Under what circumstances can ERISA plan personnel transmit PHI to other employer personnel?
The Privacy Rule generally allows covered entities to transmit PHI for treatment, payment or health care operations and other exempt purposes. However, health plans are subject to special rules (the Section 504(f ) rules) where the recipient of the PHI is the plan sponsor. Unless it is summary health information4 transmitted solely for the purpose of obtaining bids or amending or terminating the plan (so-called settlor functions), PHI can be transmitted to the plan sponsor only if the plan sponsor has either obtained an authorization from each plan participant whose PHI is received or has amended the plan documents for the group health plan to inform the plan participants as to the manner in which the plan will be sharing PHI with the sponsor and how the sponsor will be using the PHI. Additionally, the sponsor must make a series of certifications to the plan which state, among other things, that the PHI will not be utilized to make employment related decisions about the ERISA plans par
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