PAI | Privacy Policies

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.

Privacy Promise
We understand the importance of handling your medical information with care. We are committed to protecting the privacy of your medical information. State and federal laws require us to make sure that your medical information is kept private. Federal law requires that we provide you with this Notice of Privacy Practices, which describes our legal duties and privacy practices with respect to your medical information and your legal rights with respect to our use and disclosure of your medical information. We are required by law to follow the terms of the Notice currently in effect. This Notice is effective September 23, 2013, and will remain in effect until it is changed or replaced.

We reserve the right to change our privacy practices and the terms of this notice at any time, as long as the law allows. These changes will be effective for all medical information that we keep, including medical information we created or received before we made the changes. When we make a material change to our privacy practices, we will provide a copy of a new notice (or information about the changes to our privacy practices and how to obtain a new notice) in a mailing to members who are covered under our health plans at that time.

Uses and Disclosures of Medical Information
Treatment, Payment, Health Care Operations
We may use and disclose your medical information for purposes of treatment, payment and health care operations.

Treatment: We may disclose your medical information to a physician or other health care professional to help him or her provide your treatment.
Payment: We may use or disclose your medical information for these and other activities related to payment:
- Paying claims from physicians, hospitals and other health care providers.
- Obtaining premiums.
- Issuing explanations of benefits to the named insured.
- Providing information to health care professionals or other entities that are bound by the federal Privacy Rules for their payment activities.
Health Care Operations: We may use or disclose your medical information in the normal course of conducting health care operations, including such activities as:
- Quality assessment and improvement activities.
- Reviewing the qualifications of health care professionals.
- Compliance and detection of fraud and abuse.
- Underwriting, enrollment and other activities related to creating, renewing or replacing a plan of benefits. We may not, however, use or disclose genetic information for underwriting purposes.
- Providing information to another entity bound by the federal Privacy Rules for its health care operations, in limited circumstances.
- Loading information to our secure portal, My Benefits Manager®.

You and Your Family and Friends
We may use and disclose your medical information to communicate with you for purposes of customer service or to provide you with information you request. We may disclose your medical information to a family member, friend or other person to the extent necessary for him or her to assist with your health care or payment for your health care. Before we disclose your medical information to that person, we will give you a chance to object to us doing so. If you are not available, or if you are incapacitated or in an emergency situation, we may, in the exercise of our professional judgment, determine whether the disclosure would be in your best interest. We may also use or disclose your medical information to notify (or help notify, including identifying and locating) a family member, a personal representative or other person responsible for your care of your location, general condition or death.

Your Employer or Organization Sponsoring Your Group Health Plan
We may disclose summary information and enrollment information to your employer (or other plan sponsor). Summary information is a summary of the claims history, claims expenses or types of claims that members of your group health plan have filed. The summary information will not include demographic information about you or others in the group health plan, but your employer or plan sponsor may be able to identify individuals from the summary information provided.

Disaster Relief
We may use or disclose your medical information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

Public Benefit
We may use or disclose our members’ medical information as authorized by law for the following purposes that are in the public interest or benefit:

As required by law.
For public health activities, including disease and vital statistics reporting, child abuse reporting, FDA oversight, and to employers regarding work-related illness or injury.
To report adult abuse, neglect or domestic violence.
To health oversight agencies.
In response to court and administrative orders and other lawful processes.
To law enforcement officials in response to subpoenas and other lawful processes concerning crime victims, suspicious deaths, crimes on our premises, reporting crimes in emergencies and to identify or locate a suspect or other person.
To coroners, medical examiners and funeral directors.
To organ procurement organizations.
To avert a serious threat to health or safety.
In connection with certain research activities.
To the military and to federal officials for lawful intelligence, counterintelligence and national security activities.
To correction institutions regarding inmates.
As authorized by state workers’ compensation laws.

Your Authorization

We may not use or disclose your medical information without your written authorization, except as described in this notice. You may give us written authorization to use your medical information or to disclose it to anyone for any purpose. If you give us authorization, you may revoke it at any time by notifying us of your revocation in writing. Your revocation will not affect any use or disclosure permitted by the authorization while it was in effect. We need your written authorization to use or disclose psychotherapy notes, except in limited circumstances such as when a disclosure is required by law. We also must obtain your written authorization to sell your medical information to a third party or, in most circumstances, to send you communications about products and services. We do not need your written authorization, however, to send you communications about health-related products or services, as long as the products or services are associated with your coverage or are offered by us.
Individual Rights

You have certain rights with respect to the medical information we maintain about you. To exercise any of these rights or to obtain more information about these rights (including any applicable fees), contact us using the information listed at the end of this notice.

Access

You have the right to inspect or receive a paper or electronic copy of your medical information, with some exceptions. To inspect or receive your medical information, you must submit the request in writing. If you request to receive a copy of your records, we are allowed to charge a reasonable, cost-based fee.

Disclosure Accounting

You have the right to request, in writing, a record of instances in which we (or our business associates) disclosed your medical information for purposes other than treatment, payment, health care operations, and as allowed by law. We will provide you with a record of such disclosures for up to the previous six years. If you request a record of disclosures more than once in a 12-month period, we may charge you a reasonable, cost-based fee for each additional request.

