| IF the health plan is... |
Then the plan sponsor/employer must |
AND Wellmark |
- Fully insured and
- Receives Personal Health Information (PHI)
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- Provide certification of privacy regulation compliance to Wellmark
- Provide notice of privacy policy upon request of the plan
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- Send our Privacy Notice to all plan participants.
- Provide sample documents as appropriate at the direction of the plan sponsor. The provision of sample documents is not intended to constitute legal advice.
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- Fully insured and
- Does not receive PHI (except for enrollment and summary information). Summary health information summarizes claim history, claim expenses or types of claim experience and is "de-identified" except for limited geographic information.
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- Use the summary health information only for the purposes allowed by the HIPAA-AS privacy rule
- In this case, the plan sponsor has no obligations under the federal regulation to protect PHI.
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- Send our Privacy Notice to all plan participants.
- Provide sample documents as appropriate at the direction of the plan sponsor. The provision of sample documents is not intended to constitute legal advice.
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- Partially self funded and
- Receives PHI and
- Wellmark provides partial group health plan coverage
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- Send its Privacy Notice to all plan participants.
- Amend its plan document to include privacy provisions.
- Provide certification of privacy regulation compliance to Wellmark.
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- Send our Privacy Notice to all plan participants.
- Amend agreement with plan sponsor to comply with Business Associate contract requirements.
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- Partially self funded and
- Receives PHI and
- Wellmark does not provide partial group health plan coverage
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- Send its Privacy Notice to all plan participants.
- Amend its plan document to include privacy provisions.
- Provide certification of privacy regulation compliance to Wellmark.
|
- Amend agreement with plan sponsor to comply with Business Associate contract requirements.
- Provide sample documents as appropriate at the direction of the plan sponsor. The provision of sample documents is not intended to constitute legal advice.
|
- Fully self funded and
- Receives PHI
|
- Send its Privacy Notice to all plan participants.
- Amend its plan document to include privacy provisions.
- Provide certification of privacy regulation compliance to Wellmark.
|
- Amend agreement with plan sponsor to comply with Business Associate contract requirements.
- Provide sample documents as appropriate at the direction of the plan sponsor. The provision of sample documents is not intended to constitute legal advice.
|
