This notice combines three required yearly communications
Anthem says it is required to send members, each year, specific information about their rights and some of its duties to help keep their information safe. This one notice combines three of those required yearly communications: a state notice of privacy practices, a HIPAA notice of privacy practices, and a notice about breast reconstruction surgery benefits.
Supporting quotations
Notice of privacy practices
Each year, we’re required to send you specific information about your rights and some of our duties to help keep your information safe
This notice combines three of these required yearly communications:
State notice of privacy practices
Health Insurance Portability and Accountability Act (HIPAA) notice of privacy practices
Breast reconstruction surgery benefits
Qualifications & exceptions
The notice is addressed to people who receive it from Anthem as members; the source text does not say which plans or states each part covers beyond what the later sections state.
Account & Service Control · Procedure
Members can sign up to get these notices by email
Anthem invites members to go paperless: on anthem.com a member can sign up to get these notices by email and to read them online or on the mobile app next time.
Supporting quotations
Would you like to go paperless and read this online or on our mobile app next time? Go to anthem.com and sign up to get these notices by email.
Not stated here
The source does not say whether signing up replaces the paper mailing for all notices or only these yearly ones, or what happens to the paper copy.
Legal Rights & Agreement Rules · Company commitment
Anthem follows state law, which is sometimes stricter than HIPAA
For the state notice, Anthem says that in handling health information it follows relevant state laws, which are sometimes stricter than the federal HIPAA privacy law. The state notice explains the member's rights and Anthem's duties under state law and applies to health, dental, vision and life insurance benefits the member may have.
Supporting quotations
State notice of privacy practices
we follow relevant state laws, which are sometimes stricter than the federal HIPAA privacy law
Explains your rights and our duties under state law.
Applies to health, dental, vision, and life insurance benefits you may have.
Qualifications & exceptions
The notice applies to those benefits only to the extent a member 'may have' them.
'Sometimes stricter' is the source's own limit: it does not say which state laws are stricter or in which respects.
Not stated here
The state notice does not name any state or state law.
Sharing & Disclosure · User right or choice
A member's state may give additional rights to limit sharing
Anthem says a member's state may give additional rights to limit the sharing of health information. For details, the member should call the Member Services phone number on the health plan ID card.
Supporting quotations
Your state may give you additional rights to limit sharing your health information.
Please call the Member Services phone number on your health plan ID card for more details.
Qualifications & exceptions
Whether any additional right exists depends on the member's state; the notice states only that it may.
Not stated here
The paragraph lists no state right; it only directs the member to call Member Services.
Data Access & Collection · Context
Personal information (PI) is nonpublic information that identifies you
In the state notice, nonpublic (private) personal information (PI) is information that identifies a member and is often gathered in an insurance matter. Anthem says it may collect, use and share PI as the notice describes, and that its goal is to protect PI because PI can be used to make judgments about a person's health, finances, character, habits, hobbies, reputation, career and credit.
Supporting quotations
Your personal information
Your nonpublic (private) personal information (PI) identifies you and it’s often gathered in an insurance matter.
We may collect, use, and share your PI as described in this notice.
Our goal is to protect your PI because your information can be used to make judgments about your health, finances, character, habits, hobbies, reputation, career, and credit.
Qualifications & exceptions
'Often gathered in an insurance matter' is a description, not a limit on what counts as PI in this notice.
Account & Service Control · User right or choice
Members have the right to see and correct their PI
The state notice says a member has the right to see and correct their personal information (PI). The state notice text does not itself describe how to make a request.
Supporting quotations
You have the right to see and correct your PI.
Not stated here
The state notice does not say how a PI request is made or what limits apply. The later HIPAA 'Your rights' section describes written requests for PHI; the source does not say those steps also govern PI.
Data Access & Collection · Company practice
Anthem may receive PI from doctors, hospitals or other insurers
Anthem says it may receive a member's PI from others, such as doctors, hospitals, or other insurance companies.
Supporting quotations
We may receive your PI from others, such as doctors, hospitals, or other insurance companies.
Qualifications & exceptions
'Such as' makes the three examples illustrative, not a complete list of sources.
Sharing & Disclosure · Company practice
Anthem may share PI outside the company, in some cases without approval
Anthem says it may share a member's PI with others outside the company, in some cases without the member's approval, while taking reasonable measures to protect the information.
Supporting quotations
We may also share your PI with others outside our company — without your approval, in some cases.
But we take reasonable measures to protect your information.
Qualifications & exceptions
'In some cases' limits the without-approval sharing to unspecified cases.
The protective measures are described only as 'reasonable'.
Not stated here
This paragraph does not name the recipients or the cases in which approval is not needed.
Sharing & Disclosure · User right or choice
Where an activity requires an opt-out chance, Anthem says it will tell members how
If an activity requires Anthem to give a member a chance to opt out, Anthem says it will let the member know, and will explain how to tell it that the member does not want PI used or shared for an activity the member can opt out of.
Supporting quotations
If an activity requires us to give you a chance to opt out, we’ll let you know, and we’ll let you know how to tell us you don’t want your PI used or shared for an activity you can opt out of.
Qualifications & exceptions
Applies only to an activity that requires an opt-out chance; the notice does not say which activities those are.
Not stated here
This paragraph does not identify which activities carry an opt-out or how to opt out.
Legal Rights & Agreement Rules · Company commitment
Anthem keeps current and former members' information private as required
Anthem says it keeps the health and financial information of current and former members private as required by law, accreditation standards, and its own internal rules, and that federal law requires it to give this notice explaining members' rights and Anthem's legal duties and privacy practices.
Supporting quotations
HIPAA notice of privacy practices
We keep the health and financial information of our current and former members private as required by law, accreditation standards, and our own internal rules.
We’re also required by federal law to give you this notice to explain your rights and our legal duties and privacy practices.
Qualifications & exceptions
The privacy commitment is framed as keeping information private 'as required by' law, accreditation standards and internal rules; later sections set out the uses and sharing the notice allows.