Restriction

You have the right to request, in writing, that we place additional restrictions on our use or disclosure of your medical information. By law, we are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). Any agreement to additional restrictions will be made in writing and signed by a person authorized to make such an agreement for us.

Confidential Communications

You have the right to request, in writing, that we communicate with you about your medical information by other means, or to another location. We are not required to agree to your request unless you state that you could be in danger if we do not communicate to you in confidence. In that case, we must accommodate your request if it is reasonable, if it specifies the other means or location, and if it permits us to continue to collect premiums and pay claims under your health plan. We will not be bound to your request unless our agreement is in writing.
Even if we agree to communicate with you in confidence, an explanation of benefits we issue to the named insured for health care services the named insured (or others covered by the health plan) received might contain sufficient information (such as deductible and out-of-pocket amounts) to reveal that you obtained health care services for which we paid.

Amendment

You have the right to request, in writing, that we amend your medical information. Your request must explain why we should amend the information. We may deny your request if we did not create the information you want amended and the person or entity that did create it is available, or we may deny your request for certain other reasons. If we deny your request, we will send you a written explanation.

Notice of Breach

We are required to notify affected individuals following a breach of unsecured medical information.

Electronic Notice

You may request a written copy of this notice at any time or download it from our website.

Questions and Complaints

If you want more information about our privacy practices, or if you have questions or concerns, please contact us using the information below.

If you believe we may have violated your privacy rights, you may submit a complaint to us using the contact information listed below. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with that address upon request.

We support your right to the privacy of your medical information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

Contact Information

Attention: Privacy Official
Planned Administrators, Incorporated

Physical Location:
17 Technology Circle, Suite E2AG
Columbia, South Carolina 29203-9591

Mailing Address:
P.O. Box 6927
Columbia, South Carolina 29260

Email: paicomplianceteam@paisc.com
Tollfree Telephone: 1(800)768-4375, Option 8

Declaración Sobre Las Prácticas De Privacidad (PAI)

Declaraciónsobre las prácticas de privacidad

ESTA DECLARACIÓN DESCRIBE EN QUÉ MANERA SE PUEDE USAR Y REVELAR SU INFORMACIÓN MÉDICA Y CÓMO USTED PUEDE TENER ACCESO A ESTA INFORMACIÓN. LÉALA CON ATENCIÓN.

Promesasobre la privacidad

Entendemos la importancia de manejar con cuidadosuinformaciónmédica. Tenemoselcompromiso de proteger la privacidad de suinformaciónmédica. Las leyes federales y estatalesrequieren que nosaseguremos de mantener la privacidad de suinformaciónmédica. Las leyes federales requieren que le demos estaDeclaración de prácticas de privacidad, la cual describe nuestrasresponsabilidadeslegales y prácticas de privacidadrespecto a suinformaciónmédica y sus derechos legalesrespecto al uso y revelación de suinformaciónmédica. La ley requiere que respetemoslostérminos de la Declaración que estáen vigor. EstaDeclaraciónentróenvigenciael 23 de septiembre de 2013 y seguiráen vigor hasta que sea modificada o reemplazada.

Nos reservamosel derecho a cambiarnuestrasprácticas de privacidad y lostérminos de estadeclaraciónencualquiermomento, mientras las leyes lo permitan. Estoscambios se aplicarán a toda la informaciónmédica que mantenemos, incluyendo la informaciónmédica que creamos o recibimos antes de que hiciéramosloscambios. Cuandohagamos un cambio material a nuestrasprácticas de privacidad, le daremosunacopia de la nuevadeclaración (o informaciónsobreloscambios a nuestrasprácticas de privacidad y sobrecómoobtener la declaraciónnueva) enel material que enviemosporcorreo a quienesesténcubiertospornuestros planes de salud al momento del cambio.

Uso y revelación de la informaciónmédica

Tratamiento, pago y operaciones de atenciónmédica

Podríamos usar y revelarsuinformaciónmédica para eltratamiento, elpago y las operaciones de atenciónmédica.

Tratamiento: Podríamosrevelarsuinformaciónmédica a un doctor o a otroprofesional de atenciónmédica para ayudarles a que le den tratamiento a usted.
Pago: Podríamos usar o revelarsuinformaciónmédica para estasactividades y otrasrelacionadas a lospagos:

o Para pagarlosreclamos de doctores, hospitales y otrosprofesionales de atenciónmédica.

o Para obtener las primas.

o Para darexplicacionessobrelosbeneficios a las personas aseguradas.

o Para darinformación a losprofesionales de atenciónmédica y a otrasentidades que cumplenlosreglamentos federales de privacidad, para sus actividades de pago.

