SECTION FOURTEEN: PRIVACY REQUIREMENTS OF THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA)
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)
Your Individual Privacy Rights
The Plan's Duties
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 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.