Business Associate Agreement Page 7

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Business Associate will not enter into, or permit its subcontractors or agents to enter into, any
trading partner agreement in connection with the conduct of Standard Transactions for or on behalf
of Company that:
a) Changes the definition, data condition or use of a data element or segment in a Standard
Transaction.
b) Adds any data elements or segments to the maximum defined data set;
c) Uses any code or data element that is marked “not used” in the Standard Transaction’s
Implementation Specification or is not in the Standard Transaction’s Implementation
Specification; or
d) Changes the meaning or intent of the Standard Transaction’s Implementation Specification.
2. Concurrence for Test Modification to Standard Transactions. Business Associate agrees and
understands that there exists the possibility that Company or others may request from HHS an
exception from the uses of a Standard in the HHS Transaction Standards. If this request is granted
by HHS, Business Associate agrees that it will participate in such test modification.
3. Incorporation of Modifications to Standard Transactions Business Associate agrees and
understands that from time-to-time, HHS may modify and set compliance dates for the Transaction
Standards. Business Associate agrees to incorporate by reference into this Agreement any such
modifications or changes.
4. Code Set Retention (Only for Plans). Both parties understand and agree to keep open code sets
being processed or used in the Agreement for at least the current billing period or any appeal
period, whichever is longer.
5. Guidelines and Requirements. Business Associate further agrees to comply with any guidelines
or requirements adopted by Company consistent with the requirements of HIPAA and any
regulations promulgated thereunder, governing the exchange of information between Business
Associate and the Company.
E. Obligations upon Termination.
1. Return or Destruction.
Upon termination, cancellation, expiration or other conclusion of the
Agreement, Business Associate will if feasible return to Company or destroy all PHI, in whatever
form or medium (including in any electronic medium under Business Associate’s custody or
control), that Business Associate created or received for or from Company, including all copies of
and any data or compilations derived from and allowing identification of any Individual who is a
subject of the PHI. Business Associate will complete such return or destruction as promptly as
possible, but not later than 30 days after the effective date of the termination, cancellation,
expiration or other conclusion of Agreement. Business Associate will identify any PHI that Business
Associate created or received for or from Company that cannot feasibly be returned to Company or
destroyed, and will limit its further Use or Disclosure of that PHI to those purposes that make return
or destruction of that PHI infeasible and will otherwise continue to protect the security any PHI that
is maintained pursuant to the security provisions of this Agreement for so long as the PHI is
maintained. Within such 30 days, Business Associate will certify in writing to Company that such
return or destruction has been completed, will deliver to Company the identification of any PHI for
which return or destruction is infeasible and, for that PHI, will certify that it will only Use or disclose
such PHI for those purposes that make return or destruction infeasible.
Broker BA Agreement (Template revised October 2009)
Form No: BKR0003
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