Page 37 - Dentsu 2022 Annual Enrollment Flyer
P. 37
Notice of Privacy Practices
Please carefully review this notice. It describes how Health care operations include activities by this Plan (and,
medical information about you may be used and in limited circumstances, by other plans or providers),
disclosed and how you can get access to this information. such as wellness and risk assessment programs, quality
The Health Insurance Portability and Accountability Act assessment and improvement activities, customer
service, and internal grievance resolution. Health care
of 1996 (HIPAA) imposes numerous requirements on operations also include evaluating vendors; engaging
the use and disclosure of individual health information in credentialing, training, and accreditation activities;
by employer health plans. This information, known as performing underwriting or premium rating; arranging
protected health information (PHI), includes almost all for medical review and audit activities; and conducting
individually identifiable health information held by a plan business planning and development. For example, the Plan
— whether received in writing, in an electronic medium, may use information about your claims to audit the third
or as an oral communication. This notice describes the parties that approve payment for Plan benefits.
privacy practices of the BenefitsPlus plan. The plans
covered by this notice may share health information with The amount of health information used, disclosed or
each other to carry out treatment, payment, or health requested will be limited and, when needed, restricted
care operations. The BenefitsPlus plans are collectively to the minimum necessary to accomplish the intended
referred to as the Plan in this notice, unless specified purposes, as defined under the HIPAA rules. If the Plan
otherwise. The BenefitsPlus plans are provided by Aegis uses or discloses PHI for underwriting purposes, the
Media Americas, LLC otherwise referred to as ‘your Plan will not use or disclose PHI that is your genetic
employer’ in this notice, unless specified otherwise. information for such purposes.
The Plan’s duties with respect to health information How the Plan may share your health information with
about you your employer
The Plan is required by law to maintain the privacy of your The Plan, or its health insurer or HMO, may disclose your
health information and to provide you with this notice of health information without your written authorization
the Plan’s legal duties and privacy practices with respect to your employer for plan administration purposes. (Your
to your health information. If you participate in an insured employer may need your health information to administer
plan option, you will receive a notice directly from the benefits under the Plan.) Your employer agrees not to
Insurer. It’s important to note that these rules apply to the use or disclose your health information other than as
plan, not your employer — that’s the way the HIPAA rules permitted or required by the Plan documents and by law.
work. Different policies may apply to other BenefitsPlus Benefits staff, payroll, and finance are the only employees
plans or to data unrelated to the plans. who will have access to your health information for plan
administration functions.
How the Plan may use or disclose your health
information Here’s how additional information may be shared between
the Plan and your employer, as allowed under the HIPAA
The privacy rules generally allow the use and disclosure rules:
of your health information without your permission
(known as an authorization) for purposes of health care The Plan, or its insurer or HMO, may disclose “summary
treatment, payment activities, and health care operations. health information” to the employer, if requested, for
Here are some examples of what that might entail: purposes of obtaining premium bids to provide coverage
Treatment includes providing, coordinating, or managing under the Plan or for modifying, amending, or terminating
the Plan. Summary health information is information
health care by one or more health care providers or that summarizes participants’ claims information, from
doctors. Treatment can also include coordination or which names and other identifying information have been
management of care between a provider and a third party, removed.
and consultation and referrals between providers. For
example, the Plan may share your health information with The Plan, or its insurer or HMO, may disclose to your
physicians who are treating you. employer information on whether an individual is
Payment includes activities by this Plan, other plans, participating in the Plan or has enrolled or disenrolled in
an insurance option or HMO offered by the Plan.
or providers to obtain premiums, make coverage
determinations, and provide reimbursement for health In addition, you should know that your employer cannot
care. This can include determining eligibility, reviewing and will not use health information obtained from the
services for medical necessity or appropriateness, Plan for any employment-related actions. However, health
engaging in utilization management activities, claims information collected by the employer from other sources
management, and billing; as well as performing “behind — for example, under the Family and Medical Leave Act,
the scenes” plan functions, such as risk adjustment, Americans with Disabilities Act, or workers’ compensation
collection, or reinsurance. For example, the Plan may programs — is not protected under HIPAA (although this
share information about your coverage or the type of information may be protected under other federal
or state laws).
