PRIVACY OF = PROTECTED HEALTH INFORMATION

PRIVACY=20 OF MEDICAL INFORMATION

THIS = NOTICE=20 DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED = AND HOW=20 YOU CAN GET ACCESS TO THIS INFORMATION. =20 PLEASE REVIEW IT CAREFULLY.

We=20 understand that your medical information is private, and we are = committed to=20 maintaining the privacy of your medical = information.

This=20 notice describes the ways in which the ECTOR COUNTY Employee Health = Benefit Plan=20 (the =93Plan=94) may use and disclose medical information about = you. This notice also describes = your rights=20 regarding the use and disclosure of your medical information.

The=20 Plan is required by law to maintain the privacy of medical information = about=20 you, provide you with this notice about the Plan=92s legal duties and = privacy=20 practices with respect to medical information about you, to maintain the = privacy=20 of medical information about you, and to abide by the terms of this = notice as it=20 is currently in effect.

Each=20 time you submit a claim to the Plan for reimbursement, and each time you = see a=20 health care provider who is paid by the Plan, a record is created. The record may contain your = medical=20 information. In general, = the Plan=20 will only use or disclose your medical information without your = authorization=20 for the specific reasons detailed below. =20 Except in limited circumstances, the amount of information used = or=20 disclosed will be limited to the minimum necessary to accomplish the = intent of=20 the use or disclosure.

PERMITTED USES AND=20 DISCLOSURES

The following = categories=20 describe different ways that the Plan may use or disclose your medical=20 information. Not every = use or=20 disclosure in a category will be listed. =20 However, all of the ways the Plan is permitted to use and = disclose=20 information will fall within one of the = categories.

Treatment. The Plan may use or disclose = your=20 medical information to facilitate medical treatment or services by=20 providers. The Plan may = disclose=20 your medical information to providers, including doctors, nurses, = technicians,=20 pharmacists, medical students, or other hospital personnel who are = involved in=20 your care. For example, = the Plan=20 might disclose information about your prior prescriptions to a = pharmacist to=20 determine if a pending prescription is contraindicative of prior=20 prescriptions.

Payment. The=20 Plan=20 may=20 use and disclose your medical information to determine eligibility for = Plan=20 benefits, to facilitate payment for the treatment and services you = receive from=20 health care providers, to determine benefit responsibility under the = Plan, or to=20 coordinate Plan coverage. = For=20 example, the Plan may tell your health care provider about your medical = history=20 to determine whether a particular treatment is = Experimental/Investigational, or=20 Medically Necessary or to determine whether the Plan will cover the=20 treatment. The Plan may = also share=20 medical information with a utilization review or precertification = service=20 provider. Likewise, the = Plan may=20 share medical information with another entity to assist with the = adjudication or=20 subrogation of health claims or to another health plan to coordinate = benefit=20 payments.

Health=20 Care Operations. The Plan may use and disclose = your=20 medical information for other Plan operations. These uses and disclosures are = necessary=20 to run the Plan. For = example, the=20 Plan may use medical information in connection with: conducting quality assessment = and=20 improvement activities; underwriting, premium rating, and other = activities=20 relating to Plan coverage; submitting claims for stop-loss (or excess = loss)=20 coverage; conducting or arranging for medical review, legal services, = audit=20 services, and fraud and abuse detection programs; business planning and=20 development such as cost management; and business management and general = Plan=20 administrative activities.

Requirement=20 by Law. The=20 Plan will disclose your = medical=20 information when required to do so by federal, state, or local law. For example, the Plan may = disclose=20 medical information when required by a court order in a litigation = proceeding=20 such as a malpractice action.

Aversion=20 of a Serious Threat to Health or Safety. =20 The=20 Plan may use or disclose your medical information when necessary to = prevent a=20 serious threat to your health and safety or the health and safety of the = public=20 or another person. Any = disclosure,=20 however, would only be to someone able to help prevent the threat. For example, the Plan may = disclose your=20 medical information in a proceeding regarding the licensure of a=20 physician.

