HomeMy WebLinkAboutAddenda - RFP - P832 BENEFITS (3)AMENDMENT NUMBER 3 TO THE
CITY OF FORT COLLINS GROUP BASIC DENTAL PLAN
GROUP #1858
Effective April 14, 2003, the City of Fort Collins Group Dental Plan is amended to add Part 8 for
the purpose of complying with the privacy requirements of the Health Insurance Portability and
Accountability Act (HIPAA) of 1986.
Part 8 HIPAA PRIVACY COMPLIANCE
8.1 P ose
This article is intended to adopt Plan policies and procedures consistent with the Standards
for Privacy of Individually Identifiable Health Information of the Health Insurance Portability
and Accountability Act of 1996 (HIPAA), and the Final Rules as published by the Office of
the Secretary, Department of Health and Human Services in the Federal Register and found
at 45 C.F.R. Part 160 and Part 164 ("Privacy Regulations"), and any amendments thereto.
8.2 Use and Disclosure of Protected Health Information by Plan Sponsor
The Plan Sponsor may use and disclose protected health information, as that term is defined
in 45 C.F.R. '164.501, only as expressly provided under the Privacy Regulations and the
terms and conditions of this Plan Document.
8.3 Disclosures by the Plan to the Plan Sponsor.
The Plan Sponsor will:
(A) Not use or further disclose the information other than as permitted or required by the
plan documents or as required by law;
(B) Ensure that any agents, including subcontractors, to whom it provides protected
health information received from the Plan agree to the same restrictions and
conditions that apply to the Plan Sponsor with respect to such information;
(C) Not use or disclose the information for employment -related actions and decisions or
in connection with any other benefit or employee benefit Plan of the Plan Sponsor
without the written authorization of the Participant;
(D) Report to the Plan any use or disclosure of the information that is inconsistent with
the uses or disclosures provided for herein of which it becomes aware;
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(E) Make available protected health information in accordance with '164.524 of the
Privacy Regulations that provides individuals a right of access to inspect and obtain
copies of protected health information about the individual contained in a designated
record set;
(F) Make available protected health information for amendment and incorporate any
amendments to protected health information in accordance with ' 164.526 of the
Privacy Regulations;
(G) Make available the information required to provide an accounting of disclosures in
accordance with ' 164.528 of the Privacy Regulations;
(H) Make its internal practices, books, and records relating to the use and disclosure of
protected health information received from the Plan available to the Secretary of the
Department of Health and Human Services or those acting under the authority or at
the direction of the Secretary for purposes of determining compliance by the Plan
with the Privacy Regulations;
(I) If feasible, return or destroy all protected health information received from the Plan
that the Plan Sponsor still maintains in any form and retain no copies of such
information when no longer needed for the purpose for which disclosure was made,
except that, if such return or destruction is not feasible, the Plan Sponsor will limit
further uses and disclosures to those purposes that make the return or destruction of
the information infeasible; and
(J) Ensure that the adequate separation required in ' 164.504(f)(2)(iii) of the Privacy
Regulations is established.
8.4 Disclosures by Others to the Plan S onsor
The Plan Sponsor shall be entitled to receive protected health information from:
(A) the Plan;
(B) any business associate of the Plan;
(C) any person or entity that contracts with such business associate;
(D) any person or entity that contracts with the Plan Sponsor to provide services to or on
behalf of the Plan;
(E) any health insurer or health insurance issuer or HMO that provides health benefits
coverage or services to or on behalf of the Plan;
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(F) any health care clearinghouse that provides services to or on behalf of the Plan or
with respect to Plan Participants; and
(G) any other person or entity that maintains, or has the authority to direct the disclosure
of, protected health information related to any Plan Participant.
8.5 Adequate Separation
(A) Only those persons or classes of persons described below that are under the control
of the Plan Sponsor shall be given access to protected health information that is
disclosed to or otherwise obtained by the Plan Sponsor; provided that any employee
or person under the control of the Plan Sponsor who receives protected health
information relating to payment under, health care operations of, or other matters
pertaining to, the Plan in the ordinary course of business shall be included and treated
as such a person or as within the class of persons described below:
(1) the Benefits Administrator;
(2) the Director of Human Resources;
(3) the Benefits work group within the Human Resources Department;
(4) the employees who perform functions related to the Plan, including
but not limited to legal and systems personnel.
(B) The persons and classes of persons described in paragraph (A) above shall be given
access to and permitted to use protected health information that is disclosed to or
otherwise obtained by the Plan Sponsor solely for Plan purposes and functions set
forth in this article.
(C) Any person or class of persons described in paragraph (A) above who obtains access
to or uses protected health information in a manner that it contrary to the
requirements of this article shall be subject to the Plan Sponsor's disciplinary policies
and procedures up to and including termination of employment. Regardless of
whether a person is disciplined or terminated pursuant to this article or the Plan
Sponsor's disciplinary policies and procedures, the Plan reserves the right to direct
that the Plan Sponsor, and upon receipt of such direction the Plan Sponsor shall,
modify or revoke any person's access to or use of protected health information.