Legal Rights & Agreement Rules · Context
The HIPAA notice describes use, disclosure and access for medical, vision and dental information
A capitalized statement at the head of the notice says that it describes how medical, vision and dental information about the member may be used and disclosed, and how the member can get access to that information, and asks the member to read it carefully.
Supporting quotations
THIS NOTICE DESCRIBES HOW MEDICAL, VISION, AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Qualifications & exceptions
This statement lists medical, vision and dental information; the state notice above separately lists life insurance benefits.
Use & Processing · Permission or license
Anthem may collect, use and share PHI as the law allows or requires
Anthem says there are times it may collect, use and share a member's Protected Health Information (PHI) as allowed or required by law, including the HIPAA Privacy rule, and then lists some of those times: payment, healthcare operations and treatment activities, with examples.
Supporting quotations
Your protected health information
There are times we may collect, use, and share your Protected Health Information (PHI) as allowed or required by law, including the HIPAA Privacy rule.
Here are some of those times:
Qualifications & exceptions
'Some of those times' means the list that follows is not stated to be complete.
Use & Processing · Company practice
PHI is used and shared to manage accounts and benefits and pay claims
For payment, Anthem says it collects, uses and shares PHI to take care of a member's account and benefits or to pay claims for healthcare the member gets through the plan.
Supporting quotations
Payment: We collect, use, and share PHI to take care of your account and benefits or to pay claims for healthcare you get through your plan.
Use & Processing · Company practice
PHI is used and shared for Anthem's healthcare operations
Anthem says it collects, uses and shares PHI for its healthcare operations. This paragraph does not itself say what those operations include.
Supporting quotations
Healthcare operations: We collect, use, and share PHI for our healthcare operations.
Not stated here
The source does not define healthcare operations in this paragraph; the examples after it (such as quality review) may illustrate it, but the notice does not say they are the whole of it.
Use & Processing · Company practice
Anthem does not provide treatment but uses and shares treatment information to offer services
Anthem says it does not provide treatment, but it collects, uses and shares information about a member's treatment to offer services that may help the member, including sharing information with others who provide the member treatment.
Supporting quotations
Treatment activities: We don’t provide treatment, but we collect, use, and share information about your treatment to offer services that may help you, including sharing information with others providing you treatment.
Qualifications & exceptions
Anthem disclaims providing treatment itself.
Data Access & Collection · Company practice
Example: Anthem keeps premium and deductible payment information on file
As an example of how it uses information, Anthem says it keeps information on file about a member's premium and deductible payments.
Supporting quotations
Examples of ways we use your information:
We keep information on file about your premium and deductible payments.
Qualifications & exceptions
Offered as an example of a use, within a list the notice calls examples.
Sharing & Disclosure · Company practice
Example: Anthem may give information to a doctor's office to confirm benefits
As an example, Anthem says it may give information to a doctor's office to confirm a member's benefits.
Supporting quotations
We may give information to a doctor’s office to confirm your benefits.
Qualifications & exceptions
'May' makes this a permitted use, not a statement that it always happens.
Sharing & Disclosure · Company practice
Example: Anthem may share a member's explanation of benefits with the plan subscriber
As an example, Anthem says it may share a member's explanation of benefits (EOB) with the subscriber of the plan for payment purposes. The subscriber is the person who holds the plan, who may be a different person from the member whose benefits the EOB describes.
Supporting quotations
We may share your explanation of benefits (EOB) with the subscriber of your plan for payment purposes.
Qualifications & exceptions
Stated purpose is payment.
Not stated here
The notice does not say what an EOB contains or what limits apply when the member and subscriber differ.
Sharing & Disclosure · Company practice
Example: Anthem may share PHI with a doctor or hospital so they can treat the member
As an example, Anthem says it may share PHI with a member's doctor or hospital so that they may treat the member.
Supporting quotations
We may share PHI with your doctor or hospital so that they may treat you.
Use & Processing · Company practice
Example: Anthem may use PHI to review the quality of care and services
As an example, Anthem says it may use PHI to review the quality of care and services a member gets.
Supporting quotations
We may use PHI to review the quality of care and services you get.
Use & Processing · Company practice
Example: Anthem may use PHI to help with services for conditions like asthma, diabetes or traumatic injury
As an example, Anthem says it may use PHI to help a member with services for conditions like asthma, diabetes, or traumatic injury.
Supporting quotations
We may use PHI to help you with services for conditions like asthma, diabetes, or traumatic injury.
Qualifications & exceptions
'Conditions like' makes the three conditions illustrative.
Data Access & Collection · Company practice
Example: Anthem may collect and use public and commercially available data about members
As an example, Anthem says it may collect and use publicly and/or commercially available data about a member to support the member and help the member get health plan benefits and services.
Supporting quotations
We may collect and use publicly and/or commercially available data about you to support you and help you get health plan benefits and services.
Qualifications & exceptions
The stated purpose is to support the member and help the member get plan benefits and services.
Not stated here
The source does not say which data or which commercial sources are meant.
Use & Processing · Company practice
Example: Anthem may use PHI with technology to support and enable services
As an example, Anthem says it may use PHI with technology to support and enable services provided to a member.
Supporting quotations
We may use PHI with technology to support and enable services provided to you.
Not stated here
The source does not say what technology is used.
Use & Processing · Permission or license
Example: Anthem may use PHI to create, use or share de-identified data as HIPAA allows
As an example, Anthem says it may use a member's PHI to create, use, or share de-identified data as allowed by HIPAA.
Supporting quotations
We may use your PHI to create, use, or share de-identified data as allowed by HIPAA.
Qualifications & exceptions
Limited to what HIPAA allows for de-identified data.
Not stated here
The source does not say who may receive de-identified data or for what purposes.
Sharing & Disclosure · User right or choice
Example: Anthem may share PHI with health information exchanges
As an example, Anthem says it may use and share PHI directly or indirectly with health information exchanges for payment, healthcare operations, and treatment. A member who does not want PHI shared in these situations is directed to anthem.com/privacy for more information.
