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UNUMPROVIDENT’S NOTICE OF PRIVACY PRACTICES
For Long Term Care, Cancer Assistance, Certain Medical Coverages and other Health
Plans
Pursuant to the Health Insurance Portability and Accountability Act ("HIPAA")
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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
UnumProvident Understands 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.
UnumProvident is committed to preserving the confidentiality of PHI about its customers and
in accordance with the requirements of the law, we pledge 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
It may be necessary 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 we created or maintained in the past. If we make
material changes to our privacy practices, copies of revised notices will be mailed to all
policyholders then covered by a health plan.
Uses and Disclosures of PHI for Treatment, Payment or Operations
- For Treatment – UnumProvident is not a health care provider and does 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 in order 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 in order to determine
whether you are eligible for coverage or to decide your claim for benefits under your
policy.
- For Health Care Operations – We may use and disclose PHI about you in order to
operate our business. For example, we use PHI about you in order 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 PHI relating 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 in order to comply with workers’
compensation laws.
Research Organizations. We may disclose PHI to research organizations if the
organization has satisfied 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 identified by you if directly relevant to 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.
In the event 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 more stringent 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, at 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
insurance coverage.
Your Rights
Right to a Paper Copy of this Notice. An electronic copy of this Notice is available
on our web site, www.unumprovident.com. If you would like to have another paper copy of this
Notice, send a written request to the UnumProvident Privacy Officer.
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 (e.g., 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) if you believe it is incorrect or incomplete. Such requests must be in writing
to the Privacy Officer and must include a reason for the request. If your request and a reason
supporting the request are not submitted in writing, we may deny your 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, so 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. If we do agree,
however, 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 incurring 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.
In order to exercise any of your rights as set forth in this Notice, please write to:
Privacy Officer
UnumProvident Corporation
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) 227-4165 if you are a Long Term Care customer
or 1 (800) 635-5597 if you are a Cancer Assistance customer.
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