Fundraising communications and your right to opt out
The affiliates may use your PHI to send you fundraising communications. The Notice states you have the right to opt out of receiving such communications.
Details
Who
The Cigna affiliates ("we")
Why
Send fundraising communications
Condition
You can opt out
Supporting quotations
We may use your PHI to send you fundraising communications, but you have the right to opt out of receiving such communications.
Qualifications & exceptions
You may opt out of fundraising communications.
Not stated here
This passage does not say how to opt out.
Use & Processing · Permission or license
Facility directory information
The affiliates may use your PHI to maintain contact information in a facility directory. The Notice says this information may include names, facility location, general information about conditions, and religious affiliation.
Details
Who
The Cigna affiliates ("we")
Why
Maintain contact information in a facility directory
What it covers
Names, facility location, general information about conditions, religious affiliation
Supporting quotations
We may use your PHI for purposes of maintaining contact information in a facility directory.
Such information may include names, facility location, general information about conditions, and religious affiliation.
Not stated here
The passage does not say which facilities, whether the directory is public, or who can see it.
Use & Processing · Permission or license
Underwriting, with a ban on genetic information
The affiliates may use or disclose your PHI for underwriting and other activities relating to the creation, renewal or replacement of a contract of health insurance or health benefits. They state they are prohibited from using or disclosing PHI that is genetic information for these purposes.
Details
Who
The Cigna affiliates ("we")
Why
Underwriting and other activities relating to creating, renewing or replacing a health insurance or benefits contract
Exception
PHI that is genetic information may not be used or disclosed for these purposes
Supporting quotations
We may use or disclose your PHI for the purpose of underwriting and other activities relating to the creation, renewal or replacement of a contract of health insurance or health benefits.
We are prohibited from using or disclosing PHI that is genetic information for such purposes.
Qualifications & exceptions
Genetic information is excluded from underwriting use and disclosure.
Use & Processing · User right or choice
Right to request restrictions on use and disclosure
You may request a restriction or limitation on the PHI the affiliates use and disclose for treatment, payment or health care operations, and may ask that your PHI not be disclosed to family members or friends involved in your care or its payment. The request must be in writing and state the restriction and to whom it applies. The affiliates are not required to agree. If they do agree, they will comply unless the restricted information is needed to provide you with emergency treatment.
Details
Who
You (the individual)
Condition
Written request; affiliates may refuse; emergency treatment exception
Supporting quotations
You have the right to request a restriction or limitation on the PHI we use and disclose about you for treatment, payment or health care operations.
You may also request your PHI not be disclosed to family members or friends who may be involved in your care or paying for your care.
Your request must be in writing; state the restrictions you are requesting and state to whom the restriction applies. We are not required to agree to your request.
If we do agree, we will comply with your request unless the restricted information is needed to provide you with emergency treatment.
Qualifications & exceptions
Request must be in writing and state the restrictions and to whom they apply.
The affiliates are "not required to agree", with a required exception for out-of-pocket medications described in a separate card.
An agreed restriction does not apply if the information is needed for emergency treatment.
Cross-references
has exception (model-proposed): Required agreement for medications you paid for in full — Restriction requests need not be agreed to in general, but the affiliates will agree where the information is about a medication you paid for out-of-pocket in full and is disclosed to a health plan for payment or operations.
Use & Processing · User right or choice
Required agreement for medications you paid for in full
The affiliates say they will agree to your request to restrict PHI disclosed to a health plan for payment or health care operations (non-treatment) purposes if the information is about a medication for which you paid them, out-of-pocket, in full. This is an exception to the general statement that they are not required to agree to restriction requests.
Details
Who
The Cigna affiliates ("we")
Condition
Medication paid for out-of-pocket, in full; disclosure to a health plan for payment or operations
Supporting quotations
We will agree to your request to restrict PHI disclosed to a health plan for payment or health care operations (that is, non-treatment) purposes if the information is about a medication for which you paid us, out-of-pocket, in full.
Qualifications & exceptions
Applies to disclosures to a health plan for payment or health care operations, not treatment.
Applies only when you paid out-of-pocket, in full, for the medication.
Not stated here
Whether the written-request requirement for restrictions also applies here is not separately stated; the surrounding text says requests must be in writing.
