United Agricultural Benefit Trust (UABT) understands that medical information about you and your health is personal and confidential. Protecting medical information about you is important. UABT maintains records of medical claims and services that you have received. We need this information to continue to provide you with prompt and professional claims payment and/or reimbursement and to comply with certain legal requirements.
We are required by law to:
Protected Health Information
Protected health information (PHI) means any information that is created or received by UABT which identifies you and relates to your past, present or future physical or mental health or condition.
Use and Disclosure of Medical Information About You
Payment. We may obtain, use and disclose medical information about you for claims payment. For example, UABT may need to know about surgery you received in order to adjudicate your claim for benefits. We may also require medical information about you to give you and your provider prior authorization/ certification for certain medical treatments.
Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
Employer Monthly Benefits Invoice. We will also include certain limited information about you on the benefits invoice sent to your employer each month. This information may include your name, social security number, birthdate and number of dependents. This information is used for calculating and processing the monthly premium/contribution paid for your health benefits.
As Required by Law. We will also disclose medical information about you when required to do so by Federal, state or local law or in response to a duly authorized subpoena, discovery request or other lawful order from a court of competent jurisdiction.
Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor health benefit programs and compliance with civil rights laws.
UABT shall not disclose any of your Protected Health Information (PHI) collected or received in connection with your UABT health benefit plan(s) unless the disclosure is permitted or required by law.
You. Your PHI will only be released to you or your legal representative or guardian, upon presentation to UABT of a valid Social Security Number, health identifier and/or group participation number.
Medical Provider. Your PHI may be provided to a medical care institution or medical professional for the purpose of verifying coverage or benefits, informing an individual of medical problem of which the individual may not be aware, or conducting an operations or services audit to verify your treatment by the medical professional or at the medical care institution; provided only such information is disclosed as is reasonably necessary to accomplish the foregoing.
Written Authorization. With your written authorization in the form and manner prescribed by UABT (please refer to the UABT Authorization for Use and Disclosure Form), your PHI may be released to a designated individual for the specified purpose, limited duration and subject to revocation.
Claims Experience. UABT may provide your employer with aggregate claims experience, which may include your PHI, for reporting purposes or for conducting an audit of UABT’s operations or services, provided the information disclosed is reasonably necessary for your employer to conduct the review or audit.
Actuarial Analysis. UABT may provide health information to a consulting actuary or for a research study. However, you will not be identified in any actuarial or research report and the actuarial or research consultant has agreed not to disclose the information unless the disclosure would otherwise be permitted by law.
Peer Group Review. It may be necessary for UABT to provide your PHI to an internal or external professional peer review organization for the purpose of reviewing the service or conduct of a medical care institution or provider.
Stop Loss Carrier. UABT’s stop loss insurance carrier, Pacific Life Insurance Company, may require your PHI for purposes of reimbursement of stop loss claims. Pacific Life Insurance Company is a business association of UABT and contractually obligated to protect your PHI.
All affiliated companies or individuals with whom UABT does business utilizing PHI are required to sign a Business Associates Contract and/or Confidentiality Statement and Agreement.
Any of your specific information and medical records will be considered confidential and will be shared only with those parties who have the authority to receive such information as described above. If disclosure is required through a court order or subpoena, the order or subpoena will first be reviewed by the UABT Legal Department to determine the legitimacy of the order, the purpose for the disclosure and limitations on the information disclosed.
All patient specific medical information will be stored for the appropriate length of time as required by legal statutes and company policy, in files that are located and made accessible only for the purposes stated above. System stored patient specific medical and personal information will be protected through system security measures designed to protect against access by unauthorized individuals or organizations.
Privacy Notice and Policy