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Sample HIPAA Documents for Benefit Funds

If Benefit Funds offer health-related benefits to their members, they are most likely subject to the Privacy and Security rules of the Health Insurance Portability & Accountability Act of 1996 (“HIPAA”). HIPAA compliance is rather involved, and may require that covered entities such as Benefit Funds take a number of actions to comply with HIPAA rules. NYSUT Member Benefits is pleased to make available sample HIPAA Privacy & Security templates to assist Benefit Funds with their HIPAA compliance efforts. Please keep in mind that these templates should only serve as general guidance. A Benefit Fund’s legal counsel should assist it in developing documents that are right for each Benefit Fund’s unique situation.

Click on each item to view the template:

Microsoft Word Version
Adobe PDF Version

Should you have any questions regarding these documents, please contact:

Kim Haefelin, NYSUT Member Benefits Coordinator of Benefits, at 516-496-2035 or khaefeli@nysutmail.org, or Laura Calhoun, NYSUT Member Benefits Coordinator of Benefits, at 800-626-8101, ext. 1302 or lcalhoun@nysutmail.org.

Benefit Funds should consult with their legal counsel to determine exactly what is required under HIPAA in their particular circumstances, as HIPAA rules differ depending upon a number of different factors relevant to a Benefit Fund’s unique operations.

NYSUT Member Benefits does not and cannot provide investment, financial, legal, or tax advice, and the information contained herein should not and cannot be construed as such. NYSUT Member Benefits strongly encourages its participants and Benefit Funds to seek guidance from their own investment, financial, legal, or tax advisors.