Supporting quotations
We may also use and share PHI directly or indirectly with health information exchanges for payment, healthcare operations, and treatment.
If you don’t want your PHI to be shared in these situations, visit anthem.com/privacy for more information.
Qualifications & exceptions
Purposes are limited to payment, healthcare operations and treatment.
Not stated here
The anthem.com/privacy page is not part of the supplied source, so how to stop this sharing is not stated here.
Account & Service Control · User right or choice
Anthem must give members access to their own PHI
Anthem says it must give members access to their own PHI.
Supporting quotations
Sharing your PHI with you: We must give you access to your own PHI.
Not stated here
How to request access is not described in this paragraph.
Use & Processing · Company practice
Anthem may contact members about treatment options, benefits and other plans
Anthem says it may contact a member about treatment options or other health-related benefits and services. When a member or dependent reaches a certain age, it may tell the member about other plans or programs they may be eligible for, including individual coverage. It may also send reminders about routine medical checkups and tests.
Supporting quotations
We may also contact you about treatment options or other health-related benefits and services.
When you or your dependents reach a certain age, we may tell you about other plans or programs for which you may be eligible, including individual coverage.
We may also send you reminders about routine medical checkups and tests.
Qualifications & exceptions
Each is 'may', a permitted contact, not a promise to contact.
Not stated here
The source does not say what age triggers the plan information.
Sharing & Disclosure · User right or choice
Emails may carry limited PHI and Anthem says it will ask permission before contacting
Anthem says a member may get emails that have limited PHI, such as welcome materials, and that it will ask the member's permission before it contacts them.
Supporting quotations
You may get emails that have limited PHI, such as welcome materials.
We’ll ask your permission before we contact you.
Qualifications & exceptions
'Limited PHI, such as welcome materials' limits the emails the sentence describes.
Not stated here
The notice does not say whether the permission commitment covers only the emails or all the contacts described earlier in the paragraph.
Cross-references
contrast (model-proposed): A member who does not want phone contact can tell the caller or call 844-203-3796 — contrast: One passage says Anthem will ask permission before it contacts the member, while another describes phone and text contact that Anthem may make using an autodialer, which the member stops by telling the caller or calling the Do Not Call number. The notice does not say whether the permission sentence covers phone and text contact.
Sharing & Disclosure · Restriction or exception
Outside treatment, payment, operations or research, Anthem generally needs written permission
Anthem says that in most cases, if it uses or shares PHI outside of treatment, payment, operations or research activities, it has to get the member's okay in writing first.
Supporting quotations
Sharing your PHI with others: In most cases, if we use or share your PHI outside of treatment, payment, operations, or research activities, we have to get your okay in writing first.
Qualifications & exceptions
'In most cases' means there are exceptions; the notice lists several in the sections that follow (for example uses for the public good, and best-interest sharing in an emergency).
Sharing & Disclosure · Restriction or exception
Written permission is required before certain marketing, selling PHI or sharing psychotherapy notes
Anthem says it must also get the member's written permission before using PHI for certain marketing activities, selling PHI, or sharing any psychotherapy notes from the member's doctor or therapist.
Supporting quotations
We must also get your written permission before:
Using your PHI for certain marketing activities.
Selling your PHI.
Sharing any psychotherapy notes from your doctor or therapist
Qualifications & exceptions
Only 'certain' marketing activities are named; the notice does not say which.
Not stated here
The notice does not say which marketing activities need written permission.
Sharing & Disclosure · User right or choice
Other situations may need written permission, and a member can cancel written permission at any time
Anthem says it may also need written permission for other situations not mentioned in the list. The member always has the right to cancel any written permission given, at any time.
Supporting quotations
We may also need your written permission for other situations not mentioned above.
You always have the right to cancel any written permission you give at any time.
Qualifications & exceptions
'May also need' is not a list of those situations.
Not stated here
This paragraph does not say how to cancel; the later Authorization paragraph says cancellation is in writing and not retroactive.
Sharing & Disclosure · User right or choice
Members can tell Anthem to share information with family, friends or others involved in care or payment
Anthem says the member has the right and choice to tell it to share information with family, close friends, or others involved with the member's current treatment or payment for care.
Supporting quotations
You have the right and choice to tell us to:
Share information with your family, close friends, or others involved with your current treatment or payment for your care.
Not stated here
The source does not say how a member tells Anthem this.
Sharing & Disclosure · User right or choice
Members can tell Anthem to share information in an emergency or disaster relief situation
Anthem says the member has the right and choice to tell it to share information in an emergency or disaster relief situation.
Supporting quotations
You have the right and choice to tell us to:
Share information in an emergency or disaster relief situation.
Not stated here
The source does not say how a member tells Anthem this.
Sharing & Disclosure · Permission or license
If a member can't state a preference, Anthem may share PHI it believes is in their best interest
If a member can't tell Anthem their preference, for example in an emergency or if unconscious, Anthem says it may share PHI if it believes this is in the member's best interest. It may also share information when needed to lessen a serious and likely threat to the member's health or safety.
Supporting quotations
If you can’t tell us your preference, for example in an emergency or if you’re unconscious, we may share your PHI if we believe it’s in your best interest.
We may also share your information when needed to lessen a serious and likely threat to your health or safety.
Qualifications & exceptions
The best-interest sharing depends on Anthem's own belief; the threat sharing requires a threat that is both serious and likely.
Cross-references
qualifies (model-proposed): Members can tell Anthem to share information in an emergency or disaster relief situation — qualifies: When the member cannot state a preference, for example in an emergency, Anthem says it may share PHI it believes is in the member's best interest, which qualifies the member's choice to tell Anthem what to share in an emergency.
Sharing & Disclosure · Permission or license
Anthem is allowed, and sometimes required, to share information for specific public-good purposes
Anthem says it is allowed, and in some cases required, to share a member's information in other ways, usually for the good of the public, such as public health and research, for the specific purposes listed. The list covers public health and safety issues, research, obeying the law, organ donation groups, workers' compensation, law enforcement and other government requests, lawsuits, and responses to the Secretary of Health and Human Services.
