7/5/2016 2:27:35 PM
9/30/2015 7:40:02 PM
Official Document Type
Agenda Item Number
Blue Cross and Blue Shield of Florida
Symetra :Life Insurance Co.
HIPAA-AS Addendum to Agreement
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. bs X30 <br /> HIPAA-AS ADDENDUM TO ADMINISTRATIVE SERVICES AGREEMENT <br /> This addendum ("Addendum") is effective upon execution and amends that Administrative Services <br /> Agreement ("Agreement") made as of October 1 , 1996 by and among Blue Cross and Blue Shield of <br /> Florida, Inc . ("Administrator") ; Indian River County ("Employer") and Indian River County Group <br /> Health Plan ("GHP") . <br /> WHEREAS , Employer has established and maintains GHP as a self-insured employee welfare benefit <br /> plan, as described in GHP ' s Plan Document (referred to in the Agreement as the Group Health Plan) ; and <br /> WHEREAS , Employer and GHP desire to retain Administrator to provide certain claim processing and <br /> administrative services with respect to GHP ; and <br /> WHEREAS , Employer, GHP , and Administrator agree to modify the Agreement to incorporate the <br /> provisions of this Addendum to address applicable requirements of the implementing regulations, codified <br /> at 45 Code of Federal Regulations ("C . F . R. ") Parts 160-64 , for the Administrative Simplification <br /> provisions of Title 11, Subtitle F of the Health Insurance Portability and Accountability Act of 1996 <br /> (collectively, "HIPAA-AS ") , so that GHP may meet its compliance obligations under HIPAA-AS , and to <br /> include additional provisions that Employer, GHP , and Administrator desire to have as part of the <br /> Agreement ; <br /> NOW, THEREFORE , in consideration of the mutual promises contained herein, Employer, GHP , and <br /> Administrator hereby agree as follows : <br /> PART 1—DEFINITIONS <br /> L DEFINITIONS <br /> All capitalized terms in this Addendum that are not defined by this Addendum will have the meaning <br /> ascribed to them by 45 C . F . R. Parts 160- 64 . The following terms have the following meanings when used <br /> in this Addendum : <br /> A . "Covered Employee" means the person to whom coverage under GHP has been extended <br /> by Employer. <br /> B . "Covered Person" means the Covered Employee and any other persons to whom coverage <br /> has been extended under GHP as specified by GHP ' s Plan Document . <br /> C . "Creditable Coverage Certificate" means a certificate disclosing information relating to an <br /> individual ' s creditable coverage under a health care benefit program for purposes of <br /> reducing any preexisting condition limitation or exclusion imposed by any group health <br /> plan coverage . <br /> D . "Disclose" and "disclosure" mean, with respect to Protected Health Information, release, <br /> transfer, providing access to or divulging to a person or entity not within Administrator. <br /> E . "Electronic Protected Health Information" means Protected Health Information that is <br /> ( 1 ) transmitted by electronic media or (2 ) maintained in electronic media. <br /> F . "Protected Health Information" means the Protected Health Information, as that term is <br /> defined in 45 C . F . R. § 160 . 103 , that Administrator creates or receives for, on behalf of, or <br /> from GHP (or from a GHP Business Associate) in the performance of Administrator ' s <br /> 1 <br /> HIPAA\BA Amend to ASO Agmt - fini <br /> August 12 , 2004 <br />
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