NOTICE OF PRIVACY PRACTICES - EMPLOYEE HEALTH BENEFIT PLAN

Pike Electric Corporation Group Benefit Plan
100 Pike Way
Mount Airy, NC
336-789-2171


Effective date of this notice: April 14, 2003
If you have questions about this notice, please contact the person listed under "Whom to Contact" at the end of this notice.

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

SUMMARY

In order to provide you with benefits, the Pike Electric Corporation Group Benefit Plan will receive personal information about your health, from you, your physicians, hospitals, and others who provide you with health care services. We are required by law to maintain the privacy of your protected health information. This notice of our privacy practices is intended to inform you of the ways we may use your information and the occasions on which we may disclose this information to others.

Occasionally, we may use members' information when providing treatment. We use members' health information to provide benefits. We disclose members' information to health care providers to assist them to provide you with treatment or to help them receive payment, we may disclose information to other insurance companies as necessary to receive payment, we may use the information within our organization to evaluate quality and improve health care operations, and we may make other uses and disclosures of members' information as required by law or as permitted by Pike Electric Corporation policies.

KINDS OF INFORMATION THAT THIS NOTICE APPLIES TO

This notice applies to any information in our possession that would allow someone to identify you and learn something about your health. Specifically, this "protected health information" is individually identifiable health information, including demographic information, collected from you or created or received by a healthcare provider, a health plan, your employer, or a healthcare clearinghouse that relates to: (i) your past, present, or future physical or mental health or condition; (ii) the provision of healthcare to you; or (iii) the past, present, or future payment for the provision of healthcare to you. It does not apply to information that contains nothing that could reasonably be used to identify you.

WHO MUST ABIDE BY THIS NOTICE The people and organizations to which this notice applies (referred to as "we," "our," and "us") have agreed to abide by its terms. We may share your protected health information with each other for purposes of treatment, and as necessary for payment and operations activities as described below.

OUR LEGAL DUTIES HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION.