Operaciones de atenciónmédica: Podríamos usar o revelarsuinformaciónmédicaduranteelcurso normal a nuestrasoperaciones de atenciónmédica, incluyendoactividadescomo:

o Actividades de evaluación y mejora de la calidad.

o Revisar las calificaciones de losprofesionales de atenciónmédica.

o Cumplimiento de losreglamentos y detección de abusos y fraude.

o Avalar, registrar y otrasactividadesrelacionadas con la creación, la renovación o elreemplazo de un plan de beneficios. Sin embargo, no podemos usar nirevelarsuinformacióngenética para avalar.

o Dar información a otraentidad, que respetelosreglamentos federales de privacidad, para sus operaciones de atenciónmédicarelacionadasencircunstanciaslimitadas.

Usted y sufamilia y amigos

Podríamos usar o revelarsuinformaciónmédica para comunicarnos con ustedporcuestiones de servicio al cliente o para darleinformación que hayapedido. Tambiénpodríamosdar a un familiar, amigo u otra persona la informaciónmédica que sea necesaria para ayudarles a darle a ustedatenciónmédica o a pagarésta. Antes de revelarsuinformaciónmédica a esa persona, le daremos a usted la oportunidad de que se oponga a que lo hagamos. Si usted no está disponible, o siestáincapacitado o es unaemergencia, podríamos, basándonosennuestrocriterioprofesional, determinarsidarestainformación es ensumejorinterés. Tambiénpodríamos usar o revelarsuinformaciónmédica para notificar (o ayudar a notificar, incluyendoidentificar y localizar) suubicación, suestado de salud o sumuerte, a un familiar, a un representante de la persona o a la persona encargada de darleatenciónmédica.

Suempleador o la organización que patrocinasu plan de salud de grupo

Podríamosrevelarinformaciónsumaria e informaciónsobresuregistro al empleador (o al patrocinador del plan). La informaciónsumaria es un resumen del historial de reclamos, gastos de losreclamos y tipos de reclamos de losmiembros del plan de salud de grupo. La informaciónsumaria no incluyeinformacióndemográfica de usted y de losotrosparticipantes del plan de salud de grupo, perosuempleador o elpatrocinador del plan podríanidentificar a las personas basándoseen la informaciónsumaria.

Ayudaencaso de desastres

Ayudaencaso de desastresPodríamos usar o revelarsuinformaciónmédica a entidadespúblicas y privadasautorizadaspor la ley o porsumatriz para ayudarencaso de desastres.

Beneficiospúblicos

Podríamos usar o revelar la informaciónmédica de nuestrosmiembrossi lo autoriza la ley para lossiguientespropósitosenbeneficio o interéspúblico:

Cuando lo requiera la ley.
Para actividadesrelacionadas con la saludpública, incluyendoelreporte de estadísticasvitales y enfermedades, elreporte de abusoinfantil, las fallas de la FDA y elreporte a losempleadoressobrelesiones y enfermedadesrelacionadas con eltrabajo.
Para reportarabuso a adultos, descuido o violenciadoméstica.
Para monitorearfallas de las agencias de salud.
Como respuesta a órdenesadministrativas y de la corte y otrosprocesoslegales.
A losrepresentantes de la ley comorespuesta a citaciones u otrosprocesoslegalesrelacionados con víctimas de delitos, muertessospechosas, delitoscometidosennuestraspropiedades, reportes de delitosensituaciones de emergencia y para identificar o buscar a un sospechoso o a otra persona.
A losmédicos y oficialesencargados de investigarmuertessospechosas y a losdirectores de funerarias.
A organizaciones para la donación de órganos.
Para combatirpeligros graves a la salud o a la seguridad.
Para ciertasactividades de investigación.
A militares y oficiales federales para actividadeslegales de inteligencia, contrainteligencia y seguridadnacional.
A institucionescorreccionales, sobrelosprisioneros.
Enloscasosautorizadospor las leyesestatales de compensación a losempleados.

Suautorización

Excepto las situaciones que se describenenestadeclaración, si no nos da suautorizaciónporescrito, no podemos usar nirevelarsuinformaciónmédica. Puededarnossuautorizaciónporescrito para usar suinformaciónmédica o para revelarla a terceros para lospropósitos que éstosquierandarle. Si nos da suautorización, puederevocarlaencualquiermomentosinos lo notificaporescrito. Surevocación no afectarálosusos y las revelaciones que se permitieronmientrassuautorizaciónestabaen vigor. Necesitamossuautorizaciónporescrito para usar o revelar las notas de susicoterapia, exceptoenlimitadascircunstancias, porejemplo, cuando lo requiera la ley. Tambiéndebemosobtenersuautorizaciónporescrito para vender suinformaciónmédica a terceros o, en la mayoría de las circunstancias, para que le envíen material informativosobreproductos y servicios. Sin embargo, no necesitamossuautorizaciónporescrito para enviarle material informativosobreproductos y serviciosrelacionados con la salud, siempre y cuandoestosproductos o serviciosesténrelacionados con sucobertura o losofrezcamosnosotros.

Derechos individuales

Ustedtieneciertos derechos sobresuinformaciónmédica que mantenemosnosotros. Para ejercitarcualquiera de estos derechos o para obtenermásinformaciónsobreestos derechos (incluyendo las cuotasaplicables), use la información que está al final de estadeclaración para ponerseencontacto con nosotros.