Supporting quotations
Other reasons we may use or share your information:
We are allowed, and in some cases required, to share your information in other ways
We can share your information for these specific purposes:
Qualifications & exceptions
The notice says 'usually' for the good of the public, so not every listed purpose is public-good in kind.
Sharing & Disclosure · Permission or license
Information may be shared to help with public health and safety issues
Among the specific purposes, Anthem lists helping with public health and safety issues, such as preventing disease, helping with product recalls, reporting adverse reactions to medicines, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.
Supporting quotations
Helping with public health and safety issues, such as:
Preventing disease
Helping with product recalls
Reporting adverse reactions to medicines
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone’s health or safety
Qualifications & exceptions
'Such as' makes the five examples illustrative.
Not stated here
The notice does not say who receives the information in these cases.
Sharing & Disclosure · Permission or license
Information may be shared for health research
Among the specific purposes, Anthem lists doing health research. The earlier written-permission rule treats research as outside the cases where Anthem generally needs a written okay, and this item does not describe any research-specific conditions.
Supporting quotations
Doing health research.
Not stated here
The notice does not describe conditions, safeguards or recipients for research use.
Sharing & Disclosure · Permission or license
Information may be shared if the law requires it
Among the specific purposes, Anthem lists obeying the law, if it requires sharing the member's information.
Supporting quotations
Obeying the law, if it requires sharing your information.
Qualifications & exceptions
Applies when a law requires the sharing.
Sharing & Disclosure · Permission or license
Information may be shared with organ donation groups
Among the specific purposes, Anthem lists responding to organ donation groups for research and other reasons.
Supporting quotations
Responding to organ donation groups for research and other reasons.
Qualifications & exceptions
'Other reasons' is not specified.
Sharing & Disclosure · Permission or license
Information may be shared for workers' compensation, law enforcement and other government requests
Among the specific purposes, Anthem lists addressing workers' compensation, law enforcement and other government requests, and alerting proper authorities if it believes the member may be a victim of abuse or other crimes.
Supporting quotations
Addressing workers’ compensation, law enforcement, and other government requests, and to alert proper authorities if we believe you may be a victim of abuse or other crimes.
Qualifications & exceptions
The alert to authorities depends on Anthem's belief that the member may be a victim.
Not stated here
The notice does not say what conditions a law enforcement or government request must meet.
Sharing & Disclosure · Permission or license
Information may be shared in responding to lawsuits and legal actions
Among the specific purposes, Anthem lists responding to lawsuits and legal actions.
Supporting quotations
Responding to lawsuits and legal actions.
Not stated here
The notice does not say what limits apply to sharing in legal proceedings.
Sharing & Disclosure · Permission or license
Information may be shared with the Secretary of Health and Human Services for HIPAA compliance
Among the specific purposes, Anthem lists responding to the Secretary of Health and Human Services for HIPAA rules compliance and enforcement purposes.
Supporting quotations
Responding to the Secretary of Health and Human Services for HIPAA rules compliance and enforcement purposes.
Sharing & Disclosure · Permission or license
Employer-based members: PHI may be shared with the group health plan; an employer may get PHI only for permitted reasons
For members enrolled through an employer, Anthem says it may share PHI with the member's group health plan. If the employer pays the premium or part of it but does not pay health insurance claims, the employer can only have the member's PHI for permitted reasons and is required by law to protect it.
Supporting quotations
If you’re enrolled with us through an employer, we may share your PHI with your group health plan.
If the employer pays your premium or part of it, but doesn’t pay your health insurance claims, your employer can only have your PHI for permitted reasons and is required by law to protect it.
Qualifications & exceptions
Applies to members enrolled through an employer.
The 'permitted reasons' limit applies to an employer that pays premium but not claims.
Not stated here
The notice does not say what the permitted reasons are or what happens when an employer pays claims.
Sharing & Disclosure · User right or choice
Anthem gets written permission for any purpose not stated; permission can be cancelled in writing but not undone
Anthem says it will get the member's written permission before using or sharing PHI for any purpose not stated in the notice. The member may cancel permission at any time, in writing, and Anthem will then stop using PHI for that purpose. If Anthem has already used or shared PHI with permission, it cannot undo actions taken before the member told it to stop.
Supporting quotations
Authorization: We’ll get your written permission before we use or share your PHI for any purpose not stated in this notice.
You may cancel your permission at any time, in writing.
We will then stop using your PHI for that purpose.
But if we’ve already used or shared your PHI with your permission, we cannot undo any actions we took before you told us to stop.
Qualifications & exceptions
Cancellation must be in writing and is not retroactive.
Anthem cannot use genetic information to decide coverage or its price
Anthem says it cannot use a member's genetic information to decide whether it will give coverage or how it determines the price of that coverage.
Supporting quotations
Genetic information: We cannot use your genetic information to decide whether we’ll give you coverage or how we determine the price of that coverage.
Data Access & Collection · Company practice
Anthem may collect, infer, receive or maintain race, language, sexual orientation and gender identity data
Anthem says it may collect, infer, receive and/or maintain race, ethnicity, language, sexual orientation and gender identity information about a member and protect this information as described in the notice.
Supporting quotations
Race, ethnicity, language, sexual orientation, and gender identity: We may collect, infer, receive and/ or maintain race, ethnicity, language, sexual orientation, and gender identity information about you and protect this information as described in this notice.
Not stated here
The notice does not say how the information is inferred or what sources are used.
Use & Processing · Company practice
Anthem may use this demographic information to identify needs, develop programs and offer interpretation
Anthem says it may use race, ethnicity, language, sexual orientation and gender identity information to help the member, including identifying specific needs, developing programs and educational materials, and offering interpretation services.
Supporting quotations
We may use this information to help you, including identifying your specific needs, developing programs and educational materials, and offering interpretation services.
Qualifications & exceptions
'Including' makes the three uses illustrative.
