Director of HR cgiambona@spearcenter.com
Annual Notice Doyou know thatyour plan, asrequired by theWomen’sHealth and CancerRights Act of 1998, provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema? Contact your plan administrator for more information. Newborns’ and Mother’s Health ProtectionAct (NMHPA) Notice Group health plans and health insurance issuers generally may not, under Federallaw, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following avaginal delivery, or less than 96 hours following acesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that aprovider obtain authorization from the plan or the insurance issuer for prescribing alength of stay not in excess of 48 hours (or 96 hours). Medical Loss Ratio (MLR) Rule Notice The Affordable Care Act requires health insurers in the individual and small group markets to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality (in the large group marketof 51+ employees, this amountis 85 percent). This is referred to asthe Medical LossRatio (MLR) rule or the 80/20rule. If ahealthinsurer doesnot spendat least 80(85forlarge groups) percent of the premiums it receives on health care services and activities to improve health care quality, the insurer must rebate the difference.
Notice of HIPAA Privacy Practices
This notice describes how medical information about you may be used and disclosed andhow you canget accessto this information. Please review it carefully.
This notice is intended to inform you of the privacy practices followed by the Spear PTHealth Plan and the Plan’s legal obligations regarding your protected health information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The notice also explains the privacy rights you and your family members have as participants of the Plan. It is effective on 01/01/2026. The Plan often needs access to your protected health information in order to provide payment for health services and perform plan administrative functions. We want to assure the plan participants covered under the Plan that we comply with federal privacy laws and respect your right to privacy. Spear PTrequires all members of our workforce and third parties that are provided access to protected health information to comply with the privacy practices outlined below. Protected Health Information Your protected health information is protected by the HIPAA Privacy Rule. Generally, protected health information is information that identifies an individual created or received by ahealth care provider, health plan or an employer on behalf of a group health plan that relates to physical or mental health conditions, provision of health care,or payment for health care, whether past, present or future.
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