Acceso

Ustedtieneel derecho de inspeccionar o recibirunacopia impresa o electrónica de suinformaciónmédica, con algunasexcepciones. Para inspeccionar o recibirsuinformaciónmédica, debeenviar la peticiónporescrito. Si pideunacopia de sus registros, le podríamoscobrarunacuotarazonablesegúnelcosto de la copia.

Lista de losdatosrevelados

Ustedtieneel derecho de solicitar, porescrito, unalista de las situacionesen las que nosotros (o nuestrosasociadoscomerciales) revelamossuinformaciónmédica para cuestiones que no estánrelacionadas al tratamiento, pago, operaciones de atenciónmédica y otrassituacionespermitidaspor la ley. Le daremosunalista de todas las situacionesen que estosucedióen un período de hasta seis años. Si pideestalistamás de unavezen un período de 12 meses, le podríamoscobrarunacuotarazonablesegúnelcosto de cadacopiaadicional.

Restricción

Ustedtieneel derecho a solicitar, porescrito, que pongamosmásrestricciones al uso o revelación de suinformaciónmédica. Según las leyes, no tenemos la obligación de aceptarestasrestriccionesadicionales, perosi lo hacemos, respetaremosnuestroacuerdo (exceptoencaso de emergencia). Todoslosacuerdossobrerestriccionesadicionales se debenpresentarporescrito y losdebefirmaruna persona autorizada para estetipo de acuerdos.

Comunicaciónconfidencial

Ustedtieneel derecho a solicitar, porescrito, que le enviemossuinformaciónmédicaporotrosmedios o a otradirección. No tenemos la obligación de aceptarsupetición, a menos de que usted declare que podríaestarenpeligrosi no noscomunicamosenconfidencia. En ese caso, cumpliremossupeticiónsi es razonable, especificalosmedios o lugares alternativos, y nospermiteseguirlededuciendo las primas y pagandolosreclamos de su plan de salud. No estamosobligados a cumplirsupetición a menos de que nuestroacuerdo se hagaporescrito.

Aunquehayamosacordado que noscomunicaríamosconfidencialmente con usted, la explicación de beneficios que enviamos a las personas nombradasenlosservicios de atenciónmédica, que recibieron las personas aseguradas (y otrascubiertasporenel plan de atenciónmédica) podríancontenersuficienteinformación (porejemploel deducible y lospagos de subolsillo), que podríanrevelarlosservicios de atenciónmédicaporlos que nosotrospagamos.

Enmienda

Ustedtieneel derecho a pedir, porescrito, que hagamosenmiendas a suinformaciónmédica. Supeticióndebeexplicarporquédebemosenmendar la información. Podríamosnegarsupeticiónsinosotros no creamos la información que deseaenmendar y la persona o la entidad que la creó no estándisponibles, o porotrasrazonesespecíficas. Si negamossupetición, le enviaremosunaexplicaciónporescrito.

Notificación de la fuga de información

Se requiere que notifiquemos a las personas afectadascuando hay unafuga de informaciónmédica.

Notificacioneselectrónicas

Puedepedirunacopia impresa de estadeclaraciónencualquiermomento o puededescargarla de nuestrapágina de internet.

Preguntas y quejas

Si deseamásinformaciónsobrenuestrasprácticas de privacidad o sitienepreguntas, contáctenosusando la siguienteinformación.

Si cree que hemosviolado sus derechos de privacidad, nospuedeenviarunaquejausando la información para comunicación que apareceabajo. Tambiénpuedeenviarunaquejaporescrito al departamentollamado U.S. Department of Health and Human Services. Si lo pide, le daremossudirección.

Respaldamossu derecho a la privacidad de suinformaciónmédica. No tendremosningunarepresalia contra ustedsi decide enviarnosunaqueja a nosotros o a U.S. Department of Health and Human Services.

Información para comunicación

Attention: Privacy Official

Planned Administrators, Incorporated

Physical Location:

17 Technology Circle, Suite E2AG

Columbia, South Carolina 29203-9591

Dirección de contacto:

P.O. Box 6927

Columbia, South Carolina 29260

Email: paicomplianceteam@paisc.com

Línea de teléfono gratis: 1(800)768- 4375, Opción 8

Notice of Privacy Practices (4 Ever Life Insurance Company)

F I D E L I T Y S E C U R I T Y L I F E I N S U R A N C E C O M P A N Y®

3130 Broadway

Kansas City, Missouri 64111-2406

Phone 800-648-8624

A STOCK COMPANY

(Herein Called “the Company”)

HIPAA Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This notice describes how the Company, (herein referred to as “we”, “our” or “us”), protects personal health information we have about you which relates to our medical, dental, vision and prescription drug coverage. Protected Health Information (“PHI”) is individually identifiable information about you. All of the following are examples of PHI: demographic information like your name, address and social security number; health information that relates to your past, present or future physical or mental health that is collected, created or received from you, a health care provider, a health plan, employer or a health care clearinghouse; the providing of health care; or the past, present or future payment for providing health care to you.

