One notice combines three required yearly communications
The company says it must send members, each year, specific information about their rights and some of its duties to keep their information safe. This single document combines three of those required communications: a state notice of privacy practices, a HIPAA notice of privacy practices, and a notice about breast reconstruction surgery benefits.
Supporting quotations
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 three parts have different stated coverage: the state part names health, dental, vision and life insurance benefits, while the HIPAA part is introduced as covering medical, vision and dental information.
Not stated here
The stored text never uses the words Medicare or Group Retiree Solutions; those come from the document title in the publisher registration, so the stored text does not itself say which plans or members this copy is for.
Legal Rights & Agreement Rules · Company commitment
State privacy law is followed and can be stricter than HIPAA
For handling health information, the company says it follows relevant state laws, which are sometimes stricter than the federal HIPAA privacy law. The state notice explains members' rights and the company's duties under state law, and applies to the health, dental, vision and life insurance benefits a member may have.
Supporting quotations
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 scope list is limited to benefits the member may have; it does not say which benefits this particular member actually holds.
Not stated here
The text does not name which state laws apply or which states are covered.
Legal Rights & Agreement Rules · Context
The HIPAA notice header covers medical, vision and dental information
A capitalized statement placed just before the HIPAA section says the notice describes how medical, vision and dental information about the member may be used and disclosed, and how the member can get access to it. It asks the member to review 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. PLEASE REVIEW IT CAREFULLY.
Qualifications & exceptions
It names medical, vision and dental information, not life insurance information, which the state notice separately lists.
Not stated here
The stored text places this statement after the state section and before the HIPAA heading, so it is not tagged as belonging to one part; whether it also frames the state part is not stated.
Legal Rights & Agreement Rules · Company commitment
Members' health and financial information is kept private; this notice is federally required
The company 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. It also says federal law requires it to give this notice, which explains members' rights and the company's legal duties and privacy practices.
Supporting quotations
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
Covers current and former members.
Legal Rights & Agreement Rules · Context
A footer line reads Effective May 2025
Between the treatment description and the examples, the stored text contains a form-code line ending in "Effective May 2025". This is the only dated line in the stored text. A later section says the notice's most recent revision is noted in the footer.
Supporting quotations
Effective May 2025
Not stated here
The text does not state that this line is the revision date the later section refers to; the line sits in the middle of the document, as a page footer would in a PDF.
Legal Rights & Agreement Rules · Permission or license
Information may be shared when the law requires, in lawsuits and for HHS enforcement
The company may share information to obey the law when it requires sharing, to respond to lawsuits and legal actions, and to respond to the Secretary of Human and Health Services (as the notice words it) for HIPAA rules compliance and enforcement purposes.
Supporting quotations
Obeying the law, if it requires sharing your information.
Responding to lawsuits and legal actions.
Responding to the Secretary of Human and Health Services for HIPAA rules compliance and enforcement purposes.
Qualifications & exceptions
Obeying the law applies only if the law requires sharing.
Legal Rights & Agreement Rules · Company commitment
State or federal laws that give more protection are followed in addition to HIPAA
The notice says HIPAA generally does not cancel other laws that give people greater privacy protections. If a state or federal privacy law requires the company to give more privacy protections, the company must follow that law in addition to HIPAA.
Supporting quotations
HIPAA, the federal privacy law, generally doesn’t cancel other laws that give people greater privacy protections. As a result, 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" signals that HIPAA can override in some cases; the text does not say which.
Legal Rights & Agreement Rules · Procedure
More detail on collection, use and privacy rights is on the Anthem privacy web page
For more information on how the company collects and uses information, on privacy rights and on other state and federal privacy laws, the notice points the member to the Anthem privacy web page at www.anthem.com/privacy.
Supporting quotations
To read more information about how we collect and use your information, your privacy rights, and details about other state and federal privacy laws, please visit our Privacy web page at www.anthem.com/privacy.
Not stated here
The text of the linked web page was not supplied with this document and is not analyzed here, so anything on that page is unknown.
Legal Rights & Agreement Rules · Procedure
You can complain to the company or to the federal Office for Civil Rights
A member who thinks the company has not protected their privacy can file a complaint with the company at the Member Services phone number on the ID card, and can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights through its website.
Supporting quotations
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/.
Legal Rights & Agreement Rules · Permission or license
The company can change the notice, and the revised notice applies to PHI it already has
The company reserves the right to change this notice. A revised notice will apply to PHI the company already has about the member as well as PHI it may get in the future. The company 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 revision applies to both existing and future PHI.
Legal Rights & Agreement Rules · Company practice
Changes may be announced through a newsletter, the website or a letter
The company 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
The wording is "may", so the notice does not promise direct notice of every change.
Not stated here
The text does not say how far ahead of a change members are told.
Legal Rights & Agreement Rules · Context
Original effective date is April 14, 2003; the latest revision is noted in the footer
The notice says its original effective date was April 14, 2003, and that its most recent revision is noted in the footer at the end of the document.
