HIPAA Privacy

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.

Your Information. Your Rights. Our Responsibilities.
Contact information for questions or complaints is available at the end of this notice.

Your Rights

You have the right to:

• Get a copy of your health and claims records
• Correct your health and claims records
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we've shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rigths have been violated

Your Choices

You have some choices in the way that we use and share information as we:

• Answer coverage questions from your family and friends
• Provide disaster relief
• Market our services and sell your information

Our Uses and Disclosures

We may use and share your information as we:

• Help manage the health care treatment you receive
• Run our organization
• Pay for your health services
• Administer your health plan
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to organ and tissue donation requests and work with a medical examiner or funeral director
• Address workers' compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of health and claims records:

• You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. 

Ask us to correct health and claims records:

• You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do this.
• If your requested adjustment is not possible, we will notify you in writing of the reason within 60 days.

Request confidential communications:

• You can ask us to contact you in a specific way (ex: by home or office phone) or to send mail to a different address.
• We will consider all reasonable requests, and must say yes if you tell us you would be in danger if we do not.

Ask us to limit what we use or share:

• You can ask us to not use or share certain health information for treatment, payment, or our operations.
• We are not required to agree to your requests.

Get a list of those with whom we've shared information:

• You can ask for a list (accounting) of the times we've shared your health information for up to six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). Get a copy of this privacy notice:

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act on your behalf:

• If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you prior to taking any action.

File a complaint if you feel your rights are violated:

• You can complain if you feel we have violated your rights by contacting us using the information at the end of this notice.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/hipaa/filing-a-complaint/index.html.
• We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share.

If you have a clear preference for how we share your information in the situations described below, share with us. Tell us what you prefer, and we will follow your request. In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in payment for your care
• Share information in a disaster relief situation (If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
• In these cases, we never share your information unless you give us written permission.

Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways:

• Help manage the health care treatment you receive
• Pay for your health services
• Administer your plan
• Run our organization

How else can we use or share your health information?

• We are allowed or required to share your information in other ways - usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the lawithedical examiner or funeral director.

• We can share health information about you with organ procurement organizations.
• We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers' compensation, law enforcement, and other governmental requests - We can use or share health information about you:

• For workers' compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions - We can share health information about you in response to a court or administrative order, or in response to a supeona.

Uses and Disclosures of Substance Use Disorder (SUD) Treatment Information

• If we receive or maintain records about you from a SUD treatment program subject to 42 CFR part 2 (a Part 2 Program) through consent you provide the Part 2 Program to use a disclose the records shall not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide written consent, or a court order, is issued after notice and an opportunity to be heard is provided by you or the holder of the records.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we may in writing. If you tell us we may, you may change your mind at any time. Notify us in writing that you do change your mind.

For more information, please see www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html .

Changes to the Terms of this Notice

We may change the terms of this notice, and the changes will apply to all information we have regarding you. The new notice will be available upon request on our web site, and via mail.

Other Instructions

Notice date:  1/1/2026

Bowling Green State University
Sandra K. Heck, Director, Benefits & Retirement
1851 N. Research Dr.
Bowling Green, Ohio 43403
419-372-2114