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~ <br />P <br />ClIT y~ p El i p~A~4 <br /> <br />II-. <br />March 12, 2002 <br />HCFA <br />Attn: David Holstein <br />7500 Security Blvd. Room S-L17 <br />Baltimore, MD 21244-1850 <br />RE: E[ection to be exempted from cenain requirements under HIPAA <br />Dear Mr. Holstein: <br />The City of Paris elects that its group medical plan be exempted from the following <br />requirements of the Health Insurance Portability and Accountability Act of 1996 for the Plan Year <br />beginning October 1, 1999: <br />1. L'unitations on pre-existing condition exclusion periods (146.111); <br />2. Special enrollment periods for individuals (and dependents) losing other coverage <br />and special enrollment periods with respect to certain dependent beneficiaries <br />(146.117); <br />3. Prohibitions against discriminating against individual participants and beneficiaries <br />based on health status (146.121); <br />4. Standards relating to benefits for mothers and newborns (section 2704 of the PHS <br />Act); <br />5. Parity in the application of certain limits to mental health benefits; and <br />6. Benefits relating to women's heal[h and cancer rights (section 903 of the PH5 Act). <br />Treatment or reduction of the non-affected breast following a mastectomy. <br />The medical benefits payable by the City's health plan are self-funded. The plan is <br />protected against catastrophic loss by aggregate and individual stop loss policies which reimburse <br />the City for medical claims paid in excess of stop loss levels. <br />The City of Paris group medical plan is identified as follows: <br />Name of Plan: City of Paris, Texas Intergovernmental Employee Benefits Pool <br />Plan Sponsor: City of Paris <br />Plan Manager: W. E. Anderson <br />P.O. BO% 9037 • PARIS, TEXAS 75461-9037 •(903) 785-7511 • FAX (903) 785-8519 <br />`~?_NBIT A <br />