NOTICE OF PRIVACY PRACTICES
OF YORK ELECTRIC COOPERATIVE, INC.

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.

I. Section 125 Plan

This Notice describes the pri­va­cy prac­tices of York Elec­tric Coop­er­a­tive, Inc. (YEC). YEC makes a
Sec­tion 125 Plan avail­able as a ben­e­fit to their eli­gi­ble employ­ees.

II. York Electric Cooperative, Inc.‘s Privacy Obligations

YEC is required by fed­er­al law and applic­a­ble state law to pro­tect the pri­va­cy of indi­vid­u­al­ly iden­ti­fi­able health infor­ma­tion about you that it cre­ates or receives (“your Pro­tect­ed Health Infor­ma­tion”) and to pro­vide you with this Notice of its legal duties and pri­va­cy prac­tices. When YEC uses or dis­clos­es your Pro­tect­ed Health Infor­ma­tion, it is required to abide by the terms of this Notice (or oth­er Notice in effect at the time of the use or dis­clo­sure).

III. Uses and Disclosures With Your Written Authorization

YEC may use or dis­close your Pro­tect­ed Health Infor­ma­tion to oth­ers for any pur­pose oth­er than the pur­pos­es described in Sec­tion IV below, only when you give YEC your autho­riza­tion on its Autho­riza­tion Form. You may revoke your Autho­riza­tion, except to the extent YEC has tak­en action in reliance on it, by deliv­er­ing a writ­ten Revo­ca­tion Notice to the Pri­va­cy Officer(s) of YEC iden­ti­fied below. You may obtain a copy of both the Autho­riza­tion Form and the Revo­ca­tion Notice from your ben­e­fits admin­is­tra­tor.

IV. Uses and Disclosures without your written Authorization

YEC may use and dis­close your Pro­tect­ed Health Infor­ma­tion to oth­ers with­out your writ­ten autho­riza­tion for the fol­low­ing pur­pos­es:

A. To com­ply with the Law. YEC may use and dis­close your Pro­tect­ed Health Infor­ma­tion to the extent
required to com­ply with applic­a­ble law.

B. Judi­cial and Admin­is­tra­tive Pro­ceed­ings. YEC may dis­close your Pro­tect­ed Health infor­ma­tion in the
course of a judi­cial or admin­is­tra­tive pro­ceed­ing in response to a legal order or oth­er law­ful process.

C. Law Enforce­ment Offi­cials. YEC may dis­close your Pro­tect­ed Health Infor­ma­tion to the police or oth­er law enforce­ment offi­cials as required by law or in com­pli­ance with a court order or oth­er law­ful process.

D. Health or Safe­ty. YEC may dis­close your Pro­tect­ed Health Infor­ma­tion to pre­vent or lessen a seri­ous
and immi­nent threat to the health or safe­ty of an indi­vid­ual or the pub­lic.

E. Spe­cial­ized Gov­ern­ment Func­tions. YEC may dis­close your Pro­tect­ed Health Infor­ma­tion to units of
the gov­ern­ment with spe­cial func­tions, such as the U.S. mil­i­tary or the U.S. Depart­ment of State.

F. Work­ers Com­pen­sa­tion. YEC may dis­close your Pro­tect­ed Health Infor­ma­tion as nec­es­sary to com­ply
with work­ers’ com­pen­sa­tion laws.

V. Your Individual Rights

A. Right to Request Addi­tion­al Restric­tions. You may request restric­tions on YEC’s use and dis­clo­sure of your Pro­tect­ed Health Infor­ma­tion for pay­ment and health care oper­a­tions in addi­tion to those explained in this Notice. While YEC will con­sid­er all requests for addi­tion­al restric­tions care­ful­ly, it is not required to agree to a request­ed restric­tion. If you wish to request addi­tion­al restric­tions, please obtain a Right of Indi­vid­ual to Request Restric­tions on Uses and Dis­clo­sures Form from your Ben­e­fits Admin­is­tra­tor and sub­mit the com­plet­ed form to the Pri­va­cy Officer(s). You will be giv­en a writ­ten response.

B. Right to Receive Con­fi­den­tial Com­mu­ni­ca­tions. YEC will accom­mo­date any rea­son­able request for you to receive your Pro­tect­ed Health Infor­ma­tion by alter­na­tive means of com­mu­ni­ca­tion or at alter­na­tive loca­tions if the request clear­ly states that dis­clo­sure of that infor­ma­tion could endan­ger you. Please obtain a Request for Con­fi­den­tial Com­mu­ni­ca­tion of Health Infor­ma­tion Form from your ben­e­fits admin­is­tra­tor.

