6.6. ERMUSR 05-16-2006 - Laserfiche WebLink

Home Browse Search

HIPAA Privacy and Security Policy Acknowledgment Form This notice tells all employees how and why personal information about employees will be collected, how it will be handled and secured, and with whom the information is shared. ~y'e respect the privacy of personal information and maintain it securely according to the privacy and security rules under HIPAA. This notice applies to information regarding all current and former employees. Why we collect personal information: • To determine eligibility for health care coverage • To transmit premium payments to the health insurance carrier • To provide test results to an officer of the company, government regulatory agencies, or companies that require certain tests under contract • For pre-employment physicals and to determine fitness-for-duty of the employee's job • To evaluate work-related injuries and comply with workers' compensation laws • For requests for accommodation under the ADA • To administer leave under FMLA (where applicable) • To comply with OSHA, MSHA, and similar state laws • For judicial or administrative proceedings Personal information we collect from employees: We ask people seeking employment and benefits to provide certain information when they begin employment and enroll in a benefit plan. This information includes but is not limited to: • Name, address, and phone number • Social Security Number • Birth date • Marital status • Information regarding current illnesses, injuries, or disabilities that may affect the ability to perform the job. • Consent to release all applicable information, including physical exam, drug screening and fitness-for- duty results to the company and its agents and service providers How ~~'e protect personal information under federal la~v: Employee personal medical information is maintained in accordance with HIPAA and/or any other state or federal law to protect the privacy of such information. The confidentiality, integrity, and availability of any electronic protected health information (ePHI) will be ensured via appropriate safeguards as specified under HIPAA's security rule beginning on or before the rule's effective date (4/21/06 for small health plans; 4/21/05 for all other covered entities). How we protect personal information under state law: Employee personal medical information is maintained in accordance with state law where such rules are more stringent than, but not contrary to, the federal law to protect the privacy of such information. In general, state laws that are contrary to HIPAA's privacy rule are preempted by the federal requirements, which mean that the federal requirements will apply. The HIPAA privacy rule provides exceptions to the general rule of federal preemption for contrary state laws that require certain health plan reporting, provide greater privacy protections, or provide for the reporting of disease or injury, child abuse, birth, or death. If you want more information on HIPAA as it applies to your personal health information, please contact the owner or an officer of the company or customer service for: Elk River Municipal Utilities Health Care Plan Acknowledgment of receipt: Employee Date