Use & Processing · Restriction or exception
Anthem does not use this demographic information to decide coverage, kind of coverage or price
Anthem says it does not use race, ethnicity, language, sexual orientation and gender identity information to decide whether it will give coverage, what kind of coverage, or the price of that coverage. It says it does not share this information with unauthorized persons.
Supporting quotations
We don’t use race, ethnicity, language, sexual orientation, and gender identity information to decide whether we’ll give you coverage, what kind of coverage and the price of that coverage.
We don’t share this information with unauthorized persons.
Not stated here
The notice does not say who counts as an authorized person.
Account & Service Control · User right or choice
Members have rights under federal law, exercised through the listed requests
The notice states that under federal law the member has the rights listed next: to see or copy PHI, to ask for corrections, to ask that PHI not be used for treatment, payment or operations, to request confidential communications, to get a list of those with whom PHI was shared, and to ask for a restriction on services paid for out of pocket. The last item says how to use these rights.
Supporting quotations
Your rights
Under federal law, you have the right to:
Qualifications & exceptions
Each right has its own limits, described in the items that follow.
Account & Service Control · User right or choice
Members can send a written request to see or get a copy of their PHI
The member can send Anthem a written request to see or get a copy of their PHI, including a copy by email. Anthem says it will usually provide the copy within 30 days of the request, and will tell the member if it needs more time.
Supporting quotations
Send us a written request to see or get a copy of your PHI, including a request for a copy of your PHI through email.
We will provide you a copy of your PHI usually within 30 days of your request. If we need more time, we will let you know.
Qualifications & exceptions
The request must be in writing.
'Usually within 30 days' is not a guaranteed deadline.
Security & Safeguards · Company commitment
Anthem will confirm before sending PHI by unencrypted email
Anthem warns that PHI sent unencrypted, meaning regular email, could be read by a third party. It says it will first confirm that the member wants to get PHI by unencrypted email before sending it.
Supporting quotations
Remember, there’s a risk your PHI could be read by a third party when it’s sent unencrypted, meaning regular email. So we will first confirm that you want to get your PHI by unencrypted email before sending it to you.
Qualifications & exceptions
Applies when a copy of PHI is requested through email.
Members can ask Anthem to correct PHI they believe is wrong or incomplete
The member can ask Anthem to correct any PHI the member believes is wrong or incomplete. If someone else, such as the member's doctor, gave Anthem the PHI, Anthem will say so, so the member can ask that person to correct it. Anthem may say no, but it will explain why in writing within 60 days.
Supporting quotations
Ask that we correct any PHI that you believe is wrong or incomplete.
If someone else, such as your doctor, gave us the PHI, we’ll let you know so you can ask him or her to correct it.
We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Qualifications & exceptions
Anthem may refuse; it commits to a written reason within 60 days.
Not stated here
The notice does not say what happens to the PHI when the source of the information is someone else.
Use & Processing · User right or choice
Members can request that PHI not be used for treatment, payment or healthcare operations, but Anthem may say no
The member can send Anthem a written request not to use PHI for treatment, payment, or healthcare operations activities. Anthem may say no, but it will tell the member why in writing.
Supporting quotations
Send us a written request not to use your PHI for treatment, payment, or healthcare operations activities.
We may say “no” to your request, but we’ll tell you why in writing.
Qualifications & exceptions
This is a right to ask; Anthem may refuse.
Not stated here
The notice does not say when Anthem agrees.
Account & Service Control · User right or choice
Members can request confidential communications
The member can ask Anthem to send PHI or contact the member by other reasonable ways. The member can also say if they want mail sent to a different address if sending it to their home could put them in danger.
Supporting quotations
Request confidential communications. You can ask us to send your PHI or contact you using other ways that are reasonable.
Also, let us know if you want us to send your mail to a different address if sending it to your home could put you in danger.
Qualifications & exceptions
Limited to 'other ways that are reasonable'.
Account & Service Control · User right or choice
Members can request a list of those with whom PHI was shared
The member can send Anthem a written request for a list of those with whom it has shared the member's PHI. Anthem says it will usually provide the list within 60 days, and will tell the member if it needs more time.
Supporting quotations
Send us a written request to ask us for a list of those with whom we’ve shared your PHI.
We will provide you a list, usually within 60 days of your request. If we need more time, we will let you know.
Qualifications & exceptions
'Usually within 60 days' is not a guaranteed deadline.
Not stated here
The notice does not say which disclosures the list covers or whether any are excluded.
Sharing & Disclosure · User right or choice
Members who pay in full out of pocket can ask for a restriction; Anthem may not agree in some cases
If the member pays in full for any medical services out of pocket, the member has the right to ask for a restriction that would prevent the use or sharing of that PHI for treatment, payment, or operations reasons. If the member or the care provider submits a claim to Anthem, Anthem may not agree to a restriction. If a law requires sharing the information, Anthem does not have to agree to the restriction.
Supporting quotations
Ask for a restriction for services you pay for out of your own pocket:
If you pay in full for any medical services out of your own pocket, you have the right to ask for a restriction.
The restriction would prevent the use or sharing of that PHI for treatment, payment, or operations reasons.
If you or your care provider submits a claim to us, we may not agree to a restriction
If a law requires sharing your information, we don’t have to agree to your restriction.
Qualifications & exceptions
Applies when the member pays in full out of pocket.
Does not apply the same way if a claim is submitted to Anthem, or where a law requires sharing.
Not stated here
The notice does not say whether the member must tell the provider not to submit a claim.
Anthem tells members to call Member Services at the phone number on the ID card to use any of these rights. A representative can give the address to send the request and any forms that may help.
Supporting quotations
Call Member Services at the phone number on your ID card to use any of these rights.
A representative can give you the address to send the request. They can also give you any forms we have that may help you with this process.
Not stated here
The notice gives no address or form name.
Security & Safeguards · Company commitment
Anthem says it protects PHI with policies and practices and must tell members of a breach it believes occurred
Anthem says it is dedicated to protecting PHI and has set up policies and information practices to keep it secure and private. If it believes a member's PHI has been breached, it must let the member know.
