Page 35 - 2018 DAN Enrollment
P. 35
criminal, or administrative proceedings. The Plan may deny denied and any rights you may have to disagree or ile a Changes to the information in this notice should qualify for coverage under Medicare in the future. Please
your right to access, although in certain circumstances, you may complaint The Plan must abide by the terms of the privacy notice currently note, however, that later notices might supersede this notice.
request a review of the denial. in effect. This notice takes effect on September 23, 2013.
Provide a written statement that the time period for reviewing Medicare prescription drug coverage became available in 2006
If you want to exercise this right, your request to the Plan must your request will be extended for no more than 30 more days, However, the Plan reserves the right to change the terms of its to everyone with Medicare. You can get this coverage if you join
be in writing. Within 30 days of receipt of your request (60 days along with the reasons for the delay and the date by which the privacy policies, as described in this notice, at any time and to a Medicare Prescription Drug Plan or join a Medicare Advantage
if the health information is not accessible on site), the Plan will Plan expects to address your request make new provisions effective for all health information that Plan (like an HMO or PPO) that offers prescription drug
provide you with one of these responses: the Plan maintains. This includes health information that was coverage. All Medicare drug plans provide at least a standard
previously created or received, not just health information
Right to receive an accounting of disclosures of your health level of coverage set by Medicare. Some plans may also offer
The access or copies you requested information created or received after the policy is changed. If changes are more coverage for a higher monthly premium.
made to the Plan’s privacy policies described in this notice, you
A written denial that explains why your request was denied and You have the right to a list of certain disclosures of your health will be provided with a revised privacy notice via email and it AMA has determined that the prescription drug coverage
any rights you may have to have the denial reviewed or ile a information the Plan has made. This is often referred to as an will also be posted on the company intranet. offered by the beneitsPLUS Medical Plan is, on average for
complaint “accounting of disclosures.” You generally may receive this all plan participants, expected to pay out as much as standard
accounting if the disclosure is required by law, in connection with Complaints Medicare prescription drug coverage pays and is considered
A written statement that the time period for reviewing your public health activities, or in similar situations listed in the table “creditable” prescription drug coverage. This is important for
request will be extended for no more than 30 more days, along earlier in this notice, unless otherwise indicated below. If you believe your privacy rights have been violated or your the reasons described below.
with the reasons for the delay and the date by which the Plan Plan has not followed its legal obligations under HIPAA, you
expects to address your request You may receive information on disclosures of your health may complain to the Plan and to the Secretary of Health and Because your existing coverage is, on average, at least as good
information for up to six years before the date of your request. Human Services. You won’t be retaliated against for iling as standard Medicare prescription drug coverage, you can keep
You may also request your health information be sent to You do not have a right to receive an accounting of any a complaint. To ile a complaint, please put your complaint this coverage and not pay a higher premium (a penalty) if you
another entity or person, so long as that request is clear, disclosures made in any of these circumstances: in writing to the Privacy Oficer as indicated below under later decide to enroll in a Medicare drug plan, as long as you
conspicuous and speciic. The Plan may provide you with “contact.” If your contact complaint pertains to an insured later enroll within speciic time periods.
a summary or explanation of the information instead of For treatment, payment, or health care operations beneit, please contact the person indicated in the notice
access to or copies of your health information, if you agree distributed by the insurance company. Any complaints to
in advance and pay any applicable fees. The Plan also may To you about your own health information the secretary should be addressed to the Secretary of the
charge reasonable fees for copies or postage. If the Plan Incidental to other permitted or required disclosures US Department of Health and Human Services, Hubert
doesn’t maintain the health information but knows where it is H. Humphrey Building, 200 Independence Avenue, S.W.,
maintained, you will be informed where to direct your request. Where authorization was provided Washington, D.C. 20201. (You may get additional information
at www.hhs.gov). The Plan encourages you to express
If the Plan keeps your records in an electronic format, you may To family members or friends involved in your care (where any concerns you may have regarding the Privacy of your
request an electronic copy of your health information in a form disclosure is permitted without authorization) information.