Our Legal Duty

We are required by applicable federal and state laws to maintain the privacy of your PHI. We are required to give you this notice about our privacy practices, our legal duties, and your rights concerning your PHI. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect February 1, 2022, or the date coverage became effective for you, whichever is later, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this notice at any time. The new terms of our notice will be effective for all PHI that we maintain, including PHI we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this notice and send the new notice to you at the time of change.

You may request a copy of our notice at any time. For more information about our privacy practices, or for additional copies of this notice, please contact us using the “Contact Information” provided at the end of this Notice.

Uses and Disclosures of Your PHI

In conducting our business we may create, receive and maintain PHI records regarding you and the insurance services we provide you. The main reasons for which we may use and may disclose your PHI are to evaluate and process any requests for medical coverage and claims for benefits you may make. The following describe these and other uses and disclosures, together with some examples:

For Treatment: We may use or disclose your PHI to facilitate medical treatment by providers. For example, your PHI may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to treat you. We may request the services of a business associate to assist us in these activities.

For Payment: We may use and disclose your PHI to facilitate payment of benefits under your insurance coverage. For example, we might disclose your PHI to determine your eligibility for benefits, to coordinate benefits with other insurance carriers, to examine medical necessity, to obtain payments including obtaining payment under a contract for re-insurance, and related health care data processing, and to issue explanations of benefits. We also may use your PHI to obtain payment from third parties that may be responsible for your premium payments, such as family members.

For Health Care Operations: We may use and disclose your PHI as necessary, and as permitted by law, for our health care operations. Health care operations include: (i) rating our risk and determining our premiums for your insurance; (ii) conducting quality assessment and improvement activities; (iii) conducting or arranging for medical review, legal services, audit services, fraud and abuse detection and compliance programs; and (iv) business planning and development.

On Your Authorization: You may give us written authorization to use your PHI or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect. You should understand that we will not be able to take back any disclosures we have already made with authorization. Unless you give us a written authorization, we cannot use or disclose your PHI for any reason except those described in this notice. We also need to obtain your prior written authorization if your PHI relates to psychotherapy notes or where the PHI is to be used for marketing or sales purposes.

To Your Family and Friends: We may disclose your PHI to a family member, friend, or other person to the extent necessary to help with your health care or for payment of your health care. We may use or disclose your name, location and general condition or death to notify, or assist in the notification, of (including identifying or locating) a person involved in your care.

Before we disclose your PHI to a person involved with your health care or payment for your health care, we will provide you with an opportunity to object to such uses or disclosures. If you are not present, or in the event of your incapacity or an emergency, we will disclose your PHI based on our professional judgment of whether the disclosure would be in your best interest.

To Your Employer or Organization Sponsoring Your Health Plan: We may disclose your PHI and the PHI of others enrolled in your group insurance plan to the employer or other organization that sponsors your group insurance plan to permit the plan administrator to perform plan administration functions. We may also disclose summary information about the enrollees in your group insurance plan to the plan administrator to use to obtain premium bids for the health insurance coverage offered through your group insurance plan or to decide whether to modify, amend or terminate your group insurance plan. The summary information we may disclose may summarize claims history, claims expenses, or types of claims experienced by the enrollees in your group insurance plan. The summary information will be stripped of demographic information about the enrollees in the group insurance plan, but the plan administrator may still be able to identify you or other participants in your group health plan from the summary information. W

For Underwriting: We may receive your PHI for underwriting, premium rating or other activities relating to the creation, renewal or replacement of a contract of health insurance or health benefits. We will not use or further disclose your PHI for any other purpose, except as required by law, unless the contract of health insurance or health benefits is placed with us, or where we disclose such information to MIB, LLC., a non-profit membership organization of life and health insurance companies, which operates an information exchange on behalf of its members. In those cases, our use and disclosure of your PHI will only be as described in this notice. We are also prohibited from using or disclosing your genetic information for underwriting.

For the Public Benefit: We may use or disclose your PHI without your authorization when required or permitted by law for the following purposes deemed in the public interest or benefit:

- for public health activities, including disease and vital statistic reporting, child abuse reporting, FDA oversight, and to employers regarding work-related illness or injury;

- to report adult abuse, neglect, or domestic violence;

- to health oversight agencies;

- in response to court and administrative orders and other lawful processes;

- to law enforcement officials pursuant to subpoenas and other lawful processes, concerning crime victims, suspicious deaths, crimes on our premises, reporting crimes in emergencies, and for purposes of identifying or locating a suspect or other person;

- to coroners, medical examiners, and funeral directors;

- to organ procurement organizations;

- to avert a serious threat to health and safety;

- to the military and to federal officials for lawful intelligence, counterintelligence, and national security activities;

- to correctional institutions regarding inmates; and

- as authorized by state worker’s compensation laws.

To Avert a Serious Threat to Health or Safety: We may disclose PHI to avert a serious threat to someone’s health or safety. We may also disclose PHI to federal, state or local agencies engaged in disaster relief, as well as to private disaster relief or disaster assistance agencies to allow such entities to carry out their responsibilities in specific disaster situations.

