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  ***HIPAA NOTICE DEVELOPMENT/SAMPLE (NOT A VALID HIPAA NOTICE)***
 


THIS NOTICE DESCRIBES HOW PERSONAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE READ CAREFULLY.

Questions: If you have any questions about this notice, please contact:

USI Midwest
312 Elm Street - 24th Floor
Cincinnati, OH 45202

We understand that health information about you is personal. We are committed to protecting the personal health information that we maintain as part of the group health care coverage that we sponsor. We have set up policies and procedures to make sure that this health coverage information that identifies you is kept private.

This notice applies to all personal health information that USI maintains. It will tell you about the ways that we may use and share personal health information about you. It describes our responsibilities for personal health information that we use. Also, this notice tells you about your rights in relation to your personal health information.

USI is required by law to make sure that we protect and safeguard your personal health information that we maintain.

• We must give you this notice that describes our legal duties and our privacy practices concerning your personal health information.
• We must take reasonable efforts to release only the minimum personal health information necessary to accomplish the use, disclosure or request.
• By law, we must follow the terms of our privacy notice that is currently in effect.


 
 

Privacy Statement • HIPAA • Disclaimer