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Privacy & Compliance

Affordable Care Act Reporting Services
Authorization for Disclosure
Request to access PHI
California Consumer Privacy Act
Privacy Notice
Aviso de Privacidad
Web Site Accessibility

Affordable Care Act (ACA) Reporting Services

IRS code Sections 6055 and 6056 require most employers and plan sponsors to provide information returns and statements to employees and the IRS about health coverage offered for each tax year. This information reporting effort is substantial in scope and requires a coordinated effort between payroll and benefits administrators. Delta Health Systems provides 1094 and 1095 filing services on behalf of our clients who elect this service. We offer multiple services associated with reporting, which include the production of eligibility data extracts, form 1095-C offer of coverage and safe harbor coding, IRS filing, and mailing of 1095 forms to employees. Please contact your Delta Health Systems Account Manager or email privacyandcompliance@delapro.com for assistance.

We offer multiple reporting services, which include:

  • Eligibility data extracts
  • 1095 B and C forms
  • 1094 IRS filing
  • Safe harbor coding
Portal
Portal

Authorization for Disclosure

Delta Health Systems (DHS) is committed to safeguarding your protected health information (PHI). The Health Insurance Portability and Accountability Act (HIPAA) requires that DHS have permission to disclose your protected health information in certain cases. Complete the Authorization for Disclosure of health information form if you would like to grant DHS authorization to disclose your PHI to a third party and return to privacyandcompliance@delapro.com.

Request to Access PHI

If you’d like to simply access your PHI complete and return the Request to Access PHI form and return to privacyandcompliance@delarpro.com.

California Consumer Privacy Act (CCPA)

Effective January 1, 2020, California consumers can enforce the right to know what personal information (PI) is collected, used, shared or sold by companies that maintain their information and the right to request that their PI be deleted. If you’d like to exercise your right to know what personal information is collected, used, or shared by Delta or if you’d like to delete the personal information that we have about you and from you, please complete the CCPA Web Intake Form found here.

Privacy Notice

This notice provides an overview of how we use and protect your personal information (PI). We do not engage in the sale of your PI, but may share it with third parties for business purposes.

Whose information do we collect? What information do we collect (and from whom)? With whom do we share your information (or how do we use it) and why?
Employees Name
Address
Telephone Number
Email Address
Birthdate
SSN
Signature
Driver’s License
Education
Employment History
Browsing History
(Collected from employees and corporate screening firms)
We may share and disclose personal information to the following individuals and for the following purposes:
  • 401K and payroll vendors (to process payments and perform other tasks on our behalf)
  • The employee Union (to confirm member registration and payment of dues)
  • Corporate Screening Firms or and employers (for employment verification)
  • Workers’ Compensation insurance (to determine eligibility and pay for benefits)
  • Public authorities or others (where required by law).
Participants Name
Address
Telephone Number
Gender
Email Address
Birthdate
Group ID
SSN
Employment
Bank Account Number
Bank Routing Number
Signature (Collected from participants, employers and attorneys)
We may share and disclose personal information to the following individuals and for the following purposes:
  • Banks (for direct deposit)
  • Brokers (to assist us with FSA appeals and customer service)
  • Employers (to notify you of your FSA spending and balances)
  • Transportation/Parking/Dependent Care Providers (to verify FSA claims)
  • Our FSA Website Host (to track claims and send benefit cards)
  • Public authorities or others (where required by law).
Your personal information may be used for the following purpose:
  • to process any legal services claims that you submit for payment.
Providers Tax ID Number
Company Name
Physician/Hospital Name
Job Title
Phone Number
E-Mail Address (Collected from providers and participants)
  • Your personal information is not shared or disclosed, but is used to process and pay claims.
  • Your personal information is also used to provide eligibility, authorization, and/or claims status via the provider portal.
  • In rare circumstances, we may disclose your information where required by law or in response to a valid request by public authorities.
Brokers/Clients Name
Address
Email Address
Job Title
Phone Number
Fax Number (Collected from the Broker/Client)
  • Your personal information is not shared or disclosed, but is used to allow representatives of our client health plans with access to our claims system.
  • In rare circumstances, we may disclose your information where required by law or in response to a valid request by public authorities.
Website Visitors Name
Address
Telephone Number
Email Address
Employer Name
Health Care ID
Birthdate
User ID
Password
IP Address
Computer Name
Hosting Vendor
Browsing History (Collected through website cookies)
We may share and disclose personal information to the following individuals and for the following purposes:
  • Third party vendor (to store IP addresses and other information on our behalf)
  • Public authorities or others (where required by law.
Your personal information used for the following purposes:
  • To monitor access to the website.
  • To track browsing activity within the website.

