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This information is to assist you with the task of executing a business associate agreement between you and your Ben-e-lect clients.
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As you may know the Federal Government, through the HIPAA laws requires employers to establish business associate agreements with certain parties. This agreement assures employees and employers that those parties currently privy to their Protected Health Information will maintain certain standards with respect to the handling of that Protected Health Information.
Ben-e-lect is providing you the "template" for this in an attempt to make the process easier for you.
Please review the attached Business Associate Agreement. If the agreement is acceptable to you, please complete (fill in the blanks) where indicated. Both parties will need to sign and retain a copy of the agreement.
Please do the following:
1. Page one: Insert the name of the group health plan (covered entity). One example is ABC Company Inc. should be entered as ABC Company Inc. Employee Benefit Plan.
2. Page five: Insert the name and mailing address of the employer as the covered entity. Insert your name and mailing address as the business associate.
3. Page seven: This is merely the signature page for both parties to sign in agreement.
If you have any questions or need further information about this form please contact our office and ask for Cindy Chacon or Janet Wilson.
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