Health Plan Privacy Notice

This webpage is provided as a resource for Allen County Government employees only.

The Board of Commissioners of the County of Allen Health Plan

HIPAA Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review this notice carefully.

This Notice is provided to you pursuant to the Health Insurance Portability and Accessibility Act of 1996 and its implementation regulations ("HIPAA"). It is designed to tell you how we may, under federal law, use or disclose your Health Information. It has been updated to the HITECH Omnibus Rule requirements. Protection of personal health information is an important matter for the Board of Commissioners of the County of Allen Group Health Plan (hereinafter "we" or "Health Plan"). We recognize that access to personal health information must be protected, and this notice explains the Health Plan's commitment to the protection of personal health information we maintain.

I. Information Collected By the Health Plan

We collect personal information directly from you as the policyholder. Generally, we request identification information from you such as name, address, telephone number, date of birth, marital status, and Social Security Number.

We also collect personal information where necessary:

  • To determine eligibility for health care coverage
  • To provide benefits and pay claims
  • To provide other information and services valuable to our employees

We may also be required to collect and keep certain information so that we meet legal and regulatory requirements. We keep information after an employee's health care coverage ends.

II. Your Rights.

You have the right to request restrictions on the uses and disclosures of your Health Information. However, we are not required to comply with all requests. You are allowed to restrict transmittal of health care charges to your carrier, if you pay for those services, in full, by other means.

You have the right to receive your Health Information through confidential means and in a manner that is reasonably convenient for you and us.

You have the right to inspect and copy your Health Information. You may request your records in digital format and have your records sent digitally to a provider with written authorization.

You have a right to request that we amend your Health Information that is incorrect or incomplete. We are not required to change your Health Information and will provide you with information about our denial and how you can disagree with the denial.

You have a right to receive an accounting of disclosure of your Health Information made by us, except that we do not have to account for disclosure; authorized by you; made for treatment, payment, health care operations; provided to you; provided in response to an Authorization; made in order to notify and communicate with approved family members; and/or for certain government functions, to name a few.

You have been provided with a paper copy of this notice of Privacy Practices. If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, please contact our HIPAA Compliance Officer at 260-449-7689.

III. We May Use or Disclose Your Health Information Without Obtaining Your Prior Authorization

The information we collect as described above is used to make service, benefit and other insurance-related decisions. We may share information we collect with employees in the Insurance Department as permitted by law. We do not share personal employee information outside of the Insurance Department except when the law allows or requires us to do so. Some examples of persons to who we disclose personal information include the following:

  • To business associates who help us administer employee benefits and services
  • To health care providers, insurance agents and brokers, other insurers, and consumer reporting agencies for treatment, payment, or health care operations
  • To The Board of Commissioners of the County of Allen in accordance with the Plan Document and Summary Plan Description for the Board of Commissioners of the County of Allen
  • To authorized representatives such as parents and guardians or people given permission by the employee. We will only communicate with family members that we are authorized to communicate with based on your completion of the authorization form
  • To law enforcement, regulatory authorities, and other entities to the extent that such use or disclosure is required by law and is limited to the relevant requirements; or to comply with a court order or grand jury subpoena nad other law enforcement purposes
  • To our attorneys, accountants and auditors who need the information to provide their services to us
  • For health oversight activities, we may use or disclose your Health Information to health oversight agencies during the course of audits, investigations, certification and other proceedings
  • In response to a Civil Subpoena or for Judicial Administrative Proceeding. We may use or disclose your Health Information, as directed, in the course of any civil administrative or judicial proceeding
  • For worker's compensation, as necessary to comply with worker's compensation laws

IV. For All Other Circumstances, We May Only Use or Disclose Your Health Information After You Have Signed An Authorization.

All authorizations must be in writing and employees must be given a copy of the authorization for their records. An employee may revoke an authorization at any time, provided that the revocation is in writing, except to the extent that (1) the Health Plan has taken action in reliance upon the authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, other law provides the Health Plan with the right to contest a claim under the policy itself.

  • Fundraising. Should the Health Plan use health information for fundraising we will inform individuals that they have the right to opt out of fundraising solicitations and explain that process. You do have the capability to opt back in with written notice.
  • Marketing. Should the Health Plan use health information for marketing purposes we will first obtain your written authorization and fully explain the uses and disclosures of PHI for marketing purposes, and disclosures that constitute a sale of PHI require a separate written authorization.
  • Use or Disclosure of Psychotherapy Notes. Written authorization is required if our Health Plan intends to use or disclose psychotherapy notes.
  • Breach Notice. All plan participants and policyholders will be informed if there is a breach, as defined by federal rules, of their unsecured protected health information as required by the HIPAA regulations.
  • Right to Request Restrictions for Disclosures Related to Self-Payment. We are required to comply with a request not to disclose health information to a health plan for treatment when the individual has paid in full out-of-pocket for a health care item or service and has submitted a request in writing.

V. Protection of Employee's Privacy

We are required by law to maintain the privacy of protected health information and to provide notice of our legal duties and privacy practices with respect to protected health information. The Health Plan had adopted safeguards to prevent inappropriate or inadvertent disclosures of personal health information. Furthermore, we restrict access to information to those employees or service providers who need to know the information in order to provide services or benefits under the Health Plan. We regularly review our security measures and employee education programs to help protect this information.

Furthermore, we are required to abide by the terms of the notice currently in effect. These privacy policies continue to apply even when your relationship with the Health Plan has terminated. We reserve the right to change the terms of this notice and to make new notice provisions effective for all protected health information that it maintains. If any such amendment is made that materially changes this Notice, we will send you another copy.

This notice will be posted on the Allen County website.

VI. Questions or Complaints

Employees that have questions about our privacy practices or notice can contact the Insurance Department at 260-449-7689 or 260-449-7869. You may make complaints to the Privacy Officer or the Security of the Department of Health and Human Services if you believe your rights have been violated. We will review all complaints in a professional manner and keep you informed of your rights. You will not be penalized for filing a complaint with the Insurance Department or the Office of Civil Rights.

You may contact the Department of Health and Human Services at 
200 Independence Avenue, SW
Washington, D.C., 20201
Phone: 202-619-0257

You may contact us about our privacy practices or file a complaint by calling our Privacy Officer at: 
Insurance Department
200 E Berry Street, Suite 380
Fort Wayne, IN 46802
Phone: 260-449-7689