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2005-030
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2005-030
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Last modified
7/5/2016 2:27:35 PM
Creation date
9/30/2015 7:40:02 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Addendum
Approved Date
01/18/2005
Control Number
2005-030
Agenda Item Number
11.D.1
Entity Name
Blue Cross and Blue Shield of Florida
Symetra :Life Insurance Co.
Subject
HIPAA-AS Addendum to Agreement
Archived Roll/Disk#
4000
Supplemental fields
SmeadsoftID
3862
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3 . Use with or disclosure to a Covered Person who is the subject of Protected Health <br /> Information, or that Covered Person ' s Personal Representative ; <br /> 4 . Use or disclosure made pursuant to an authorization compliant with 45 C . F . R . <br /> § 164 . 508 that is signed by an Individual who is the subject of Protected Health <br /> Information to be used or disclosed, or by that Individual ' s Personal <br /> Representative, as defined in 45 C . F . R . § 164 . 502 (g) ; <br /> 5 . Disclosure to the United States Department of Health and Human Services <br /> ("DHHS ") in accordance with Section VIII below ; <br /> 6 . Use or disclosure that is Required by Law ; or <br /> 7 . Any other use or disclosure that is excepted from the minimum necessary limitation <br /> as specified in 45 C . F . R. § 164 . 502 (b)(2 ) . <br /> E . Disclosure to GHP and GHP ' s Business Associates <br /> Other than disclosures permitted by Section III . C . above, Administrator will not disclose Protected <br /> Health Information to GHP , a GHP Business Associate, or a GHP Vendor, except as directed by <br /> GHP in writing. <br /> F. Disclosure to Administrator ' s Subcontractors and Agents <br /> Administrator may disclose Protected Health Information to a subcontractor or agent . <br /> Administrator will require each subcontractor and agent to which Administrator may disclose <br /> Protected Health Information to provide reasonable assurance, evidenced by written contract, that <br /> such subcontractor or agent will comply with the same privacy and security obligations with <br /> respect to Protected Health Information as this Addendum applies to Administrator. <br /> G. Disclosure to Employer <br /> Administrator will not disclose any Protected Health Information to Employer, except as permitted <br /> by and in accordance with PART 3 below . <br /> H. Reporting Non-Permitted Use or Disclosure and Security Incidents <br /> 1 . Privacy Breach <br /> Administrator will report to GHP any use or disclosure of Protected Health Information not <br /> permitted by this Addendum or in writing by GHP of which Administrator becomes aware . <br /> 2 . Security Incidents <br /> Administrator will report to GHP any incident of which Administrator becomes aware that <br /> is (a) a successful unauthorized access, use or disclosure of Electronic Protected Health <br /> Information; or (b) a successful major (i) modification or destruction of Electronic <br /> Protected Health Information or (ii) interference with system operations in an Information <br /> System containing Electronic Protected Health Information. Upon GHP ' s request, <br /> Administrator will report any incident of which Administrator becomes aware that is a <br /> successful minor (a) modification or destruction of Electronic Protected Health <br /> 5 <br /> HIPAA\BA Amend to ASO Agmt - fini <br /> August 12 , 2004 <br />
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