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. 

The Local Government Captive Insurance Company, LLC (“LGC”), the Municipal Employee Benefits Consortium (“MEBCO”), and MEBCORP, Inc. (“MEBCORP”) (hereinafter each referred to as a “Sponsor” and together as the “Sponsors”) participate in an Organized Health Care Arrangement (“OHCA”). This allows the Sponsors to share health information to conduct certain joint activities relating to the OHCA, including integrated information system management, health information exchange, financial and billing services, insurance, and risk management activities.

This Notice of Privacy Practices (the “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.

The Sponsors are required by law to maintain the privacy and security of Protected Health Information (“PHI”) as defined under the Health Insurance Portability and Accountability Act of 1996. Sponsors must follow the duties and privacy practices described in this Notice and give you a copy of it.  This Notice describes how the Sponsors may use and disclose PHI to conduct the high quality, cost effective group health and other employee benefits plan or for other specified purposes that are permitted or required by law. This Notice also describes your rights with respect to your PHI. The Sponsors will not use or disclose your PHI without your written authorization, except as described or otherwise permitted by this Notice. The Sponsors reserve the right to change their practices and the terms of this Notice and to make the new Notice effective for all PHI the Sponsors maintain. If any changes are made, an update to this Notice will be available upon request and on the MEBCO website.

Examples of How the Sponsors Use and Disclose Protected Health Information About You:

The following categories describe different ways that the Sponsors may use and disclose your PHI. However, not every use or disclosure in a category will be listed.

Payment: The Sponsors may use your health information for various claims processing and payment-related functions. The information on or accompanying a bill may include information that identifies you, as well as the medical service or prescription provided to you.

Health Care Operations: The Sponsors may use your health information for certain operational, administrative and quality assurance activities. The Sponsors may disclose health information to business associates if they need to receive this information to provide a service to us and will agree to abide by specific HIPAA rules relating to the protection of PHI. The Sponsors may also use your health information to provide you with information about the benefits available to you.

The Sponsors are permitted to use or disclose your PHI for the following purposes:

Treatment and Payment: The Sponsors may use and disclose your PHI to health care professionals or other third parties to provide, coordinate and manage the delivery of health care. For example, the Sponsors also may provide you with treatment reminders and information about potential side effects, drug interactions, and other treatment-related issues involving your medicine. The Sponsors also may use and disclose PHI about you to receive payment for our services or for your coverage, manage your benefits coverage, fulfill our responsibilities under your benefit plan and process your claims for drugs you have received.

Workers’ Compensation: The Sponsors may disclose your PHI to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.Public Health: As required by law, the Sponsors may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability.Law Enforcement: The Sponsors may disclose your PHI for law enforcement purposes as required by law or in response to a subpoena or court order.As Required by Law: The Sponsors will disclose your PHI when required to do so by federal, state, or local law.

Health Oversight Activities: The Sponsors may disclose your PHI to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and credentialing, as necessary for licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Judicial and Administrative Proceedings: If you are involved in a lawsuit or a dispute, the Sponsors may disclose your PHI in response to a court or administrative order. The Sponsors may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process instituted by someone else involved in the dispute, but only if efforts have been made, either by the requesting party or us, to tell you about the request or to obtain an order protecting the information requested.

Coroner’s Medical examiner, and Funeral Directors: The Sponsors may release your PHI to a coroner or medical examiner. This may be necessary, for example, so identify a deceased person or determine the cause of death. The Sponsors may also disclose PHI to funeral directors consistent with applicable law to enable them to carry out their duties.

Organ or Tissue Procurement Organizations: Consistent with applicable law, the Sponsors may disclose your PHI to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Notification: The Sponsors may use or disclose your PHI to notify or assist in notifying a family member, personal representative, or another person responsible for your coverage.

Correctional Institution: If you are or become an inmate of a correctional institution, the Sponsors may disclose to the institution or its agents PHI necessary for your health and the health and safety of other individuals.

To Avert a Serious Threat to Health or Safety: The Sponsors may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

Military and Veterans: If you are a member of the armed forces, the Sponsors may release PHI about you as required by military command authorities. The Sponsors may also release PHI about foreign military personnel to the appropriate foreign military authority. 

National Security, Intelligence Activities, and Protective Services for the President and Others: The Sponsors may release PHI about you so federal officials for intelligence, counterintelligence, protection to the President, and other national security activities authorized by law.

Victims of Abuse or Neglect: The Sponsors may disclose PHI about you to a government authority if the Sponsors reasonably believe you are a victim of abuse or neglect. The Sponsors will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and the Sponsors believe it is necessary to prevent serious harm to you or someone else.

Other Uses and Disclosures of PHI: The Sponsors will obtain your written authorization before using or disclosing your PHI for purposes other than those provided for above (or as otherwise permitted or required by law). You may revoke an authorization in writing at any time. Upon receipt of the written revocation, the Sponsors will stop using or disclosing your PHI, except to the extent that the Sponsors have already taken action in reliance on the authorization.

Your Health Information Rights:

Obtain a paper copy of the Notice upon request: You may request a copy of the Sponsors current Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy. You may obtain a paper copy upon request to the Security Officer.

Request a restriction on certain uses and disclosures of PHI: You have the right to request additional restrictions on our use or disclosure of PHI by sending a written request to the Security Officer. The Sponsors are not required to agree to those restrictions. The Sponsors cannot agree to restrictions on use or disclosures that are legally required, or which are necessary to administer their business.Inspect and obtain a copy of PHI: In most cases, you have the right to access and copy the PHI  that the Sponsors maintain about you. To inspect or copy your PHI you must send a written request to the Security Officer. The Sponsors may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request. The Sponsors may deny your request to inspect and copy in certain limited circumstances.Request an amendment of PHI: If you feel the PHI the Sponsors maintain about you is incomplete or incorrect, you may request to amend it. To request an amendment, you must send a written request to the Security Officer. You must include a reason that supports your request. In certain cases, the Security Officer may deny your request for amendment.

Receive an accounting of disclosures of PHI: You have the right to receive an accounting of the disclosures the Sponsors have made of your PHI for most purposes other than health coverage services. The right to receive an accounting is subject to certain exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to the Security Officer. Your request must specify the time period. The time period may not be longer than six years.

Request communication of PHI by alternative means or at alternative locations: For instance, you may request that the Security Officer contact you at a different residence or post office box. To request confidential communication of your PHI, you must submit a request in writing to the Security Officer. Your request must tell us how or where you would like to be contacted. The Security Officer will accommodate all reasonable requests. 

Where to obtain forms for submitting written requests:You may obtain forms for submitting written requests by contacting the Security Officer:

Dawn Donovan, Security Officer

Email:dawn.donovan@mebcorp.net

Phone: Compliance Hotline will be established. Please contact MEBCORP.

 

Incidental Disclosures: The Sponsors will make reasonable efforts to avoid incidental disclosures of PHI .Minors: If you are a minor who has lawfully provided consent for treatment and you wish for the Sponsors to treat you as an adult for purposes of access to and disclosure of records related to such treatment, please notify the Security Officer.

For More Information or To Report a Problem:If you have questions or would like additional information about the Sponsors data privacy and security practices, you may contact our Security Officer.

If you believe your privacy rights have been violated, you can file a complaint with the Security Officer. The Security Officer will pursue the complaint diligently and attend to the complaint with an appropriate level of seriousness as it pertains to your health rights.

Effective Date: This Notice is effective as of July 17, 2025.

For Further Information, please visit: MEBCORP.NET

45 C.F.R. § 160.103 (2024).