Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Our Company’s Pledge to You This notice explains the privacy practices followed by the Life Is Good Health Plan and the Plan’s legal obligations under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). It also describes the privacy rights you and your family members have as participants of the Plan. This notice is effective 1/1/2027. The Plan often needs access to your protected health information in order to provide payment for health services and perform administrative functions. We want to assure you that we comply with federal privacy laws and respect your right to privacy. Life Is Good requires all members of our workforce and any third parties with access to protected health information to comply with these practices. Protected Health Information Your protected health information is protected by the HIPAA Privacy Rule. Generally, protected health information is information that identifies an individual created or received by a health care provider, health plan or an employer on behalf of a group health plan that relates to physical or mental health conditions, provision of health care, or payment for health care, whether past, present or future. Certain types of information—such as HIV-related information, genetic information, mental health records, and substance use disorder treatment records—may be entitled to additional confidentiality protections under applicable state or federal law. The Plan will comply with all applicable special protections when handling these records. For example, if the Plan receives PHI from a substance use disorder treatment program covered under federal law (42 CFR Part 2), the Plan will apply the protections required for those records. How We May Use Your Protected Health Information Payment. We may use or disclose your PHI without your written authorization to determine eligibility for benefits, seek reimbursement from a third party, or coordinate benefits with other health plans under which you are covered. For example, a health care provider that treated you may send information to us so we can determine whether the services are covered by the Plan. Health Care Operations. We may use or disclose your PHI as necessary to perform Plan administration functions, including quality assurance activities, resolving internal grievances, and evaluating Plan performance. For example, we may review claims experience to understand participant utilization or to make Plan design changes that are intended to control health care costs. Treatment. Although HIPAA allows health plans to use or disclose PHI for treatment purposes, the Plan generally does not need to do so. Your physician and other health care providers are required to provide you with their own explanation of how they use and share your health information for purposes of treatment, payment, and health care operations. As Permitted or Required by Law. We may use or disclose your PHI without your authorization when permitted or required by law. We are permitted by law to share information, subject to certain requirements, in order to communicate information on health-related benefits or services that may be of interest to you, respond to a court order, or provide information to further public health activities (e.g., preventing the spread of disease) without your written authorization. We are also permitted to share protected health information during a corporate restructuring such as a merger, sale, or acquisition. We will also disclose health information about you when required by law, for example, in order to prevent serious harm to you or others. Pursuant to Your Authorization. In all other situations not covered by this notice or by law, we will obtain your written authorization before using or disclosing your PHI. You may revoke your authorization at any time and once the revocation is received by the Plan, it will prevent future uses or disclosures.
Compliance Notices for Health Coverage Page 13 Page 15