We may use your protected health information, or disclose it to others, for a number of different reasons. This notice describes these reasons. For each reason, we have written a brief explanation. We also provide some examples. These examples do not include all of the specific ways we may use or disclose your information.
  1. Treatment. We may use your protected health information to provide you with medical care and services. This means that our employees, staff, volunteers and others whose work is under our direct control, may read your health information to learn about your medical condition and use it to help you make decisions about your care. For instance, an employee health benefit plan nurse may take your blood pressure at a health fair. We will also disclose your information to others to provide you with medical treatment or services. For instance, we may use health information to identify members with certain chronic illnesses, and send information to them or to their doctors regarding treatment alternatives. We may also use your protected health information to send appointment reminders to your attention.
  2. Payment. We will use your protected health information, and disclose it to others, as necessary to make payment for the health care services you receive. For instance, our third party administrator's processing department may use your protected health information to pay your claims or to determine if the treatment you received was medically necessary. And they may send information about you and your claim payments to the doctor or hospital that provided you with the health care services. They will also send you information about claims they pay and claims they do not pay (called an "explanation of benefits"). The explanation of benefits will include information about claims they receive for the subscriber and each dependent who are enrolled together under a single contract or identification number. Under certain circumstances, you may receive this information confidentially: see the "Confidential Communication" section in this notice. We may also disclose some of your protected health information to companies with whom we contract for payment-related services. For instance, if you owe us money, we may give information about you to a collection company that we contract with to collect bills for us. We will not use or disclose more protected health information for payment purposes than is necessary.
  3. Health Care Operations. We may use your protected health information for activities that are necessary to operate this organization. This includes reading your protected health information to review the performance of our third party administrator. We may also use your information and the information of other members to plan what services we need to provide, expand, or reduce. We may disclose your protected health information as necessary to others who we contract with to provide administrative services. This includes our lawyers, auditors, accreditation services, and consultants, for instance. We may also disclose your protected information to the Group Benefit Plan Sponsor, Pike Electric Inc., in compliance with applicable law.
  4. Legal Requirement to Disclose Information. We will disclose your protected health information when we are required by law to do so. This includes reporting information to government agencies that have the legal responsibility to monitor the health care system.
  5. Public Health Activities. We will disclose your protected health information when required to do so for public health purposes. This includes reporting certain diseases, births, deaths, and reactions to certain medications. It may also include notifying people who have been exposed to a disease.
  6. To Report Abuse. We may disclose your protected health information when the information relates to a victim of abuse, neglect or domestic violence. We will make this report only in accordance with laws that require or allow such reporting, or with your permission.
  7. Uses and Disclosures for Health Oversight. We may disclose your protected health information to a health oversight agency for oversight activities including by way of example, audits; civil, administrative, or criminal investigations or proceedings and actions; inspections; and licensure or disciplinary actions.
  8. Disclosures for Judicial and Administrative Proceedings. We may disclose your protected health information in a trial or other administrative proceeding.
  9. Law Enforcement. We may disclose your protected health information for law enforcement purposes. This includes providing information to help locate a suspect, fugitive, material witness or missing person, or in connection with suspected criminal activity. We must also disclose your health information to a federal agency investigating our compliance with federal privacy regulations.
  10. Specialized Purposes. We may disclose the protected health information of members of the armed forces as authorized by military command authorities. We may disclose your protected health information for a number of other specialized purposes. We will only disclose as much information as is necessary for the purpose. For instance, we may disclose your information to coroners, medical examiners and funeral directors; to organ procurement organizations (for organ, eye, or tissue donation); or for national security, intelligence, and protection of the president.
  11. To Avert a Serious Threat. We may disclose your protected health information if we decide that the disclosure is necessary to prevent serious harm to the public or to an individual. The disclosure will only be made to someone who is able to prevent or reduce the threat.
  12. Family and Friends. We may disclose your protected health information to a member of your family or to someone else who is involved in your medical care or payment for care. This may include telling a family member about the status of a claim, or what benefits you are eligible to receive. In the event of a disaster, we may provide information about you to a disaster relief organization so they can notify your family of your condition and location. We will not disclose your information to family or friends if you object.
  13. Research. We may disclose your protected health information in connection with medical research projects. Federal rules govern any disclosure of your health information for research purposes without your authorization.
  14. Information to Members. We may use your health information to provide you with additional information. This may include sending appointment reminders to your address. This may also include giving you information about treatment options, alternative setting for care, or other health-related services that we provide.
  15. Health Benefits Information. Your protected health information may be disclosed to your employer, the Plan Sponsor, as necessary for the administration of the Group Benefit Plan.
  16. Workers' Compensation. We may disclose your protected health information to comply with workers' compensation laws and other similar programs that provide benefits for work related injuries or illnesses without regard to fault.
  17. Inmates. If you are incarcerated, we may disclose your protected health information to the correctional institution or to a law enforcement official for (1) the institution to provide you with care; (2) your health and safety and the health and safety of others; or for (3) the safety and security of the correctional institution.
REQUIRED DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION.

The following is a description of disclosures that we are required by law to make.

  1. Disclosures to the Secretary of the U.S. Department of Health and Human Services. We are required to disclose your protected health information to the Secretary of the U.S. Department of Health and Human Services when the Secretary is investigating or determining our compliance with the HIPAA Privacy Regulations.
  2. Disclosures to You. We are required to disclose to you most of your protected health information in a "designated record set" when you request access to this information. Generally, a "designated record set" contains medical and billing records, as well as other records that are used to make decisions about your healthcare benefits.
YOUR RIGHTS