Organ=20 and Tissue Donation. If you are an organ donor, the = Plan may=20 release your medical information to organizations that handle organ = procurement=20 or organ, eye, or tissue transplantation or to an organ donation bank, = as=20 necessary to facilitate organ or tissue donation and=20 transplantation.

Military=20 and Veterans. If you are a member of the = armed forces,=20 the Plan may release your medical information as required by military = command=20 authorities. The Plan may = also=20 release medical information about foreign military personnel to the = appropriate=20 foreign military authority.

Workers=92=20 Compensation. The Plan may release your = medical=20 information for workers=92 compensation or similar programs. These programs provide = benefits for=20 work-related injuries or illness.

Public=20 Health Risks. The Plan may disclose your = medical=20 information for public health activities. =20 These activities generally include the = following:

=B7 =20 to=20 prevent or control disease, injury, or disability;

=B7 =20 to=20 report births and deaths;

=B7 =20 to=20 report child abuse or neglect;

=B7 =20 to=20 report reactions to medications or problems with = products;

=B7 =20 to=20 notify people of recalls of products they may be = using;

=B7 =20 to=20 notify a person who may have been exposed to a disease or may be at risk = for=20 contracting or spreading a disease or condition;

=B7 =20 to=20 notify the appropriate government authority if we believe a patient has = been the=20 victim of abuse, neglect, or domestic violence. We will only make this = disclosure if you=20 agree or when required or authorized by law.

Health=20 Oversight Activities. The Plan may disclose medical=20 information to a health oversight agency for activities authorized by = law. These oversight activities = include, for=20 example, audits, investigations, inspections, and licensure. These activities are necessary = for the=20 government to monitor the health care system, government programs, and=20 compliance with civil rights laws.

Lawsuits=20 and Disputes. If you are involved in a = lawsuit or=20 dispute, the Plan may disclose your medical information in response to a = court=20 or administrative order. = The Plan=20 may also disclose your medical information in response to a subpoena, = discovery=20 request, or other lawful process by someone else involved in the = dispute, but=20 only if efforts have been made to tell you about the request or to = obtain an=20 order protecting the information requested.

Law=20 Enforcement. The Plan may release your = medical=20 information if asked to do so by a law enforcement=20 official:

=B7 =20 in=20 response to a court order, subpoena, warrant, summons or similar=20 process;

=B7 =20 to=20 identify or locate a suspect, fugitive, material witness or missing=20 person;

=B7 =20 if=20 you are, or are suspected to be, the victim of a crime, under certain = limited=20 circumstances, and the Plan Administrator is unable to obtain your=20 agreement;

=B7 =20 about=20 a death the Plan Administrator believes may be the result of criminal=20 conduct;

=B7 =20 about=20 criminal conduct on the Company=92s premises; or

=B7 =20 in=20 emergency circumstances to report a crime, the location of the crime or = victims,=20 or the identity, description, or location of the person who committed = the=20 crime.

Department=20 of Health and Human Services. The Plan will disclose your medical information to = the U.S.=20 Department of Health and Human Services when requested for purposes of=20 determining the Plan=92s compliance with applicable=20 regulations.

Coroners,=20 Medical Examiners, and Funeral Directors. The Plan may release medical = information=20 to a coroner or medical examiner. =20 This may be necessary, for example, to identify a deceased person = or=20 determine the cause of death. = The=20 Plan may also release medical information about patients of the hospital = to=20 funeral directors as necessary to carry out their duties. =

National=20 Security and Intelligence Activities. The Plan may release your = medical=20 information to authorized federal officials for intelligence,=20 counterintelligence, and other national security activities authorized = by=20 law.

