DRUMMOND COMPANY, INC.
SELECT VALUE CARE HEALTH AND DENTAL PLANS 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 GIVES YOU INFORMATION REQUIRED BY LAW about the duties and
privacy practices of the following group health plans (singly, the “Plan” and collectively,
the “Plans”) to protect the privacy of your medical information:
Drummond Company, Inc./United Mine Workers of America Select Value Care
2002 Benefit Plan;
Drummond Company, Inc./United Mine Workers of America Select Value Care
2002 Dental Plan;
ABC Coke Division of Drummond Company, Inc./United Steelworkers of America
Select Value Care Health Plan;
ABC Coke Division of Drummond Company, Inc./United Steelworkers of America
Select Value Care Dental Plan;
Drummond Company, Inc. Salaried Employees Select Value Care Health Plan;
and
Drummond Company, Inc. Salaried Employees Select Value Care Dental Plan.
The Plans provide health and/or dental benefits to you as described in
your summary plan descriptions. Each Plan receives and maintains your medical
information in the course of providing the respective health and/or dental benefits
to you. Each Plan hires business associates to help it provide these benefits
to you. These business associates also receive and maintain your medical information
in the course of assisting the respective Plan. The Plans are sponsored by
Drummond Company, Inc. (the “Plan Sponsor”).
THE EFFECTIVE DATE OF THIS NOTICE IS APRIL 14, 2003. The Plans
are 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
one or both of the Plans make changes to this notice, the Plans will revise it and
send a new notice to all subscribers covered by the Plans at that time. The
Plans reserve the right to make the new changes apply to all your medical information
maintained by the Plans before and after the effective date of the new notice.
Purposes for which the Plans May Use or Disclose Your Medical Information
Without Your Consent or Authorization
Each Plan may use and disclose your medical information for the following
purposes:
· Health Care Providers’ Treatment Purposes.
For example, each Plan may disclose your medical information to your doctor, at
the doctor’s request, for your treatment by him.
· Payment. For example, each Plan may use
or disclose your medical information to pay claims for covered health care services
or to provide eligibility information to your doctor when you receive treatment.
Each Plan may also use and disclose your medical information to another covered
entity or health care provider for the payment activities of the entity that receives
your medical information.
· Health Care Operations. For example, each
Plan may use or disclose your medical information (i) to conduct quality assessment
and improvement activities, (ii) for underwriting, premium rating, or other activities
relating to the creation, renewal or replacement of a contract of health insurance,
(iii) to authorize business associates to perform data aggregation services, (iv)
to engage in care coordination or case management, and (v) to manage, plan or develop
its business. Each Plan may also disclose your medical information to another
covered entity for the limited health care operations activities and health care
fraud and abuse compliance activities of the entity that receives your medical information.
·
Organized Health Care Arrangement.
Because the same Plan Sponsor sponsors the Plans,
the Plans are deemed to be participants in an organized health care arrangement
(the “Arrangement”). As such, the Plans may share your medical information
with each other as needed for the purposes of treatment, payment or health care
operations (described above) relating to the Arrangement.
· Health Services. Each Plan may use your
medical information to contact you to give you information about treatment alternatives
or other health-related benefits and services that may be of interest to you.
Each Plan may disclose your medical information to its business associates to assist
the Plan in these activities.
· As required by law. For example, each Plan
must allow the U.S. Department of Health and Human Services to audit Plan records.
Each Plan may also disclose your medical information as authorized by and to the
extent necessary to comply with workers’ compensation or other similar laws.
· To Business Associates. Each Plan may disclose
your medical information to business associates the Plan hires to assist the Plan.
Each business associate of the Plans must agree in writing to ensure the continuing
confidentiality and security of your medical information.
· To Plan Sponsor. The Plans may disclose
to the Plan Sponsor, in summary form, claims history and other similar information.
Such summary information does not disclose your name or other distinguishing characteristics.
The Plans may also disclose to the Plan Sponsor the fact that you are enrolled in,
or disenrolled from the Plans. The Plans may disclose your medical information
to the Plan Sponsor for Plan administrative functions that the Plan Sponsor provides
to the Plans if the Plan Sponsor agrees in writing to ensure the continuing confidentiality
and security of your medical information. The Plan Sponsor must also agree
not to use or disclose your medical information for employment-related activities
or for any other benefit or benefit plans of the Plan Sponsor.
Each Plan may also use and disclose your medical information as follows:
·
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 family member, friend or other person, for the purpose of helping you with
your health care or with payment for your health care, if you are in a situation
such as a medical emergency and you cannot give your agreement to the Plan to do
this.
·
To your personal representatives appointed by you or designated by applicable law.
·
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 the health or safety of others.
·
To a governmental agency authorized to oversee the health care system or government
programs.
·
To federal officials for lawful intelligence, counterintelligence and other national
security purposes.
·
To public health authorities for public health purposes.
·
To appropriate military authorities, if you are a member of the armed forces.
Uses and Disclosures with Your Permission
The Plans will not use or disclose your medical information for any other
purposes unless you give the Plans your written authorization to do so. If you give
the Plans written authorization to use or disclose your medical 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
medical information the Plans maintain, unless the Plans have taken action in reliance
on your authorization.
Your Rights
You may make a written request to each Plan to do one or more of the
following concerning your medical information that the Plan maintains:
·
To put additional restrictions on the Plan’s use and disclosure of your medical
information. The Plan does not have to agree to your request.
·
To communicate with you in confidence about your medical information by a different
means or at a different location than the Plan is currently doing. The Plan
does not have to agree to your request unless such confidential communications are
necessary to avoid endangering you and your request continues to allow the Plan
to collect premiums and pay claims. Your request must specify the alternative
means or location to communicate with you in confidence. Even though you requested
that we communicate with you in confidence, the Plan may give subscribers cost information.
·
To see and get copies of your medical information. In limited cases, the Plan
does not have to agree to your request.
·
To correct your medical information. In some cases, the Plan does not have
to agree to your request.
·
To receive a list of disclosures of your medical information that the Plan and its
business associates made for certain purposes for the last 6 years (but not for
disclosures before April 14, 2003).
·
To send you a paper copy of this notice if you received this notice by e-mail or
on the Internet.
If you want to exercise any of these rights described in this notice,
please contact the Plans’ Contact Office (below). The Plans will give you
the necessary information and forms for you to complete and return to the Contact
Office. In some cases, the Plans may charge you a nominal, cost-based fee
to carry out your request.
Complaints
If you believe your privacy rights have been violated by the Plans, you
have the right to complain to the Plans or to the Secretary of the U.S. Department
of Health and Human Services. You may file a complaint with the Plans at our
Contact Office (below). We will not retaliate against you if you choose to
file a complaint with the Plans or with the U.S. Department of Health and Human
Services.
Contact Office
To request additional copies of this notice or to receive more information
about our privacy practices or your rights, please contact us at the following Contact
Office:
Drummond Company, Inc.
Health Services
3000 Highway 78 East
Jasper, Alabama 35501
1-800-824-8342
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