PROCEDURE – Request to Inspect PHI
You have a right to inspect your Protected Health Information (PHI) contained in a “designated
record set” for as long as the Plan maintains the PHI.
The Dow Corning HR Service Center (HRSC) will maintain all authorizations, restrictions,
a log of disclosures, an enrollment and eligibility file, an appeal and issue resolution file and
life event notices in the Designated Record Set. The records retention will be current year +6.
Except as required for an appeal or issue resolution, the HRSC will NOT maintain medical
or billing records. Such records may be obtained from the provider, the insurance
company or the Third Party Administrator. Click here for contact information.
The Plan has executed Business Associate Agreements (contracts) with the Third Party
Administrators to insure that they also adhere to the HIPAA regulations to protect PHI for plan
To request a copy of your PHI from the HRSC, click here to fill out the attached form, sign it and
mail it to the HR Service Center at:
Dow Corning Corporation
HR Service Center
P.O. Box 994
Midland, MI 48686-0994
The HR Service Center (HRSC) will review the request, retrieve the information, copy it and
mail it via interoffice mail for active employees and via US Mail to the home address for inactive
participants. The HRSC will log the disclosure. The HRSC will respond within 30 days.
If you are requesting Protected Health Information for someone other than yourself, the HRSC
will insure that the necessary authorization is on file prior to processing the request. If there is
no authorization, the request will be denied. It will be your responsibility to obtain the written
authorization to review someone else’s PHI (please see the Authorization to Release Privacy
Procedure for instructions).