The Health Insurance portability and Accountability Act (HIPAA) and related rules require group health plans to protect the privacy of health information.

This notice gives you information about the duties and practices to protect the privacy of your medical or health information for each group health plan for state employees and retirees that is administered and self-insured by the state of Michigan (“Plan”). Each Plan is sponsored by the state of Michigan (“Plan sponsor”).Each plan is required by law to maintain the privacy of protected health information and to provide enrollees with a notice of it’s legal duties and privacy practices with respect to protected health information.

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.

The effective date of this notice is September 23, 2013. Each plan is required to follow the terms of this notice until it is replaced. Each plan reserves the right to change the terms of this notice at any time. If a Plan amends this notice, the Plan will send a new notice to all subscribers covered by the Plan. Each Plan reserves the right to make the new changes apply to all your health information maintained by the Plan before and after the effective date of the new notice.

Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record:
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. A Plan may charge a reasonable fee to cover expenses associated with your request. In limited cases, a Plan does not have to agree to your request.

Ask us to amend your health information:
You can ask us to correct health information about you that you think is incorrect or incomplete. In some cases, a Plan does not have to agree to your request.

Request confidential communications:
You can ask us to contact you in a specific way. Your request must specify the alternative means to communicate with you. A Plan does not have to agree to your request.

Ask us to limit what we use or share:
Each Plan will not use or disclose your health information for other purposes, Unless you give a Plan your written authorization. If you give a Plan written authorization to use or disclose your health information for a purpose that is not described in this notice, then, in most cases, you may revoke it in writing at any time. Your revocation will be effective for all your health information a Plan maintains, unless the Plan has taken action in reliance on your authorization.

You have the right to restrict disclosure of encounter information to an insurer if you pay fully out of pocket.

Get a copy of this privacy notice:
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.

Choose someone to act for you:
If you have given someone medical power of attorney or if someone is your
legal guardian, that person can exercise your rights and make choices about
your health information. We will make sure the person has this authority and can act for you before we take any action.

When a Plan may use or disclose your medical or health information without your consent or authorization: The following categories describe when a plan may use or disclose your medical or health information without your consent or authorization. Each category includes general examples of the type of use or disclosure, but not every use or disclosure that falls within a category will be listed. Any breaches in patient health information will be reported.

Treatment: For example, a plan may disclose health information at your doctor’s request to facilitate receipt of treatment.

Payment: For example, a Plan may use or disclose your health information to determine eligibility or plan responsibility for benefits; confirm enrollment and coverages; facilitate payment for treatment and covered services received; coordinate benefits with other insurance carriers; and adjudicate benefit claims and appeals.

Health Care Operations: For example, a Plan may use or disclose your health information to conduct quality assessment and improvement activities; underwriting, premium rating, or other activities related to creating an insurance contract; data aggregation services ; care coordination, case management, and customer service; auditing, legal, and medical reviews of the Plan; and to manage, plan and develop a Plan’s business.
Update: Plans cannot collect your genetic information, including your family medical history, either before you enroll or in connection with your enrollment in the group health plan. Under GINA, collecting genetic information includes requiring, requesting or purchasing health information.

Health Services: A Plan or it’s business associates may use your health information to contact you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.

To Business Associates: A Plan may disclose your health information to business associates that assist the Plan in administrative, billing, claims, and other matters. Each business associate must agree in writing to ensure the continuing confidentiality and security of your health information.

To Plan Sponsor: A Plan may disclose to the Plan sponsor, in summary form, claims history and other similar information. Summary information does not disclose your name and other distinguishing characteristics. It may also disclose that you are enrolled in or dis-enrolled from the Plan.

As required by law:
A Plan may use or disclose your personal health information for other important activities permitted or required by state or federal law, with or without your authorization. These include, for example:

·    To the U.S. Department of Health and Human Services to audit Plan records.
·    As authorized by state workers’ compensation laws.
·    To comply with legal proceedings, such as a court or administrative order or subpoena
·    To law enforcement officials for limited law enforcement purposes
·    To a government agency authorized to oversee the health care system or government programs
·    To public officials for lawful intelligence, counterintelligence, and other national security purposes.
·    To public health authorities for public health purposes.

Each Plan may also use and disclose your health information as follows:

·    To a family member, friend or other person, to help with your health care payment for health care, if you are in a situation such as a medical emergency and cannot give your agreement to a Plan to do this.
·    To your personal representatives appointed to you or designated by applicable law.
·    To consider claims and appeals regarding coverage, exclusion, cost and privacy issues.
·    For research purposes in limited circumstances.
·    To a coroner, medical examiner, or funeral director about a deceased person.
·    To an organ procurement organization in limited circumstances.
·    To avert a serious threat to your health or safety or safety or the health or safety of others.

File a complaint if you feel your rights are violated:
If you believe your privacy rights have been violated by the Plan, you have the right to complain in writing to the Plan or to the Secretary of the United States Department of Health and Human Services. You may file a written complaint with the Plan at the address below. We will not retaliate against you if you choose to file a complaint with the Plan or the Department of Health and Human Services.