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HIPAA
Privacy Notice
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NOTICE OF PRIVACY PRACTICES
FOR COLONIAL LIFE & ACCIDENT INSURANCE COMPANY
For expense-based Cancer, Hospital Confinement, and Intensive Care policies
Pursuant to the Health Insurance Portability and Accountability Act ("HIPAA")
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS INFORMATION CAREFULLY.
We Understand the Importance of Your Privacy
This Notice describes your rights concerning "protected health information" (PHI) about you.
PHI is information that may identify you and that relates to (a) your past, present, or
future physical or mental health or condition or (b) the past, present or future payment for
your health care.
We are committed to preserving the confidentiality of PHI about our customers and in
accordance with the requirements of the law, we commit to:
- Maintain the privacy of PHI about you.
- Provide you with a notice of our legal duties and privacy practices with respect to PHI.
- Abide by the terms of our current notice of privacy practices.
We may need to change the terms of this Notice in the future. We reserve the right to make
changes and to make the new notice effective for all PHI that we maintain about you, including
PHI that we created or maintained in the past. If we make material changes to our privacy
practices, we will mail copies of the revised notices to all policyholders who were then
covered by a health plan.
Uses and Disclosures of Protected PHI for Treatment, Payment or Operations
- For Treatment – We are not a health care provider and do not engage in “treatment” of
individuals as a health care provider (a doctor, for example) would. Accordingly, although
we are permitted to use or disclose PHI about you for treatment purposes, we do not do so.
- For Payment – We may use and disclose PHI about you to obtain premiums or to determine
or fulfill our responsibility to provide you with insurance coverage or benefits under your
policy. For example, we may use or disclose PHI about you to help us determine whether you
are eligible for coverage or to review your claim for benefits under your policy.
- For Health Care Operations – We may use and disclose PHI about you to operate our
business. For example, we use PHI about you to underwrite your insurance policy.
Uses and Disclosures in Special Circumstances
Public Health Activities. We may disclose PHI about you in order to notify public health
authorities of public health risks, such as potential exposure to a communicable disease, or
to report child abuse or neglect.
Health Oversight Activities. We may disclose PHI about you to a health oversight agency
for oversight activities, including for investigations relating to possible insurance fraud.
Judicial and Administrative Proceedings. We may disclose PHI in the course of a judicial
or administrative proceeding, such as in response to a subpoena, discovery request or other
lawful process.
Law Enforcement. We may disclose PHI to law enforcement, for purposes such as reporting
a crime on our premises or in an emergency. We may also disclose to law enforcement or a
correctional facility any PHI that relates to inmates as necessary for health, safety and security.
Prevention of Serious Harm. We may use or disclose PHI about you if we believe it is
necessary to prevent or lessen serious harm (abuse, neglect, or domestic violence) to you or
to other potential victims.
Serious Threat to Health/Safety. We may use or disclose PHI when it is necessary to
prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Specialized Government Functions. We may use or disclose PHI about you for certain
government functions, including but not limited to military and veterans’ activities and
national security and intelligence activities.
Workers’ Compensation. We may disclose PHI about you to comply with Workers’
Compensation laws.
Research Organizations. We may disclose PHI to research organizations if the organization
has met certain conditions about protecting the privacy of PHI.
Plan Sponsors. We may disclose PHI to the plan sponsor of a group health plan for plan
administrative functions if the plan documents contain provisions concerning restrictions on how
the plan sponsor may use or further disclose PHI.
Related Benefits and Services. We may contact you to inform you of benefits or services
related to your policy that may be of interest to you.
Decedents. We may disclose PHI to a coroner, medical examiner, or funeral director to
permit them to carry out their legal duties.
Donation/Transplantation. We may use or disclose PHI for the purpose of facilitating organ,
eye or tissue donation and transplantation.
Business Associates. We may disclose PHI to our business associates, such as our third-party
administrators, accountants, or attorneys if those business associates have signed a written agreement
concerning appropriate uses and disclosures of PHI.
Involvement in Individual's Care. We may disclose PHI about you to a family member, close
personal friend or other person you identify if specifically needed or that person's involvement with
your care or payment related to your health care.
Notification of Location/Condition. We may use or disclose PHI to give notice or assist in
giving notice of your location, general condition or death to a family member, personal representative
or another person responsible for your care.
Disclosures Required by Law. We will use and disclose PHI about you when we are required to do
so by federal, state, or local law.
If applicable law, other than HIPAA, prohibits or materially limits our uses and disclosures of PHI, as
described above, we will restrict our uses or disclosure of PHI in accordance with the stricter standard.
Uses and Disclosures of PHI Made Only With Your Written Authorization
- Other uses and disclosure of PHI about you will be made only with your written authorization,
unless otherwise permitted or required by law as described in this notice.
- You may revoke your written authorization any time, in writing, except to the extent we have
taken action in reliance on that written authorization before you have revoked it.
- You may not revoke your authorization to the extent that other law provides us with the right
to contest a claim under the policy or the policy itself, if the authorization was obtained as a
condition of obtaining this insurance coverage.
Your Rights
Right to a Copy of this Notice. If you would like to have a paper copy of this Notice, send a
written request to the Privacy Officer as indicated in this document
Inspection and Copying. You have the right to access your information. Certain requests for
access to your PHI must be in writing, must state that you want access to your PHI, and must be signed
by you or your representative (such as requests for medical records provided to us directly from your
health care provider).
You have the right, upon written notice, to inspect and copy certain PHI that may be used to make decisions
about your insurance coverage, including medical records and billing records, but not including
psychotherapy notes. We may deny your request to inspect and/or copy in certain limited circumstances;
however, you may request a review of our denial.
Amendment. You may ask us to amend PHI about you (as long as the information is kept by or for us)
and must include a reason for the request. If your request and reason supporting the request are not
submitted in writing, we may deny the request.
Alternative Contact Information. You have the right to receive communications of PHI about you
from us in a certain manner or at a certain location, as long as the request is reasonable under the
circumstances. For example, you may prefer to have mail from us sent to your work address rather than
to your home. Submit requests for an alternative method of contact in writing to the Privacy Officer.
Requesting Restrictions. You have the right to request restrictions on our use or disclosure of
PHI about you. We are not required to agree to your request. However, if we do agree, we are bound
by our agreement except when otherwise required by law, in emergencies, or when the information is
necessary for your treatment. Your request must clearly and concisely describe;
(a) the information you wish restricted;
(b) whether you are requesting to limit our use, disclosure or both; and
(c) to whom you want the limits to apply.
Accounting. You have the right to request an “accounting of disclosures.” An “accounting of
disclosures” is a list of certain disclosures we have made of PHI about you other than disclosures
you authorized and other than disclosures made for treatment, payment or operations. The request must
be in writing. The first request for an accounting that you make within a 12-month period is free;
however, we may charge you for additional requests within the same 12-month period. We will notify you
of the costs of the additional requests, and you may withdraw your request before you incur any costs.
Complaints. If you believe your privacy rights have been violated, you may file a complaint
with us or with the Secretary of Health and Human Services. All complaints must be submitted in
writing. We will not penalize you for filing such a complaint.
To exercise any of your rights as set forth in this Notice, please write to:
Privacy Officer
Colonial Life & Accident Insurance Company
2211 Congress Street, M385
Portland, ME 04122
For further information about matters covered by this notice, please contact the Privacy Office
at the above address or call 1-800-325-4368. You may also refer to the "Frequently Asked
Questions" document regarding this notice that is included with this document on our web
site.
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