SENIOR HEALTH INSURANCE COMPANY OF PENNSYLVANIA (IN REHABILITATION) INFORMATION PRIVACY PRACTICES NOTICE
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.
This Privacy Notice is applicable to the long-term care insurance business of Senior Health Insurance Company of Pennsylvania (In Rehabilitation). Our goal is to provide you with high-quality services. To do that, we may collect, use, and disclose health information about you. We realize we have an important responsibility to protect the privacy and security of your health information. We are providing this notice to give you a better understanding of our privacy and security policies. Uses and disclosures of health information not described in this notice will be made only with your written authorization.
The terms "information" and "health information" in this notice include any information we maintain that reasonably can be used to identify you and that relates to your physical or mental health condition, the provision of health care to you, or the payment for such health care.
Uses and Disclosures of Your Health Information
We may use or disclose health Information as described below. Please note that your policy is administered by Long Term Care Group, Inc.
For Treatment: We do not make treatment decisions, but we may disclose health information to those who do. For example, we may disclose information regarding your benefits to doctors, hospitals, long-term care facilities and other health care providers who take care of you.
For Claim Processing and Payment Related Purposes: We may use and disclose your health information for benefit verification and claim processing purposes. For instance, we may use information regarding long term care services you receive from service providers such as nursing homes, assisted living facilities, and home health care agencies to process and pay claims. Other examples of payment related purposes for which may use or disclose health information include authorizing covered services, collecting premiums and obtaining payment from reinsurers.
For Health Care Operations: We may use and disclose your health information as necessary to operate and manage our business. For example, we may use health information for underwriting, premium rating, customer service, reinsurance, regulatory compliance, and fraud prevention and reporting.
To Communicate With Family and Friends Involved in Your Care: We may from time to time disclose your health information to certain family members, friends and others who are involved in your care or in the payment for your care. If you are unavailable, incapacitated or facing an emergency medical situation and we determine that a limited disclosure is in your best interest, we may share limited health information with such individuals without your written authorization. If you have designated a person to help prevent the unintentional lapse of your coverage, we will inform that person prior to terminating the policy for nonpayment of premium. We may also disclose limited health information to a public or private entity that is authorized to assist in disaster relief efforts in order for that entity to locate a family member or other persons who may be involved in some aspect of caring for you.
Other Uses and Disclosures for Public Health, Government Oversight, or Similar Activities
We also may use or disclose health information as follows:
We may use or disclose your health information as required by law
We may disclose your health information to law enforcement officials as allowed by law
We may use or disclose your health information for public health activities, such as permitted reporting of disease, injury, or death and for required public health investigations
We may disclose your health information as required by law if we believe you to be a victim of abuse, neglect, or domestic violence
We may disclose your health information if required by law to a government oversight agency conducting audits, investigations (such as investigations into consumer complaints) or civil or criminal proceedings
We may disclose your health information if required to do so by a court or administrative ordered subpoena or discovery request
We may use or disclose your health information to prevent criminal activity, fraud, material misrepresentation, or material non-disclosure in connection with your coverage or application for coverage
We may disclose your health information to a coroner, medical examiner, or funeral director as allowed by law
We may use or disclose your health information to facilitate organ, eye, or tissue donation or transplantation
We may use or disclose your health information for research purposes as allowed by law but subject to certain privacy controls
We may use or disclose your health information to avert a serious and imminent threat to the health and safety of a person or the public
We may use or disclosure your health information for certain specialized government functions such as military and veterans activities, national security and intelligence activities, and medical suitability determinations and activities related to correctional institutions and other custodial situations
We may disclose your health information to comply with workers compensation laws
Your rights with respect to your health information are explained below. Any written requests to exercise your rights should be directed to the address provided at the end of this notice.
Right to Access. You have the right to inspect and copy health information we may use to make decisions about you. All requests must be made in writing and signed by you or your representative. We may charge a reasonable fee for copies and postage.
Right to Confidential Communications. You have the right to request that you receive communications of health information by alternative means or at alternative locations, if all or part of the information could endanger you. For example, you may ask that we contact you at work, rather than at home. We will accommodate reasonable requests.
Right to Amend. You have the right to request in writing that Personal Information that we maintain about you be amended or corrected. We are not obligated to make all requested amendments but will give each request careful consideration. All amendment requests, in order to be considered by us, must be in writing, signed by you or your representative, and must state the reasons for the amendment/correction request. If an amendment or correction you request is made by us, we may also notify others who work with us and have copies of the uncorrected record if we believe that such notification is necessary.
Right to an Accounting of Certain Disclosures. You have the right to receive an accounting of certain disclosures made by us of your health information. Requests must be made in writing and signed by you or your representative. The first accounting in any 12-month period is free; you may be charged a reasonable fee for each subsequent accounting you request within the same 12-month period.
Right to Request Restrictions. You have the right to request restrictions on certain of our uses and disclosures of your health information for payment, or health care operations by notifying us of your request for a restriction in writing. Your request must describe in detail the restriction you are requesting. We are not required to agree to your request but will attempt to accommodate reasonable requests when appropriate and we retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate in writing any agreed-to restriction by sending such termination notice to us at the address given below.
Right to Revoke Your Authorization. If you have signed an authorization for uses and disclosures not related to payment or health care operations, you have the right to revoke that authorization in writing at any time, except to the extent that we have taken action in reliance on the authorization, or if other law provides us with the right to contest a claim under the policy or the policy itself. Note: your revocation will not prevent us from using collected information in conjunction with our fraud prevention program.
Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy.
If you believe your privacy rights have been violated, you can file a complaint with us by sending your written complaint to us at the address given below. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
To file a complaint or to make a request as described in the section titled "Your Rights," please send your written request to:
Senior Health Insurance Company of Pennsylvania (In Rehabilitation)
P.O. Box 64913
St. Paul, MN 55164
Please be sure to include the following information:
Your Full Name
Date of birth
The nature of your request or complaint.
Additional Restrictions on Use and Disclosures
Certain state or federal laws may require special privacy protections for highly sensitive information, such as information about HIV/AIDS, mental health, genetic tests, alcohol and drug abuse, sexually transmitted diseases, or abuse or neglect, including sexual assault. If any law requires us to provide you with greater privacy protections than are stated in this notice, we will comply with that law.
A Final Word
We are committed to maintaining the security and confidentiality of your health information, and we are required by law to maintain the privacy of your health information. We also are required to provide you with a copy of this notice and abide by its terms so long as it is in effect. We maintain reasonable physical, administrative, and electronic security measures to protect your information. If there is any breach of your unsecured health information, we are required to notify you
We do not sell your health information but are required by law to inform you that any sale of health information would require your written authorization. We may not use or disclose protected health information for marketing purposes without your written authorization, except for face-to-face communications and promotional gifts of nominal value. We also may not use or disclose psychotherapy notes without your authorization.
We typically will retain your personal information for a period of time after the end of a customer relationship. In some cases, we may be required to retain certain information for a certain amount of time by law or by industry standard. We maintain the same standards of privacy and security after the customer relationship has ended as we do for current customers.
Changes to Our Privacy or Security Practices
We reserve the right to change any of our privacy or security practices and the terms of this notice, and to make the new notice effective for all health information maintained by us. In the event of a material change, we will mail a revised notice to all of our policyholders.
For Further Information
If you would like to exercise your right to opt out of information sharing you may contact us by
(1) calling us at 1-877-450-5824, (2) writing to us at the address above, or (3) emailing us at firstname.lastname@example.org.
Effective Date: October 31, 2017