The company may collect, use and share personal information
The company may collect, use and share a member's personal information as described in the notice. It says its goal is to protect that information because it can be used to make judgments about the member's health, finances, character, habits, hobbies, reputation, career and credit.
Supporting quotations
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
Collection, use and sharing are permitted only as described in the notice.
Use & Processing · Company commitment
Opt-out chances are announced when an activity requires them
If an activity requires the company to give the member a chance to opt out, the company says it will tell the member, and will explain how to say that the member does not want their personal information used or shared for that activity.
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 activities that require an opt-out chance; the text does not say which activities those are.
Not stated here
The text does not list the opt-out activities or the method for opting out.
Cross-references
qualifies (model-proposed): PI can be shared outside the company without approval in some cases — qualifies: Sharing outside the company without approval in some cases is qualified by the statement that where an activity requires an opt-out chance, the member will be told and told how to opt out.
Use & Processing · Permission or license
PHI may be collected, used and shared as allowed or required by law
The company says there are times it may collect, use and share a member's Protected Health Information (PHI) when the law, including the HIPAA privacy rule, allows or requires it. The paragraph introduces payment, healthcare operations and treatment activities as some of those times.
Supporting quotations
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
The three listed activities are only "some of those times", so the list is not stated to be complete.
Use & Processing · Company practice
PHI is used for payment: accounts, benefits and paying claims
For payment, the company collects, uses and shares PHI to take care of the 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 for the company's healthcare operations
The company collects, uses and shares PHI for its healthcare operations.
Supporting quotations
Healthcare operations: We collect, use, and share PHI for our healthcare operations.
Not stated here
The sentence does not say what counts as healthcare operations; it only names the category.
Use & Processing · Company practice
The company does not provide treatment but uses treatment information to offer services
The company says it does not provide treatment. It does collect, use and share information about a member's treatment to offer services that may help the member, including sharing information with others who are providing 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
The purpose is offering services that may help the member; the company states it does not itself provide treatment.
Use & Processing · Company practice
Examples: payment records, benefit checks and explanation of benefits
As examples of how it uses information, the company says it keeps information on file about the member's premium and deductible payments, may give information to a doctor's office to confirm the member's benefits, and may share the explanation of benefits (EOB) with the subscriber of the plan for payment purposes.
Supporting quotations
We keep information on file about your premium and deductible payments.
We may give information to a doctor’s office to confirm your benefits.
We may share explanation of benefits (EOB) with the subscriber of your plan for payment purposes.
Qualifications & exceptions
Sharing the EOB is limited to the subscriber and to payment purposes.
These are described as examples of ways the information is used.
Not stated here
The text does not say whether the subscriber is always the member or may be a different person such as a policyholder.
Use & Processing · Company practice
Examples: quality-of-care review and help with conditions like asthma or diabetes
The company may use PHI to review the quality of care and services the member gets, and to help the member with services for conditions such as asthma, diabetes or traumatic injury.
Supporting quotations
We may use PHI to review the quality of care and services you get.
We may use PHI to help you with services for conditions like asthma, diabetes, or traumatic injury.
Qualifications & exceptions
The named conditions are introduced with "like", so they are examples and not an exhaustive list.
Use & Processing · Company practice
Example: PHI may be used with technology to support services
The company may use PHI with technology to support and enable services provided to the member.
Supporting quotations
We may use PHI with technology to support and enable services provided to you.
Not stated here
The text does not say what technology is meant or whether it is operated by the company or by others.
Use & Processing · Permission or license
Example: PHI may be used to create, use or share de-identified data
The company may use a member's PHI to create, use or share de-identified data, as HIPAA allows.
Supporting quotations
We may use your PHI to create, use, or share de-identified data as allowed by HIPAA.
Qualifications & exceptions
Allowed only to the extent HIPAA permits.
Not stated here
The text does not say who receives de-identified data or for what uses.
Use & Processing · Company practice
The company may contact you about treatment options, other plans and reminders
The company may contact the member about treatment options or other health-related benefits and services. When the member or their dependents reach a certain age, it may tell them about other plans or programs they may be eligible for, including individual coverage. It may send reminders about routine medical checkups and tests, and members may get emails with limited PHI, such as welcome materials.
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. You may get emails that have limited PHI, such as welcome materials.
Qualifications & exceptions
The emails are described as having limited PHI.
Not stated here
The text does not say what age triggers the notice about other plans.
Use & Processing · Company commitment
The paragraph ends: we will ask your permission before we contact you
The last sentence of the paragraph on sharing PHI with the member says the company will ask the member's permission before it contacts them.
Supporting quotations
We’ll ask your permission before we contact you.
Qualifications & exceptions
It follows the sentence about emails with limited PHI.
Not stated here
The sentence does not say whether the permission applies to every contact in the paragraph or only to the emails just before it, or how permission is asked for.
Cross-references
contrast (model-proposed): The company, affiliates and vendors may call or text using automated dialing or an artificial voice — contrast: The paragraph on sharing PHI with the member says the company will ask permission before it contacts the member, while the calling section says affiliates and vendors may call or text using automated dialing under the TCPA and the member can opt out afterwards. The notice does not reconcile the two.
Use & Processing · Company commitment
Written permission is needed before PHI is used for any purpose not stated in the notice
The company says it will get the member's written permission before it uses or shares PHI for any purpose not stated in this notice.
Supporting quotations
We’ll get your written permission before we use or share your PHI for any purpose not stated in this notice.
Qualifications & exceptions
Applies to purposes not stated in the notice; the stated uses and disclosures do not need this permission unless another part of the notice says so.
Use & Processing · Restriction or exception
Genetic information is not used to decide coverage or price
The company says it cannot use a member's genetic information to decide whether to give coverage or to decide the price of that coverage.
Supporting quotations
We cannot use your genetic information to decide whether we’ll give you coverage or decide the price of that coverage.
Use & Processing · Restriction or exception
That information is not used for coverage decisions or shared with unauthorized persons
The company 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, and that 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 text does not say who counts as an authorized person.
Use & Processing · User right or choice
Right to ask the company not to use your PHI for treatment, payment or operations
The member may send a written request asking the company not to use their PHI for treatment, payment or healthcare operations activities. The company may say no, but will explain 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
It is a request the company may refuse.
Use & Processing · Permission or license
The company, affiliates and vendors may call or text using automated dialing or an artificial voice
The company, including its affiliates and/or vendors, may call or text the member using an automatic telephone dialing system and/or an artificial voice, but says it does so only in accordance with the Telephone Consumer Protection Act (TCPA). The calls may be about treatment options or other health-related benefits and services for the member.
Supporting quotations
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
Limited by the company's statement that it acts in accordance with the TCPA.
Not stated here
The statute is cited by name only and is not part of the supplied text; the notice does not say whether the member's consent is collected before calls.