LEGAL NOTICES
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
The Health Insurance Portability and Accountability Act of 1996 addresses how an employer can enforce eligibility and
enrollment for health care benefits, and ensures that protected health information which identifies you is kept private. You
have a right to inspect copy-protected health information that is maintained by and for the plan for enrollment, payment,
claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may
ask your benefits administrator to amend the information. For a full copy of the Notice of Privacy Practices, describing how
protected health information about you may be used and disclosed and how you get access to the information, contact
Human Resources.
The HIPAA Privacy Rule was effective beginning April 14, 2003. The Privacy Rule is intended to safeguard protected health
information (PHI). The provisions of the Privacy Rule have a significant impact on those who deal with health information
and on all citizens with regard to their personal PHI. Our health insurance broker and all our contracted plans adhere to the
HIPAA Privacy Rule.
Medicaid and the Children’s Health Insurance Program (CHIP)
If you’re eligible for health coverage from Private Prep , but can’t afford the premiums, some states have premium -
assistance programs that can help pay for coverage with funds from their Medicaid or CHIP programs. If you or your
dependents are already enrolled in Medicaid or CHIP, contact your state Medicaid or CHIP office to find out if premium
assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, once it is determined that you or your
dependents are eligible for premium assistance under either of these programs, the employer’s health plan is required to
permit you and your dependents to enroll in the plan - as long as you and your dependents are eligible, and not already
enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being
determined eligible for premium assistance.
Women’s Health and Cancer Rights Act Enrollment Notice
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Woman’s Health
and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided
in a manner determined in consultation with the attending physician and the patient, for:
1. All stages of reconstruction of the breast on which mastectomy was performed.
2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; prostheses.
3. Treatment of physical complications of the mastectomy, including lymphedema.
Newborns’ and Mothers’ Health Protection Act Disclosure
Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital
length of stay in connection with child birth for the mother or newborn child to less than 48 hours following a vaginal
delivery, or less than 96 hours following a cesarean 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 a provider
obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96
hours).
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PRIVATE PREP BENEFITS GUIDE
LEGAL NOTICES
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