The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a comprehensive federal law which established standards and requirements for the electronic transmission of medical claims and mandated the adoption of privacy rules to protect the confidentiality of personal health information.
The purpose of HIPAA’s privacy rules is to safeguard “Protected Health Information” that is shared between hospitals, doctors’ offices, and health plans. The HIPAA Privacy Rules give Plan participants more control over their health information, limit the use and release of health or claim records, and establish appropriate safeguards to protect the privacy of health information. The Seafarers Health and Benefits Plan Notice of Privacy Practices is available on this site (see links below).
The notice/forms linked on the bottom half of this page have been drafted to meet the needs of Plan participants with regard to some of the newly adopted Plan procedures and practices. These forms are intended to assist you with regard to the processing of medical claims. Please feel free to download them for your use or the use of your family members.
- Notice of Privacy Practices (PDF)
- Authorization to Release Health Information (PDF)
- Authorization to Release Health Information to Port Official (PDF)
- Power of Attorney for Health Care Claims (PDF)
- Request to Inspect and/or Copy Protected Health Information (PDF)
- Request for an Accounting of Disclosures of Protected Health Information (PDF)
- Request for Confidential Communications (PDF)
- Request for Restrictions on Use and Disclosure of Protected Health Information (PDF)
- Request to Amend Protected Health Information (PDF)