What rights do you have?

You can always choose not to disclose information to us, but it may impact your navigation of our website, your use of our services or your right to reimbursement or payment. In addition, California residents have certain rights under the California Consumer Privacy Act (CCPA). Those rights include, for example, the right to access the personal data that we hold about you; the right to request that we delete any information that we have collected from you and about you; the right to notice regarding the information that we have collected about you and how that information will be used; and the right to receive equal services and prices if you choose to exercise any of the above rights.

How can I exercise my rights?

You can exercise any of the rights enumerated above by contacting our Privacy and Compliance Department via our toll-free telephone number at 1-800-422-6099. In the alternative, you may also exercise your rights via our website at www.deltahealthsystems.com/privacy.

How do we secure your information?

We use appropriate technical, organizational and administrative security measures to protect any information we hold in our records from loss, misuse, and unauthorized access, disclosure, alteration and destruction. Some of those measures include limiting which of our employees have access to the information on a need to know basis and requiring that our employees participate in annual privacy and security training.

Additional Questions?

Contact our Director of Compliance and Privacy Officer at privacyandcompliance@delapro.com .

Aviso de Privacidad

Este aviso le provee un resumen sobre cómo usamos y protegemos su información personal (IP). No tomamos parte en la venta de su IP, pero podemos compartirlo con partidos terceros con propósitos de negocio.

¿De quién recopilamos información? ¿Qué información recopilamos (y de quién)? ¿Con quién compartimos su información (o cómo lo usamos) y por qué?
Empleados Nombre
Dirección
Número de Teléfono
Dirección Email
Fecha de Nacimiento
Número de Seguro Social
Firma
Licencia de Conductor
Educación
Antecedentes de Empleo Historial
de Navegación (Se recopila de empleados y empresas de investigaciones corporativas)
Podemos compartir y divulgar información personal a los siguientes individuos y con los siguientes propósitos:
  • Vendedores de 401K y la nómina (para procesar pagos y llevar a cabo otras funciones en nuestro nombre)
  • La Unión de empleados (para confirmar la registración de miembros y el pago de deudas)
  • Empresas de Investigaciones Corporativas o empleadores (para la verificación de empleo)
  • El seguro de Compensación de Trabajadores (para determinar la elegibilidad y pagar beneficios)
  • Autoridades públicas u otros (cuando se requiera por ley).
Participantes Nombre
Dirección
Número de Teléfono
Género
Dirección Email
Fecha de Nacimiento
No. de Identificación de Grupo
Número de Seguro Social
Empleo
Número de Cuenta de Banco
Número de Ruta de Banco
Firma (Se recopila de participantes, empleadores y abogados)
Podemos compartir y revelar información personal a los siguientes individuos y con los siguientes propósitos:
  • Bancos (para depósitos directos)
  • Intermediarios (para ayudarnos con apelaciones de CFG y atención al cliente)
  • Empleadores (para avisarle de sus gastos y saldos de la CFG)
  • Transportación /Estacionamiento/Proveedores de Cuido de Dependientes (para verificar reclamos de CFG)
  • Nuestro Portador del Sitio Web de CFG (para monitorear reclamos y enviar tarjetas de beneficio)
  • Autoridades públicas u otros (según se requiera por ley).
Su información personal puede ser utilizada para el siguiente propósito:
  • para procesar cualquier reclamo de servicios legales que envíe para su pago.
Proveedores No. de Identificación de Ingresos
Nombre de la Compañía
Médico/Nombre de Hospital
Título de su Puesto
Número de Teléfono
Dirección Email (Se recopila de proveedores y participantes)
  • Su información personal no se comparte ni se divulga, pero se usa para procesar y pagar reclamos.
  • Su información personal también se usa para proveer la elegibilidad, autorización y/o el estado de reclamos por medio del portal de proveedores.
  • En circunstancias raras, podemos revelar su información cuando se requiera legalmente o en cumplimiento con una solicitud válida por las autoridades públicas.
Intermediarios /Clientes Nombre
Dirección
Dirección Email
Título de su Puesto
Número de Teléfono
Numero de Fax (Se recopila del Intermediario/Cliente)
  • Su información personal no se comparte ni se divulga, pero se usa para permitir que los representantes de nuestros planes médicos tengan acceso a nuestro sistema de reclamos.
  • En circunstancias raras, podemos revelar su información cuando se requiera legalmente o en cumplimiento con una solicitud válida por las autoridades públicas.
Visitantes de Sitios Web Nombre
Dirección
Número de Teléfono
Dirección Email
Nombre del Empleador
No. de Identificación Médico
Fecha de Nacimiento
Número de Identificación del
Usuario
Dirección IP
Nombre de Computadora
Vendedor de Portador
Historial de Navegación (Recopilada por cookies de los sitios web)
Podemos compartir y revelar información personal a los siguientes individuos y con los siguientes propósitos:
  • Terceros vendedores (para guardar direcciones IP y otra información en nuestro nombre)
  • Autoridades públicas u otros (cuando se requiera por ley).
Su información personal se usa con los siguientes propósitos:
  • Para vigilar el acceso de nuestro sitio.
  • Para monitorear actividad de navegación dentro del sitio web.