To Business Associates: Certain aspects and components of our business are preformed through contracts with outside persons or organizations. Examples of these outside persons and organizations include our duly appointed insurance agents, third party administrators, financial auditors, actuarial and underwriting services, reinsurers, legal services, enrollment and billing services, claim payment and medical management services and collection agencies. At times it may be necessary for us to provide your PHI to one or more of these outside persons or organizations who assist us with our payment or health care operations. In all cases, we disclose only the minimum information necessary for these business associates to perform their responsibilities, and we require them to abide by specific HIPAA rules to appropriately safeguard the privacy of your information.

For Disclosures of PHI Deemed Highly Sensitive or Confidential: For certain kinds of PHI, federal and state law may require enhanced privacy protection. These may include PHI that is (1) About alcohol and drug abuse prevention, treatment and referral; (2) About HIV/AIDS testing, diagnosis or treatment; (3) About genetic testing; or (4) About psychotherapy notes. If the PHI is subject to enhanced protection, we can only disclose it with your prior written authorization unless specifically permitted or required by law.

Your Rights Regarding PHI That We Maintain About You

The following are your various rights as a consumer under HIPAA concerning your PHI. Should you have questions about or wish to exercise a specific right, please contact us in writing using the “Contact Information” provided at the end of this Notice.

Right to Inspect and Copy Your PHI: In most cases, you have the right to inspect and/or obtain an electronic or hard copy of the PHI that we maintain about you. You may also send a written request designating another individual to receive your PHI on your behalf. Written requests must be signed and dated by you or your personal representative using the “Contact Information” provided at the end of this Notice. The request must clearly identify the individual to receive your PHI. We may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. However, certain types of PHI will not be made available for inspection and copying. This includes psychotherapy notes and PHI collected by us in connection with, or in reasonable anticipation of any claim or legal proceeding. In very limited circumstances we may deny your request to inspect and obtain a copy of your PHI. If we do, you may request that the denial be reviewed. The review will be conducted by an individual chosen by

Right to List of Disclosures: You have the right to receive a list of instances in which we or our business associates disclosed your PHI for purposes other than for treatment, payment, health care operations, purposes of national security, to law enforcement, to corrections personnel, directly to you or as otherwise authorized by you during the six years prior to the date the accounting is requested. For example, we would account for your PHI or demographic information we disclose during an audit by an insurance department or pursuant to a court order. You must make your request in writing using the “Contact Information” provided at the end of this Notice. Your request should indicate in what form you want the list (for example, paper or electronic). If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. We will notify you of the cost involved and you may choose to withdraw or modify your request at tha

Right to Request Restrictions. You have the right to request a restriction or limitation on PHI we use or disclose about you for treatment, payment or health care operations, or that we disclose to someone who may be involved in your care or payment for your care, like a family member or friend. While we will consider your request, we are not required to agree to it. If we do agree to it, we will comply with your request. To request a restriction, you must make your request in writing using the “Contact Information” provided at the end of this Notice. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply (for example, disclosures to your spouse or parent). We will not agree to restrictions on PHI uses or disclosures that are legally required, or which are necessary to administer our business.

Unauthorized Access: You are entitled to receive notification of unauthorized access to your PHI. We maintain physical, electronic and procedural safeguards that are compliant with applicable federal and state privacy laws. However, if your PHI is ever compromised, we will notify you of the incident.

Right to Request Confidential Communications: You have the right to request that we communicate with you about PHI in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing using the “Contact Information” provided at the end of this Notice and specify how or where you wish to be contacted. We will accommodate all reasonable requests.

Right to Amend Your PHI: If you believe that your PHI is incorrect or that an important part of it is missing, you have the right to ask us to amend your PHI while it is kept by or for us. You must provide your request and your reason for the request in writing using the “Contact Information” provided at the end of this Notice. We may deny your request if it is not in writing or does not include a reason that supports the request. In addition, we may deny your request if you ask us to amend PHI that: (i) is accurate and complete; (ii) was not created by us, unless the person or entity that created the PHI is no longer available to make the amendment; (iii) is not part of the PHI kept by or for us; or (iv) is not part of the PHI which you would be permitted to inspect and copy.

Right to Notification Following a Breach of Unsecured Protected Health Information: We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

Right to File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with us using the “Contact Information” provided at the end of this Notice. All complaints must be submitted in writing. You may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling (877) 696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. You will not be retaliated against for filing a complaint.

Contact Information: If you have questions regarding this Notice or need further assistance regarding this Notice, please contact us at:

Contact Office: Fidelity Security Life Insurance Company, HIPAA Customer Service

Telephone: 800-648-8624 Fax: 816-968-0660

Address: 3130 Broadway, Kansas City, MO 64111-2406

Notice of Privacy Practices (BCS Insurance Company)

PRIVACY NOTICE

This notice describes BCS Insurance Company’s privacy practices in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the regulations that implement HIPAA.

