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• We can share PHI with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests
We can use or share PHI about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective

services
Respond to lawsuits and legal actions
We can share PHI about you in response to a court or administrative order, or in response to a
subpoena.
Communicate with service providers
We may enter into agreements with entities or individuals to provide services (for example, claims
processing services) to the Plan. These service providers, called “business associates,” may create,
receive, have access to, use, and/or disclose (including to other business associates) PHI in
conjunction with the services they provide to the Plan, provided that we have obtained satisfactory
written assurances that the business associates will comply with all applicable Privacy Rules.

Our Responsibilities

• We are required by law to maintain the privacy and security of your PHI.
• The Plan must notify you within 60 days of discovery of a breach. A breach occurs if unsecured PHI
is acquired, used or disclosed in a manner that is impermissible under the Privacy Rules, unless there
is a low probability that the PHI has been compromised.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your PHI other than as described here unless you provide written
authorization. If you authorize use or sharing, you may change your mind at any time. Let us know
in writing if you change your mind.

For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about
you. The new notice will be available upon request, on our web site, and we will provide a copy to
you.

No Guarantee of Employment
This notice does not create any right to employment for any individual, nor does it change your
employer’s right to discharge any of its employees at any time, with or without cause.

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