¿Qué derechos tiene usted?

Puede elegir a no revelarnos su información, pero puede tener consecuencias en la navegación de nuestro sitio web, el uso de nuestros servicios o su derecho de ser reembolsado o pagado. Además, residentes de California tienen ciertos derechos bajo el Acta de Privacidad de Consumidores de California (Consumer Privacy Act [CCPA]). Esos derechos incluyen, por ejemplo, el derecho de acceder información personal sobre usted que tengamos guardado; el derecho de pedir que borremos cualquier información que hemos recopilado de usted y sobre usted; el derecho de recibir avisos sobre la información que hemos recopilado sobre usted y cómo esa información será usada; y el derecho de recibir servicios y precios equivalentes si usted elige ejercer cualesquier de los derechos antedichos.

¿Cómo puedo ejercer mis derechos?

Usted puede ejercer cualesquier de los derechos enumerados arriba por medio de comunicarse con nuestro Departamento de Privacidad y Conformidad por medio de nuestro número telefónico gratis al 1-800-422-6099. Alternativamente, también puede ejercer sus derechos por medio de nuestro sitio web, en www.deltahealthsystems.com/privacy.

¿Cómo protegemos su información?

Usamos medidas de seguridad apropiadamente técnicas, de organización y administrativas para proteger toda información que tengamos en nuestros registros contra pérdidas, mal usos y el acceso, divulgación, alteración y destrucción no autorizadas. Algunas de estas medidas incluyen limitando ciertos de nuestros empleados al acceso de cierta información según la necesidad de saber y requerir que nuestros empleados participen anualmente en instrucciones sobre la privacidad y seguridad.

¿Preguntas adicionales?

Comuníquese con nuestro Director y Oficial de Conformidad y Privacidad privacyandcompliance@delapro.com .

Website Accessibility

Delta Health System is always working to improve the accessibility of the website. If you run into any difficulties using the Delta Health System website, please let us know. Also, please try the following solutions to help make the the website more accessible.

Accessibility Features in Your Browser

To help make the Internet more user-friendly for everyone — even those with vision problems, poor motor control and other physical challenges — the latest Web browsers include a wide range of accessibility features. The ability to easily zoom in on text or change the color or contrast of the browser — as well as keyboard shortcuts and mouse gestures — makes for easier Internet navigation. They're not widely promoted, but these helpful tools are built into today's most popular browsers, including Microsoft's Internet Explorer, Google's Chrome, Mozilla's Firefox and Opera, though in some cases an optional free "plug-in" or "extension" is required to add extra functionality.

For accessibility features in the Mac OS X Safari browser, please refer to the “accessibility features in Mac OS X computers” section below.

Accessibility Features in Your Operating System

The Windows operating system and the Mac OS X operating system both offer accessibility features such as the ability to turn on “high contrast mode”, or to have the computer read web page text aloud. To learn more about the accessibility features of your computer, please select a link below.

Legal Notice

Eligibility, benefits and claims information is based on the data available. Final determination of payment is based on eligibility, fee allowances, medical necessity and contract exclusions and limitations in effect at the time service is provided. If you disagree with the payment of a claim or have information that could change our decision, please contact special.project@delapro.com.

All content contained in this website is the property of Delta Health Systems, 3244 Brookside Rd, Stockton, CA 95219.

California Consumer Privacy Act
Request Form
  Individual Requesting CCPA Rights  
  Participant on whose behalf Rights are Requested (If NOT the same as Above)  
  Summary of Request  
If you have questions about exercising your CCPA rights, email Privacy and Compliance at privacyandcompliance@delapro.com.
Internal Use Only
1. Has the Request Been Verified? Yes No
2.Does the Request relate to medical information, clinical information or FCRA information?

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