Legal Documents

HIPAA Privacy Notice to Employees

The Health Information Portability and Accountability Act ("HIPAA") requires that health plans protect the privacy of health information and provide employees certain rights regarding this information. The HIPAA Privacy Notice to Employees sets forth our responsibilities as well as your rights. If you have questions about this Notice, please contact the Privacy Officer referenced in the Contact Information at the end of the Notice.

          •   HIPAA Notice of Privacy Practices

Summary of Benefits and Coverage

2025 SBCs

          •   SBC 1: Franklin County - Standard
          •   SBC 2: Franklin County - Incentive
          •   SBC 3: Elected Officials - Post 2019
          •   SBC 4: Elected Officials - Post 2021
          •   SBC 5: Elected Officials - Post 2023
          •   SBC 6: Elected Officials - Post 2025

2024 SBC’s

          •   Choice Plus-Non Incentive = Franklin County-Standard
          •   Choice Plus Incentive = Franklin County Incentive
          •   EO Post 2019 = Elected Officials Post 2019 
          •   EO Post 2021 = Elected Officials Post 2021
          •   EO Post 2023 = Elected Officials Post 2023

Creditable Coverage Disclosure Notice

          •   2022 Creditable Coverage Disclosure Notice

Medicare Part D Coverage Disclosure Notice

          •   2024 Medicare Part D Coverage Disclosure Notice

No Surprises Act-Transparency in Coverage Rule-Pricing

Pursuant to Centers for Medicare and Medicaid Services (CMS) Transparency in Coverage (TiC) Rule, health insurers and group health plans must create an online tool (Machine-Readable Files or MRFs) that provides members with detailed pricing and cost-share estimates for covered services and items. One of the primary goals of the release of these data files is to provide more transparency across the industry. It is seen as a step toward putting health care price information in the hands of consumers and other stakeholders in an effort to promote more informed health care decisions.  

There are three (3) types of MRFs:

File type	Medical	Behavioral Health	Pharmacy
Negotiated rates for all covered items and services	x	x
Historical payments to and billed charges from out-of-network providers	x	x
In-network negotiated rates and historical net prices for all covered prescription drugs at the pharmacy location level			x

Currently, MRFs are available for the Medical (Medical and Surgical) and Behavioral Health (Mental Health and Substance Use Disorder) plans. These files are updated monthly.

To find information for the Franklin County Cooperative plans in the MRFs:

Medical (Medical and Surgical)

          •   For Medical and Surgical services, click on this link: Transparency-in-Coverage.UHC.com.
          •   Select Ctrl-F on your keyboard to bring up a search bar.
          •   Type in Franklin County and the associated MRFs will appear.

Example file name:  2022-07-01_customer name_Choice-Plus_in-network-rates.json. Multiple files may appear. Select the files with the Franklin County Cooperative name and the information and area of interests (network rates, allowed amounts, etc.).

Behavioral Health (Mental Health and Substance Use Disorder)

          •   For Mental Health and Substance Use Disorder (MH/SUD) services, click on this link: Transparency in Coverage (optum.com)
          •   Select Ctrl-F on your keyboard to bring up a search bar.
          •   Type in Franklin County and the associated MRFs will appear.

Example file name:  2022-07-01_customer name_Choice-Plus_in-network-rates.json. Multiple files may appear. Select the files with the Franklin County Cooperative name and the information and areas of interest (network rates, allowed amounts, etc.).

In addition, the Transparency in Coverage ​requirements found in the Patient Protection and Affordable Care Act, allow members to compare prices for healthcare services to ensure they can make informed health care decisions. Effective January 1, 2023, members will have access to cost-sharing information that is specific to their plan for at least 500 healthcare items or services.

          •   Members may access charges related to medical services by logging into their account at myuhc.com and clicking on the "Find                  Care and Cost" tab.
          •   Members may access charges related to mental health and substances use disorders by logging into their account at                                   liveandworkwell.com and selecting "Find Care" from the menu.