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Privacy NOTICE FOR SELF-INSURED & FULLY
INSURED GROUP HEALTH PLANS (Including fully
insured plans with Health FSAs)
Los Rios Community College District
NOTICE OF PRIVACY PRACTICES
Effective April 14, 2003
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.
This notice is provided to you in accordance with federal and state privacy laws
enacted to protect your medical information. This notice describes the privacy
practices of health care carriers listed below and of our Plan, our legal duties,
and your rights concerning your medical information.
Health care carriers and our Plan are required to follow the privacy practices that
are described in this notice while it is in effect. However, health care carriers and
our Plan reserve the right to change privacy practices and the terms of this notice
at any time, provided that applicable law permits such changes. If health care
carriers and/or our Plan make any substantive changes to our privacy practices,
we will modify this notice and send you a new notice within 60 days of the
change of the health care carrier and/or our practices.
You may request a copy of this notice at any time. For more information about
our privacy practices, or for additional copies of this notice, please contact the
Employee Benefits Department.
This notice applies to the privacy practices of the health care carriers, third party
administrators and our group health plan listed below:
TYPE OF COVERAGE
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Flexible Spending Account
USES AND DISCLOSURES OF YOUR MEDICAL INFORMATION
Health care carriers, Third Party Administrators and our Plan are permitted to use
or disclose your protected health information (PHI) for the following purposes:
Treatment Health care car