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(b) Health care operations include, but are not limited to, the following activities: <br />assessment; Deleted: (1) Quality <br />activities relating to improving health or health care Deleted: (2) Population-based <br />costs, protocol development, case management and care coordination, disease Deleted: reduction <br />management, contacting health care providers and patients with information <br />about treatment alternatives and related functions; <br />provider and plan performance, including accreditation, certification, Deleted: (3) Rating <br />licensing or credentialing activities; <br />premium rating and other activities relating to the creation, Deleted: (4) underwriting, <br />renewal or replacement of a contract of health insurance or health benefits, and Deleted: <br />ceding, securing or placing a contract for reinsurance of risk relating to health <br />care claims (including stop-loss insurance and excess of loss insurance); <br />or arranging for medical review, legal services and auditing function, Deleted: (s) conducting <br />including fraud and abuse detection and compliance programs; <br />planning and development, such as conducting cost-management and Deleted: (6) Business <br />planning-related analyses related to managing and operating the including Deleted: Plan, <br />formulary development and administration, development or improvement of <br />payment methods or coverage policies; <br />management and general administration activities of the Deleted: (7) Business <br />including, but nOt limited t0: Deleted: Plan, <br />activities relating to the implementation of and compliance Deleted: a. Management <br />with HIPAA's administrative simplification requirements; <br />service, including data analyses for Deleted: b. Customer <br /> Deleted: policyholders; <br />of internal grievances; and <br /> Deleted: (8) Resolution <br />diligence in connection with the sale or transfer of assets to a potential Deleted: (9) oue <br />successor in interest, if the potential successor in interest is a covered entity <br />under HIPAA or following completion of the sale or transfer, will become a <br />covered entity. Deleted: <br />13.2 Employer's Obligations under the Privacy Under the Privacy the may Deleted: Rule. <br />not disclose PHI to the Employer unless the Employer agrees to certain conditions. The Employer Deleted: Rule, <br />agrees to the following conditions, thereby allowing the to disclose PHI to the Employer. <br /> <br />The Employer Deleted: Plan <br /> Deleted: Plan <br />a. use or further disclose PHI other than as permitted or required by the document Deleted: will: <br />or as required by law; Deleted: Not <br />b. that any agents, including a subcontractor, to whom the provides PHI Deleted: Plan <br />received from the agree to the same restrictions and conditions that apply to the Deleted: Ensure <br />Employer with respect to such PHI; Deleted: Plan <br /> Deleted: Plan <br />c. use or disclose PHI for employment related actions and decision unless authorized by <br />an individual; Deleted: Not <br />© 2009 Hitesman & Associates, P.A. 34 Elk River Municipal Utilities <br />Flexible Benefits Plan (NO. 8.0.0.0) <br />