Supporting quotations
How we protect information
We’re dedicated to protecting your PHI, and we’ve set up a number of policies and information practices to help keep your PHI secure and private.
If we believe your PHI has been breached, we must let you know.
Qualifications & exceptions
The breach notice depends on Anthem's own belief that PHI has been breached.
Not stated here
The notice does not say how or when a breach notice will be sent.
Security & Safeguards · Company practice
Safeguards: physical and electronic protections, limited employee access and business partner duties
Anthem says it keeps oral, written and electronic PHI safe with physical and electronic means that follow federal and state laws, including secured offices, password-protected computers, and locked storage. Employees must protect PHI under written policies that limit access to those who need the data, and wear ID badges. Where required by law, business partners must protect the privacy of shared data and may not give PHI to others without written permission unless the law allows it and the notice states it.
Supporting quotations
We keep your oral, written, and electronic PHI safe using the right procedures, and through physical and electronic means.
Some of the ways we keep your PHI safe include securing offices that hold PHI, password-protecting computers, and locking storage areas and filing cabinets.
These policies limit access to PHI to only those employees who need the data to do their jobs.
Also, where required by law, our business partners must protect the privacy of data we share with them as they work with us.
They’re not allowed to give your PHI to others without your written permission, unless the law allows it and it’s stated in this notice.
Qualifications & exceptions
The business partner duty applies 'where required by law'.
'Some of the ways' means the examples are not a complete list.
Legal Rights & Agreement Rules · Company commitment
HIPAA does not cancel other laws; where a law gives more privacy protection, Anthem follows it too
Anthem says HIPAA generally does not cancel out other laws that give people greater privacy protections. If any state or federal privacy law requires Anthem to give more privacy protections, it must follow that law in addition to HIPAA.
Supporting quotations
Potential impact of other applicable laws
HIPAA, the federal privacy law, generally doesn’t cancel out other laws that give people greater privacy protections.
if any state or federal privacy law requires us to give you more privacy protections, then we must follow that law in addition to HIPAA.
Qualifications & exceptions
'Generally' limits the statement about HIPAA not cancelling other laws.
Legal Rights & Agreement Rules · User right or choice
Substance use disorder information is covered by 42 CFR Part 2 and consent rules
As one example, Anthem says it may receive substance use disorder (SUD) information from providers or programs regulated by federal law (42 CFR Part 2). All disclosures of SUD information must comply with all applicable federal and state privacy laws, including 42 CFR Part 2. Anthem says it is allowed to use and disclose SUD information for certain treatment, payment and health care operations activities. The member has the right to consent to disclosure of SUD information in certain circumstances and can revoke this consent in writing at any time.
Supporting quotations
One example is with Substance Use Disorder (SUD) information we may receive from Providers or programs regulated by federal law (42 CFR Part 2).
All disclosures of SUD information must comply with all applicable Federal and State privacy laws, including 42 CFR Part 2.
We are allowed to Use and Disclose SUD information for certain Treatment, Payment, and Health Care Operations activities.
You have the right to consent to disclosure of SUD information in certain circumstances.
You can revoke this consent in writing at any time.
Qualifications & exceptions
Use and disclosure for treatment, payment and operations is allowed only for 'certain' such activities.
The consent right applies 'in certain circumstances'.
Not stated here
42 CFR Part 2 is an external law that is not supplied here; the notice does not say which circumstances need consent or which activities are covered.
Cross-references
qualifies (model-proposed): Anthem may collect, use and share PHI as the law allows or requires — qualifies: The substance use disorder passage adds that disclosures of that information must also comply with 42 CFR Part 2 and other privacy laws, so the general permission to use and share PHI is limited for that information.
Legal Rights & Agreement Rules · Context
More information is on Anthem's Privacy web page, which is not part of this source
Anthem points members to its Privacy web page at anthem.com/privacy to read more about how it collects and uses information, privacy rights, and other state and federal privacy laws. That page is not part of the supplied source.
Supporting quotations
To see more information
To read more information about how we collect and use your information, your privacy rights, and other state and federal privacy laws, please visit our Privacy web page at anthem.com/privacy.
Not stated here
The content of anthem.com/privacy is not supplied and is not summarized here.
Use & Processing · Company practice
Anthem, its affiliates and vendors may call or text using an autodialer or artificial voice
Anthem says it, including its affiliates and/or vendors, may call or text a member using an automatic telephone dialing system and/or an artificial voice, but only in accordance with the Telephone Consumer Protection Act (TCPA). The calls may be about treatment options or other health-related benefits and services.
Supporting quotations
Calling or texting you
We, including our affiliates and/or vendors, may call or text you by using an automatic telephone dialing system and/or an artificial voice.
But we only do this in accordance with the Telephone Consumer Protection Act (TCPA).
The calls may be about treatment options or other health-related benefits and services for you.
Qualifications & exceptions
Subject to the TCPA, an external law not supplied here.
Not stated here
The notice does not say what the TCPA requires.
Account & Service Control · User right or choice
A member who does not want phone contact can tell the caller or call 844-203-3796
A member who does not want to be contacted by phone can let the caller know or call 844-203-3796 to add their number to Anthem's Do Not Call list. Anthem says it will then no longer call or text.
Supporting quotations
If you don’t want to be contacted by phone, let the caller know or call 844-203-3796 to add your phone number to our Do Not Call list.
We will then no longer call or text you.
Legal Rights & Agreement Rules · User right or choice
Members can file a privacy complaint with Anthem or HHS; Anthem says it will not retaliate
A member who thinks Anthem has not protected their privacy can file a complaint with Anthem at the Member Services phone number on the ID card. The member can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Anthem says it will not take action against a member for filing a complaint.
Supporting quotations
Complaints
If you think we haven’t protected your privacy, you can file a complaint with us at the Member Services phone number on your ID card.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting hhs.gov/ocr/privacy/hipaa/complaints/.
