May disclose to your employer for plan administration in limited situations
For group health insurance plans, Aetna may disclose health information to your employer for plan administration in two situations: when it has been informed that appropriate language has been included in the plan documents, or when only summary data is disclosed to assist in bidding or amending a group health plan.
Supporting quotations
We also may disclose such information in support of:
Plan Administration – to your employer (for group health insurance plans), when we have been informed that appropriate language has been included in your plan documents, or when summary data is disclosed to assist in bidding or amending a group health plan.
Qualifications & exceptions
Applies to group health insurance plans only.
Conditioned on either appropriate plan-document language or summary data only.
Not stated here
The notice does not say what the "appropriate language" must be.
Sharing & Disclosure · Permission or license
May disclose to researchers if measures protect your privacy
Aetna may disclose health information to researchers, provided measures are taken to protect your privacy.
Supporting quotations
We also may disclose such information in support of:
Research – to researchers, provided measures are taken to protect your privacy.
Qualifications & exceptions
Conditioned on privacy-protecting measures being taken.
Not stated here
The measures are not described.
Sharing & Disclosure · Permission or license
May disclose to service providers who assure they will protect it
Aetna may disclose health information to persons who provide services to it and assure it they will protect the information.
Supporting quotations
We also may disclose such information in support of:
Business Partners – to persons who provide services to us and assure us they will protect the information.
Qualifications & exceptions
Conditioned on the service provider assuring Aetna that it will protect the information.
Not stated here
The notice does not describe the kind of assurance or name the service providers.
Sharing & Disclosure · Permission or license
May disclose to regulators, for workers' compensation and as required by law
Aetna may disclose health information to state insurance departments, boards of pharmacy, the U.S. Food and Drug Administration, the U.S. Department of Labor and other government agencies that regulate it; to comply with workers' compensation laws; and to comply with legal obligations and requirements.
Supporting quotations
We also may disclose such information in support of:
Industry Regulation – to state insurance departments, boards of pharmacy, U.S. Food and Drug Administration, U.S. Department of Labor and other government agencies that regulate us.
Workers’ Compensation – to comply with workers’ compensation laws.
As Required by Law – to comply with legal obligations and requirements.
Qualifications & exceptions
The regulator list ends with "other government agencies that regulate us," so it is not limited to the named agencies.
Sharing & Disclosure · Permission or license
May disclose to law enforcement and in response to court orders or lawful process
Aetna may disclose health information to federal, state and local law enforcement officials, and in response to a court order or other lawful process.
Supporting quotations
We also may disclose such information in support of:
Law Enforcement – to federal, state, and local law enforcement officials.
Legal Proceedings – in response to a court order or other lawful process.
Qualifications & exceptions
The law enforcement item states no further condition in this text; the legal-proceedings item requires a court order or other lawful process.
Not stated here
The notice does not say what conditions apply to law enforcement requests.
Sharing & Disclosure · Permission or license
May disclose for matters of public interest as required or permitted by law
Aetna may disclose health information to address matters of public interest as required or permitted by law, such as child abuse and neglect, threats to public health and safety, and national security.
Supporting quotations
We also may disclose such information in support of:
Public Welfare – to address matters of public interest as required or permitted by law (e.g., child abuse and neglect, threats to public health and safety, and national security).
Qualifications & exceptions
Limited to what is required or permitted by law; the examples are introduced by "e.g." and are not exhaustive.
Sharing & Disclosure · Permission or license
May disclose to coroners, funeral directors and organ donation groups
Aetna may disclose health information to a coroner or medical examiner to identify a deceased person, determine a cause of death, or as authorized by law; to funeral directors as necessary to carry out their duties; and to organ donation groups to facilitate donation and transplantation.
Supporting quotations
We also may disclose such information in support of:
Decedents – to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or as authorized by law; and to funeral directors as necessary to carry out their duties.
Organ Procurement – to respond to organ donation groups for the purpose of facilitating donation and transplantation.
Qualifications & exceptions
Funeral director disclosures are limited to what is necessary for their duties.
