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CHARITIES HOUSING DEVELOPMENT CORPORATION HEALTH
BENEFITS
PLAN NOTICE OF PRIVACY PRACTICES
Pursuant
to the Health Insurance Portability and Accountability Act ("HIPAA
") effective January 1, 2004.
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAYBE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
THE PRIVACY OF YOUR PERSONAL AND HEALTH INFORMATION IS IMPORTANT.
CHARITIES
HOUSING DEVELOPMENT CORPORATION ("Employer") is committed
to protecting the privacy of health information maintained by the health
plans it sponsors. This Notice is provided to you as required by the Health
Insurance Portability and Accountability Act and the HIPAA Privacy Regulations
(collectively, "HIPAA”). It applies to employees and covered
dependents enrolled in CHARITIES HOUSING DEVELOPMENT CORPORATION
Health Benefits Plan ("Plan").
This
Notice describes how the Plan may use health information about you and
your covered dependents and when such information may be used and disclosed.
This notice also describes how you may have access to this information.
WHAT
HEALTH INFORMATION IS COLLECTED?
The
Plan considers personal health information to be confidential. The Plan
will protect the privacy of that information in accordance with federal
and state privacy laws, as well as the Plans' privacy policies. "Health
Information" is used to mean information that identifies you and
relates to your medical history, such as the health care you receive and
or the amounts paid for that care.
Health information
subject to the provisions explained in this Notice is information maintained
by the Plan. The provisions do not extend to similar information, which
may be on file with the Employer as an Employer in its normal course of
doing business. The type of health information typically received and
maintained by the Plan, which is subject to this Notice, includes enrollment
and claims information, benefit determinations, appeals information, eligibility,
and case management information.
SUMMARY
OF PERMISSIBLE USES AND DISCLOSURES AND YOUR RIGHTS REGARDING YOUR HEALTH
INFORMATION, WHICH DO NOT REQUIRE YOUR AUTHORIZATION
In order
to provide and administer your benefits, the Plans may use and disclose
your health information in various ways without your express authorization.
These include:
- Payment:
The Plan may use and disclose your health information for purposes of
paying your health care services or to obtain premiums/contributions
from you. The Plan may also use and disclose your health information
to make determinations about your eligibility for benefit plan coverage,
for coordination of benefits with other benefit plans, to perform claims
management and collection activities to review the medical necessity
or the appropriateness of the care you received, and to conduct utilization
review such as pre-authorizations, or reviews, of services.
- Health
Care Operations:
The Plan may use and disclose your health information as necessary to
operate and manage their business operations. For example the Employer,
on behalf of the Plan, has contracts with an outside firm called a "third
party administrator" (TPA) to provide administrative services to
the Plan. The Plan may use your health information to evaluate the performance
of the TP A in managing and providing you with health care benefits.
The Plan might use and disclose your health information to contract
for reinsurance or to investigate the validity of benefits claims. In
addition, the Plan may share your health information with another company
that performs certain services, such as billing or compiling information
to help the Plan determine how the Plan is doing relative to other plans.
Whenever the Plan has such an arrangement, they will have a written
confidentiality agreement to ensure that the company that performs these
services will protect the privacy of your health information, maintain
its confidentiality and limit the uses or further disclosures to the
purpose for which the information was disclosed or as required by law.
- Benefits
and Services: As a part of health care operations, the Plan
may use your health information to contact you regarding benefits or
services that may be of interest to you, such as benefits that are included
in the Plan, your medical treatment, case management and coordination
of benefits, recommendations or alternative treatments, therapies, health
care providers or settings of care.
- Employer:
The Plan may disclose certain health information to the Employer since
it is the Employer, which sponsors the Plan. Upon a request from the
Employer, the Plan may disclose health information about enrolled employees
and their covered dependents to enable the Employer to obtain premium
bids from other health plans, or to modify, amend or terminate the Plan;
however, the information the Plan discloses in such situations will
not include any information that explicitly identifies individuals.
The Plan may disclose to the Employer information on whether you are
participating in, enrolled in, or un-enrolled from the Plan. The Plan
also may disclose health information about you, including information
that identifies you, only if it is necessary for the Employer to administer
the Plan. For example, the Employer may need such information to process
health benefits claims, to audit or monitor the business operations
of the Plan, or to ensure that the Plans are operating effectively and
efficiently. The Plan may also disclose information to the Employer
with respect to workers' compensation and the Family and Medical Leave
Act. The Plan, however will restrict their use of your information to
purposes related only to Plan administration. The Plan prohibits the
Employer from using your information for uses unrelated to Plan administration.
