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2023-098B
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2023-098B
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Last modified
3/18/2024 12:03:39 PM
Creation date
3/18/2024 11:53:00 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
05/16/2023
Control Number
2023-098B
Agenda Item Number
12.D.2.
Entity Name
Blue Cross and Blue Shield
Subject
Shield Transition Health Plan Administrative Services from
Blue Cross Shield of Florida Inc.(Florida Blue)
to Blue Cross Blue Shield National Alliance effective 10/01/2023 thru 9/30/2026
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EXHIBIT 1— BCBSF NOTICE OF PRIVACY PRACTICES <br />The current BCBSF Notice of Privacy Practices is available at: <br />www.floridablue.com/y,eneral/hi-oaa-notice-i)rivacy-12ractice <br />Florida Blue reserves the right to amend its Notice of Privacy Practices and the web address where <br />it, is located at any time. Florida Blue will make reasonable efforts to inform GHP when such <br />changes are made. <br />EXHIBIT 2—EMPLOYER'S CERTIFICATION <br />PART 1– Employer to Amend Plan Documents for Privacy provisions <br />Employer certifies that Employer has amended GHP's Plan Document to incorporate the <br />provisions required by 45 C.F.R. § 164.504(f)(2), as set forth below, and agrees to comply with <br />GHP's Plan Document as amended. <br />Neither use nor further disclose Protected Health Information, except as permitted or <br />required by GHP's Plan Document or as required by law. <br />2. Neither use nor disclose Protected Health Information for any employment-related action <br />or decision, or in connection with any other benefit or employee benefit plan of Employer. <br />3. Ensure adequate separation between Employer and GHP by (a) describing those employees <br />or classes of employees or other persons under Employer's control who will be given <br />access to Protected Health Information to perform plan administration functions for GHP, <br />(b) restricting the access to and use of Protected Health Information by such employees or <br />other persons to the plan administration functions that Employer will perform for GHP, <br />and (c) instituting an effective mechanism for resolving any noncompliance with GHP's <br />Plan Document by such employees or other persons. <br />4. Ensure that any subcontractor or agent to which Employer provides Protected Health <br />Information agrees to the restrictions and conditions of GHP's Plan Document with respect <br />to Protected Health Information. <br />5. Report to GHP any use or disclosure of Protected Health Information of which Employer <br />becomes aware that is inconsistent with the uses and disclosures allowed by GHP's Plan <br />Document. <br />6. Make Protected Health Information available to GHP or, at GHP's direction, to the <br />Covered Person who is the subject of Protected Health Information (or the Covered <br />Person's Personal Representative) so that GHP can meet its access obligations under 45 <br />C.F.R. § 164.524. <br />7. Make Protected Health Information available to GHP for amendment and, on notice from <br />GHP, amend Protected Health Information, so that GHP can meet its amendment <br />obligations under 45 C.F.R. § 164.526. <br />
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