Sharing & Disclosure · Company commitment
Must disclose to you or your representative and to the federal health department
Aetna says it must use and disclose personal information to you or someone with the legal right to act for you (your personal representative) in order to administer your rights under the notice, and to the Secretary of the Department of Health and Human Services as necessary for HIPAA compliance and enforcement.
Supporting quotations
Required Disclosures: We must use and disclose your personal information in the following manner:
To you or someone who has the legal right to act for you (your personal representative) in order to administer your rights as described in this notice; and
To the Secretary of the Department of Health and Human Services, as necessary, for HIPAA compliance and enforcement purposes.
Qualifications & exceptions
Stated as "must," unlike the "may" disclosures above.
Disclosure to the federal health department is limited to what is necessary for HIPAA compliance and enforcement.
Sharing & Disclosure · Permission or license
May disclose to relatives, friends, the subscriber or others you identify when relevant to your care or payment
Aetna may disclose personal information to a relative, a friend, the subscriber of your health benefits plan or any other person you identify, provided the information is directly relevant to that person's involvement with your health care or payment for it. For example, if a family member or caregiver calls with prior knowledge of a claim, Aetna may confirm whether the claim has been received and paid.
Supporting quotations
Disclosure to Others Involved in Your Health Care
We may disclose personal information about you to a relative, a friend, the subscriber of your health benefits plan or any other person you identify, provided the information is directly relevant to that person’s involvement with your health care or payment for that care.
For example, if a family member or a caregiver calls us with prior knowledge of a claim, we may confirm whether or not the claim has been received and paid.
Qualifications & exceptions
Limited to information directly relevant to that person's involvement in your care or payment.
The recipient can be the plan subscriber, who may be a different person from the member.
Sharing & Disclosure · User right or choice
You can stop or limit disclosures to people involved in your care by phone
The notice says you have the right to stop or limit disclosures to relatives, friends, the subscriber and others involved in your care by calling the toll-free Privacy Compliance Department number, 1-800-264-4000.
Supporting quotations
You have the right to stop or limit this kind of disclosure by calling the toll-free Privacy Compliance Department number at 1-800-264-4000.
Minors may be able to block parental access if state law permits
If you are a minor, you may also have the right to block parental access to your health information in certain circumstances, if state law permits. You can contact Aetna at the toll-free Privacy Compliance Department number, 1-800-264-4000, or have your provider contact Aetna.
Supporting quotations
If you are a minor, you also may have the right to block parental access to your health information in certain circumstances, if permitted by state law. You can contact us using the toll-free Privacy Compliance Department number at 1-800-264-4000 – or have your provider contact us.
Qualifications & exceptions
Depends on "certain circumstances" and on state law permitting it.
Not stated here
The notice does not say which circumstances or which states' laws apply.
Sharing & Disclosure · Restriction or exception
Disclosed health information may be redisclosed and lose HIPAA protection
The notice warns that protected health information (PHI) disclosed as permitted by HIPAA may be redisclosed by the recipient and no longer protected by HIPAA.
Supporting quotations
PHI disclosed as permitted by HIPAA may be subject to redisclosure by the recipient and no longer protected by HIPAA.
Qualifications & exceptions
Applies to PHI disclosed as HIPAA permits.
Sharing & Disclosure · User right or choice
You can ask for a list of certain disclosures; repeat requests within 12 months may carry a fee
You have the right to ask Aetna for a list of certain disclosures it has made about you, such as disclosures of health information to government agencies that license it. The request must be in writing. If you ask for such an accounting more than once in a 12-month period, Aetna may charge a reasonable fee.
Supporting quotations
You have the right to ask us to provide a list of certain disclosures we have made about you, such as disclosures of health information to government agencies that license us. Your request must be in writing. If you request such an accounting more than once in a 12-month period, we may charge a reasonable fee.
Qualifications & exceptions
Covers "certain" disclosures; the written request is required; a fee may apply only after more than one request in 12 months.
Not stated here
The notice does not say which disclosures are included or excluded.
