IMPORTANT NOTICE
HIPAA NOTIFICATION OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION

To All Fund Participants and their eligible dependents:

In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA). This regulation was intended to provide better access to health insurance and provide health care reform by reducing administrative costs. Additional rules were added to the Act in order to protect patients’ medical information as well as inform the patient of his or her rights to review their medical information, and notice of how their information may be used. Below is the notice of privacy practices. Please keep this notice with your Summary Plan Description booklet.

Notice of Privacy Practices - Effective April 14, 2003

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

This is your Health Information Privacy Notice from the SEIU Local 32BJ District 36 Benefit Funds. This notice describes how the Funds protect your health information and how we may use and disclose this information. Protected Health Information (PHI) includes individually identifiable information that relates to your past, present or future medical condition, provision of medical services, or for payment. This notice also provides you with how you can exercise your rights with respect to your PHI.

Uses and Disclosures

The SEIU Local 32BJ District 36 Benefit Funds will protect your Health Information from inappropriate use or disclosure. Benefit Fund Employees as well as the companies that help service your benefits are required to comply with our requirements to protect your Health Information. Your PHI may be used for the purpose of administering, evaluating and processing any requests for coverage, eligibility, and claim for benefits that you may make or in connection with other health benefits or services that may be of interest to you. We will not disclose your PHI to any company for the purpose of marketing their products to you. However, we will use and disclose PHI for business purposes relating to your health insurance coverage.

• For Treatment: The SEIU Local 32BJ District 36 Benefit Funds may use and disclose your health information to a health care provider, such as a hospital or physician, to assist the provider in treating you. For example: if you are being treated for a knee injury, the Fund may disclose your PHI to the rehabilitation department in order to coordinate your care.
• For Payment: The SEIU Local 32BJ District 36 Benefit Funds may use and disclose your health information to pay benefits. For example: The Fund or its intermediaries may review PHI contained on claims to reimburse providers for services rendered. The Fund may also disclose PHI to other insurance carriers for the process of coordination of benefits as well as other payment functions such as verification of eligibility, precertification of benefits, claim audits and reviews or to assist your inquires or disputes.
• For Health Care Operations: The SEIU Local 32BJ District 36 Benefit Funds may use and disclose PHI as necessary to support the day to day operations of the Benefit Funds. These functions include evaluating requests for health insurance products or services, administering those products and services and processing transactions by you. The Benefit Fund may also disclose PHI to Business Associates outside the Fund if they need to receive PHI to provide a service to or for us and will follow the specific HIPAA rules relating to the protection of PHI.