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BEN-E-LECT HIPAA Privacy Notice
As you may know the Federal Government, through the HIPAA laws, requires employers to establish a privacy policy/notice. This is a form you must give to your employees stating your company's guidelines for protecting the employee's privacy.
Ben-e-lect is providing you the "template" for this in an attempt to make the process easier for you.
Please review the attached Privacy Notice. If the notice is acceptable to you, please complete (fill in the blanks) where indicated. Once this has been completed, please print the notice and provide a copy to each employee covered by your health plan.
Please do the following:
1. Page one: Insert the name of the individual at your company who will be your "point person" and answer questions for your employees regarding this notice.
2. Page four: Insert the name of the individual at your company to whom requests for amendments will be submitted.
3. Page five: In the first area indicated, insert the name of the individual at your company who will handle PHI disclosures. This person, will, in all likelihood be the same individual used on the previous pages.
In the second area indicated, insert your web address. This would only be completed if you are planning to post this notice on that website.
In the final field insert the name of the individual at your company who will provide employees with a paper copy of this notice.
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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