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<br />4. Conducting or arranging for medical review, legal services, and auditing functions, <br />including fraud and abuse detection and compliance programs; <br /> <br />5. Planning and development, such as conducting cost-management and planning related <br />analyses relating to managing and operating the Plan (including formulary development <br />and administration, development or improvement of methods of payment or coverage <br />policies); and <br /> <br />6. Management and general administrative activities of the Plan, including but not limited <br />to: <br /> <br />A. Managing activities related to implementing and complying with the Privacy <br />Regulations; <br /> <br />B. Resolving claim appeals and other internal grievances; <br /> <br />C. Merging or consolidating the Plan with another Plan, including related due diligence; <br />and <br /> <br />D. As permitted under the Privacy Regulations, creating de-identified health information <br />or a limited data set. <br /> <br />. <br /> <br />B. Other Uses and Disclosures of Pill <br /> <br />The Privacy Regulations permit certain other uses and disclosures of your PHI. These include, for <br />example, releasing PHI to personal representatives of deceased covered persons, releasing PHI <br />for public health activities, releasing PHI for court proceedings, and releasing PHI for law <br />enforcement and similar purposes. If the Plan releases PHI in any of these other pennitted <br />situations, it will do so according to the requirements of the Privacy Regulations. <br /> <br />The Privacy Regulations also permit the Plan to release PHI if it receives a valid authori~ation <br />from you. If the Plan receives a valid authornation, the Plan will disclose PHI to the person or <br />orga~ation you authori~e to receive the information. This may include, for example, releasing <br />information to your spouse, to the pension plan, other retirement plans, vacation plan or similar <br />plan for the purposes related to administering those plans. <br /> <br />C. Release of PHI to the Plan Sponsor <br /> <br />The Plan may disclose PHI to the Plan Sponsor. The plan documents, including this Summary of <br />Benefits, have been amended to incorporate the following provisions. <br /> <br />The Plan Sponsor will receive and use PHI only for the Plan administration functions that the <br />Plan Sponsor performs for the Plan. In addition, the Plan Sponsor will: <br /> <br />1. Not use or further disclose PHI other than as permitted or required by the Summary of <br />Benefits or as required by law. <br /> <br />2. Ensure that any agents, to whom the Plan Sponsor provides PHI received from the Plan, <br />agree to the same restrictions and conditions that apply to the Plan Sponsor with respect <br />to such PHI; <br /> <br />3. Not use or disclose PHI for employment-related actions and decisions unless authori~ed <br />by the person who is the subject of the PHI; <br /> <br />4. Not use or disclose PHI in connection with any other benefit or employee benefit plan of <br />the Plan Sponsor unless authori~ed by the person who is the subject of the information; <br /> <br />3 <br />