Privacy & Legal
Privacy & Legal
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.
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.
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.
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.
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.
You may give us written authorization to use your medical information or to disclose it to anyone for any purpose. You may revoke your authorization in writing at any time. However, this will not affect any uses and disclosures we made while your authorization was in effect. Without your written authorization, we will not use or disclose your medical information for any reason except those described in this notice.
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.
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.
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.
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.
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.
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. explanation.
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.
Attn: Privacy Officer
I 20 East @ Alpine Road (AC-200) Columbia, SC 29219
1. General Terms
1.2. The right to use the Site is personal to you and is not transferable to any other person or entity. You are responsible for protecting the confidentiality of your password and user name, if you have them. You may only use this Site to access information about you or your minor child. Do not use this Site to access information about any other person, including a friend or family member.
1.3. You acknowledge that the Site may experience service interruptions or events that are beyond Company’s control and that Company will not be responsible for any information you may lose while you are using the Site or when you transmit information to the Site via the Internet.
1.4. Your use of the Internet is solely at your own risk and is subject to all applicable state, national, and international laws and regulations.
1.5. You are required to provide your email address in order to use the Site. You agree we may use this email address to correspond with you regarding the Site and to send other communications to you. We also may retain this email address for such future use as we may determine. Additionally, we may send email responses to questions submitted to “Ask Customer Service” or “Ask Provider Services”. If you have not previously provided an email address in your registration profile, we will require an email address when you sign on in the future.
2. Information on the Site
2.1. Company has no legal duty to you to update information on the Site. This means information on the Site may be out of date at any given time. Company also may make improvements or changes to the information, products, or services described on the Site at any given time without notice.
2.2. We have attempted to make sure the contents of the Site are accurate and complete; but Company has no legal duty to you to ensure that the Site is correct in every respect. By using this Site, you agree not to hold Company liable for any inaccuracy of this information and you assume all the risks associated with its use.
2.3. We may modify, remove, or update information on the Site without notice. Company may change or terminate any feature of the Site, including, but not limited to, content, hours of availability, and equipment needed for access or use. Company may stop providing any information or category of information, may change or eliminate any transmission method, and may change transmission speeds or other aspects of the Site’s operation.
3. Proprietary Rights
3.1. This Site and all contents posted on the Site are the exclusive property of Company or are licensed to Company for its use. Company is the owner or licensee of the copyright in the entire content (including images, text, and look and feel attributes) of the Site and reserves all rights in that regard. Except as provided in Section 3.3, below, YOU MAY NOT POST, LINK, OR MAKE OTHER MODIFICATIONS TO THE SITE OR COPY MATERIAL FROM THE SITE WITHOUT COMPANY’S EXPRESS WRITTEN CONSENT.
3.2. Company does not transfer or grant any of its intellectual property or other rights to you, including any copyright, trademark, service mark or patent rights, all of which Company expressly reserves for itself. You may not remove or change any copyright notice on any material on the Site.
3.3. You may make reasonable use of the Site and content on the Site for your personal or household purposes, such as making a single copy of content on the Site for your personal records. You may not use content on the Site for any commercial purpose. You agree not to distribute, manipulate, create derivative works from, or use the information on this Site for any purpose other than as described above or as expressly authorized by Company. You acknowledge that you do not acquire any ownership rights by copying or downloading copyrighted material.
3.4. Any violation of this policy may result in copyright, trademark, or other intellectual property right infringement that may subject the you to civil and/or criminal penalties. The Site contains Company’s copyrighted material, trademarks, and other proprietary information, including, but not limited to, text, software, photos, video, graphics, music, and sound. This content is protected by copyright as a collective work under the United States copyright laws.
4. Other Websites
5. Limitation of Liability; Warranties
5.1. By using the Site, any programs or tools on the Site, and any third-party sites to which you may link through the Site you agree to (a) release Company from any and all claims, liabilities or damages related to such use and (b) accept all risks related to such use.
5.2. You agree not to hold Company responsible for any damages or injury, whether for breach of contract, tortious behavior, negligence, or under any other cause of action, caused by any failure of performance, error, omission, interruption, deletion, defect, delay in operation or transmission, computer virus, communication line failure, theft or destruction, or unauthorized access to, alteration of, or use of records or information made available on (a) the Site, (b) any program or other tool available at the Site, or (c) any third-party site to which you may link through the Site. Without limiting the foregoing, you specifically agree not to hold Company responsible for the defamatory, offensive, or illegal conduct of any third party using the Site.
5.3. ALL MATERIALS ON THIS SITE ARE PROVIDED AS IS, WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESS OR IMPLIED. COMPANY DISCLAIMS ANY AND ALL EXPRESS AND IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT..
