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If administrative functions are not performed
  • The group health plan is only permitted to disclose select information about individuals to employers that do not perform administrative functions.

Where the employer does not perform plan administration functions on behalf of the group health plan, the group health plan is generally permitted to disclose to the plan sponsor only:

  • Information on which individuals are participating in the group health plan or enrolled in the health insurance issuer or health maintenance organization (HMO) offered by the plan; and/or
  • Summary health information if requested for purposes of modifying the plan or obtaining premium bids for coverage under the plan.