37 2022 Benefits Enrollment
Please carefully review this notice. It describes how Health care operations include activities by this Plan (and,
medical information about you may be used and in limited circumstances, by other plans or providers),
disclosed and how you can get access to this information. such as wellness and risk assessment programs, quality
The Health Insurance Portability and Accountability Act assessment and improvement activities, customer
service, and internal grievance resolution. Health care
of 1996 (HIPAA) imposes numerous requirements on operations also include evaluating vendors; engaging
the use and disclosure of individual health information in credentialing, training, and accreditation activities;
by employer health plans. This information, known as performing underwriting or premium rating; arranging
protected health information (PHI), includes almost all for medical review and audit activities; and conducting
individually identifiable health information held by a plan business planning and development. For example, the Plan
— whether received in writing, in an electronic medium, may use information about your claims to audit the third
or as an oral communication. This notice describes the parties that approve payment for Plan benefits.
privacy practices of the BenefitsPlus plan. The plans
covered by this notice may share health information with The amount of health information used, disclosed or
each other to carry out treatment, payment, or health requested will be limited and, when needed, restricted
care operations. The BenefitsPlus plans are collectively to the minimum necessary to accomplish the intended
referred to as the Plan in this notice, unless specified purposes, as defined under the HIPAA rules. If the Plan
otherwise. The BenefitsPlus plans are provided by Aegis uses or discloses PHI for underwriting purposes, the
Media Americas, LLC otherwise referred to as ‘your Plan will not use or disclose PHI that is your genetic
employer’ in this notice, unless specified otherwise. information for such purposes.
The Plan’s duties with respect to health information How the Plan may share your health information with
about you your employer
The Plan is required by law to maintain the privacy of your The Plan, or its health insurer or HMO, may disclose your
health information and to provide you with this notice of health information without your written authorization
the Plan’s legal duties and privacy practices with respect to your employer for plan administration purposes. (Your
to your health information. If you participate in an insured employer may need your health information to administer
plan option, you will receive a notice directly from the benefits under the Plan.) Your employer agrees not to
Insurer. It’s important to note that these rules apply to the use or disclose your health information other than as
plan, not your employer — that’s the way the HIPAA rules permitted or required by the Plan documents and by law.
work. Different policies may apply to other BenefitsPlus Benefits staff, payroll, and finance are the only employees
plans or to data unrelated to the plans. who will have access to your health information for plan
administration functions.
How the Plan may use or disclose your health
information Here’s how additional information may be shared between
the Plan and your employer, as allowed under the HIPAA
The privacy rules generally allow the use and disclosure rules:
of your health information without your permission
(known as an authorization) for purposes of health care The Plan, or its insurer or HMO, may disclose “summary
treatment, payment activities, and health care operations. health information” to the employer, if requested, for
Here are some examples of what that might entail: purposes of obtaining premium bids to provide coverage
Treatment includes providing, coordinating, or managing under the Plan or for modifying, amending, or terminating
the Plan. Summary health information is information
health care by one or more health care providers or that summarizes participants’ claims information, from
doctors. Treatment can also include coordination or which names and other identifying information have been
management of care between a provider and a third party, removed.
and consultation and referrals between providers. For
example, the Plan may share your health information with The Plan, or its insurer or HMO, may disclose to your
physicians who are treating you. employer information on whether an individual is
Payment includes activities by this Plan, other plans, participating in the Plan or has enrolled or disenrolled in
an insurance option or HMO offered by the Plan.
or providers to obtain premiums, make coverage
determinations, and provide reimbursement for health In addition, you should know that your employer cannot
care. This can include determining eligibility, reviewing and will not use health information obtained from the
services for medical necessity or appropriateness, Plan for any employment-related actions. However, health
engaging in utilization management activities, claims information collected by the employer from other sources
management, and billing; as well as performing “behind — for example, under the Family and Medical Leave Act,
the scenes” plan functions, such as risk adjustment, Americans with Disabilities Act, or workers’ compensation
collection, or reinsurance. For example, the Plan may programs — is not protected under HIPAA (although this
share information about your coverage or the type of information may be protected under other federal
or state laws).
37 2022 Benefits Enrollment
