Dear Participants,

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that health plans (and healthcare providers) protect the confidentiality and privacy of Protected Health Information (PHI). The term "Protected Health Information" includes all information related to your past or present health condition that individually identifies you or could reasonably be used to identify you and is transferred to another entity or maintained by the Plan in oral, written, electronic or any other form. This not only includes medical records, but also includes information regarding your eligibility for benefits under the Plan, claim status or coverage issues regarding a particular claim and other specific information regarding you and your dependents.

A group health plan is required to allow special enrollment for certain individuals to enroll in the plan without having to wait until the plan's next regular enrollment season.

Group health plans and health insurance issuers are required to provide special enrollment periods during which individuals who previously declined coverage for themselves and their dependents may be allowed to enroll (without having to wait until the plan's next open enrollment period).

A special enrollment opportunity occurs if an individual with other health insurance loses that coverage or if a person becomes a new dependent through marriage, birth, adoption or placement for adoption. However, an individual must notify the plan of their request for special enrollment with 30 days after losing their coverage or within 30 days of having (or becoming) a new dependent.

A description of your HIPAA Privacy rights is found in the Privacy Notice, which has been distributed to you. The Privacy Notice includes the following information:

Your Protected Health Information (PHI)

  • When the Plan may disclose your PHI
  • When the disclosure of your PHI requires your written authorization
  • Use or disclosure of your PHI that requires you to be given an opportunity to agree or disagree before its use or release.
  • Use or disclosure of your PHI for which consent, authorization or opportunity to object is not required.

Your Individual Privacy Rights

  • Requesting restrictions on PHI uses and disclosures
  • Inspecting and copying PHI
  • Requesting that the Plan amend your PHI
  • Receiving an accounting of the Plan's PHI disclosures
  • Exercising your rights through a personal representative

The Plan's Duties

  • Maintaining your privacy by duties and privacy practices
  • Disclosing only the minimum necessary PHI

Your Right to File a Complaint with the Plan or the Secretary of the U.S. Department of Health and Human Services (HHS Secretary)

  • If you believe that your privacy right have been violated, you may file a complaint with a Plan's Privacy Officer at the Fund Office or you may contact the Secretary of the U.S. Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Washington, DC., 20201

If you have any questions about your Privacy Rights under HIPAA, you may contact the Privacy Officer at the Fund Office.


The Board of Trustees

Please note that this is a summary of the Plan. The full plan of benefits is contained in the formal Plan document. If there is any discrepancy between this summary and the Plan document, the Plan document governs.


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