HIPAA Privacy Notice

Our role

TG Benefit Solutions, LLC ("TG Benefit Solutions," "we," "us," or "our") is an independent insurance brokerage. Under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and its implementing rules at 45 CFR Parts 160 and 164, we are generally a business associate of the health plans and insurance carriers whose products we place. The covered entities themselves (the health plans and carriers) are the parties that issue formal Notices of Privacy Practices for the plans you enroll in.

This notice describes how TG Benefit Solutions, in our role as a business associate, uses and protects the protected health information ("PHI") we receive about you, and what your rights are. Each carrier you enroll in will provide you with its own Notice of Privacy Practices that governs how that carrier handles your PHI. If you would like a copy of any carrier's Notice of Privacy Practices, contact us and we will help you get it.

What is protected health information?

Protected health information is individually identifiable health information that we create, receive, maintain, or transmit on behalf of the health plans and carriers we work with. It can include information about your physical or mental health, the health care you have received, payment for that health care, and identifying information such as your name, address, date of birth, and Social Security number when those details are tied to your health information.

How we may use and disclose your health information

We use and disclose PHI only as needed to perform our function on behalf of the health plans and carriers we work with, and only as the HIPAA Privacy Rule and our business associate agreements with those carriers permit. The most common uses and disclosures are described below.

For treatment, payment, and health care operations

As a business associate, we may use or disclose PHI to support the treatment, payment, and health care operations of the plans we represent. Examples include:

• Sending your application, supporting documents, and medical questionnaires to a carrier so the carrier can underwrite, approve, and issue your coverage.
• Helping you understand a claim, an Explanation of Benefits, a denial, or an appeal, and communicating with the carrier on your behalf.
• Coordinating your coverage at renewal, including obtaining updated information from your prescription history (with your permission) to compare Medicare Part D plan fit.
• Quality measurement, audit, and case management activities of the plans we represent, when we are asked to assist as the business associate.

For insurance functions permitted by law

State insurance privacy regulations in Kansas, Missouri, and Nebraska also permit us to use and disclose PHI without your written authorization for a defined list of insurance functions, including claims administration, underwriting, fraud detection, policy placement, reinsurance, risk management, case management, disease management, peer review, grievance procedures, policyholder service, auditing, reporting, database security, and similar activities that are part of administering your coverage.

For uses and disclosures required by law

We will use and disclose PHI when we are required to do so by federal, state, or local law. We will also disclose PHI to the U.S. Department of Health and Human Services as needed for the Department to investigate or determine our compliance with HIPAA.

For public health and safety

We may disclose PHI for public health activities, to report suspected abuse, neglect, or domestic violence, to respond to health oversight authorities, in connection with judicial and administrative proceedings, to law enforcement officials when required by law, to coroners and medical examiners, in connection with serious threats to health or safety, for specialized government functions, and in connection with workers' compensation programs, all to the limited extent permitted by 45 CFR Part 164.

With your written authorization

Other uses and disclosures of PHI not described in this notice will be made only with your written authorization. In particular, the following always require your written authorization:

• Most uses and disclosures of psychotherapy notes.
• Uses and disclosures of PHI for marketing purposes.
• Sales of PHI.
• Disclosures of substance use disorder treatment records protected by 42 CFR Part 2.

You may revoke any authorization at any time, in writing, except to the extent we have already acted in reliance on it. Send a revocation to the address at the end of this notice.

Your rights

You have the following rights regarding the PHI we maintain about you.

Right to inspect and copy

You have the right to inspect and obtain a copy of the PHI we maintain about you in a designated record set, with limited exceptions specified by HIPAA. You may request a copy in paper or electronic form. We may charge a reasonable, cost-based fee.

Right to amend

If you believe PHI we maintain about you is inaccurate or incomplete, you have the right to request that we amend the information. We may deny your request in certain limited cases. If we deny your request, we will tell you why in writing and explain your right to file a written statement of disagreement.

Right to an accounting of disclosures

You have the right to request an accounting of certain disclosures of your PHI made by us during the six years before your request, excluding disclosures made for treatment, payment, or health care operations and certain other categories listed in the rule.

Right to request restrictions

You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations, or to family members or friends involved in your care. We are not required to agree to most such restrictions. We must agree to a restriction on disclosures to a health plan for payment or health care operations if the disclosure is not otherwise required by law and the PHI relates to a health care item or service for which you paid out of pocket in full.

Right to confidential communications

You have the right to request that we communicate with you about your health information by alternative means or at alternative locations. We will accommodate reasonable requests.

Right to a paper copy of this notice

You have the right to obtain a paper copy of this notice at any time, even if you have agreed to receive it electronically. Contact us using the information at the end of this notice and we will mail it to you.

Right to notification of a breach

You have the right to be notified following a breach of your unsecured PHI, as required by 45 CFR sections 164.404 through 164.414. We will notify you in writing without unreasonable delay and in no case later than 60 days after we discover the breach.

How to exercise these rights

To exercise any of these rights, contact us using the information at the end of this notice. We will provide forms and instructions and will respond as required by HIPAA. Some requests must be in writing; we will tell you when that is the case.

Our duties

We are required by law to maintain the privacy of PHI, to provide you with notice of our legal duties and privacy practices regarding PHI, and to notify affected individuals following a breach of unsecured PHI. We are required to abide by the terms of the notice currently in effect. We reserve the right to change the terms of this notice and to make any revised notice effective for PHI we already maintain as well as for PHI we receive in the future. If we make a material change, we will post the revised notice on this page and, if you have an active relationship with us, send it to you by email or mail.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information at the end of this notice. You may also file a written complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue SW, Room 509F, HHH Building
Washington, D.C. 20201
Phone: 1-800-368-1019 · TDD: 1-800-537-7697
Online complaint portal: ocrportal.hhs.gov (opens new tab)

You will not be retaliated against for filing a complaint.

Business associate agreements

When we use a service provider that needs access to PHI to help us perform our work (for example, our client management software or document storage), we put a HIPAA-compliant business associate agreement in place with that provider before sharing any PHI. The agreement requires the provider to safeguard your information and limit its use to the services it provides to us.

State insurance privacy law

In addition to HIPAA, your health information is protected by state insurance privacy law in Kansas (K.A.R. 40-1-46), Missouri (20 CSR 100-6.100), and Nebraska (Neb. Rev. Stat. sections 44-901 to 44-925). These rules generally require us to obtain your written or electronic authorization before disclosing your nonpublic personal health information for purposes other than the insurance functions specifically permitted by the rules. For more detail on how we collect, use, and share information about you, see our Privacy Policy.

Contact us

For questions about this notice, to exercise any right described above, or to file a privacy complaint with us, contact our Privacy Officer:

Privacy Officer
TG Benefit Solutions, LLC
521 Grant Ave, Suite D
Clay Center, KS 67432
Phone: (785) 530-9781
Email: benefits.tg@gmail.com