Health Plan Privacy Notice

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Contact Info

Citizen Square, Suite 380
200 East Berry Street
Fort Wayne, IN 46802

(260) 449-7217 Phone
(260) 449-4220 Fax
(260) 449-3392 TDD

Hours:
M-F 8:00 am - 5:00 pm

Human Resources Director
Cathy Serrano

Human Resources Manager
Janette Jacquay

Human Resources Manager-Sheriff's Dept
Kim Steere

Insurance Manager
Deb Hudson

Risk Manager/Trainer
Vanessa Miller

Compensation Specialist
Tracy Mitchener

Human Resources Asst.
Linda San Pietro

Health Plan Privacy Notice

This webpage is provided as a resource for Allen County Government employees only.
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The Board of Commissioners of the County of Allen
Health Plan Privacy Notice

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Protection of personal health information is an important matter for the Board of Commissioners of the County of Allen Group Health Plan (hereinafter "we" or "Health Plan"). We recognize that access to personal health information must be protected, and this notice explains the Health Plan's commitment to the protection of personal health information we maintain.

Information Collected By The Health Plan
We collect information directly from you as the policyholder. Generally, we request identification information from you such as name, address, telephone number, date of birth, marital status, and Social Security Number.

We also collect personal information where necessary:

to determine eligibility for health care coverage
to provide benefits and pay claims
to provide other information and services valuable to our employees

We may also be required to collect and keep certain information so that we meet legal and regulatory requirements. We keep this information after a employee's health care coverage ends.

When We Are Permitted To Disclose Information
The information we collect as described above is used to make service, benefit and other insurance-related decisions. We may share information we collect with employees in the Insurance Department as permitted by law. We do not share personal employee information outside of the Insurance Department except when the law allows or requires us to do so. Some examples of persons to who we disclose personal information include the following:

to business associates who help us administer employee benefits and services;
to health care providers, insurance agents and brokers, other insurers, and consumer reporting agencies for treatment, payment, or health care operations;
to The Board of Commissioners of the County of Allen in accordance with the Plan Document and Summary Plan Description for the Board of Commissioners of the County of Allen;
to authorized representatives such as parents and guardians or people given permission by the employee;
to law enforcement, regulatory authorities, and other entities to the extent that such use or disclosure is required by law and is limited to the relevant requirements;
to our attorneys, accountants and auditors who need the information to provide their services to us;
companies that market our products and services or companies with whom we have joint marketing.

For any other types of disclosures to third parties, we require a employee request and authorization. All authorizations must be in writing and employees must be given a copy of the authorization for their records. An employee may revoke an authorization at any time, provided that the revocation is in writing, except to the extent that (1) the Health Plan has taken action in reliance upon the authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, other law provides the Health Plan with the right to contest a claim under the policy or the policy itself.

Protection Of Employee's Privacy
We are required by law to maintain the privacy of protected health information and to provide notice of our legal duties and privacy practices with respect to protected health information. The Health Plan has adopted safeguards to prevent the inappropriate or inadvertent disclosures of personal health information. Furthermore, we restrict access to information to those employees or service providers who need to know the information in order to provide services or benefits under the Health Plan. We regularly review our security measures and employee education programs to help protect this information.

Furthermore, we are required to abide by the terms of the notice currently in effect. These privacy policies continue to apply even when your relationship with the Health Plan has terminated. We reserve the right to change the terms of this notice and to make new notice provisions effective for all protected health information that it maintains.

All new employees will obtain a copy of this notice upon enrollment in the Health Plan. Employees enrolled in the Health Plan will receive a revised copy of this Notice upon request or within sixty (60) days of a material change. Furthermore, a Privacy Notice will be mailed out to all Employees enrolled in the Health Plan at least once every three (3) years. This notice will be posted on the Health Plan's website at allencounty.us.

Individual Rights
Under the federal law employees have various rights, including:

Employees may contact to Insurance Department to request restrictions on certain uses and disclosures of protected health information in accordance with 45 C.F.R. § 164.522(a). However, we are not required to agree to any such requested restrictions;
Employees have the right to receive confidential communications of protected health information;
Employees have the right to inspect and copy protected health information about themselves;
Employees have the right to amend protected health information as provided by 45 C.F.R. § 164.526;
Employees have the right to receive an accounting of disclosures of protected health information to third parties;
Employees also have the right to obtain a copy of this notice from the covered entity upon request.

Questions or Complaints
Employees that have questions about our privacy practices or notice can contact the Insurance Department at (260) 449-7689 or (260) 449-7689. If any employee wants to file a complaint, you can write to us at: Insurance Department, 1 East Berry Street, Suite 380, Fort Wayne, Indiana 46802-1804.

You also have the right to file a complaint with the federal government. You may write to:

Office for Civil Rights
U.S. Department of Health and Human Services
233 N. Michigan Ave., Suite 240
Chicago, Ill. 60601

You will not be penalized for filing a complaint with the Insurance Department or the Office for Civil Rights.

Effective Date
This notice and its provisions shall become effective April 14, 2003