The eligibility and enrollment rules for the U

More documents

Recommendations

Info

Retiree Health Care SPD Effective January 1, 2012 (ii) through inter-office mail or other internal distribution, (iii) through electronic communication (such as e-mail or on an intranet), or (iv) along with your paycheck. The Program will not use or disclose your health information without your authorization, except as described in the notice that then applies to the health programs, and will abide by the terms of the notice currently in effect. Examples of Disclosures for Treatment, Payment, and Health Operations The Program will use your health information for authorizing treatment. For example: The health program requires a preauthorization for treatment by the health program or a third party administrator, and you request pre-service authorization. The Program or a third party administrator may consider your health information to determine whether to authorize the treatment. The Program will use your health information for payment. For example: A health program or a third party administrator may receive a bill requesting payment for health care services provided to you. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used that will be used by the Program or third party administrator in making any payments on the bill. The Program will use your health information for regular health operations. For example: A health program or a third party administrator may receive a claim for benefits from you. The information contained in the claim, accompanying the claim, or subsequently submitted as part of the claim process may be used by the health program or third party administrator in deciding your claim. Examples of Uses of Health Information by U.S. Bank The Program may use or disclose your private health information for any of the following purposes: • Business Associates: The Program may disclose health information to business associates, with whom U.S. Bank or the Program contract for services. When the health programs contract for these services, the health programs may disclose your health information to the business associate so that they can perform their jobs. To protect your health information, the Program requires the business associate to appropriately safeguard your information. • Claims Processing: The Program may use or disclose health information to process payment claims for health care services. • Claims Review: The Program may use or disclose health information relevant to that person’s involvement in your care or payment related to your care. • Communication with Your Family: The Program may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. • Court Orders: The Program may disclose health information as required under a court order. • Education: The Program may use health information to contact you about treatment alternatives or other health-related benefits and services that may be of interest to you. • Employee Assistance Program: If U.S. Bank maintains or establishes an employee assistance program, the Program may use or disclose health information you provide when you contact the employee assistance program as provided under the terms and operation of that program. 140
Retiree Health Care SPD Effective January 1, 2012 • Federal, State, and Local Governmental Agencies: The Program may disclose health information to federal, state and local governmental agencies as required under law. • Funeral Directors: The Program may use or disclose health information to funeral directors consistent with applicable law to carry out their duties. • Health Program Design: The Program may use or disclose de-identified or aggregated health information to U.S. Bancorp, the plan sponsor, business associates, and providers in the health care and record keeping fields to assist U.S. Bank in the design and changes to the design of its Program. U.S. Bank will not have any individually identifiable health information for this purpose. • Health Program Provider Selection: The Program may use or disclose health information to business associates, and providers in the health care and record keeping fields to assist in the selection of health program providers and to solicit bids from those entities. • Law Enforcement: The Program may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. • Notification: The Program may use or disclose health information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition. • Organ Donation: The Program may disclose health information to organ donation organizations and to related entities that facilitate organ donations and transplants. • Public Health: The Program may disclose health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability. • Threats: The Program may, consistent with applicable law and ethics, disclose health information to lessen a serious and imminent threat to the health or safety of a person or persons to lessen that threat. • Workers’ Compensation: The Program may use or disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law. Additional Uses of Health Information by U.S. Bank U.S. Bank may amend or change the list of uses of health information from time to time. When U.S. Bank amends or changes the list of uses, it will inform you of the change. Other uses and disclosures not on this list (or the list as subsequently amended) require your written authorization. You may revoke your authorization for such other uses by submitting a written request to revoke your authorization. This revocation is not effective with respect to any action already taken by the Program in reliance on the authorization. For More Information or to Report a Problem If you have questions or would like additional information, including a copy of the HIPAA Privacy Notice, you may contact the U.S. Bank Employee Service Center at 1-800-806-7009 or send your written request to: U.S. Bank – EP-MN-R2BN Benefits Administration 4000 West Broadway Robbinsdale, MN 55422-2299 If you believe your privacy rights have been violated, you can file a complaint with the Human Resources Department or with the Secretary of Health and Human Services. You can file a 141
Page 1 and 2:
Retiree Health Care SPD Effective J
Page 3 and 4:
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90: Retiree Health Care SPD Effective J
Page 139: Retiree Health Care SPD Effective J
show all

The eligibility and enrollment rules for the U

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?