Equity-League Health Trust Fund Privacy Procedures


April 1, 2009

Below is a summary of the privacy responsibilities of the Equity-League Health Trust Fund (the “Plan”) and your rights with respect to your health information that the Plan maintains. For a complete description of the Plan’s privacy practices, please review the Plan’s Privacy Notice, which is available upon request from the Plan’s Privacy Official (see contact information below), or from the Plan’s website www.equityleague.org/health/health_privacy.html..

The Plan's Responsibilities

The Plan is required to:

• Maintain the privacy of your personal health information;
  
• Provide participants with a Privacy Notice of the Plan that sets forth the Plan’s legal obligations and privacy practices with respect to health information that the Plan collects and maintains about you; and
  
• Abide by the terms of this Notice.
  

Your Rights

If you receive health benefits through the Plan, you have several rights regarding your personal health information, including the following:

• The right to request that the Plan not use or disclose your personal health information in certain ways;
• The right to request to receive communications from the Plan in an alternative manner (such as to a different address or via email);
• The right to inspect and obtain a copy of your health information;
• The right to request an amendment to your health information; and
• The right to an accounting of certain non-routine disclosures of your health information.

The Plan reserves the right to change its privacy practices and to make the new provisions effective for all personal health information the Plan maintains. Should the Plan make material changes to its privacy practices, the Plan will post a revised Privacy Notice in a clear and prominent location and make the revised Privacy Notice available to you.

The Plan will not use or disclose your personal health information without your written permission (known as an authorization), except as described in the Privacy Notice.

Please note that effective April 1, 2006, the Plan’s privacy procedures as set forth in the Privacy Notice apply to the medical, hospital and prescription drug services that the Plan provides through Cigna (except mail order pharmacy), as well as to the offices of the Plan, optical coverage through Davis Vision and services through other business associates of the Plan. (The Plan’s HMOs and mail order pharmacy provider have their own privacy procedures. )

If you have questions or would like further information regarding your privacy rights, please contact the Plan’s Privacy Official at the following address and phone number: