;color:#006E6D'>&nbsp;Health and Welfare Law Alert</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:18.0pt;color:#245B7C'><o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <p class=MsoNormal style="margin-top: 0; margin-bottom: 0;"><span style='mso-bookmark:_MailOriginal'><span style='display:none;mso-hide:all'><o:p>&nbsp;</o:p></span></span></p> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:3.75pt 3.75pt 3.75pt 3.75pt;display:table' id="content_LETTER.BLOCK6"> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow: yes'> <td style='padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:14.0pt;color:#006E6D'>ACA FAQs Address Coverage of </span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:14.0pt; color:#006E6D'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><strong><span style='font-size:14.0pt;color:#006E6D'>Preventive Services </span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:14.0pt; color:#006E6D'><o:p></o:p></span></span></p> <p align=center style='margin:0in;margin-bottom:.0001pt;text-align: center'><span style='mso-bookmark:_MailOriginal'><span style='font-size:14.0pt;color:#006E6D'>&nbsp;</span><strong><span style='color:#006E6D'>&nbsp;</span></strong></span><span style='mso-bookmark:_MailOriginal'><span style='font-size:14.0pt; color:#006E6D'><o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <p class=MsoNormal style="margin-top: 0; margin-bottom: 0;"><span style='mso-bookmark:_MailOriginal'><a name=LETTER.BLOCK7></a><span style='display:none;mso-hide:all'><o:p>&nbsp;</o:p></span></span></p> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;background:white; mso-yfti-tbllook:1184;mso-padding-alt:3.75pt 3.75pt 3.75pt 3.75pt; display:table' id="content_LETTER.BLOCK7"> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow: yes'> <td style='padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p class=MsoNormal style='margin-bottom:3.75pt'><span style='mso-bookmark:_MailOriginal'><span style='color:black'>DOL, HHS and IRS (the &quot;Departments&quot;) have released FAQs About Affordable Care Act (ACA) Implementation Part XXVI (&quot;FAQ XXVI&quot;). FAQ XXVI provides clarification of the no-cost preventive services required under ACA for non-grandfathered group health plans. </span><span style='color:#8595A3'><o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><b><span style='color:black'>Background</span></b><span style='color:black'>. ACA requires non-grandfathered group health plans to cover the following preventive services without cost sharing:<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <ul style='margin-top:0in;' type=disc> <li class=MsoNormal style='color:black;mso-list:l1 level1 lfo1; tab-stops:list .5in'><span style='mso-bookmark:_MailOriginal'>evidence-based items and services given an &quot;A&quot; or &quot;B&quot; rating by the United States Preventive Services Task Force (&quot;USPSTF&quot;) with respect to the individual involved;<o:p></o:p></span></li> <li class=MsoNormal style='color:black;mso-list:l1 level1 lfo1; tab-stops:list .5in'><span style='mso-bookmark:_MailOriginal'>immunizations as recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control;<o:p></o:p></span></li> <li class=MsoNormal style='color:black;mso-list:l1 level1 lfo1; tab-stops:list .5in'><span style='mso-bookmark:_MailOriginal'>children's preventive care and screenings as recommended by Health Resources and Services Administration (&quot;HRSA&quot;) guidelines; and<o:p></o:p></span></li> <li class=MsoNormal style='color:black;mso-list:l1 level1 lfo1; tab-stops:list .5in'><span style='mso-bookmark:_MailOriginal'>Women's preventive care and screenings as recommended by HRSA guidelines. The HRSA guidelines specifically require coverage of all FDA-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity, as prescribed by a health care provider.&nbsp;<o:p></o:p></span></li> </ul> <p style='margin:0in; margin-bottom: .0001pt;'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>If the relevant preventive services recommendation or guideline does not specify the frequency, method, treatment, or setting for a recommended preventive service, ACA allows the group health plan to use reasonable medical management techniques to limit coverage.<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><b><span style='color:black'>FAQ XXVI.</span></b><span style='color:black'> FAQ XXVI provides further clarification on the responsibilities of group health plans to cover contraceptives and other preventive services.<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><u><span style='color:black'>Contraceptives</span></u><span style='color:black'>. FAQ XXVI explains that group health plans must cover, without cost sharing, at least one type of each of the 18 methods of birth control identified by the FDA. This coverage must include clinical services, including patient education and counseling needed for the</span><span style='color:#8595A3'> </span><span style='color:black'>provision of the contraceptive method. Within each method, group health plans may use reasonable medical management techniques, including the imposition of cost-sharing on some types of birth control to encourage the use of other types when several types are available within a particular method.</span><span style='color:#8595A3'><o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><span style='color:black'>FAQ XXVI clarifies that if a provider recommends a particular type as medically necessary for an individual, the group health plan must defer to the professional's determination. Medical necessity considerations include the severity of side effects, differences in permanence and reversibility of contraceptives, and an individual's ability to appropriately use the item or service.