Benefits for 2024
Legal Notices
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that addresses the privacy and security of certain individually identifiable health information, called protected health information (or PHI). You have certain rights with respect to your PHI, including a right to see or get a copy of your health and claims records and other health information maintained by a health plan or carrier.For a copyof the Notice of PrivacyPractices,describinghow your PHI maybe used and disclosed and how you get access to the information, contact Human Resources.
Women’s Healthand Cancer RightsAct EnrollmentNotice
If you have had or are going to have a mastectomy,you maybe entitledto certainbenefits under the Woman’s Health and Cancer Rights Act of 1998 (WHCRA).For individualsreceivingmastectomy-relatedbenefits,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.
These will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this benefitsplan.
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 childbirth 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, fromdischarging the motheror her newborn earlierthan 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 prescribinga length of staynot in excessof 48 hours (or96 hours).
Patient Protection Notice
Your carrier generally may require the designation of a primary care provider. You have the right to designate any primary care provider who participates in your network and who is available to accept you or your familymembers. Untilyou make this designation, your carriermaydesignate one for you. For informationon how to select a primarycare provider, and for a listof the participating primary care providers, contact the plan administrator. For children,you maydesignate a pediatrician as the primarycare provider. You do not need priorauthorization fromyour carrier or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professionalin your network who specializesin obstetrics or gynecology. The health care professional,however, maybe required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the plan administrator.
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.
2024 Employee Benefit Guide
18
Made with FlippingBook Online newsletter maker