HIPAA Notice of Privacy Practices

 
 

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.

As your insurer, PALIC Insurance Company (“PALIC”) may collect certain health information from you, either from your insurance application for coverage or from yourself or your provider for reimbursement of medical expenses, and for other purposes that are permitted or required by law.

We are required by law to protect the privacy of your Protected Health Information (as defined by the HIPAA Privacy Rule). We also are required to send you this Notice, which explains how we may use Protected Health Information about you and when we can disclose it to others. You also have rights regarding your Protected Health Information that are described in this Notice. As described further below in this Notice, we will let you know promptly if a breach occurs that may have compromised the privacy and security of your information. We are required by law to follow the terms of this Notice. In the event applicable law, other than HIPAA, prohibits or materially limits our uses and disclosures of Protected Health Information, as set forth below, we will restrict our uses or disclosure of your Protected Health Information in accordance with the more stringent standard.

We understand that Protected Health Information about you and your health is personal. We are committed to protecting Protected Health Information about you and will use it to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request of it.

USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION

PALIC is permitted or required by law to use or disclose your Protected Health Information without your consent or authorization for the following purposes:

  • TREATMENT: When and as appropriate, we may use and disclose your Protected Health Information to a physician or other health care provider. For example, we might disclose information about you with your physicians who are treating you.
  • PAYMENT: When and as appropriate, we may use and disclose your Protected Health Information for payment purposes or to fulfill our responsibilities for coverage under your policy. For example, we may disclose your Protected Health Information to process or pay claims, or to collect payment from third parties, such as other health plans or providers, for the care you receive. We may also disclose information regarding your coverage or your Protected Health Information to other health plans to coordinate payment of benefits.
  • HEALTH CARE OPERATIONS: When and as appropriate, we may use and disclose your Protected Health Information for our own health care insurance operations. For example, these purposes include (i) to conduct quality assessment and improvement activities, (ii) for underwriting, premium rating or related functions to create, renew or replace health insurance or health benefits, (iii) review and auditing, including claims submissions for stop loss (or excess loss), compliance reviews, medical reviews, legal services and compliance programs, (iv) business planning and development including cost management and planning related analyses and formulary development, (v) business management and general administrative activities of PALIC administered health plans, including customer service and resolution of internal grievances. We will not use genetic information for underwriting purposes.
  • HEALTH RELATED SERVICES: When and as appropriate, we may use and disclose your Protected Health Information to contact you about health-related products and services that may be of interest to you.
  • BUSINESS ASSOCIATES: We may use and disclose your Protected Health Information to business associates. For example, PALIC may disclose health information to a business associate to assist with payment or health care operations. In all cases, PALIC contractually requires these business associates to appropriately safeguard the privacy of your information.
  • PLAN SPONSOR: We may, under certain conditions, use and disclose your health information to a plan sponsor for plan administration. For example, this may be for statistical, renewal or quotation purposes. However, your plan sponsor is not permitted to use such information for employment purposes.

OTHER USES AND DISCLOSURES

We may use or disclose your Protected Health Information as authorized by law as follows:

  • for any purposes as required by state or federal law.
  • for public health activities, such as required reporting of certain diseases.
  • as required by law if we believe you to be a victim of abuse, neglect, or domestic violence.
  • to health oversight agencies.
  • in response to court and administrative orders, subpoenas, and other lawful processes.
  • to law enforcement officials as required by law.
  • to coroners, medical examiners and/or funeral directors consistent with law.
  • if necessary to arrange an organ or tissue donation from you or a transplant for you.
  • to avert a serious threat to health or safety.
  • to the military and to federal officials for lawful intelligence, counterintelligence, and national security activities.
  • to correctional institutions regarding inmates; and
  • as authorized by and to the extent necessary to comply with state worker’s compensation laws.

Uses and disclosures other than those described in this Notice will require your written authorization. You may revoke your authorization at any time, but you cannot revoke your authorization if we have already acted on it.

YOUR RIGHTS

You have the following rights regarding Protected Health Information that we maintain about you:

  • RESTRICTIONS: You have the right to request restrictions on certain uses and disclosures of your protected health information; however, PALIC is not required to comply with such requests. We will make every effort to do so; however, to request restriction, you must send a written request and tell us:
  • What information you want to limit
  • Whether you want to limit our use, disclosure, or both.
  • To whom you want the limits to apply, e.g., disclosures to your spouse.
  • RECEIVING CONFIDENTIAL COMMUNICATION: You have the right to request that PALIC communicates with you in a certain way if you feel the disclosure of your health information could endanger you. For example, you may ask that PALIC only communicate with you at a certain telephone number or by email. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
  • ACCESS: You have the right to inspect and obtain a copy of your Protected Health Information that may be used to make decisions about your benefits under the Plans. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to Protected Health Information, you may request that the denial be reviewed. If we do not maintain the health information, but know where it is maintained, you will be informed of where to direct your request. A request to inspect and copy records containing your health information must be made in writing.
  • AMENDMENT: If you feel that the Protected Health Information, we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for us. You also must provide a reason that supports your request.

