Lisa Brennan

Lisa Brennan, Director of FinanceLBrennan@cseaebf.org

Lisa Brennan, Privacy Officer, CSEA Employee Benefit Fund, One Lear Jet Lane, Suite One, Latham, NY 12110-2395, 800/323-2732 or 518/782-1500.

WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION IN THE FOLLOWING WAYS:
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In order to request a type of confidential communication, you must make a written request to, Lisa Brennan, Privacy Officer, CSEA Employee Benefit Fund, One Lear Jet Lane, Suite One, Latham, NY 12110-2395, specifying the requested method of contact, or the location where you wish to be contacted.Our organization will accommodate reasonable requests. Requesting Restrictions.You have the right to request a restriction in our use or disclosure of your identifiable health information for treatment, payment, or health care operations.Additionally, you have the right to request that we limit our disclosure of your identifiable health information to individuals involved in your care or the payment for your care, such as family members and friends.We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.In order to request a restriction in our use or disclosure of your identifiable health information, you must make your request in writing to, Lisa Brennan, Privacy Officer, CSEA Employee Benefit Fund, One Lear Jet Lane, Suite One, Latham, NY 12110-2395.Your request must describe in a clear and concise fashion: (a) the information you wish restricted; (b) whether you are requesting to limit our organization's use, disclosure or both; and (c) to whom you want the limits to apply. Inspection and Copies.You have the right to inspect and obtain a copy of the identifiable health information that may be used to make decisions about you, including medical records and billing records, but not including psychotherapy notes.You must submit your request in writing to, Lisa Brennan, Privacy Officer, CSEA Employee Benefit Fund, One Lear Jet Lane, Suite One, Latham, NY, 12110-2395, in order to inspect and/or obtain a copy of your identifiable health information.Our organization may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. Amendment.You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our organization.To request an amendment, your request must be made in writing and submitted to, Lisa Brennan, Privacy Officer, CSEA Employee Benefit Fund, One Lear Jet Lane, Suite One, Latham, NY, 12110-2395.
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In order to obtain an accounting of disclosures, you must submit your request in writing to, Lisa Brennan, Privacy Officer, CSEA Employee Benefit Fund, One Lear Jet Lane, Suite One, Latham, NY, 12110-2395.All requests for an 'accounting of disclosures' must state a time period which may not be longer than six years and may not include dates before April 14, 2003.The first list you request within a 12-month period is free of charge but our organization may charge you for additional lists within the same 12-month period.Our organization will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs. Right to File a Complaint.If you believe your privacy rights have been violated, you may file a complaint with our organization or with the Secretary of Health and Human Services.To file a complaint with our organization, contact Lisa Brennan, Privacy Contact Person, CSEA Employee Benefit Fund, One Lear Jet Lane, Suite One, Latham, NY, 12110-2395.All complaints must be submitted in writing.You will not be penalized for filing a complaint. Right to Provide an Authorization for Other Uses and Disclosures.