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Policy Manual

1419.02 - Privacy Protections of Fully Insured Group Health Plans

The Board provides coverage to eligible employees under fully insured group health plans. The Board has established the following fully insured group health plans:

  A. Group Health Plan


  B. Prescription Drug Plan


  C. Dental Plan


  D. Vision Plan


  E. Employee Assistance Plan


  F. Long-Term Care Plan


The Board acknowledges that these group health plans are required to comply with the HIPAA Privacy Rule. Fully insured group health plans generally are exempt from many of the requirements imposed upon self-funded group health plans.

The fully insured group health plans established by the Board shall

  A. refrain from taking any retaliatory action against any individual for exercising any right under the plan, filing a complaint with Health and Human Services, participating in any proceeding under Part C of Title XI of the Social Security Act, or opposing any act or practice made unlawful by the Privacy Rule provided that the individual has a good faith belief that the practice opposed is unlawful.


  B. not impose a requirement that participants waive their rights under the Privacy Rule as a condition of the provision of payment, enrollment in a health plan, or eligibility of benefits.


  C. in accordance with the Privacy Rule, retain a copy of the plan document if amended for six years from the date of its amendment or the date when it last was in effect, whichever is later.


Fully insured group health plans established by the Board shall not create or receive protected health information, except for

  A. summary health information.
    Summary health information is de-identified information that summarized claims history, claims expenses, or type of claims experienced by health plan participants.


  B. information identifying a participant's enrollment in or disenrollment from a group or individual health plan.


F.S. 1002.02
20 U.S.C. 1232g
42 U.S.C. 1320d-2
Health Insurance Portability and Accountability Act (HIPAA)

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