Common use of Notice of Information Use and Disclosure Clause in Contracts

Notice of Information Use and Disclosure. We may collect, use, or disclose certain information about you. This protected personal information (PPI) may include health information, or personal data such as your address, telephone number or Social Security number. We may receive this information from, or release it to, health care providers, insurance companies, or other sources. This information is collected, used or released for conducting routine business operations such as:  Determining your eligibility for benefits and paying claims  Coordinating benefits with other health care plans  Conducting care management, case management, or quality reviews  Fulfilling other legal obligations that are specified under the contract  This information may also be collected, used or released as required or permitted by law. To safeguard your privacy, we take care to ensure that your information remains confidential by having a company confidentiality policy and by requiring all employees to sign it. If a disclosure of PPI is not related to a routine business function, we remove anything that could be used to easily identify you or we obtain your prior written authorization. You also have the right to request inspection and/or amendment of records retained by us that contain your PPI. Please contact Customer Service and ask that a request form be mailed to you.

Notice of Information Use and Disclosure. We may collect, use, or disclose certain information about you. This protected personal information (PPI) may include health information, or personal data such as your address, telephone number or Social Security number. We may receive this information from, or release it to, health care providers, insurance companies, or other sources. This information is collected, used or released for conducting routine business operations such as:  • Determining your eligibility for benefits and paying claims  • Coordinating benefits with other health care plans  • Conducting care management, case management, or quality reviews  • Fulfilling other legal obligations that are specified under the contract  • This information may also be collected, used or released as required or permitted by law. To safeguard your privacy, we take care to ensure that your information remains confidential by having a company confidentiality policy and by requiring all employees to sign it. If a disclosure of PPI is not related to a routine business function, we remove anything that could be used to easily identify you or we obtain your prior written authorization. You also have the right to request inspection and/or amendment of records retained by us that contain your PPI. Please contact Customer Service and ask that a request form be mailed to you.