Amendment III
THIRD AMENDMENT
TO THE
WRITERS’ GUILD-INDUSTRY HEALTH FUND
WHEREAS, the Board Of Trustees of the Writers’ Guild-Industry Health Fund (the“Health Fund”) has the right to amend the Health Fund; and
WHEREAS, the Board of Trustees desires to amend the Health Fund to reflect the
privacy requirements of the Standards for Privacy of Individually Identifiable Health Information
(the “Privacy Rule”) under the Health Insurance Portability and Accountability Act of 1996 as
they relate to disclosures to a plan sponsor;
NOW, THEREFORE, the Health Fund’s Trust Agreement is amended, effective as set
forth below:
The following new Article V, Section 11 is added effective as of April 14, 2003 (or, if later, such
effective date permitted under the Privacy Rule):
“Section 11. HIPAA Privacy Provisions.
- The provisions of this Section 11 shall apply only to those portions of the Health
Fund which are considered a group health plan under the Standards for Privacy of
Individually Identifiable Health Information (the “Privacy Rule”) under the
Health Insurance Portability and Accountability Act of 1996. Thus, the Health
Fund is a hybrid entity under the Privacy Rule and only the following health care
components are subject to the Privacy Rule: medical plan benefits, prescription
drug plan benefits, dental plan benefits, and vision plan benefits. Additionally,
this Section 11 only addresses the extent to which the Health Fund may disclose
Protected Health Information (“PHI”) to the Board of Trustees (the “Plan
Sponsor”).
- The Health Fund shall not disclose PHI to the Plan Sponsor, nor provide for or
permit the disclosure of PHI to the Plan Sponsor by a health insurance issuer or
HMO with respect to the Health Fund, except in accordance with this Section or
as otherwise permitted by law.
Summary Health Information. The Health Fund, or a health insurance issuer or HMO with respect to the Health Fund, may disclose summary health information to the Plan Sponsor, if the Plan Sponsor requests the summary health information for the purpose of:
(a) Obtaining premium bids from health plans for providing health
insurance coverage under the Health Fund; or
(b) Modifying, amending, or terminating the Health Fund.
Enrollment Information. The Health Fund, or a health insurance issuer or
HMO with respect to the Health Fund, may disclose to the Plan Sponsor
information on whether an individual is enrolled in or has disenrolled in
the Health Fund.
Plan Administration Functions. The Health Fund, or a health insurance
issuer or HMO with respect to the Health Fund, may disclose PHI to the
Plan Sponsor to permit the Plan Sponsor to carry out plan administration
functions for the Health Fund, subject to the provisions of this Section. |
- The Health Fund, or a health insurance issuer or HMO with respect to the Health
Fund, will disclose PHI to the Plan Sponsor only upon receipt of a certification by
the Plan Sponsor that Health Fund documents have been amended to incorporate
the provisions of this Section and the Plan Sponsor agrees to abide by this
Section.
- The Plan Sponsor agrees, with respect to PHI disclosed to the Plan Sponsor by the
Health Fund, that the Plan Sponsor shall, other than as permitted or required by
applicable law:
Not use or further disclose the PHI other than as permitted or required by
the Health Fund documents, as amended, or as required by law;
Ensure that any agents, including a subcontractor, to whom it provides
PHI, agree to the same restrictions and conditions that apply to the Plan
Sponsor with respect to such information;
Not use or disclose the PHI for employment-related actions and decisions
or in connection with any other benefit or employee benefit plan of the
Plan Sponsor; provided, however, that PHI does not include employment
records held by the Health Fund in its role as employer;
Report to the Health Fund any use or disclosure of the PHI that is
inconsistent with the uses or disclosures permitted under this Section;
To the extent, if any, the Plan Sponsor maintains PHI, make available to
an individual PHI about that individual, to the extent required by the
Privacy Rule;
To the extent, if any, the Plan Sponsor maintains PHI, make available to
an individual PHI about that individual for amendment and incorporation
of any amendments to the PHI, to the extent required by the Privacy Rule;
Track disclosures it makes of PHI and make available to an individual an
accounting of such disclosures during the six years prior to the date on which the accounting is requested, to the extent required by the Privacy
Rule;
Make its internal practices, books, and records relating to the use and
disclosure of PHI available to the Secretary for purposes of determining
compliance by the Health Fund with this Article;
If feasible, return or destroy all PHI received from the Health Fund that
the Plan Sponsor maintains in any form and retain no copies of such
information when no longer needed for the purpose for which disclosure
was made, except that, if such return or destruction is not feasible, the Plan
Sponsor shall limit further uses and disclosures to those purposes that
make the return or destruction of the information infeasible; and
Ensure that adequate separation between the Health Fund and the Plan
Sponsor is established in accordance with the following rules:
The Trustees shall be given access to the PHI as necessary to
perform Health Fund administrative functions.
Any incidents of noncompliance by a Trustee with the provisions
of this Section shall subject such individual to disciplinary action
and sanctions, including the possibility of removal from the Board. The Plan Sponsor will report such noncompliance to the Health
Fund and will cooperate with the Health Fund to correct the
noncompliance, impose an appropriate disciplinary action or
sanction, and mitigate the effect of the noncompliance.
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- Terms used in this Section and not otherwise defined shall have the meaning
provided in the Privacy Rule.”
IN WITNESS WHEREOF, this Amendment is hereby adopted effective as of the date set forth
above.
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