AETNA PPO PLAN - My Benefits Portfolio - Trinity Health

Privacy of Health Information
HIPAA requires that health plans protect the confidentiality of private health information. The Plan may
have access to certain private health information about you and your covered Dependents. This
information is necessary to administer claims and provide benefits under the Plan. The Plan understands
and recognizes the confidentiality and sensitivity of your health information and is committed to protecting
this information from inappropriate uses and disclosures.
The Plan and its business associates (which are generally, people or entities that perform certain
functions or activities that involve the use or disclosure of protected health information on behalf of, or
provides services to, the Plan) may use and disclose information about you that is protected by HIPAA
(referred to as “protected health information” or “PHI”) without your consent, written authorization or
opportunity to agree or object for treatment, payment, and health plan operations. The Plan and its
business associates may also use or disclose your PHI without your consent as required by law. The Plan
and its business associates will disclose your PHI to your personal representative when the personal
representative has been properly designated through appropriate written documentation. In addition, you
may authorize the use or disclosure of your PHI to another person and for the purpose you designate. If
you grant an authorization, you may withdraw it, in writing, at any time. Your withdrawal will not affect any
use or disclosures permitted by your authorization while it was in effect. The Plan, its business associates
and Trinity Health will not, without your authorization, use or disclose PHI for employment-related actions
and decisions or in connection with any other benefit or employee benefit plan of Trinity Health.
Under HIPAA, you have certain rights with respect to your protected health information, including certain
rights to see and copy the information, to receive an accounting of certain disclosures of the information
and, under certain circumstances, to amend the information. You also have the right to file a complaint
with the Plan or with the Secretary of the U.S. Department of Health and Human Services if you believe
your rights under the HIPAA privacy rules have been violated.
As required by HIPAA, the Trinity Health Welfare Benefit Plan (“Welfare Plan”) has adopted certain
privacy policies and procedures related to the use and disclosure of your PHI. You will receive a copy of
the Welfare Plan’s Notice of Privacy Practices (the “Notice”) that outlines how and when the Plan can use
or disclose your PHI as well as your rights and protections under the law. If there are material changes
made to the Welfare Plan’s practices and procedures regarding the use and protection of your PHI, you
will receive a revised Notice. In addition, you may receive a copy of the Notice at any time by contacting
the Welfare Plan’s Privacy Officer at:
Trinity Health
34605 Twelve Mile Road
Farmington Hills, MI 48331
The Welfare Plan has appointed its Privacy Officer to oversee the Welfare Plan’s compliance with
the HIPAA privacy rules and to address complaints. If you have any questions about how the Plan
protects your PHI and your question is not answered by reviewing the information in the Notice, if
you would like more information about the Welfare Plan’s privacy practices or if you want to make
a complaint about the Welfare Plan’s privacy activities, contact the individual(s) identified in the
Notice.
Non-Discrimination Due to Health Status
Any rule for eligibility that discriminates based on a “health factor” of an Associate or a Dependent of that
Associate is prohibited. For instance, the Plan is prohibited from containing an actively-at-work
requirement that is based on a health factor of an Associate. An exception is made with regard to an
Associate’s first day of work (e.g., if an individual does not report to work on his/her first scheduled work
day he/she need not be covered and any waiting period for coverage need not begin). Similarly, a
Dependent cannot be refused enrollment or coverage based on a “health factor” such as confinement in a
health care facility.
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