Maintaining Your Privacy. Delta Dental has always respected and carefully preserved the privacy and confidentiality of Subscribers, Members, and their Dependents. As part of that protection, compliance with all state and federal laws regarding privacy of personal and health information is maintained. By receiving coverage pursuant to this dental plan, each Pediatric Enrollee, including a parent or guardian in the case of a minor Dependent, agrees that, except as restricted by applicable state and federal laws, Northeast Delta Dental may have access to all dental and health records, and medical data from Dentists, ODPs, and other health care providers for reasons of essential insurance functions; claims administration; claims adjustment and the management, detection, investigation, or reporting of actual or potential fraud; misrepresentation or criminal activity; underwriting; policy placement or issuance; loss control; ratemaking and guaranty fund functions; reinsurance and excess loss insurance; risk management; case management; disease management; quality assurance; or quality improvement; performance evaluation; provider credentialing verification; utilization review; peer review activities; actuarial, scientific, medical or public policy research; grievance procedures; internal administration of compliance, managerial, and information systems; policyholder service functions; auditing; reporting; database security; administration of consumer disputes and inquiries; external accreditation standards; the replacement of a group benefit plan or workers’ compensation policy or program; activities in connection with a sale, merger, transfer or exchange of all or part of a business or operating unit. For a copy of Delta Dental’s Notice of Privacy Practices which describes in detail our respective privacy practices, or if you have any questions about the privacy of your health information, please contact: Privacy Officer Northeast Delta Dental Xxx Xxxxx Xxxxx PO Box 2002 Concord, NH 03302-2002 1-800- 537-1715