    We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. The request also may be denied if your health information records were not created by PALIC, if the health information you are requesting to amend is not part of PALIC’s records, if the health information you wish to amend falls within an exception to the health information you are permitted to inspect and copy, or if PALIC determines the records containing your health information are accurate and complete. We will notify you of the denial in writing within 60 days.
  • DISCLOSURES: You have the right to request an “accounting of disclosures”. This is a list of persons or organizations to which we have disclosed your health information for certain purposes. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). Your request may cover any disclosures made in the six years before the date of your request. You must submit your request in writing.

You can make any of the requests described above to by filling out an online request here or by contacting the Privacy Officer listed in the Contact section below.

  • COPY OF THIS NOTICE: You may request a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.  We will provide you with a paper copy promptly.
  • CHOOSE SOMEONE TO ACT FOR YOU: You may designate a person with medical power of attorney or who is your legal guardian to exercise your rights and/or act on your behalf. We will ensure that the person has authority to act for you before we take any action.
  • FILE A COMPLAINT: You may submit a complaint if you feel we have violated your rights by contacting our Privacy Officer using the information in the Contact section below.

    You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775 or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html

We will not take any action against you or retaliate in any way for any complaint.

BREACH NOTIFICATION

Pursuant to changes to HIPAA required by the Health Information Technology for Economic and Clinical Health Act of 2009 and its implementing regulations (collectively, “the HITECH Act”) under the American Recovery and Reinvestment Act of 2009 (“ARRA”), this Notice also reflects federal breach notification requirements imposed on the Plans in the event that your “unsecured” protected health information (as defined under the HITECH Act) is acquired by an unauthorized party.

We understand that Protected Health Information about you and your health is personal, and we are committed to protecting your Protected Health Information. Furthermore, we will notify you following the discovery of any “breach” of your unsecured protected health information as defined in the HITECH Act (the “Notice of Breach”). Your Notice of Breach will be in writing and provided via first-class mail, or alternatively, by e-mail if you have previously agreed to receive such notices electronically. If the breach involves:

  • Ten or more individuals for whom we have insufficient or out-of-date contact information, then we will provide substitute individual Notice of Breach by either posting the notice on the benefits website or by providing the notice in major print or broadcast media where the affected individuals likely reside.
  • Less than 10 individuals for whom we have insufficient or out-of-date contact information, then we will provide a substitute Notice of Breach by an alternative form.
  • Your Notice of Breach shall be provided without unreasonable delay and in no case later than 60 days following the discovery of a breach and shall include, to the extent possible:
  • A description of the breach.
  • A description of the types of information that were involved in the breach.
  • The steps you should take to protect yourself from potential harm.
  • A brief description of what we are doing to investigate the breach, mitigate the harm, and prevent further breaches.
  • Our relevant contact information.

Additionally, for any substitute Notice of Breach provided via web posting or major print or broadcast media, the Notice of Breach shall include a toll-free number for you to contact us to determine if your protected health information was involved in the breach.

PALIC will adhere to all state and federal laws or regulations that provide additional privacy protection.

If you have any questions or concerns about PALIC privacy practice, please contact us at:

In the Continental United States:
PALIC Insurance Group
Attn: Privacy Officer
601 Poydras Street
New Orleans, LA 70130

Email: privacy@palig.com

Telephone: 1-877-939-4550

In Puerto Rico:

PALIC Company of Puerto Rico
Attn: Compliance Department
P.O. Box 364865
San Juan, Puerto Rico 00936

Email: privacy@palig.com

Telephone: 787-620-1414 

This notice is provided on behalf of the following PALIC Insurance Group member companies and their subsidiaries: PALIC Insurance Company and PALIC Insurance Company of Puerto Rico

The effective date of this notice is 4/13/2003. This notice was last revised on 4/23/24.

We reserve the right to change this notice at any time to comply with applicable laws or to reflect our updated business practices. We also reserve the right to make the changes in our privacy practices and the new notice effective for all Protected Health Information that we already have about you as well as for Protected Health Information that we may receive in the future. If we change it, we will post the current notice on this page. Any changes to this notice will be effective as of the day they are posted. By using our site, you consent to our privacy practices.