We will not take action against you for filing a complaint.
Account & Service Control · Procedure
Members can call Member Services for help applying rights, filing complaints or discussing privacy
Members may call Member Services at the number on the ID card, where representatives can help apply rights, file a complaint, or talk about privacy issues.
Supporting quotations
Contact information
You may call us at the Member Services phone number on your ID card. Our representatives can help you apply your rights, file a complaint, or talk with you about privacy issues.
Account & Service Control · User right or choice
Members can get a new copy of the notice at any time, including a paper copy
The member has the right to get a new copy of the notice at any time. Even if the member has agreed to get the notice by electronic means, the member still has the right to ask for a paper copy.
Supporting quotations
Copies and changes
You have the right to get a new copy of this notice at any time.
Even if you have agreed to get this notice by electronic means, you still have the right to ask for a paper copy.
Legal Rights & Agreement Rules · Permission or license
Anthem reserves the right to change the notice; a revised notice applies to PHI it already has and will get
Anthem reserves the right to change the notice. A revised notice applies to PHI Anthem already has about the member, as well as any PHI it may get in the future. Anthem says it is required by law to follow the privacy notice in effect at this time.
Supporting quotations
We reserve the right to change this notice.
A revised notice will apply to PHI we already have about you, as well as any PHI we may get in the future.
We’re required by law to follow the privacy notice that’s in effect at this time.
Qualifications & exceptions
The legal duty is to follow the notice 'in effect at this time'.
Not stated here
The notice does not say how far in advance a change is announced or when it takes effect.
Legal Rights & Agreement Rules · Procedure
Anthem may tell members about changes through a newsletter, its website or a letter
Anthem says it may tell members about changes to the notice through a newsletter, its website, or a letter.
Supporting quotations
We may tell you about any changes to our notice through a newsletter, our website, or a letter.
Qualifications & exceptions
'May' means notice by these channels is permitted, not promised for every change.
Legal Rights & Agreement Rules · Context
Original effective date was April 14, 2003; the latest revision is noted in the footer
The notice says its original effective date was April 14, 2003. It says the most recent revision is noted in the footer at the end of the document.
Supporting quotations
Effective date of this notice
The original effective date of this notice was April 14, 2003.
The most recent revision is noted in the footer at the end of this document.
Not stated here
The date of the current revision is in the footer, which this card does not restate.
Cross-references
related (model-proposed): The notice's footer states it was reviewed 2/2026 — references: The effective-date section says the most recent revision is noted in the footer, which reads Reviewed 2/2026.
Legal Rights & Agreement Rules · Company commitment
A covered mastectomy includes benefits that comply with the Women's Health and Cancer Rights Act of 1998
Anthem says a mastectomy that is covered by the health plan includes benefits that comply with the Women's Health and Cancer Rights Act of 1998. These provide for reconstruction of the breast(s) that underwent a covered mastectomy; surgery and reconstruction of the other breast to restore a symmetrical appearance; and prostheses and coverage for physical complications related to all stages of a covered mastectomy, including lymphedema.
Supporting quotations
Breast reconstruction surgery benefits
A mastectomy that’s covered by your health plan includes benefits that comply with the Women’s Health and Cancer Rights Act of 1998, which provides for:
Reconstruction of the breast(s) that underwent a covered mastectomy.
Surgery and reconstruction of the other breast to restore a symmetrical appearance.
Prostheses and coverage for physical complications related to all stages of a covered mastectomy, including lymphedema.
Qualifications & exceptions
Applies when the mastectomy is covered by the member's health plan.
Not stated here
The Women's Health and Cancer Rights Act is an external law that is not supplied here.
Charges & Financial Obligations · Company practice
The member pays the usual deductible, copay and/or coinsurance for these benefits
For the breast reconstruction benefits, the notice says the member will pay the usual deductible, copay, and/or coinsurance, and refers the member to the plan administrator for details. It points to the United States Department of Labor website for more information about the Women's Health and Cancer Rights Act.
Supporting quotations
You’ll pay your usual deductible, copay, and/or coinsurance. For details, contact your plan administrator.
For more information about the Women’s Health and Cancer Rights Act, go to the United States Department of Labor website at dol.gov/agencies/ebsa/laws-and-regulations/laws/whcra.
Not stated here
The amounts depend on the member's plan, which is not supplied; the Department of Labor page is not supplied.
Legal Rights & Agreement Rules · Company commitment
Anthem follows federal civil rights laws, does not discriminate, and offers free aids and language help
Anthem says it follows federal civil rights laws in its health programs and activities and does not discriminate, exclude people, or treat them differently based on race, color, national origin, sex, age, or disability. It offers free aids and services for people with disabilities, and free interpreters and other written languages if a person's main language isn't English. Members can call the Member Services number on the ID card for help.
Supporting quotations
It’s important we treat you fairly
We follow federal civil rights laws in our health programs and activities.
We don’t discriminate, exclude people, or treat them differently based on race, color, national origin, sex, age, or disability.
If you have disabilities, we offer free aids and services.
If your main language isn’t English, we offer help for free through interpreters and other written languages.
Qualifications & exceptions
The commitment is stated for Anthem's health programs and activities.
Legal Rights & Agreement Rules · User right or choice
Members can file a discrimination complaint (grievance) with Anthem or HHS in four ways
A member who thinks Anthem failed to offer these services or discriminated based on race, color, national origin, age, disability, or sex can file a complaint, also known as a grievance. The member can write to Anthem's Compliance Coordinator at the address given, file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by mail, call 800-368-1019 (TDD 800-537-7697), or go online at the OCR portal and complaint form pages.
Supporting quotations
If you think we failed to offer these services or discriminated based on race, color, national origin, age, disability, or sex, you can file a complaint, also known as a grievance.
Write to Compliance Coordinator, P.O. Box 27401, Mail Drop VA2002-N160, Richmond, VA 23279.
File a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights
Call 800-368-1019 (TDD: 800-537-7697).
