Our Legal Responsibilities. We are required by law to protect the privacy of your protected health information, provide you with certain rights with respect to your protected health information, provide you with this notice about our privacy practices, and follow the information practices that are described in this notice. We may change our policies at any time. In the event that we make a significant change in our policies, we will provide you with arevised copy of this notice. Youcan also request acopy of our notice at anytime. Formore information about our privacy practices, contact the person listed below.
If you have any questions or complaints, please contact:
Carla Giambona Director of HR cgiambona@spearcenter.com
Complaints If you are concerned that we have violated your privacy rights, or you disagree with adecision we made about access to your records, you may contact the person listed above. You also may send a written complaint to the U.S.Department of Health and Human Services — Office of Civil Rights. Theperson listed above can provide you with the appropriate address upon request or you may visit www.hhs.gov/ocr for further information. You will not be penalized or retaliated against for filing a complaint with the Office of Civil Rights or with us. Notice of HIPAASpecialEnrollment Rights This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time. Loss of Other Coverage If you are declining coverage for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you haveanew dependentasaresult of marriage, birth, adoption, or placementfor adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. Medicaid or CHIP If you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program (CHIP)or becomeeligible for apremium assistance subsidyunder Medicaid or CHIP,you may be able to enroll yourself and your dependents. You must request enrollment within 60 days of the loss of Medicaid or CHIP coverage or the determination of eligibility for a premium assistance subsidy.
Torequest special enrollment or obtain more information, please contact:
Carla Giambona, Director of HR cgiambona@spearcenter.com
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