Cross-references
exception to (model-proposed): Right to request restrictions on use and disclosure — Restriction requests need not be agreed to in general, but the affiliates will agree where the information is about a medication you paid for out-of-pocket in full and is disclosed to a health plan for payment or operations.
Use & Processing · Permission or license
Payment: using and disclosing PHI for payment and claims
The affiliates may use and disclose PHI about you to receive payment for their services or premiums for your coverage, manage your account, fulfill their responsibilities under your benefit plan and process your claims for drugs you have received. For example, they may give PHI to your health plan (or its designee) to confirm eligibility or coverage, or submit claims to your health plan, employer or other third party for payment.
Details
Who
The Cigna affiliates ("we")
What it does
Use and disclose PHI
Why
Receive payment for services or premiums, manage account, meet benefit plan responsibilities, process drug claims
What it covers
PHI shared with your health plan (or designee), employer or other third party for payment
Supporting quotations
We may use and disclose PHI about you to receive payment for our services or premiums for your coverage, manage your account, fulfill our responsibilities under your benefit plan and process your claims for drugs you have received.
we may submit claims to your health plan, employer or other third party for payment
Qualifications & exceptions
Listed among uses that do not require your authorization.
Use & Processing · Permission or license
Health care operations: business planning and health-management information
The affiliates may use and disclose your PHI to carry on their own business planning and administrative operations, which they say they need to do to provide high-quality services. Examples: sharing claims information with your doctor if you have a medical need that requires attention, assessing the use or effectiveness of certain drugs, developing and monitoring medical protocols, and providing information about helpful health-management services.
Details
Who
The Cigna affiliates ("we")
What it does
Use and disclose PHI
Why
Own business planning and administrative operations
Supporting quotations
We may use and disclose your PHI to carry on our own business planning and administrative operations.
we may share your claims information with your doctor if you have a medical need that requires attention; we may use and disclose PHI about you to assess the use or effectiveness of certain drugs, develop and monitor medical protocols, and to provide information regarding helpful health-management services
Qualifications & exceptions
Examples are illustrative; the stated purpose is "our own business planning and administrative operations".
Contact about treatment options and other products
The affiliates may use or disclose your PHI to contact you about treatment options or alternatives that may be of interest to you. Examples: calling to remind you of expired prescriptions or the availability of alternative drugs, or to inform you of other products that may benefit your health.
Details
Who
The Cigna affiliates ("we")
What it does
Use or disclose PHI to contact you
Why
Tell you about treatment options, alternatives, expired prescriptions, other products that may benefit your health
Supporting quotations
We may use or disclose your PHI to contact you about treatment options or alternatives that may be of interest to you.
or to inform you of other products that may benefit your health
Qualifications & exceptions
Listed among uses without authorization; elsewhere the Notice separately says marketing uses require an authorization, and this passage does not say how the two fit together.
Not stated here
"Other products that may benefit your health" is not defined, and the passage does not say whether those could be third-party products.
Cross-references
contrast (model-proposed): Uses that require your authorization — The Notice says uses for marketing purposes require authorization, and separately says the affiliates may contact you about treatment options and other products that may benefit your health without listing authorization. It does not say whether that contact counts as marketing, so both statements are shown.
Use & Processing · Permission or license
Research uses of PHI
Under certain circumstances, the affiliates may use and disclose PHI about you for research purposes. Before doing so, they say they will remove information that personally identifies you, obtain your written authorization, or gain approval through a special approval process designed to protect the privacy of your PHI.
Details
Who
The Cigna affiliates ("we")
Why
Research
Condition
Remove identifying information, or obtain written authorization, or gain approval through a special approval process
Supporting quotations
Under certain circumstances, we may use and disclose PHI about you for research purposes.
Before we use or disclose PHI about you, we will remove information that personally identifies you, obtain your written authorization or gain approval through a special approval process designed to protect the privacy of your PHI.
Qualifications & exceptions
Only "under certain circumstances".
One of three safeguards applies before use or disclosure: removing identifying information, your written authorization, or a special approval process.
Not stated here
The Notice does not say what the "special approval process" is or when each safeguard is used.