Section 21: Privacy Rights Under the Plan

21.1 Protection of Health Information

Effective April 14, 2003 and subject to the exceptions listed in the following paragraph, your individually identifiable information in any form created or received by the Fund related to payment for health care or to your past, present or future physical or mental health or condition may not be used or disclosed without your written authorization. By participating in the Fund you authorize the Fund Office to disclose Protected Health Information to your spouse (or your parents if you are a minor). If you do not authorize this disclosure, you must immediately notify the Privacy Officer at the Fund Office. Information is individually identifiable if it actually identifies you or contains enough specific information to do so.

The Plan may disclose your individually identifiable health information without your written authorization under any of the following circumstances:

1. To provide, coordinate or manage health care treatment;
   
   
2. To obtain or provide reimbursement or premiums for the provision of health care and other activities;
   
   
3. To facilitate health care operations;
   
   
4. Upon your request for information;
   
   
5. For public policy or public health purposes;
   
   
6. When required by law;
   
   
7. For judicial and administrative proceedings;
   
   
8. For organ procurement organizations;
   
   
9. To the extent necessary to comply with workers’ compensation laws;
   
   
10. To comply with an investigation by the U.S. Department of Health and Human Services into the Fund’s compliance with the Department’s regulations; or
    
    
11. To business associates of the Fund who have signed the Fund’s Business Associates Agreement.
    

Disclosure of your individually identifiable health information in any of the above circumstances will be limited to the minimum amount of information necessary to fulfill the particular purpose.

You may make a written request for the following information from the Fund:

1. Copies of all of you individually identifiable health information, subject to certain exceptions, that the Fund has retained;
   
   
2. Amendments to your individually identifiable health information that the Fund has retained and which you believe to be inaccurate; or
   
   
3. A written accounting of the disclosures of your individually identifiable health information.
   

The Fund will maintain an accounting of all disclosures of your individually identifiable health information for a period of at least six years prior to the current date. You may request a written copy of this accounting of disclosures. The Fund will also issue a notice of the Privacy Policy to you on or before the later of (i) the date you become enrolled in the Fund, or (ii) April 14, 2003. The Fund will reissue you a copy of the Privacy Policy every three (3) years thereafter.

You may also file a grievance with the Privacy Officer if you believe that the Fund has not complied with the Privacy Policy or the requirements of this Section.

If you would like additional information regarding the Fund’s policy of protecting your health information, please review a copy of the Fund’s Privacy Policy, available at the Fund’s Office.