Inmates. If you are an inmate of a = correctional=20 institution or under the custody of a law enforcement official, the Plan = may=20 release your medical information to the correctional institution or law=20 enforcement official. = This release=20 would be necessary (1) for the institution to provide you with health = care; (2)=20 to protect your health and safety or the health and safety of others; or = (3) for=20 the safety and security of the correctional = institution.

Other=20 Benefits. The Plan may contact you to = provide=20 information about treatment alternatives or other health-related = benefits and=20 services that may be of interest to you. =20 For example, if you are suffering from a complex illness, the = Plan may=20 contact you to discuss an alternate form of care or an alternate = treatment=20 facility.

DISCLOSURES=20 TO THE COMPANY

The=20 Plan will disclose medical information about you to the Company only = upon=20 receipt of a certification from the Company that the Company=20 agrees:

=B7 =20 not=20 to further use or disclose medical information about you other than as = permitted=20 or required by the Plan documents or as required by = law;

=B7 =20 to=20 ensure that any agents, including a subcontractor, to whom it provides = medical=20 information received from the Plan agree to the same restrictions and = conditions=20 that apply to the Company with respect to the = information;

=B7 =20 not=20 to use or disclose the medical information for employment-related = actions and=20 decisions or in connection with any other benefit or employee benefit = plan of=20 the Company;

=B7 =20 to=20 report to the Plan any use or disclosure of the medical information that = is=20 inconsistent with the permitted uses and = disclosures;

=B7 =20 to=20 make its internal practices, books, and records relating to the use and=20 disclosure of medical information received from the Plan available to = the=20 Department of Health and Human Services for purposes of determining = whether the=20 Plan is complying with applicable regulations;

=B7 =20 if=20 feasible, to return or destroy all medical information received from the = Plan=20 about you and retain no copies of the information when it is no longer = needed=20 for the purpose for which disclosure was made, except that, if such = return or=20 destruction is not feasible, to limit further uses or disclosures to = those=20 purposes that make such return or destruction infeasible;=20 and

=B7 =20 to=20 ensure that there is adequate separation between the Plan and the = Company=20 (described below).

YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION

Right to Access and Copy. = The Plan will make your medical = information=20 available to you for inspection and copying upon your written = request. Please contact the individual = listed=20 below under the section titled =93For More Information=94 to request the = necessary=20 paperwork. The Plan may = charge a=20 fee for the costs of copying, mailing or other supplies associated with = your=20 request. The Plan may = deny your=20 request to inspect and copy in certain very limited circumstances. If you are denied access to = medical=20 information, you may request that the denial be reviewed in certain=20 circumstances.

Right=20 to Amend. If you feel that medical = information the=20 Plan has about you is incorrect or incomplete, you may ask the Plan to = amend the=20 information. You must = provide a=20 reason that supports your request. =20 You have the right to request an amendment for as long as the = information=20 is kept by or for the Plan. = Any=20 request to amend your medical information must be made in writing. Please contact the individual = listed=20 below under the section titled =93For More Information=94 to request the = necessary=20 paperwork. =

The=20 Plan may deny your request for an amendment if it is not in writing or = does not=20 include a reason to support the request. =20 In addition, the Plan may deny your request if you ask the Plan = to amend=20 information that:

=B7 =20 is=20 not part of the medical information kept by or for the=20 Plan;

=B7 =20 was=20 not created by the Plan, unless the person or entity that created the=20 information is no longer available to make the = amendment;

=B7 =20 is=20 not part of the information which you would be permitted to inspect and = copy;=20 or

=B7 =20 is=20 accurate and complete.

Right=20 to an Accounting of Disclosures. If you wish to know to whom = medical=20 information about you has been disclosed for any purpose other than (1)=20 treatment, payment, or health care operations, (2) pursuant to your = written=20 authorization, and (3) for certain other purposes, you may make a = written=20 request to the Plan. = Please contact=20 the individual listed below under the section titled =93For More = Information=94 to=20 request the necessary paperwork.

