Association of Orange County Deputy Sheriffs Summary of Privacy Practices
This summary of Privacy Practices summarizes how medical information about you may be used and disclosed by the Association of Orange County Deputy Sheriffs or others in the administration of your health care benefits, and certain rights that you have. For a detailed description of our privavy practices, as well as your legal rights, please refer to the Notice of Privacy Practices.
Our Pledge Regarding Medical Information
We are committed to protecting your personal health information. We are required by law to (1) make sure that any medical information that identifies you is kept private; (2) provide you with certain rights with respect to your medical information; (3) give you a notice of our legal duties and privacy practices; and (4) follow all privacy practices and procedures currently in effect.
How We May Use and Disclose Medical Information About You
We may use and disclose your personal health information without your permission to assist with facilitating your medical treatment, for assistance with insurance carriers and/or administrators for payment of any medical treatments, and for any other health care insurance operation. We will disclose your medical information to employees of Brown Insurance Services (AOCDS Insurance Brokers/Adminstrators) for plan administration functions; but those employees may not share your information for employment-related purposes. We may also use and disclose your personal health information without your permission as allowed and required by law. Otherwise, we must obtain your written authorization for any other use and disclosure of your medical information. We cannot retaliate against you if you refuse to sign an authorization or revoke an authorization you had previously given.
Your Rights Regarding Your Medical Information
You have the right to inspect and copy your medical information to request corrections to your medical information and to obtain an accounting of certain disclosure of your medical information. You also have the right to request that additional restrictions or limitations be placed on the use or disclosure of your medical information, or that communications about your medical information be made in different was or at different locations.
How to File Complaints
If you believe your privacy rights have been violated, you have the right to file a complaint with our Privacy Officer at the Association of Orange County Deputy Sheriffs, 1314 West Fifth Street, Suite B, Santa Ana, CA 92703 or at 714-285-9900 or with the Office of Civil Rights, Department of Health and Human Services, 50 United Nations Plaza - Room 322, San Francisco, CA 94102 or at 800-368-1019.
Women's Health and Cancer Rights Act of 1998 (WHCRA)
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women's Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:
All stages of reconstruction of the breast on which the mastectomy was performed;
Surgery and reconstruction of the other breast to produce a symmetrical appearance;
Treatment of physical complications of the mastectomy, including lymph edemas. (The swelling of tissues caused by obstruction of the lymphatic drainage. It results from fluid accumulation and may arise from surgery, radiation of the presence of a tumor in the area of lymph nodes."
These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under the plans of the Association of Orange County Deputy Sheriffs. For more information on WHCRA benefits, please contact the Benefits Office at 714-285-9900.
ASSOCIATION OF ORANGE COUNTY DEPUTY SHERIFFS PRIVACY NOTICE EFFECTIVE APRIL 14, 2003- DATED 4-15-2013
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.
Anyone has the right to ask for a paper copy of this Notice at any time.
We are required by a new federal law, the Health Insurance Portability and Accountability Act (HIPAA), to make sure that your Protected Health Information (PHI) is kept private. We must give you this Notice of our legal duties and Privacy Practices with respect to your PHI. We are also required to follow the terms of the Notice that is currently in effect. PHI includes information that we have created or received about your past, present or future health or medical condition that could be used to identify you. It also includes information about medical treatment you have received. We are required to tell you how, when, and why we use and/or share your Protected Health Information (PHI).
HIPPA and other laws allow or require us to use or disclose your PHI for many different reasons. We can use or disclose your PHI for some reasons without your written agreement. For other reasons, we need you to agree in writing that we can use or disclose your PHI. We describe in this Notice the reasons we may use your PHI without getting your permission. Not every use or disclosure is listed, but the ways we can use and disclose information fall within one of the descriptions below.
To Operate Our Business We may use and disclose your PHI in order to administer your health plans. For example, we may use your PHI in order to review and improve the quality of health care services you receive. We may also provide your PHI to our accountants, attorneys, consultants and others in order to make sure we are obeying the laws that affect us. Before we share PHI with other organizations, they must agree to keep your PHI private.
Payment We may use and disclose medical information about you so that the medical services you receive can be properly billed and paid for.
To Meet Legal Requirements We share PHI with government or law enforcement agencies when federal, state, or local laws require us to do so. We also share PHI when we are required to in a court or other legal proceeding.
For Health Oversight Activities We may share PHI if a government agency is investigating or inspecting a health care provider or organization.
Authorizations In other situations, we will ask you for your written permission before we use or disclose your PHI. If you give us a written authorization to do so, we may use and disclose your medical information. If you give us a written authorization, you have the right to change your mind and revoke that authorization.
Copies of this Notice You have the right to receive an additional copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to receive a paper copy of this Notice.
Changes to this Notice We reserve the right to revise this Notice. A revised Notice will be effective for medical information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever Privacy Notice is currently in effect. Any change to our Privacy Notice will be mailed to you or your employer.
Your Right to Inspect and Copy Upon written request, you have the right to inspect the health information we maintain about you and to have copies of that information.
If you ask for a copy of your PHI, we will charge you a reasonable fee based on the cost of copying and postage. We can send you all your PHI, or if you request, we may send you a summary or general explanation of your PHI if you agree to the cost of preparing and sending it.
Your Right to Amend If you feel that the medical information about you that we have is incorrect or incomplete, you can make a written request to us to amend that information. We can deny your request for certain limited reasons, but we must give you a written basis for our denial.
Your Right to a List of Disclosures Upon written request, you have the right to receive a list of our disclosures of your medical information, except when you have authorized those disclosures or if the disclosures are made for treatment, payment or health care operations. We are not required to give you a list of disclosures made before April 14, 2003.
Your Right to Request Restrictions on Our Use or Disclosure of Information If you do so in writing, you have the right to request restrictions on the medical information we may use or disclose about you. We are not required to agree to such requests.
Your Right to Request Confidential Communications You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. Your request must be in writing. For example, you can ask that we only contact you at work or only at a certain address or only by mail.
How to Use Your Rights Under This Notice If you want to use your rights under this Notice, you may call us or write to us. If your request to us must be in writing, we will help you prepare your written request, if you wish.
Complaints If you believe your Privacy rights have been violated, you have the right to file a complaint with our Privacy Officer at the Association of Orange County Deputy Sheriffs, 1314 West Fifth Street, Suite B Santa Ana, CA 92703 or at 714-285-9900. You also have the right to file a complaint with the federal government. You may write to: Office of Civil Rights, Department of Health and Human Services, 50 United Nations Plaza - Room 322 San Francisco, CA 94102. You will not be penalized for filing a complaint with the federal government.