Sharing & Disclosure · Company practice
"Aetna" and "we" mean the HMO and insurer subsidiaries that share information as one covered entity
A footnote says that in this notice "Aetna," "we," "us" and "our" refer to all of the HMO and licensed insurer subsidiaries of Aetna Inc. These entities are designated a single affiliated covered entity for federal privacy purposes, and its members can share protected health information (PHI) with each other for the treatment, payment and health care operations of that group and as HIPAA and the notice allow. A full list of members is available from the Aetna Privacy Office at PrivacyAetna@aetna.com.
Supporting quotations
“Aetna” and the pronouns “we,” “us” and “our” refer to all of the HMO and licensed insurer subsidiaries of Aetna
These entities have been designated as a single affiliated covered entity for federal privacy purposes. The members of the Aetna ACE can share Protected Health Information (PHI) with each other. We do this for the treatment, payment and health care operations of the Aetna ACE and as allowed by HIPAA and this Notice.
For a full list of the members of the Aetna ACE, contact the Aetna Privacy Office at PrivacyAetna@aetna.com.
Qualifications & exceptions
Sharing inside the group is for treatment, payment and health care operations of the group and as HIPAA and the notice allow.
The sentence is split across two source blocks by a page break ("Aetna" / "Inc.").
Not stated here
The notice does not list the member entities; it points to the Privacy Office for the list.
Sharing & Disclosure · Permission or license
Information may be used to facilitate a sale, merger or consolidation, including due diligence
One listed operational activity is facilitating a sale, transfer, merger or consolidation of all or part of Aetna with another entity, including due diligence related to that activity. The notice treats this as a use and disclosure of personal information within health care operations.
Supporting quotations
facilitation of a sale, transfer, merger or consolidation of all or part of Aetna with another entity (including due diligence related to such activity)
Qualifications & exceptions
Listed among health care operations activities.
Not stated here
The notice does not say what information is disclosed or to whom in such a transaction.
Sharing & Disclosure · Company practice
Explanation of Benefits forms are mailed to the subscriber's address on record
Aetna says it mails Explanation of Benefits forms and other information to the address it has on record for the subscriber, meaning the primary insured. The subscriber can be a different person from the member, such as the primary insured for an adult dependent. Elsewhere the notice describes a right to request communications at a different address and a way to stop paper mailing.
Supporting quotations
We also mail Explanation of Benefits forms and other information to the address we have on record for the subscriber (i.e., the primary insured).
Qualifications & exceptions
The address used is the subscriber's, not necessarily the member's.
Sharing & Disclosure · Permission or license
May disclose information to health care providers who treat you
Aetna may disclose information to doctors, dentists, pharmacies, hospitals and other health care providers who take care of you. For example, doctors may request medical information from Aetna to supplement their own records. Aetna also may use personal information in providing mail order pharmacy services and in sending certain information to doctors for patient safety or other treatment-related reasons.
Supporting quotations
In administering your health benefits we may use and disclose personal information about you in various ways, including:
Treatment: We may disclose information to doctors, dentists, pharmacies, hospitals, and other health care providers who take care of you.
For example, doctors may request medical information from us to supplement their own records. We also may use personal information in providing mail order pharmacy services and by sending certain information to doctors for patient safety or other treatment-related reasons.
Qualifications & exceptions
Stated as "may"; recipients are providers who take care of you.
Sharing & Disclosure · Permission or license
May disclose information to other covered entities and their business associates
Aetna may disclose personal information to other covered entities, or business associates of those entities, for treatment, payment and certain health care operations purposes. For example, for a group health insurance plan, it may disclose personal information to other health plans maintained by your employer if arranged, so that certain expenses can be reimbursed.
Supporting quotations
In administering your health benefits we may use and disclose personal information about you in various ways, including:
Disclosures to Other Covered Entities: We may disclose personal information to other covered entities, or business associates of those entities for treatment, payment and certain health care operations purposes.
For example, if you receive benefits through a group health insurance plan, we may disclose personal information to other health plans maintained by your employer if it has been arranged for us to do so in order to have certain expenses reimbursed.
Qualifications & exceptions
Purposes are limited to treatment, payment and "certain" health care operations.
The employer-plan example applies to group health insurance plans and only if arranged.
Not stated here
The notice does not say which health care operations purposes are covered by "certain."