Airports Authority;
• Is not part of the information that you are permitted to inspect and copy;
• Is without question accurate and complete.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose for treatment, payment or health care operations. In addition, you have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment of your care, like a family member or friend. For example, you could ask that we not disclose your PHI to your spouse. To request a restriction, you must make your request, in writing, to the Privacy Officer. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to disclose the information in certain emergency treatment situations. In addition to the above, you have the right to restrict disclosure of your PHI to the Airports Authority’ s group health plans for payment or health care operations( but not for carrying out treatment) in situations where you have paid the health care provider out-of- pocket in full. In this case, we are required to implement the restrictions that you request.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at certain locations. For example, you can ask that you be contacted only at work or by mail. To request confidential communications, you must make your request, in writing, to the Privacy Officer. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
• Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask for a paper copy of this notice, as well as the full Privacy Policy and Procedures, at any time. To obtain a paper copy of this notice and / or the full Privacy Policy and Procedures, please contact the Privacy Officer.
PRIVACY OFFICER Questions, concerns or complaints about the privacy of PHI should be directed to the following:
Metropolitan Washington Airports Authority Privacy Officer 1 Aviation Circle Washington, DC 20001-6000 703-417-8983 privacy. officer @ mwaa. com
COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint with the Airports Authority’ s Privacy Officer or with the Secretary of the Department of Health and Human Services. To file a complaint with the Airports Authority’ s Privacy Officer, please direct correspondence to:
Metropolitan Washington Airports Authority Privacy Officer 1 Aviation Circle Washington, DC 20001-6000 703-417-8357 privacy. officer @ mwaa. com
To file a complaint with the Department of Health and Human Services, please direct correspondence to:
Department of Health and Human Services, Office for Civil Rights 200 Independence Avenue, SW Washington, DC 20201 Phone: 1-877-696-6775 Web: http:// www. hhs. gov / ocr / privacy / hipaa / complaints /
All complaints, whether submitted to the Airports Authority Privacy Officer or the Department of Health and Human Services, must be made in writing. You will not be penalized or otherwise retaliated against for filing a complaint.
CHANGES TO THIS NOTICE The Airports Authority may change the terms of this notice and privacy policies at any time. The revised or changed policies will be effective for all PHI maintained at that time as well as for PHI received in the future.
Continuation Coverage Rights Under COBRA As a participant in the Airports Authority’ s benefits( comprised of medical, dental, vision, and Health Care FSA plans), you are receiving this notice that describes your right to COBRA continuation coverage.
COBRA, or the Consolidated Omnibus Budget Reconciliation Act of 1985, is a federal law affecting most employers who offer group health coverage to their employees. Under this law, you and other members of your family may have the right to temporarily continue the group health benefits when you would ordinarily lose coverage. This document describes your right to this COBRA continuation coverage, when it may become available to you and your family and what you must do to protect your right to receive it.
WHAT IS COBRA CONTINUATION COVERAGE? COBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event. This is also called a“ qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a“ qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
If you’ re an employee, you’ ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
• Your hours of employment are reduced, or
• Your employment ends for any reason other than your gross misconduct.
If you’ re the spouse of an employee, you’ ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
• Your spouse dies;
• Your spouse’ s hours of employment are reduced;
• Your spouse’ s employment ends for any reason other than his or her gross misconduct;
• Your spouse becomes entitled to Medicare benefits( under Part A, Part B, or both); or
• You become divorced or legally separated from your spouse.
Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because of the following qualifying events:
• The parent-employee dies;
• The parent-employee’ s hours of employment are reduced;
• The parent-employee’ s employment ends for any reason other than his or her gross
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