8.6 Permitted and Required Use and Disclosure of Protected Health Information
(A) Permitted Uses and Disclosures. The Plan Sponsor is and shall be entitled to use and
disclose any protected health information obtained pursuant to the authority set forth
in this Plan Document, and any other information that may reasonably be deemed to
be protected health information, regardless of the source of such information, that
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comes into the possession of the Plan Sponsor, without the Participant's
authorization, only for the following purposes:
(1)
to provide treatment to you;
(2)
to provide payment -related activities, such as, to make or receive payment or
to process claims;
(3)
to conduct business -related activities, such as, to evaluate the service
provided by a Plan administrator or other business associate, improve Plan
provisions, reduce health costs, request proposals for services to be provided
to or on behalf of the Plan, investigate allegations of fraud or other unlawful
acts related to the Plan, or audit payments for claims incurred under the Plan;
(4)
for public health activities, such as, to report suspected child abuse, the
occurrence of certain diseases, or adverse reactions to a drug or medical
device;
(5)
to report concerning victims of abuse, neglect, or domestic violence if the
Plan or Plan Sponsor are required or authorized by law to do so;
(6)
to authorized health oversight government agencies to audit or investigate
Plan operations;
(7)
for lawsuits and disputes, in response to a subpoena or other lawful request,
but only if efforts have been made to tell you about the request or to obtain
a court order that will protect the personal health information requested;
(8)
to law enforcement if asked to do so by a law enforcement official, in the
following circumstances: (a) in response to a court order, subpoena, warrant,
summons, or similar process; (b) to identify or locate a suspect, fugitive,
material witness or missing person; (c) about the victim of a crime if, under
certain limited circumstances, the Plan is unable to obtain the person's
agreement; (d) about a death the Plan believes may be due to criminal
conduct; (e) about criminal conduct at a facility used by the Plan; and (f) in
emergency circumstances, to report a crime, its location or victims, or the
identity, description or location of the person who committed the crime;
(9)
to coroners, medical examiners and funeral directors to facilitate the duties
of those individuals;
(10)
to organ procurement organizations in order to facilitate organ donation and
transportation;
(11)
for approved medical research; but, with very limited exceptions, such
disclosures must be cleared through a special approval process before any
personal health information is disclosed to the researchers, who will be
(12)
required to safeguard the personal health information they receive;
to
avert a serious threat to your health or safety or to the health or safety of
another person or the public;
(13)
for specialized government functions, such as, to authorized federal officials
for intelligence and national security activities that are authorized by law, or
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so that they may provide protective services to the President or foreign heads
of state or conduct special investigations authorized by law;
(14) to workers' compensation or similar programs that provide benefits for work -
related injuries or illness without regard to fault;
(15) to the parent or guardian of a minor; but, the Plan or Plan Sponsor may deny
such disclosure in some situations, such as when a court order prohibits such
disclosure; or
(16) when required by federal, state, or local law.
(B) Required Uses and Disclosures of Protected Health Information. The Plan Sponsor
shall be required to use and/or disclose protected health information:
(1) to an individual; when requested under, and required by 45 C.F.R. ' 164.524,
in order to provide an individual with access to his or her own protected
health information;
(2) to an individual, when requested under, and required by 45 C.F.R. ' 164.528,
in order to provide an individual with an accounting of disclosures of that
individual's protected health information; and
(3) when required by the Secretary of the Department of Health and Human
Services or those acting under the authority or at the direction of the Secretary
to investigate or determine the Plan's compliance with the Privacy
Regulations.
Unless the Participant objects, the Plan Sponsor may provide relevant portions of your
Personal health information to a family member, friend, or other person the Participant
indicates is involved in the Participant's health care or in helping the Participant get payment
for the Participant's health care. In an emergency or when the Participant is not capable of
agreeing or objecting to these disclosures, the Plan Sponsor will disclose personal health
information as it determines is in the Participant's best interest, but will tell the Participant
about it later, after the emergency, and give the Participant the opportunity to object to future
disclosures to family and friends. Unless the Participant objects, the Plan Sponsor may also
disclose the Participant's personal health information to persons performing disaster relief
notification activities.
8•8 Other Uses and Disclosures of Personal Health Information
Uses and disclosures of a Participant's personal health information that are not specified in
this article or by the laws that apply to the Plan will be made only with the Participant's
authorization
written authorization. If the Participant gives the Plan or Plan Sponsor written
for a use or disclosure of the Participant's personal health information, the Participant may
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i revoke that authorization in writing at any time. If the Participant revokes the authorization,
the Plan Sponsor will no longer use or disclose the personal health information for the
purposes specified in the written authorization, except that the Plan Sponsor is unable to take
back any disclosures that have already been made with your permission, and the Plan is
required to retain certain records of the uses and disclosures made when the authorization
was in effect.
8.9 Prohibited Uses and Disclosures
The Plan Sponsor shall not be entitled to use or disclose protected health information for any
purpose for which use and disclosure is not expressly allowed under this Plan Document,
including but not limited to:
(A) using or disclosing protected health information other than as permitted or required
under this document or applicable law, or in a manner inconsistent with the Privacy
Regulations; and
(B) taking adverse employment action against any plan Participant who is an employee
of the Plan Sponsor, except with respect to any fraud or unlawful act related to the
Plan and committed or reasonably suspected to have been committed by such person.
8.10 Minimum NecessM
When using or disclosing protected health information or when requesting protected health
information from another party, the Plan Sponsor must make reasonable efforts to limit
protected health information to the minimum necessary to accomplish the intend of the use or disclosure, and limit any request for protected health information to the ed purpose
minimum necessary to satisfy the purpose of the request.
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The undersigned of the City of Fort Collins Group Dental Plan hereby certify that the foregoing
Amendment was duly adopted.
THE CITY OF FORT COLLINS
By: Qzq-
City AMnager
ATTEST:
- 4%1
City Clerk
DELTA DENTAL PLAN OF
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APPROVED:
!j-+ Huai Resource Director
APPROVED AS TO FORM:
City Attorn�lt