Go online at ocrportal.hhs.gov/ocr/portal/lobby.jsf and fill out a complaint form at hhs.gov/ocr/complaints/index.html.
Qualifications & exceptions
The address listed for Anthem's Compliance Coordinator is a Virginia address; the notice does not say whether it applies to every state's members.
Account & Service Control · User right or choice
Members can get this information in their preferred language for free and in another format
The notice says the member has the right to get this information in their preferred language for free, and members can call the Member Services number on the ID card (TTY/TDD 711) for help. Anthem also offers the notice in a different format for members with visual impairments; the member can call the Member Services number to ask.
Supporting quotations
Get help in your language
One more right that you have is the right to get this information in your preferred language for free.
If you’d like extra help to understand this in another language, call the Member Services number on your ID card (TTY/TDD: 711).
we also offer this notice in a different format for members with visual impairments.
If you need a different format, please call the Member Services number on your ID card.
Not stated here
The notice does not say which formats are available for members with visual impairments.
Account & Service Control · User right or choice
The same language-assistance statement is repeated in other languages
The notice repeats a short statement in many other languages, beginning with Spanish. The Spanish version says the member has the right to get this information and help in their language for free, and to call the Member Services number on the ID card for help (TTY/TDD 711). Other languages appear under their own headings as translations of the same statement.
Supporting quotations
Language assistance
Spanish
Tiene el derecho de obtener esta información y ayuda en su idioma en forma gratuita. Llame al número de Servicios para Miembros que figura en su tarjeta de identificación para obtener ayuda. (TTY/TDD: 711)
Not stated here
Only the Spanish text was read as a translation of the English statement; the other language versions, some of which the extraction has garbled, are not separately interpreted.
Legal Rights & Agreement Rules · Context
The notice's footer states it was reviewed 2/2026
The footer at the end of the notice reads 'Reviewed 2/2026'. The notice elsewhere says the most recent revision is noted in this footer, so this is the most recent revision date the source gives. It does not give an effective date for that revision.
Supporting quotations
Reviewed 2/2026
Qualifications & exceptions
'Reviewed' is the source's word; the footer does not say what changed.
Not stated here
The footer gives no effective date for the February 2026 review.
Legal Rights & Agreement Rules · Context
Anthem Blue Cross and Blue Shield is a trade name of different insuring entities in different states
The closing note says Anthem Blue Cross and Blue Shield is the trade name of different companies depending on the state, including Rocky Mountain Hospital and Medical Service, Inc. in Colorado; Anthem Health Plans, Inc. in Connecticut; Anthem Insurance Companies, Inc. in Indiana; Anthem Health Plans of Kentucky, Inc. in Kentucky; Anthem Health Plans of Maine, Inc. in Maine; Community Insurance Company in Ohio; and Anthem Health Plans of Virginia, Inc. in Virginia, among others it lists for Georgia, Missouri, Nevada, New Hampshire, southeastern New York and Wisconsin.
Supporting quotations
Anthem Blue Cross and Blue Shield is the trade name of:
In Colorado: Rocky Mountain Hospital and Medical Service, Inc.
In Connecticut: Anthem Health Plans, Inc.
In Indiana: Anthem Insurance Companies, Inc.
In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. and AMGP Georgia Managed Care Company, Inc.
In Kentucky: Anthem Health Plans of Kentucky, Inc.
In Maine: Anthem Health Plans of Maine, Inc.
In Ohio: Community Insurance Company.
In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield
Qualifications & exceptions
Which entity applies to a member depends on the state.
Not stated here
The source does not say which entity issues a particular member's coverage or which state's rules apply to that member.
Legal Rights & Agreement Rules · Context
In some states, the named entities underwrite or only administer different plan types
The closing note says that in Missouri (excluding 30 counties in the Kansas City area) the named entities administer non-HMO benefits underwritten by one company and HMO benefits underwritten by another, and that these entities only provide administrative services for self-funded plans and do not underwrite benefits. It also describes HMO products underwritten by HMO Colorado, Inc. in Colorado and Nevada, HMO administration in New Hampshire, and PPO, indemnity, HMO and POS arrangements in Wisconsin.
Supporting quotations
In Missouri (excluding 30 counties in the Kansas City area):
RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits.
HMO products underwritten by HMO Colorado, Inc.
HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by either Matthew Thornton Health Plan, Inc. or Anthem Health Plans of New Hampshire, Inc.
In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI) underwrites or administers PPO and indemnity policies and underwrites the out-of-network benefits in POS policies offered by Compcare Health Services Insurance Corporation.
Qualifications & exceptions
For self-funded plans in Missouri the named entities only provide administrative services; the notice does not say what that means for a member's own coverage.
Not stated here
The source does not say how these entity roles change who is responsible for the member's PHI.
Legal Rights & Agreement Rules · Context
The note also names New York and Virginia entities and a Virginia service area
The closing note names entities for 17 southeastern counties of New York and says that, in those counties, Anthem Blue Cross and Blue Shield HP is the trade name of Anthem HP, LLC. In Virginia it says HealthKeepers, Inc. trades as Anthem HealthKeepers providing HMO coverage, with a service area of all of Virginia except the City of Fairfax, the Town of Vienna, and the area east of State Route 123.
Supporting quotations
In 17 southeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc.
In these same counties Anthem Blue Cross and Blue Shield HP is the trade name of Anthem HP, LLC.
its affiliate HealthKeepers, Inc. trades as Anthem HealthKeepers providing HMO coverage
their service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123.
Qualifications & exceptions
Applies only to the named counties and Virginia service area.
Content & IP Rights · Context
Anthem is an independent licensee of the Blue Cross and Blue Shield Association; Anthem is a registered trademark
The closing note says the named entities are independent licensees of the Blue Cross and Blue Shield Association, and that Anthem is a registered trademark of Anthem Insurance Companies, Inc.
Supporting quotations
Independent licensees of the Blue Cross and Blue Shield Association.
Anthem is a registered trademark of Anthem Insurance Companies, Inc.