Page 36 - Willscot I Mobile Mini Open Enrollment Guide

OTHER ALLOWABLE USES OR DISCLOSURES OF YOUR HEALTH INFORMATION
In certain cases, your health information can be disclosed without authorization to a family member, close friend, or other person you identify who is involved in your care or payment for your care. Information about your location, general condition, or death may be provided to a similar person (or to a public or private entity authorized to assist in disaster relief efforts). You’ll generally be given the chance to agree or object to these disclosures (although exceptions may be made — for example, if you’re not present or if you’re incapacitated). In addition, your health information may be disclosed without authorization to your legal representative. The Plan also is allowed to use or disclose your health information without your written authorization for the following activities:
• Workers’compensation:Disclosurestoworkers’compensationorsimilarlegalprogramsthatprovidebenefitsforwork-relatedinjuriesorillness without regard to fault, as authorized by and necessary to comply with the laws
• Necessarytopreventseriousthreattohealthorsafety:Disclosuresmadeinthegood-faithbeliefthatreleasingyourhealthinformationis necessary to prevent or lessen a serious and imminent threat to public or personal health or safety, if made to someone reasonably able to prevent or lessen the threat (or to the target of the threat); includes disclosures to help law enforcement officials identify or apprehend an individual who has admitted participation in a violent crime that the Plan reasonably believes may have caused serious physical harm to a victim, or where it appears the individual has escaped from prison or from lawful custody
• Publichealthactivities:Disclosuresauthorizedbylawtopersonswhomaybeatriskofcontractingorspreadingadiseaseorcondition; disclosures to public health authorities to prevent or control disease or report child abuse or neglect; and disclosures to the Food and Drug Administration to collect or report adverse events or product defects
• Victimsofabuse,neglect,ordomesticviolence:Disclosurestogovernmentauthorities,includingsocialservicesorprotectedservices agencies authorized by law to receive reports of abuse, neglect or domestic violence, as required by law or if you agree or the Plan believes that disclosure is necessary to prevent serious harm to you or potential victims (you’ll be notified of the Plan’s disclosure if informing you won’t put you at further risk)
• Judicialandadministrativeproceedings:Disclosuresinresponsetoacourtoradministrativeorder,subpoena,discoveryrequestorotherlawful process (the Plan may be required to notify you of the request or receive satisfactory assurance from the party seeking your health information that efforts were made to notify you or to obtain a qualified protective order concerning the information)
• Lawenforcementpurposes:Disclosurestolawenforcementofficialsrequiredbylaworlegalprocess,ortoidentifyasuspect,fugitive,witness, or missing person; disclosures about a crime victim if you agree or if disclosure is necessary for immediate law enforcement activity; disclosures about a death that may have resulted from criminal conduct; and disclosures to provide evidence of criminal conduct on the Plan’s premises
• Decedents:Disclosurestoacoronerormedicalexaminertoidentifythedeceasedordeterminecauseofdeath;andtofuneraldirectorstocarry out their duties
• Organ,eyeortissuedonation:Disclosurestoorganprocurementorganizationsorotherentitiestofacilitateorgan,eye,ortissuedonationand transplantation after death
• Researchpurposes:Disclosuressubjecttoapprovalbyinstitutionalorprivateprivacyreviewboards,subjecttocertainassurancesand representations by researchers about the necessity of using your health information and the treatment of the information during a research project
• Healthoversightactivities:Disclosurestohealthagenciesforactivitiesauthorizedbylaw(audits,inspections,investigationsorlicensing actions) for oversight of the healthcare system, government benefits programs for which health information is relevant to beneficiary eligibility, and compliance with regulatory programs or civil rights laws
• Specializedgovernmentfunctions:DisclosuresaboutindividualswhoareArmedForcespersonnelorforeignmilitarypersonnelunder appropriate military command; disclosures to authorized federal officials for national security or intelligence activities; and disclosures to correctional facilities or custodial law enforcement officials about inmates
• HHSinvestigations:DisclosuresofyourhealthinformationtotheDepartmentofHealthandHumanServicestoinvestigateordeterminethe Plan’s compliance with the HIPAA privacy rule
Except as described in this notice, other uses and disclosures will be made only with your written authorization. For example, in most cases, the Plan will obtain your authorization before it communicates with you about products or programs if the Plan is being paid to make those communications. If we keep psychotherapy notes in our records, we will obtain your authorization in some cases before we release those records. The Plan will never sell your health information unless you have authorized us to do so. You may revoke your authorization as allowed under the HIPAA rules. However, you can’t revoke your authorization with respect to disclosures the Plan has already made. You will be notified of any unauthorized access, use, or disclosure of your unsecured health information as required by law.
The Plan will notify you if it becomes aware that there has been a loss of your health information in a manner that could compromise the privacy of your health information.
YOUR INDIVIDUAL RIGHTS
You have the following rights with respect to your health information the Plan maintains. These rights are subject to certain limitations, as discussed below. This section of the notice describes how you may exercise each individual right. See the Contact section at the end of this notice for information on how to submit requests.
36 Copyright2021MercerHealth&BenefitsLLC.Allrightsreserved. www.mercermarketplace.com/willscotmobilemini