<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><span style='color:#8595A3'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><span style='color:black'>Because the Departments' prior guidance may reasonably have been interpreted as not requiring cost-free coverage of at least one type of contraceptive treatment within each of the 18 methods identified by the FDA, the Departments will only enforce this guidance with respect to plan or policy years beginning 60 days from the publication of FAQ XXVI.<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt;background:white'><span style='mso-bookmark:_MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><u><span style='color:black'>Other Preventive Services</span></u><span style='color:black'>. With respect to other ACA-required preventive services, FAQ XXVI explains that: <o:p></o:p></span></span></p> <ul type=disc> <li class=MsoNormal style='color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo2;tab-stops: list .5in'><span style='mso-bookmark:_MailOriginal'>Under the USPSTF guidelines, a woman who has not been diagnosed as having a breast cancer susceptibility gene (BRCA) must be offered preventive screening and genetic counseling and testing as determined appropriate by her attending provider;&nbsp;<o:p></o:p></span></li> <li class=MsoNormal style='color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo2;tab-stops: list .5in'><span style='mso-bookmark:_MailOriginal'>Sex-specific recommended preventive services must be provided without cost sharing to transgender individuals, if recommended as medically appropriate for the particular individual by that individual's attending provider, regardless of the gender assigned at birth, gender identity, or recorded gender (within plan records);&nbsp;<o:p></o:p></span></li> <li class=MsoNormal style='color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo2;tab-stops: list .5in'><span style='mso-bookmark:_MailOriginal'>Health plans must cover, without cost sharing, preventive services for covered dependents of enrollees that are determined to be age and developmentally appropriate by the dependent's provider, including services related to pregnancy, such as preconception and prenatal care; and&nbsp;<o:p></o:p></span></li> <li class=MsoNormal style='color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo2;tab-stops: list .5in'><span style='mso-bookmark:_MailOriginal'>Health plans must cover, without cost sharing, anesthesia for a colonoscopy, if determined to be medically appropriate by a covered individual's attending provider.&nbsp;<o:p></o:p></span></li> </ul> <p style='margin:0in; margin-bottom: .0001pt;'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>FAQ XXVI may be accessed at: </span></span><a href="http://r20.rs6.net/tn.jsp?f=001MfQJsy5nEI_f9Q7_puZ-n4iJYtKoEnNw5yk_Qgad35VsgpXZ8238Rb31kVBO-U1P4KgdxoglrmCWByNDNnFR4KzgH1WeUhG82XCjsTzDe0FnFr9cFzyoMIi6lrfZsyNW00XuanlXcXMPKVBMAl0mE0gYXL7oTGSeIgLgtQDXfYRR3nlJV_T1oMID56qxTwMIAEmL0MBoNBYwYNlvHAEW5Opej54fgLWex1L3m5BoQ87SqkWVVo1uJH38Q7Ay1XuUOrQ5MpjLbc3BGGjvSTpjOodnuXfETU7iLuf3CHlNUVp3LJXzPf0mvuRt0BuXMji1fkueVttxQugSFVsvIiHN4Xqwsk5kEGpl1_LoeihLwyiAC0Ma6JJe6g==&amp;c=EDofUyaZwwl6ja1kIgkB_IvIairMd4jyeB7GrbftCgmnvVUDws_T8A==&amp;ch=ZCTJQtmkgAcEkZTcIp6HpzAQxMRkXRgGg6Kr-fHkAnSGJ6UE1oO2FA==" target="_blank" shape=rect alt="http://www.dol.gov/ebsa/pdf/faq-aca26.pdf?utm_source=+Health+and+Welfare+Law+Alert+5%2F21%2F15&amp;utm_campaign=State+%26+Fed&amp;utm_medium=email"><span style='mso-bookmark:_MailOriginal'>http://www.dol.gov/ebsa/pdf/faq-aca26.pdf</span><span style='mso-bookmark:_MailOriginal'></span></a><span style='mso-bookmark: _MailOriginal'><span style='color:black'><o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;&nbsp;</span><span style='color:#8595A3'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;&nbsp;&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='color:black'>&nbsp;<o:p></o:p></span></span></p> </td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> <tr style='mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td width="100%" valign=top style='width:100.0%;padding:0in 0in 0in 0in'><span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <span style='mso-bookmark:_MailOriginal'></span></td> <span style='mso-bookmark:_MailOriginal'></span> </tr> </table> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <p class=MsoNormal style="margin-top: 0; margin-bottom: 0;"><span style='mso-bookmark:_MailOriginal'><o:p>&nbsp;</o:p></span></p> <p style="margin-top: 0; margin-bottom: 0;">&nbsp;</p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in' id="content_LETTER.BLOCK8"> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width="100%" style='width:100.0%;background:#2D3E46;padding:0in 0in 0in 0in'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook: 1184;mso-padding-alt:3.75pt 3.75pt 3.75pt 3.75pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style='padding:3.75pt 3.75pt 3.75pt 3.75pt'> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='font-size:8.0pt;font-family:"Verdana","sans-serif"; color:#4E6A78'>This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='font-size:8.0pt;font-family:"Verdana","sans-serif"; color:#4E6A78'>&nbsp;<o:p></o:p></span></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span style='mso-bookmark: _MailOriginal'><span style='font-size:8.0pt;font-family:"Verdana","sans-serif"; color:#4E6A78'>This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.&nbsp; This material is not to be construed as legal advice or legal opinions on specific facts. 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