C. Right to Inspect and Copy your Pro­tect­ed Health Infor­ma­tion. You may request access to YEC’s records that con­tain your Pro­tect­ed Health Infor­ma­tion in order to inspect and request copies of the records. Under lim­it­ed cir­cum­stances, YEC may deny you access to a por­tion of your records. If you desire access to your records, please obtain an Access Request Form from your ben­e­fits admin­is­tra­tor and sub­mit the com­plet­ed form to the Pri­va­cy Officer(s).

D. Right to Receive an Account­ing of Dis­clo­sures. You may obtain an account­ing of cer­tain dis­clo­sures of your Pro­tect­ed Health Infor­ma­tion made by YEC on or after April 14, 2004, exclud­ing dis­clo­sures made ear­li­er than six years before the date of your request. You may obtain an Account­ing Request Form from your ben­e­fits admin­is­tra­tor. The account­ing will not include dis­clo­sures of your Pro­tect­ed Health Infor­ma­tion made in accor­dance with fed­er­al law; to car­ry out treat­ment, pay­ment or health care oper­a­tions activ­i­ties; to you; pur­suant to your writ­ten autho­riza­tion; for nation­al secu­ri­ty or intel­li­gence pur­pos­es; or to cor­rec­tion­al insti­tu­tions or law enforce­ment offi­cials.

E. Per­son­al Rep­re­sen­ta­tives. You may exer­cise your rights through a per­son­al rep­re­sen­ta­tive who will be required by YEC to pro­duce evi­dence of his or her author­i­ty to act on your behalf. Proof of author­i­ty may be made by a nota­rized pow­er of attor­ney, a court order of appoint­ment of the per­son as your legal guardian or con­ser­va­tor, or if you are the par­ent of a minor child. YEC reserves the right to deny access to your per­son­al rep­re­sen­ta­tive.

F. For Fur­ther Infor­ma­tion: Com­plaints. If you desire fur­ther infor­ma­tion about your pri­va­cy rights, are con­cerned that YEC has vio­lat­ed your pri­va­cy rights or dis­agree with a deci­sion that YEC has made about access to your Pro­tect­ed Health Infor­ma­tion, you may con­tact YEC’s Pri­va­cy Officer(s) or the CEO by mail, elec­tron­i­cal­ly, or in per­son. You may also file a writ­ten com­plaint with the Sec­re­tary of the U.S. Depart­ment of Health and Human Ser­vices. Upon request, the Pri­va­cy Officer(s) will pro­vide you with the cor­rect address for the Sec­re­tary. YEC will not retal­i­ate against you if you file a com­plaint with it or the Sec­re­tary.

VI. Effective Date and Duration of this Notice

A. Effec­tive Date. This Notice is effec­tive April 14, 2004

B. Right to Change Terms of this Notice. YEC may change the terms of this Notice at any time. If YEC changes this Notice, it may make the new Notice terms effec­tive for all of your Pro­tect­ed Health Infor­ma­tion that it main­tains, includ­ing any infor­ma­tion cre­at­ed or received pri­or to issu­ing the new Notice. If YEC changes this Notice, it will send the new Notice to you if you are employed by YEC as of the date of the change. You may also obtain any new Notice by con­tact­ing the Pri­va­cy Officer(s) or your ben­e­fits admin­is­tra­tor.

C. Lim­i­ta­tion on Applic­a­bil­i­ty of Notice. This Notice does not apply to infor­ma­tion that does not iden­ti­fy an indi­vid­ual and with respect to which there is no rea­son­able basis to believe that the infor­ma­tion can be used to iden­ti­fy an indi­vid­ual. In addi­tion, YEC may use or dis­close “sum­ma­ry health infor­ma­tion” to NRECA and oth­er enti­ties for its pur­pos­es of obtain­ing pre­mi­um bids or mod­i­fy­ing, amend­ing or ter­mi­nat­ing cov­er­age. Sum­ma­ry health infor­ma­tion is infor­ma­tion that sum­ma­rizes claims his­to­ry, claims expens­es or types of claims expe­ri­enced by indi­vid­u­als for whom YEC pro­vides ben­e­fits and from which the indi­vid­ual iden­ti­fy­ing infor­ma­tion has been delet­ed. YEC may also use or dis­close eli­gi­bil­i­ty and enroll­ment infor­ma­tion with­out your autho­riza­tion.

VII. Privacy Officer

You may con­tact one of the Pri­va­cy Offi­cers as well as sub­mit the forms described above in this Notice to:

Pat­ty S. Moss
Human Resources Admin­is­tra­tor
York Elec­tric Coop­er­a­tive, Inc.
P. O. Box 150
York, SC 29745
Tele­phone: (803) 684‑4248 Ext. 552
Fac­sim­i­le: (803) 628‑0232
Email: patty.moss@yorkelectric.net