Our Legal Duty

HIPAA requires us to maintain the privacy of information we use and maintain about you (your medical information). We are required to give you this notice about our privacy practices, our legal duties, and your rights concerning your medical information. We also must inform you of a breach involving your unsecured medical information. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect July 1, 2013, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this notice at any time. Any new terms will be effective for all medical information that we maintain, including medical information we create or receive before we make the changes. Before we make a significant change in our privacy practices, we will change this notice and post our new notice on our website. We will provide information about changes to the notice and how to obtain the notice in our next annual mailing to our health plan subscribers at the time of the change.

You may request a copy of our notice at any time. For more information about our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice.

Uses and Disclosures of Medical Information

We use and disclose medical information about you for the following purposes:

Treatment: We may use and disclose your medical information for treatment. For example, we may disclose your medical information to a physician or other health care provider who is providing treatment to you.

Payment: We may use and disclose your medical information to pay for benefits or to obtain premiums. For example, we pay claims to physicians, hospitals and other providers for services delivered to you that are covered by your health plan. We also use and disclose your medical information to establish your eligibility for benefits, to determine medical necessity, and to issue explanations of benefits. We may disclose your medical information to a health care provider or entity subject to HIPAA so they can engage in these type of payment activities.

Health Care Operations: We may use and disclose your medical information in connection with our everyday work activities (health care operations). These operations include, for example, customer service, resolution of grievances, quality assessment and improvement activities, and fraud and abuse detection and compliance. They also include underwriting, enrollment, and other activities related to creating, renewing, or replacing a benefits plan. We may not, however, use or disclose genetic information for underwriting purposes. In limited circumstances, we may disclose your medical information to another entity subject to HIPAA so they can engage in their own health care operations.

Required or Permitted by Law: We may use or disclose your medical information when required by law, such as in response to a court order or for government health oversight activities (i.e., inquiries from a State Department of Insurance). In limited circumstances, we may also give out medical information as permitted by law, such as for public health purposes (i.e., reporting disease outbreaks), law enforcement purposes, research studies, to avoid a serious and imminent threat to health or safety, to create de-identified information, and for emergencies.

To You or Others Involved In Your Care: We may use or disclose your medical information to provide information to you or to a family member, friend or other person to help with your health care or with payment for your health care. Before we disclose your medical information to a family member, friend or other person, we will provide you with an opportunity to object to the use or disclosure. If you are not present, or in the event of your incapacity or an emergency, we will disclose your medical information based on our professional judgment of whether the disclosure is in your best interest.

Plan Sponsors: If you are a participant in a group health plan, we may disclose summary information about the enrollees in your plan to the employer (or other organization that sponsors your plan) to use to obtain premium bids for the health insurance coverage offered through your plan or to decide whether to modify, amend or terminate your plan. Summary information is partially de-identified information about claims history, claims expenses, or types of claims experienced by plan enrollees. If the employer (or other plan sponsor) takes appropriate steps to comply with HIPAA, we may disclose medical information of individuals enrolled in your plan to the plan sponsor to permit the plan sponsor to perform plan administration functions. If this is the case, your group health plan will publish its own notice describing how it uses and disclosures your medical information.

Situations Other Than Those Above: Except as described in this notice, we may not use or disclose your medical information without your written authorization. You may give us written authorization to use your medical information or to disclose it to anyone for any purpose. If you give us written authorization, you may revoke it at any time by notifying us of your revocation in writing. Your revocation will not affect any use or disclosure permitted by the authorization while it was in effect. We need your written authorization to use or disclose psychotherapy notes, except in limited circumstances such as when the disclosure is required by law. We also must obtain your written authorization to sell information about you to a third party or, in most circumstances, to use or disclose your medical information to send you communications about products and services. We do not need your written authorization, however, to send you communications about health related products or services, as long as the products or services are associated with your coverage or are offered by us.

Individual Rights

In most cases, you have the right to look at or get a copy of the medical information that we use to make decisions about you. If you request copies, we may charge you a reasonable, cost-based fee for the copies. You also have the right to receive a list of instances in which we have disclosed health information about you for reasons other than treatment, payment, health care operations, and certain other purposes. If you believe the records we maintain about you are incorrect or are missing important information, you have the right to request that we correct our records.

If you believe that you would be in danger if we send your medical information to the address we have for you in our records, you have the right to request that we communicate with you using alternative means or an alternative location. We will accommodate your request if the request (a) states that our communications could put you in danger, (b) is reasonable, (c) specifies the alternative means or location for communicating with you, and (d) permits us to continue collecting premiums and paying claims under your health plan.

Finally, you may request that we place additional restrictions on how we use or disclose your medical information. We will consider your request but are not legally required to agree to it.

All requests to exercise these rights must be made in writing by you and directed to the contact person named below.

Your California Privacy Rights

If you are a California resident, California law may provide you with additional rights regarding our use of your personal information. To learn more about your California privacy rights, email privacyofficer@bcsigroup.com.