Supporting quotations
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 stored text has a form-code line reading "Effective May 2025" in the middle of the document, but it does not state that this is the footer revision referred to here, and the stored text ends with a trade-name paragraph that carries no date.
Cross-references
related (model-proposed): A footer line reads Effective May 2025 — references: The effective-date section says the latest revision is noted in the footer; the only dated footer-style line is the form-code line reading Effective May 2025, though the text does not state they are the same.
Legal Rights & Agreement Rules · Context
Maine residents have additional rights under the Maine Insurance Information and Privacy Protection Act
A section for Maine residents says the Maine Insurance Information and Privacy Protection Act gives consumers in Maine additional privacy rights, which the section then lists.
Supporting quotations
FOR MAINE RESIDENTS: Maine Notice of Additional Privacy Rights
The Maine Insurance Information and Privacy Protection Act provides consumers in Maine with the following additional rights.
Qualifications & exceptions
Stated for consumers in Maine.
Not stated here
The statute is named but its text is not supplied.
Legal Rights & Agreement Rules · Company commitment
Covered mastectomies include Women's Health and Cancer Rights Act benefits
A mastectomy covered by the health plan includes benefits that comply with the Women's Health and Cancer Rights Act of 1998. These are reconstruction of the breast 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
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 where a mastectomy is covered by the member's health plan.
Not stated here
The statute is named but its text is not supplied; the benefits actually available depend on the member's plan.
Legal Rights & Agreement Rules · Procedure
More on the Women's Health and Cancer Rights Act is on the Department of Labor website
For more information about the Women's Health and Cancer Rights Act, the notice points to the U.S. Department of Labor website.
Supporting quotations
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 linked page is not supplied.
Legal Rights & Agreement Rules · Company commitment
The company follows federal civil rights laws and does not discriminate
The company says it follows federal civil rights laws in its health programs and activities. It says it does not discriminate, exclude people or treat them differently based on race, color, national origin, sex, age or disability.
Supporting quotations
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.
Qualifications & exceptions
Stated for the company's health programs and activities.
Legal Rights & Agreement Rules · Procedure
How to file a discrimination complaint
A member who thinks the company failed to offer these services or discriminated based on race, color, national origin, age, disability or sex can file a complaint, also called a grievance. The notice lists four ways: write to the Compliance Coordinator at a Richmond, Virginia post office box; file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at its Washington, D.C. address; call 1-800-368-1019 (TDD: 1-800-537-7697); or go online to the Office for Civil Rights complaint portal and fill out a complaint form.
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. You can file a complaint through one of these ways:
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 at 200 Independence Avenue, SW; Room 509F, HHH Building; Washington, D.C. 20201.
Call 1-800-368-1019 (TDD: 1-800-537-7697).
Go online at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf and fill out a complaint form at https://www. hhs.gov/ocr/complaints/index.html.
Qualifications & exceptions
The grounds listed are race, color, national origin, age, disability and sex.
Legal Rights & Agreement Rules · Context
Anthem Blue Cross and Blue Shield is a trade name of different companies in each state
The notice says Anthem Blue Cross and Blue Shield is a trade name used by different legal entities depending on the state: for example Rocky Mountain Hospital and Medical Service, Inc. in Colorado and Nevada; Anthem Health Plans, Inc. in Connecticut; Anthem Insurance Companies, Inc. in Indiana; two Blue Cross Blue Shield plan companies in Georgia; Anthem Health Plans of Kentucky, of Maine, of New Hampshire and of Virginia; RightCHOICE Managed Care, Healthy Alliance Life Insurance Company and HMO Missouri in Missouri outside 30 Kansas City area counties; Anthem HealthChoice entities and Anthem HP, LLC in 17 southeastern New York counties; Community Insurance Company in Ohio; and Blue Cross Blue Shield of Wisconsin and Compcare in Wisconsin. In Virginia, Anthem HealthKeepers is the trade name of the affiliate HealthKeepers, Inc. providing HMO coverage, with a stated service area of all Virginia except the City of Fairfax, the Town of Vienna and the area east of State Route 123.
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 Community Care Health Plan of Georgia, Inc.
In Kentucky: Anthem Health Plans of Kentucky, Inc.
In Maine: Anthem Health Plans of Maine, Inc.
In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc.
In Nevada: Rocky Mountain Hospital and Medical Service, Inc.
In New Hampshire: Anthem Health Plans of New Hampshire, Inc.
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.
In Ohio: Community Insurance Company.
In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield, and its affiliate HealthKeepers, Inc. trades as Anthem HealthKeepers providing HMO coverage, and 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.
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
Missouri excludes 30 counties in the Kansas City area; the New York entry covers only 17 southeastern counties.
Not stated here
The text does not say which entity applies to a particular member, plan or group; no state or entity is tied to the group retiree plan named in the document title.
No entity is listed for states other than those named.
Legal Rights & Agreement Rules · Context
The companies are independent licensees of the Blue Cross and Blue Shield Association
The notice says the companies 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.