Hipaa Business Associate Agreement printable pdf download

Hipaa Business Associate Agreement

Information for Agents and Brokers

Regarding the HIPAA Business Associate Agreement

You may be aware that the Health Insurance Portability and Accountability Act of 1996

(“HIPAA”) requires health plans such as CompBenefits and its affiliates (collectively

“CompBenefits”) to enter into Business Agreements with any service providers or vendors with

whom protected health information is shared.

Should you desire to assist your groups and members with any possible issues regarding their

account or claims information, it will be necessary that you enter into a Business Associate

Agreement with CompBenefits before we can release to you any protected health information.

For example, if you call our Customer Care Department and request information specific to a

member or claim, we can not release the information until you have signed the Business

Associate Agreement or member completes a release form.

Please sign the following Agreement, make a copy for your records, and return the signed

original to the following address:

Compbenefits

Attention: ACS/BAA

100 Mansell Court East

Suite 400

Roswell, GA 30076

If you should have any questions regarding this Agreement, please do not hesitate to contact our

Privacy Officer at

or call (800) 252-1569.

BizAssoc.HIPAA-Agreement

Agent

Hipaa Business Associate Agreement