by other plans or providers), such as wellness and risk assessment programs, quality assessment and improvement activities, customer service, and internal grievance resolution. Health care operations also include evaluating vendors; engaging in credentialing, training, and accreditation activities; performing underwriting or premium rating; arranging for medical review and audit activities; and conducting business planning and development. For example, the Plan may use information about your claims to audit the third parties that approve payment for Plan benefits. The amount of health information used, disclosed or requested will be limited and, when needed, restricted to the minimum necessary to accomplish the intended purposes, as defined under the HIPAA rules. If the Plan uses or discloses PHI for underwriting purposes, the Plan will not use or disclose PHI that is your genetic information for such purposes. How the Plan may share your health information with Cold Spring Harbor Laboratory The Plan, or its health insurer or HMO, may disclose your health information without your written authorization to Cold Spring Harbor Laboratory for plan administration purposes. Cold Spring Harbor Laboratory may need your health information to administer benefits under the Plan. Cold Spring Harbor Laboratory agrees not to use or disclose your health information other than as permitted or required by the Plan documents and by law. The Benefits Staff and the Benefits Committee are the only Cold Spring Harbor Laboratory employees who will have access to your health information for plan administration functions. Here’s how additional information may be shared between the Plan and Cold Spring Harbor Laboratory, as allowed under the HIPAA rules: • The Plan, or its insurer or HMO, may disclose “summary health information” to Cold Spring Harbor Laboratory, if requested, for purposes of obtaining premium bids to provide coverage under the Plan or for modifying, amending, or terminating the Plan. Summary health information is information that summarizes participants’ claims information, from which names and other identifying information have been removed. • The Plan, or its insurer or HMO, may disclose to Cold Spring Harbor Laboratory information on whether an individual is participating in the Plan or has enrolled or disenrolled in an insurance option or HMO offered by the Plan. In addition, you should know that Cold Spring Harbor Laboratory cannot and will not use health information obtained from the Plan for any employment-related actions. However, health information collected by Cold Spring Harbor Laboratory from other sources — for example, under the Family and Medical Leave Act, Americans with Disabilities Act, or workers’ compensation programs — is not protected under HIPAA (although this type of
information may be protected under other federal or state laws). Other allowable uses or disclosures of your health information
In certain cases, your health information can be disclosed without authorization to a family member, close friend, or other person you identify who is involved in your care or payment for your care. Information about your location, general condition, or death may be provided to a similar person (or to a public or private entity authorized to assist in disaster relief efforts). You’ll generally be given the chance to agree or object to these disclosures (although exceptions may be made — for example, if you’re not present or if you’re incapacitated).
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