and format readily producible by the Plan. You may also request
that such electronic health information be sent to another entity For national security or intelligence purposes or to correctional
or person, so long as that request is clear, conspicuous, and institutions or law enforcement oficials in certain circumstances Contact
speciic. Any charge that is assessed to you for these copies For more information on the Plan’s privacy policies or your
must be reasonable and based on the Plan’s cost. As part of a “limited data set” (health information that excludes rights under HIPAA, contact
certain identifying information)
Director of Beneits
Right to amend your health information that is inaccurate or In addition, your right to an accounting of disclosures to a health
incomplete oversight agency or law enforcement oficial may be suspended Dentsu Aegis Network
th
With certain exceptions, you have a right to request that the at the request of the agency or oficial. 32 Avenue of Americas, 18 Floor
Plan amend your health information in a designated record New York, NY 10013
set. The Plan may deny your request for a number of reasons. If you want to exercise this right, your request to the Plan must
For example, your request may be denied if the health be in writing. Within 60 days of the request, the Plan will provide Important Notice from the beneitsPLUS Program About Your
information is accurate and complete, was not created by the you with the list of disclosures or a written statement that the Creditable Prescription Drug Coverage and Medicare
Plan (unless the person or entity that created the information is time period for providing this list will be extended for no more Please read this notice carefully and keep it where you can ind
no longer available), is not part of the designated record set, than 30 days, along with the reasons for the delay and the date it. This notice has information about your current prescription
or is not available for inspection (e.g., psychotherapy notes by which the Plan expects to address your request. You may drug coverage through the beneitsPLUS program and about
or information compiled for civil, criminal, or administrative make one request in any 12-month period at no cost to you, your options under Medicare’s prescription drug coverage. This
proceedings). but the Plan may charge a fee for subsequent requests. You’ll information can help you decide whether you want to join a
be notiied of the fee in advance and have the opportunity to
If you want to exercise this right, your request to the Plan must change or revoke your request. Medicare drug plan. Information about where you can get help
be in writing, and you must include a statement to support to make decisions about your prescription drug coverage is at
the requested amendment. Within 60 days of receipt of your Right to obtain a paper copy of this notice from the Plan the end of this notice.
request, the Plan will take one of these actions: upon request If neither you nor any of your covered dependents are eligible
Make the amendment as requested You have the right to obtain a paper copy of this privacy notice for or have Medicare, this notice does not apply to you or your
upon request. Even individuals who agreed to receive this notice dependents, as the case may be. However, you should still
Provide a written denial that explains why your request was electronically may request a paper copy at any time. keep a copy of this notice in the event you or a dependent
34 2018 Benefits Enrollment Dentsu Aegis Network 35
your right to access, although in certain circumstances, you may complaint The Plan must abide by the terms of the privacy notice currently note, however, that later notices might supersede this notice.
request a review of the denial. in effect. This notice takes effect on September 23, 2013.
Provide a written statement that the time period for reviewing Medicare prescription drug coverage became available in 2006
If you want to exercise this right, your request to the Plan must your request will be extended for no more than 30 more days, However, the Plan reserves the right to change the terms of its to everyone with Medicare. You can get this coverage if you join
be in writing. Within 30 days of receipt of your request (60 days along with the reasons for the delay and the date by which the privacy policies, as described in this notice, at any time and to a Medicare Prescription Drug Plan or join a Medicare Advantage
if the health information is not accessible on site), the Plan will Plan expects to address your request make new provisions effective for all health information that Plan (like an HMO or PPO) that offers prescription drug
provide you with one of these responses: the Plan maintains. This includes health information that was coverage. All Medicare drug plans provide at least a standard
previously created or received, not just health information
Right to receive an accounting of disclosures of your health level of coverage set by Medicare. Some plans may also offer
The access or copies you requested information created or received after the policy is changed. If changes are more coverage for a higher monthly premium.
made to the Plan’s privacy policies described in this notice, you
A written denial that explains why your request was denied and You have the right to a list of certain disclosures of your health will be provided with a revised privacy notice via email and it AMA has determined that the prescription drug coverage
any rights you may have to have the denial reviewed or ile a information the Plan has made. This is often referred to as an will also be posted on the company intranet. offered by the beneitsPLUS Medical Plan is, on average for
complaint “accounting of disclosures.” You generally may receive this all plan participants, expected to pay out as much as standard
accounting if the disclosure is required by law, in connection with Complaints Medicare prescription drug coverage pays and is considered
A written statement that the time period for reviewing your public health activities, or in similar situations listed in the table “creditable” prescription drug coverage. This is important for
request will be extended for no more than 30 more days, along earlier in this notice, unless otherwise indicated below. If you believe your privacy rights have been violated or your the reasons described below.