Under no circumstances will the Plan disclose your health information
to the Employer for the purpose of employment-related actions or decisions.
The Employer will only disclose the health information it received from
the Plan to third parties, such as to consultants or advisors, if the
Plan has first obtained a confidentiality agreement from the person
or organization, which will receive your health information.
- Disclosures
to Friend and Family Involved in Your Care and Payment for Your Care:
The Plans may share information about your health benefits to a person
involved in your care such as a family member unless you object. If
you have provided a friend or family member with copies of your claim
and other relevant identifying information, the Plan will assume that
you do not object.
- Emergencies
or Public Need: The Plan may use or disclose your health information
in an emergency or for important public needs. For example, the Plan
may share your information with public health officials authorized to
investigate and control the spread of diseases. The Plan may have information
to prevent or lessen a serious and imminent threat to health or safety.
- As
Required By Law: The Plan may use or disclose your health information
if the Plan is required by law to do so. The Plan will notify you of
these uses and disclosures if notice is required by law.
- Business
Associates: The Plan may share information with service providers
who provide administrative services for the Plans.
USES
AND DISCLOSURES OF HEALTH INFORMATION WHICH
REQUIRE YOUR WRITTEN AUTHORIZATION
Except as
otherwise described in this Notice, the Plan, through their third party
administrator, will generally obtain your written authorization before
using your health information or disclosing it outside the Plan. If you
provide the Plan with such written authorization, you may revoke the authorization
at any time, except to the extent that the Plans have already relied on
it. To revoke an authorization, write to the Plan Administrator or Privacy
Officer.
Access
and Control of Your Health Information
The Plan must provide you certain rights with respect to access and control
of your health information in your health claims file. You have the following
rights to access and control your health information.
- You generally
have the right to inspect and copy your health information, which the
Plan maintains.
- You have
the right to request that the Plan amend your protected health information
if you believe it is inaccurate or incomplete. You must submit your
request in writing to the third party administrator of the Plan in which
you are enrolled.
- You have
the right to receive from the Plan an accounting of disclosures of protected
health information. Your request must be in writing to the Privacy Officer.
Many routine disclosures the Plan makes, including disclosures to your
Employer for Plan Administration, will not be included in the accounting;
the accounting will identify only non-routine disclosures.
- You have
the right to request further restrictions on the way the Plan uses your
health information or shares it with others. The Plan is not required
to agree to the restriction you request, but if the Plan does, the Plan
will be bound by the agreement until such agreement is revoked by the
Plan and you are notified in writing of such revocation.
- You have
the right to request that the Plan contact you in a way that is more
confidential for you, such as at work instead of at home, if disclosure
of your health information could put you in danger and you clearly state
that in your request. The Plans will accommodate all reasonable requests.
To
Have Someone Act on Your Behalf
You have the right to name a personal representative who may act on your
behalf to control the privacy of your health information. This authorization
must be in writing and delivered to the Privacy Officer for the Plan.
Special
Protections for HIV, Substance Abuse, and Mental Health Information
Special privacy protections may apply to HIV related information, substance
abuse information, and mental health information. Some parts of this Notice
may not apply to these types of information.
Complaints
If you believe your privacy rights have been violated, you may file a
complaint with the Plan or with the Secretary of the Department of Health
and Human Services. To file a complaint with the Plan, please contact
the Privacy Officer listed at the end of this notice:
No one will
retaliate or take action against you for filing a complaint.
Right
to Revise
The Plan may change its privacy practices from time to time. If that happens,
the Plan will revise this Notice so you will have an accurate summary
of the Plans' practices. The revised Notice will apply to all of your
health information. If you received this Notice electronically, you have
the right to obtain a paper copy of the Notice. To request a paper copy
of this Notice or any revised Notice, please contact the Plan's Privacy
Officer. If this Notice is substantially revised, a new Notice will be
mailed to you within 60 days.
The Plan
is required by law to abide by the terms of the Notice currently in effect.
Contact
Information
For further information, please contact the Plans' Privacy Officer:
Anne Stahr
CHARITIES HOUSING DEVELOPMENT CORPORATION
465 South 1st Street
San Jose, CA 94113
(408) 282-1128
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