114 Section 3: Your Individual Privacy Rights Following is a description of your individual privacy rights. It is important to note that while all requests should be directed to the Health Fund, the Fund contracts with numerous vendors, also called “business associates,” who provide services to the Fund and services and benefits to you on the Fund’s behalf. Once the Fund is notified that you choose to invoke any of the individual rights listed below, it will notify the appropriate vendor on your behalf. Because some of your PHI is maintained and used by these business associates to provide or process your benefits, the Fund requires that they administer certain aspects of the individual privacy rights. You may contact the Privacy Official at the address and phone number listed below: Yolanda D. Montgomery, Executive Director & Counsel, Privacy Official National IAM Benefit Trust Fund 99 M Street, SE, Suite 600 Washington, DC 20003 Phone: 202-785-2658 Fax: 202-728-0585 www.iambtf.org You May Request Restrictions on PHI Uses and Disclosures You may request the Fund to: • Restrict the uses and disclosures of your PHI to carry out treatment, payment or health care operations, or • Restrict uses and disclosures to family members, relatives, friends or other persons identified by you who are involved in your care. The Fund, however, is not required to agree to your request. You must contact the Fund to receive an application to make a request to restrict the use or disclosure of PHI. You may contact the Privacy Official at the address and phone number listed above. You May Request Confidential Communications The Fund will accommodate an individual’s reasonable request to receive communications of PHI by alternative means or at alternative locations where the request includes a statement that disclosure could endanger the individual. You or your personal representative will be required to complete a form to request alternative means and/or locations for communication of PHI. You may contact the Privacy Official at the address and phone number listed above. You May Inspect and Copy PHI You have a right to inspect and obtain a copy of your PHI contained in a “designated record set,” as long as the Fund maintains the PHI. However, you do not have a right to inspect or copy psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and PHI that is subject to law(s) that otherwise prohibits access to PHI.