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Home > Health Plan > HIPAA
HIPAA
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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides important rights to plan participants and their dependents. It is the intent of this plan to fully comply with this law and where this Summary Plan Document is incomplete or in conflict with the law, the law will control.
HIPAA allows Health Plans to include provision for exclusion of some pre-existing conditions from coverage under the plan. The existing law allows for a 6 month "look back" period by the Plan when a new enrollee is admitted. If an excludable pre-existing condition is found in the "look back period" the Plan can withhold coverage for that condition for up to 18 months after that person enrolls.
The Teamsters Local 170 Health and Welfare Plan does not have a pre-existing condition exclusion provision at this time. If you are leaving the plan however, any new plan into which you are accepted may include such a provision. The pre-existing condition exclusion period can be reduced by the number of days you have gone without a significant break in coverage (63 days or more) under this plan, a prior plan or any combination of plans constituting credible health insurance coverage as defined under the law. To receive such a reduction you must present a valid Certificate of Credible Coverage from your prior plan. The Teamsters Local 170 Health and Welfare Fund will provide you with a Certificate of Credible Coverage whenever your plan eligibility ceases. This certificate will be provided with your COBRA eligibility letter. If you elect to continue in the plan under COBRA a certificate will again be provided to you when your COBRA eligibility expires or at the time you discontinue your COBRA coverage. You may also request a certificate from the plan at any time within 24 months after your coverage ceases.
Use and Disclosure of Health Information
The Teamsters Local 170 Health and Welfare Fund may use your health information, that is information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), for purposes of making or obtaining payment for your care and conducting health care operations. The Fund has established a policy to guard against unnecessary disclosure of your health information.
Right to a Paper Copy of the Privacy Notice
You have a right to request and receive a paper copy of the Privacy Notice at any time, even if you have received this Notice previously or agreed to receive the Notice electronically. To obtain a paper copy, please contact the Privacy Officer (508) 791-3416. You may also obtain a copy of the current version of the Fund's Privacy Notice on our Web site www.Teamsterhwf.com. Set forth below is the Fund’s Privacy Notice as of the date of publication of this Summary Plan Description
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