with the reasons for the delay and the date by which the Plan Plan has not followed its legal obligations under HIPAA, you
expects to address your request You may receive information on disclosures of your health may complain to the Plan and to the Secretary of Health and Because your existing coverage is, on average, at least as good
information for up to six years before the date of your request. Human Services. You won’t be retaliated against for iling as standard Medicare prescription drug coverage, you can keep
You may also request your health information be sent to You do not have a right to receive an accounting of any a complaint. To ile a complaint, please put your complaint this coverage and not pay a higher premium (a penalty) if you
another entity or person, so long as that request is clear, disclosures made in any of these circumstances: in writing to the Privacy Oficer as indicated below under later decide to enroll in a Medicare drug plan, as long as you
conspicuous and speciic. The Plan may provide you with “contact.” If your contact complaint pertains to an insured later enroll within speciic time periods.
a summary or explanation of the information instead of For treatment, payment, or health care operations beneit, please contact the person indicated in the notice
access to or copies of your health information, if you agree distributed by the insurance company. Any complaints to
in advance and pay any applicable fees. The Plan also may To you about your own health information the secretary should be addressed to the Secretary of the
charge reasonable fees for copies or postage. If the Plan Incidental to other permitted or required disclosures US Department of Health and Human Services, Hubert
doesn’t maintain the health information but knows where it is H. Humphrey Building, 200 Independence Avenue, S.W.,
maintained, you will be informed where to direct your request. Where authorization was provided Washington, D.C. 20201. (You may get additional information
at www.hhs.gov). The Plan encourages you to express
If the Plan keeps your records in an electronic format, you may To family members or friends involved in your care (where any concerns you may have regarding the Privacy of your
request an electronic copy of your health information in a form disclosure is permitted without authorization) information.
and format readily producible by the Plan. You may also request
that such electronic health information be sent to another entity For national security or intelligence purposes or to correctional
or person, so long as that request is clear, conspicuous, and institutions or law enforcement oficials in certain circumstances Contact
speciic. Any charge that is assessed to you for these copies For more information on the Plan’s privacy policies or your
must be reasonable and based on the Plan’s cost. As part of a “limited data set” (health information that excludes rights under HIPAA, contact
certain identifying information)
Director of Beneits
Right to amend your health information that is inaccurate or In addition, your right to an accounting of disclosures to a health
incomplete oversight agency or law enforcement oficial may be suspended Dentsu Aegis Network
th
With certain exceptions, you have a right to request that the at the request of the agency or oficial. 32 Avenue of Americas, 18 Floor
Plan amend your health information in a designated record New York, NY 10013
set. The Plan may deny your request for a number of reasons. If you want to exercise this right, your request to the Plan must
For example, your request may be denied if the health be in writing. Within 60 days of the request, the Plan will provide Important Notice from the beneitsPLUS Program About Your
information is accurate and complete, was not created by the you with the list of disclosures or a written statement that the Creditable Prescription Drug Coverage and Medicare
Plan (unless the person or entity that created the information is time period for providing this list will be extended for no more Please read this notice carefully and keep it where you can ind
no longer available), is not part of the designated record set, than 30 days, along with the reasons for the delay and the date it. This notice has information about your current prescription
or is not available for inspection (e.g., psychotherapy notes by which the Plan expects to address your request. You may drug coverage through the beneitsPLUS program and about
or information compiled for civil, criminal, or administrative make one request in any 12-month period at no cost to you, your options under Medicare’s prescription drug coverage. This
proceedings). but the Plan may charge a fee for subsequent requests. You’ll information can help you decide whether you want to join a
be notiied of the fee in advance and have the opportunity to
If you want to exercise this right, your request to the Plan must change or revoke your request. Medicare drug plan. Information about where you can get help
be in writing, and you must include a statement to support to make decisions about your prescription drug coverage is at
the requested amendment. Within 60 days of receipt of your Right to obtain a paper copy of this notice from the Plan the end of this notice.
request, the Plan will take one of these actions: upon request If neither you nor any of your covered dependents are eligible
Make the amendment as requested You have the right to obtain a paper copy of this privacy notice for or have Medicare, this notice does not apply to you or your
upon request. Even individuals who agreed to receive this notice dependents, as the case may be. However, you should still
Provide a written denial that explains why your request was electronically may request a paper copy at any time. keep a copy of this notice in the event you or a dependent
34 2018 Benefits Enrollment Dentsu Aegis Network 35