5.4. COMPANY SHALL NOT BE LIABLE FOR ANY SPECIAL, INDIRECT, PUNITIVE, INCIDENTAL, OR CONSEQUENTIAL DAMAGES, INCLUDING, WITHOUT LIMITATION, LOST REVENUES OR LOST PROFITS, THAT MAY RESULT FROM THE USE OF THIS SITE, THE MATERIALS POSTED ON THE SITE, AND LINKS PROVIDED ON THIS SITE.
5.6. The Site is controlled and operated by the Company from offices in the United States. Company makes no representation that materials provided on the Site are appropriate or available for use in other locations and access to them from locations in which their contents are illegal is prohibited. Those who choose to access the Site from such other locations are responsible for compliance with applicable local laws.
6.2 You agree that any cause of action arising out of or related to the Site or your use of the Site must commence within one (1) year after the cause of action accrues. Otherwise, such cause of action is permanently barred.
6.4 By using this Site, you agree that any claim, suit or dispute resolution proceeding will be conducted only on an individual basis and not in a class or representative action.
7.1. Nothing contained, expressed, or implied in the Site is intended as, nor shall be construed or understood as, medical advice. No doctor-patient relationship is established between Company and you by reason of your use of the Site or under any circumstances whatsoever. The information in the Site is for general informational purposes only. If you have questions about medical issues or health information arising from your use of the Site, you should contact your own health professional.
7.2. Nothing contained, expressed, or implied in the Site is intended as, nor shall be construed or understood as, legal or financial advice, guidance, or interpretation. No attorney-client or accountant-client relationship is established between Company and you by reason of your use of the Site or under any circumstances whatever. The information in the Site is for general informational purposes only. If you have questions about any law, statute, regulation or requirement expressly or implicitly referenced in the Site, or its financial ramifications, you should contact your own legal counsel, financial professional, or both.
7.4. You agree that, if you experience any problems in using this Site or need to request assistance in using this Site, you should contact the following: 877-274-1715
Revised: February 7, 2018
The Information We Collect, Use, and Disclose
Information About Your Use of the Site: When you visit this Site, it automatically captures your domain name, the IP address of the Web page from which you enter the Site, the pages you visit on the Site, and the amount of time you spend on the Site. This information alone does not identify you to us. In addition, we collect information about the use of various features of the Site, such as the extent to which certain features are used and the links or information that users access. We use this information to better understand how the Site is used, to improve and expand the Site, and to enhance your and other users’ experience with the Site.
We may hire third-party contractors to monitor, evaluate, and help improve users’ experience on our website. These contractors may have access to the information described above, subject to contractual obligations to comply with privacy and security requirements.
Protected Health Information. The Site includes pages that give you the opportunity to provide us with personal information about yourself. You are not required to provide personal information to use the Site, but personal information is necessary for certain functions of the Site. Personal information you provide to us on this Site(“Protected Health Information”) is subject to the HIPAA Privacy Rule. When Company collects Protected Health Information on this Site, Company’s HIPAA Privacy Practices Notice (please view the Privacy Practices section), describes how the Protected Health Information may be used and disclosed and the rights you have with respect to the information.
Once you download Protected Health Information from the Site, it is your responsibility to safeguard the information. We are not responsible for any third party’s access to your Protected Health Information once you have downloaded it.
Privacy and Security
Company is committed to taking appropriate measures to protect your privacy against unauthorized disclosures. Company and its third-party web vendor use a variety of safeguards and techniques designed to protect the confidentiality,integrity, and (when appropriate) availability of your information. You should be aware, however, that website security technology changes rapidly and that any security system can be “hacked.” Accordingly, we cannot guarantee that these safeguards will ensure the safety of your information in all situations or that your information will not be intercepted while being transmitted to or by us over the Internet. In any event, Company is not responsible for (and not liable for) third parties’ illegal or criminal activity.
The Site may contain links to websites of third parties that you may access.These websites have their own privacy policies and we recommend that you review those policies before using those websites. We cannot control the information disclosed to or by these third-party websites or how that information is used and disclosed.
The Site is not directed at children under the age of 13. Company complies with the Children’s Online Privacy Protection Act (“COPPA”) and does not knowingly permit registration or submission of Protected Health Information by anyone younger than 13 years of age without the consent of a parent or guardian. To best protect your child’s privacy, please carefully supervise your child’s access to the Internet and this Site. For more information on how to protect your child’s privacy, you can visit the Federal Trade Commission’s Kids privacy page, accessible via www.ftc.gov.
Notice for Users Outside of the United States
To contact us regarding this policy and our related privacy practices, please contact us at:
Attn: Privacy Officer
I 20 East @ Alpine Road (AC-200) Columbia, SC 29219
If you believe we or any company associated with us has misused any of your information please contact us immediately and report such misuse.