Your=20 request must state a time period which may not be longer than six years = and may=20 not include dates before April=20 14, 2004. Your request should indicate = in what=20 form you want the list (for example, paper or electronic). The first list you request = within a=20 12-month period will be free. = For=20 additional lists, the Plan may charge you for the costs of providing the = list. The Plan will = notify you of=20 the cost involved, and you may choose to withdraw or modify your request = at that=20 time before any costs are incurred.

The=20 accounting will not include disclosure for the purposes of treatment, = payment,=20 or health care operations. = In=20 addition, the accounting will not include disclosures which you have = authorized=20 in writing.

Right=20 to Request Restrictions. You may request that the Plan = restrict=20 or limit the medical information the Plan uses or discloses about you = for=20 treatment, payment, or health care operations. In addition, you may request = that the=20 Plan limit the medical information disclosed about you to someone who is = involved in your care or the payment for your care, like a family member = or=20 friend. For example, you = could ask=20 that the Plan not use or disclose information about a surgery you had.=20

To=20 request a restriction or limitation, please contact the individual = listed below=20 under the section titled =93For More Information.=94 Your request must be in = writing. In your request, you must = specify (1)=20 what information you want to limit; (2) whether you want to limit = use,=20 disclosure, or both; and (3) to whom you want the limits to apply, for = example,=20 disclosures to your spouse.

Please=20 note that the Plan is not required to agree to your=20 request.

Right=20 to Request Confidential Communications. If the disclosure of your = medical=20 information could endanger you, you may request that the Plan = communicate with=20 you about medical matters in a certain way or at a certain = location. For example, you may request = that the=20 Plan only contact you at work or by mail.

To=20 request confidential communications, please contact the individual = listed below=20 under the section titled =93For More Information=94 to request the = necessary=20 paperwork. Your request = must=20 specify how or where you wish to be contacted. The Plan will only accommodate = requests=20 for confidential communications if the disclosure of the information = would=20 endanger you.

Right=20 to a Paper Copy of this Notice. You may ask the Plan for a = copy of this=20 notice at any time by contacting the individual listed below under the = section=20 titled =93For More Information.=94 Even=20 if you have agreed to receive this notice electronically, you are still = entitled=20 to a paper copy. You may = obtain a=20 copy at our website, http://www.co.ector.tx.us/, = located=20 under the heading for the Insurance Department.

CHANGES TO THIS NOTICE

The=20 Plan reserves the right to modify this notice at any time. The Plan also reserves the = right to make=20 the revised or changed notice effective for medical information it = already has=20 about you, as well as any information received in the future.

COMPLAINTS

If=20 you believe your privacy rights have been violated, you may file a = complaint=20 with the Plan or with the Secretary of the Department of Health and = Human=20 Services. To register a = complaint=20 with the Plan, please contact the individual listed below under the = section=20 titled =93For More Information.=94 All=20 complaints must be submitted in writing.

You=20 will not be retaliated against for filing a complaint. =

OTHER=20 USES OF MEDICAL INFORMATION

Any=20 uses and disclosures of medical information other than those listed = above will=20 be made only with your written authorization. If you provide the Plan = authorization to=20 use or disclose medical information about you, you may revoke that=20 authorization, in writing, at any time. =20 If you revoke your authorization, the Plan will no longer use or = disclose=20 medical information about you for the reasons covered by your written=20 authorization. Please = note that the=20 Plan is unable to take back any disclosures it has already made with = your=20 authorization, and that the Plan is required to retain records of the = care=20 provided to you.

FOR MORE INFORMATION

If=20 you have any questions about this notice, please contact:=20 Dinorah=20 Jimenez,=20 Insurance

Department=20 Contact Person, 1010=20 E. 8^th Street,=20 Room 630, Odessa,=20 Texas=20 79761,=20 telephone 432-498-4011.

EFFECTIVE DATE

April=20 14, 2004=20

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