HIPAA Notice of Privacy Practices

Overview

This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) and how you can access this information. Please review it carefully.

Protected Health Information (PHI) includes individually identifiable health information that is created or received by us, including demographic information, related to your past, present, or future physical or mental health condition, the provision of health care to you, or payment for health care.

Uses and Disclosures of Protected Health Information

Treatment, Payment, and Health Care Operations

We may use and disclose your PHI for the following purposes:

• Underwriting and Risk Assessment: To evaluate your application for insurance and assess risk
• Policy Administration: To process and administer your insurance policy
• Claims Processing: To process claims and determine coverage eligibility
• Quality Assurance: To improve our services and ensure quality

Authorized Disclosures

We may disclose your PHI to:

• Insurance companies and their representatives for underwriting purposes
• Medical information bureaus (MIB) and similar organizations
• Health care providers who have treated you
• Business associates who assist us in operations (with appropriate safeguards)
• Legal and regulatory authorities as required by law

Your Rights

Right to Access

You have the right to request access to your PHI. We will provide you with access to your PHI, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Right to Amend

You have the right to request amendments to your PHI. We may deny your request if the information is accurate and complete, or was not created by us. If denied, we will explain why in writing within 60 days.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to all restrictions, but if we do, we will honor our agreement (except in emergencies).

Right to Request Confidential Communications

You have the right to request that we communicate with you in a specific way or at a specific location. We will accommodate reasonable requests.

Right to an Accounting of Disclosures

You have the right to request an accounting of disclosures of your PHI. We will provide one accounting per year at no charge. Additional accountings may be subject to a fee.

Right to a Paper Copy

You have the right to receive a paper copy of this notice at any time, even if you have agreed to receive it electronically.

Our Responsibilities

• We are required by law to maintain the privacy and security of your PHI
• We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information
• We must follow the duties and privacy practices described in this notice
• We will not use or share your information other than as described here unless you tell us we can in writing

Changes to This Notice

We reserve the right to change the terms of this notice and will notify you of any changes. The new notice will apply to all PHI we maintain. We will post the revised notice on our website and make it available upon request.