2022 Benefits Guide - CSHL

of the request, the Plan will provide you with the list of disclosures or a written statement that the time period for providing this list will be extended for no more than 30 more days, along with the reasons for the delay and the date by which the Plan expects to address your request. You may make one request in any 12-month period at no cost to you, but the Plan may charge a fee for subsequent requests. You’ll be notified of the fee in advance and have the opportunity to change or revoke your request. Right to obtain a paper copy of this notice from the Plan upon request You have the right to obtain a paper copy of this privacy notice upon request. Even individuals who agreed to receive this notice electronically may request a paper copy at any time. Changes to the information in this notice The Plan must abide by the terms of the privacy notice currently in effect. This notice takes effect on September 23, 2013. However, the Plan reserves the right to change the terms of its privacy policies, as described in this notice, at any time and to make new provisions effective for all health information that the Plan maintains. This includes health information that was previously created or received, not just health information created or received after the policy is changed. If changes are made to the Plan’s privacy policies described in this notice, you will be provided with a revised privacy notice. If the Health Plan makes a material revision to this Notice, it will notify by direct mail to all named insured participants who are covered by the plan within sixty (60) days after the date the material change is made. Complaints If you believe your privacy rights have been violated or your Plan has not followed its legal obligations under HIPAA, you may complain to the Plan and to the Secretary of Health and Human Services. You won’t be retaliated against for filing a complaint.

To file a complaint with the Health Plan, you must submit your complaint in writing to the following address:

Cold Spring Harbor Laboratory Katie Raftery Vice President, Chief Human Resources Officer One Bungtown Road Cold Spring Harbor, NY 11724

Alternatively, you can file a complaint with the HHS OCR at the following e-mail address: OCRComplaint@hhs.gov or you can file a complaint with the OCR regional office in the state or jurisdiction where the Plan is located.

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