  1. Authorization. We may use or disclose your protected health information for any purpose that is listed in this notice without your written authorization or as otherwise allowed under HIPAA or other applicable law. We will not use or disclose your health information for any other reason without your authorization. If you authorize us to use or disclose your health information, you have the right to revoke the authorization in writing at any time. You may not revoke an authorization for us to use and disclose your information to the extent that we have taken action in reliance on the authorization. If the authorization is to permit disclosure of your information to an insurance company, as a condition of obtaining coverage, other law may allow the insurer to continue to use your information to contest claims or your coverage, even after you have revoked the authorization. For additional information about how to authorize us to use or disclose your protected health information, or about how to revoke an authorization, contact the person listed under "Whom to Contact" at the end of this notice.
  2. Request Restrictions. You have the right to ask us to restrict how we use or disclose your protected health information. We will consider your request. But we are not required to agree. If we do agree, we will comply with the request unless the information is needed to provide you with emergency treatment. We cannot agree to restrict disclosures that are required by law.
  3. Confidential Communication. If you believe that the disclosure of certain information could endanger you, you have the right to ask us to communicate with you at a special address or by a special means. For example, you may ask us to send explanations of benefits that contain your health information to a different address rather than to your home. Or you may ask us to speak to you personally on the telephone rather than sending your health information by mail. We will agree to any reasonable request.
  4. Inspect And Receive a Copy of Health Information. You have a right to inspect the protected health information about you that we have in our records, and to receive a copy of it. This right is limited to information about you that is kept in records that are used to make decisions about you. For instance, this includes claim and enrollment records. If you want to review or receive a copy of these records, you must make the request in writing. We may charge a fee for the cost of copying and mailing the records. To ask to inspect your records, or to receive a copy, contact the person listed under "Whom to Contact" at the end of this notice. We will respond to your request within 30 days. We may deny you access to certain information. If we do, we will give you the reason, in writing. We will also explain how you may appeal the decision.
  5. Amend Health Information. You have the right to ask us to amend protected health information about you which you believe is not correct, or not complete. You must make this request in writing, and give us the reason you believe the information is not correct or complete. We will respond to your request in writing within 30 days. We may deny your request if we did not create the information, if it is not part of the records we use to make decisions about you, if the information is something you would not be permitted to inspect or copy, or if it is complete and accurate.
  6. Accounting of Disclosures. You have a right to receive an accounting of certain disclosures of your protected information to others. This accounting will list the times we have given your protected health information to others. The list will include dates of the disclosures, the names of the people or organizations to whom the information was disclosed, a description of the information, and the reason. We will provide the first list of disclosures you request at no charge. We may charge you for any additional lists you request during the following 12 months. You must tell us the time period you want the list to cover. You may not request a time period longer than six years. We cannot include disclosures made before April 14, 2003. Disclosures for the following reasons will not be included on the list: disclosures for treatment, payment, or health care operations; disclosures for national security purposes; disclosures to correctional or law enforcement personnel; disclosures that you have authorized; and disclosures made directly to you.
  7. Paper Copy of this Privacy Notice. You have a right to receive a paper copy this notice. If you have received this notice electronically, you may receive a paper copy by contacting the person listed under "Whom to Contact" at the end of this notice.
  8. Complaints. You have a right to complain about our privacy practices, if you think your privacy has been violated. You may file your complaint with the person listed under "Whom to Contact" at the end of this notice. You may also file a complaint directly with the Secretary of the U. S. Department of Health and Human Services, at the Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, D.C. 20201. All complaints must be in writing. We will not take any retaliation against you if you file a complaint.
OUR RIGHT TO CHANGE THIS NOTICE

We reserve the right to change our privacy practices, as described in this notice, at any time. We reserve the right to apply these changes to any health information that we already have, as well as to health information we receive in the future. Before we make any change in the privacy practices described in this notice, we will write a new notice that includes the change. The new notice will include an effective date. We will mail the new notice to all subscribers within 60 days of the effective date.

WHOM TO CONTACT.

Contact the person listed below:
HIPAA Privacy Official
Pike Electric Corporation Group Benefit Plan
100 Pike Way
Mount Airy, NC
336-719-4309

This notice is also available by e-mail. Contact the person named above, or send an e-mail to: hr@pike.com