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authorization is in place or the disclosure otherwise is in compliance with this Policy and the more detailed use and disclosure procedures . 4 . Permitted Uses and Disclosures : Payment and Health Care Operations PHI may be disclosed for the Plan's or the County' s own payment purposes, and PHI may be disclosed by a covered entity to -a health care provider concerning the treatments of an individual for the payment purposes of that covered entity. Payment . Payment includes activities undertaken to obtain Plan contributions or to determine or fulfill the Plan's responsibility for provision of benefits under the Plan, or to obtain or provide reimbursement for health care. Payment also includes : • eligibility and coverage determinations including coordination of benefits and adjudication (e . g. claim administration) or subrogation of health benefit claims ; • risk adjusting based on enrollee status and demographic characteristics; and • billing, claims management, collection activities, obtaining payment, under a contract for reinsurance (including stop-loss insurance and excess loss insurance) , and related health care data processing . Health Care Operations . PHI may be disclosed for purposes of the Plan Is � or the County' s own health care operations . PHI may be disclosed to another covered entity for purposes of . the other covered entity's quality assessment and improvement, case management, or health care fraud and abuse detection programs, if the other covered entity has (or had) a relationship with the participant and the PHI requested pertains to that relationship . Health care operations means any of the following activities to the extent that they are related to Plan administration. • assist plan participants in claim resolution; • determination of eligibility, coverage and cost sharing amounts (for example, cost sharing of a benefit, plan maximums and co-payments as determined for an individual ' s claim) ; • . coordination of benefits; • subrogation of health benefit claims ; • population-based activities relating to improving health or reducing health care costs ; • premium rating and other activities relating to the creation, renewal or replacement of a contract of health insurance or health benefits, and ceding, securing or placing a contract for reinsurance of risk relating to health care claims (including stop-loss insurance and excess of loss insurance) ; • conducting or arranging for medical review, legal services and auditing functions including fraud and abuse detection and compliance programs ; • business planning and development, such as conducting cost-management and planning-related analyses related to managing and operating the Plan, including formulary development and administration, development or improvement of payment methods or coverage policies ; 9