Questions and Complaints

If you want more information about our privacy practices or have questions or concerns, please contact us using the information listed at the end of this notice. If you are concerned that we may have violated your privacy rights, you may complain to us using the contact information listed at the end of this notice. You may also submit a complaint to the U.S. Department of Health and Human Services. We will provide you with their address upon request. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services. Privacy Officer at BCS Insurance Company 2 Mid America Plaza, Suite 200 Oakbrook Terrace, IL 60181 By phone: 630-472-7752, fax: 630-472-7822 or email: privacyofficer@bcsigroup.com.

If you have a question, a general complaint or concern unrelated to your privacy (for example, to request information about your plan or to request an ID card) please contact the Planned Administrators Inc. Customer Service Team toll-free at (866)798-0803, by mail to Planned Administrators Inc. P.O. Box 6927 Columbia, SC 29260, or by e-mail at paicomplianceteam@paisc.com.

Notice of Privacy Practices (Companion Life)

NOTICE OF PRIVACY PRACTICES

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.

Our Privacy Promise

We understand the importance of handling your medical information with care. We are committed to protecting the privacy of your medical information. State and federal laws require us to make sure that your medical information is kept private. Federal law requires that we provide you with this Notice of Privacy Practices, which describes our legal duties and privacy practices with respect to your medical information and your legal rights with respect to our use and disclosure of your medical information. We are required by law to follow the terms of the Notice currently in effect. This Notice is effective September 23, 2013, and will remain in effect until it is changed or replaced.

Uses and Disclosures of Medical Information Treatment, Payment, Health Care Operations

We may use and disclose your medical information for purposes of treatment, payment and health care operations.

Treatment: We may disclose your medical information to a physician or other health care professional to help him or her provide your treatment.

Payment: We may use or disclose your medical information for these and other activities related to payment:

• Paying claims from physicians, hospitals and other health care providers.

• Obtaining premiums.

• Issuing explanations of benefits to the named insured.

• Providing information to health care professionals or other entities that are bound by the federal Privacy Rules for their payment activities.

Health Care Operations: We may use or disclose your medical information in the normal course of conducting health care operations, including such activities as:

• Quality assessment and improvement activities.

• Reviewing the qualifications of health care professionals.

• Compliance and detection of fraud and abuse.

• Underwriting, enrollment and other activities related to creating, renewing or replacing a plan of benefits. We may not, however, use or disclose genetic information for underwriting purposes.

• Providing information to another entity bound by the federal Privacy Rules for its health care operations, in limited circumstances.

You and Your Family and Friends

We may use and disclose your medical information to communicate with you for purposes of customer service or to provide you with information you request. We may disclose your medical information to a family member, friend or other person to the extent necessary for him or her to assist with your health care or payment for your health care. Before we disclose your medical information to that person, we will give you a chance to object to us doing so. If you are not available, or if you are incapacitated or in an emergency situation, we may, in the exercise of our professional judgment, determine whether the disclosure would be in your best interest. We may also use or disclose your medical information to notify (or help notify, including identifying and locating) a family member, a personal representative or other person responsible for your care of your location, general condition or death.

Your Employer or Organization Sponsoring Your Group Health Plan

We may disclose summary information and enrollment information to your employer (or other plan sponsor). Summary information is a summary of the claims history, claims expenses or types of claims that members of your group health plan have filed. The summary information will not include demographic information about you or others in the group health plan, but your employer or plan sponsor may be able to identify individuals from the summary information provided.

Disaster Relief

We may use or disclose your medical information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

Public Benefit

We may use or disclose our members’ medical information as authorized by law for the following purposes that are in the public interest or benefit:

• As required by law.

• For public health activities, including disease and vital statistics reporting, child abuse reporting, FDA oversight, and to employers regarding work-related illness or injury.

• To report adult abuse, neglect or domestic violence.

• To health oversight agencies.

• In response to court and administrative orders and other lawful processes.

• To law enforcement officials in response to subpoenas and other lawful processes concerning crime victims, suspicious deaths, crimes on our premises, reporting crimes in emergencies and to identify or locate a suspect or other person.

• To coroners, medical examiners and funeral directors.

• To organ procurement organizations.

• To avert a serious threat to health or safety.

• In connection with certain research activities.

• To the military and to federal officials for lawful intelligence, counterintelligence and national security activities.

• To correctional institutions regarding inmates.

• As authorized by state workers’ compensation laws.

Your Authorization

Individual Rights

Access

Disclosure Accounting

Restriction

Confidential Communications

Even if we agree to communicate with you in confidence, an explanation of benefits we issue to the named insured for health care services the named insured (or others covered by the health plan) received might contain sufficient information (such as deductible and out-of-pocket amounts) to reveal that you obtained health care services for which we paid.

Amendment

Notice of Breach

We are required to notify affected individuals following a breach of unsecured medical information.

Electronic Notice

You may request a written copy of this notice at any time or download it from our website.

Privacy Questions and Complaints

If you want more information about our privacy practices, or if you have questions or concerns, please contact us using the information below.

We support your right to the privacy of your medical information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

Contact Information

Attn: Privacy Officer

I 20 East @ Alpine Road (AX-E01)

Columbia, SC 29219

(803) 264-7258 (telephone)

(803) 264-7257 (fax)

Privacy Policies

Declaraciónsobre las prácticas de privacidad

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