Privacy
IMPORTANT NOTICE TO ALL INSUREDS
Your Privacy is Important to Us
Healthy Ohio Cities has always been committed to protecting the information you share
with us and is required by law to maintain the privacy of your personal
information as well as your protected health information. Please review our
privacy policy below.
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.
Healthy Ohio Cities holds its employees and consultants to strict policies and
procedures protecting your information. Healthy Ohio Cities is required by law to
provide you this Notice of its duties and privacy practices. All employees must
sign confidentiality agreements. In addition, Healthy Ohio Cities employs various
technologies to prevent unauthorized access to data. This Privacy Statement will
explain the type of information we collect, how we use that information, how we
protect that information, your rights as they relate to your information and our
legal duties and privacy practices.
What Information We Collect
Healthy Ohio Cities understands your concerns regarding the confidentiality of
information you share with us. We collect information from you on applications
and other transactions with us. This information can include name, address and
social security number. Under certain conditions we may also ask you and your
covered dependents for medical history information. We also have access to your
information through claims submitted to our company from healthcare providers,
information provided by your employer if your coverage is through a group
contract and from your agent.
How We Use and Disclose Your Information
We are permitted by law to use your information for certain purposes including
healthcare payment and healthcare operations. Examples of how we may use and
disclose your information include but are not limited to:
Payment: Healthy Ohio Cities may use or disclose your information to pay claims for
covered services or to provide eligibility information to your doctor when you
receive treatment.
Healthcare Operations: Healthy Ohio Cities may use or disclose your information for
activities like (1) underwriting, premium rating or other activities relating to
the creation or renewal of a health insurance contract; (2) quality assessment
and improvement activities such as peer review and credentialing of providers;
(3) care and disease management activities; and (4) data and information systems
management.
As required by law: Healthy Ohio Cities must allow the U.S. Department of Health and
Human Services access to audit its records. In addition, Healthy Ohio Cities may be
required to release your information to comply with other laws including:
- To comply with legal proceedings, such as court orders or administrative order
or subpoenas.
- To perform mandatory licensing, regulatory/compliance reporting.
- To law enforcement officials for limited law enforcement purposes.
- To federal officials for lawful intelligence, counterintelligence and other
national security purposes.
- To Public Health Authorities for public health purposes.
- To comply with workers’ compensation and other similar programs established by
law that provide for benefits for work-related injuries or illness without
regard to fault.
- To Business Associates: Healthy Ohio Cities may disclose your information to third
parties that it hires to assist in the administration of your benefits. These
third parties are called Business Associates and they must agree in writing to
protect and maintain the confidentiality and security of your information.
Examples of a Business Associate are the doctors who do medical reviews and our
brokers who service your policy.
- To Plan Sponsors: If you receive insurance benefits through a group plan,
Healthy Ohio Cities may disclose to your Plan Sponsor, in summary form, claims
history and other similar information. Such summary information does not
disclose your name or other distinguishing characteristics. Healthy Ohio Cities may
also disclose to your Plan Sponsor the fact that you are enrolled in, or
disenrolled from the Plan. Healthy Ohio Cities may disclose your medical information
to the Plan Sponsor for Plan administrative functions that the Plan Sponsor
provides to the Plan if the Plan Sponsor agrees in writing to ensure the
continuing confidentiality and security of your medical information. The Plan
Sponsor must also agree not to use or disclose your medical information for
employment-related activities or for any other benefit or benefit plans of the
Plan Sponsor.
Other Uses and Disclosures: Other disclosures that Healthy Ohio Cities may make:
- To your personal representative appointed by you or designated by law.
- To appropriate military authorities, if you are a member of the armed forces.
- To a family member, friend or other person, for the purpose of helping you with
your healthcare or healthcare payment if you are in an emergency situation and
you cannot give your agreement to Healthy Ohio Cities to do this.
- To inform you of other health related benefits or services that may be of
interest to you.
- Uses and Disclosures with your permission: Healthy Ohio Cities will not use or
disclose your information for any purpose not outlined in this notice unless you
give Healthy Ohio Cities your written authorization to do so. We do not make
disclosures of information to any other companies that may want to sell their
products or services to you. If you give Healthy Ohio Cities your written
authorization, you may revoke that authorization at any time unless Healthy
Dublin has taken action in reliance of your authorization. To receive an
authorization form, please contact Customer Service at the telephone number on
the back of your identification card or print one from our website,
Medmutual.com under the Member Services Section. If a family member calls with
knowledge of your claim, we may confirm certain information about it, unless you
have informed us in writing of a need for confidential communication.
Your Rights
Below are your privacy and confidentiality rights as a member of Healthy Ohio Cities.
Please note that all requests must be made in writing. We have provided forms to
help in processing your request. The appropriate forms are available under the
Member Services Section at our web-site, www.medmutual.com. You also may call Customer Service at
the telephone number on the back of your identification card to obtain a copy of
this form. Hearing-impaired customers may contact us at 1-800-851-0479 or
1-800-982-8109. All completed forms and requests are to be mailed to:
Healthy Ohio Cities
P.O. Box 89499
Cleveland, Oh 44101-6499
Requests with incomplete information will not be processed and you will not be
notified.
Restriction: You may request that Healthy Ohio Cities place additional restrictions
on the use and disclosure of your information to carry out treatment, payment or
healthcare operations. Healthy Ohio Cities does not have to agree to your request.
Please use the form provided under the Member Services Section at our web site
www.medmutual.com to
submit your request. Be sure to provide all required information including your
name, your birthday, the policy number under which you are covered, and a clear
explanation of your request. Healthy Ohio Cities will send a written confirmation
regarding the disposition of your request.
Confidential Communication: You may request that Healthy Ohio Cities communicate with
you in confidence about your information at a different location. Healthy Ohio Cities
does not have to honor this request unless (1) such a change in communication is
necessary to avoid endangering you; (2) your request allows Healthy Ohio Cities to
continue collecting premiums and pay claims; and (3) your request is reasonable.
Please use the form provided under the Member Services Section at our web site,
www.medmutual.com to
submit your request. Be sure to provide all required information including your
name, your social security number, your group number, your birthday, the policy
number under which you are covered, the full address of where you would like
future communication to be sent and the reason for the request.
The request will take ten (10) business days to process from the date received.
You will receive a letter confirming the activation of the alternate address.
All communications regarding your information will be sent to the alternate
address once this request has been made or until you notify us otherwise. Use of
an alternate address cannot be applied to communications sent prior to
processing your request.
Access to your information: You have a right to access your information used and
stored by Healthy Ohio Cities in its designated record set. For access to your entire
medical record, you will have to contact the provider of service. Please use the
form provided under the Member Services Section at our web site,
www.medmutual.com to
submit your request for Access to your records. Be sure to provide all required
information including your name, your birthday, the policy number under which
you are covered, the group number under which you are covered, your social
security number, the information you would like to access and the dates of
information you would like to see (if applicable).
Amend your information: You have the right to request an amendment of your
information. Healthy Ohio Cities cannot amend information it did not create and will
refer you to the provider of service if you are requesting an amendment to
diagnosis or treatment information. Please use the form provided under the
Member Services Section at our web site, www.medmutual.com to submit your request to amend your
records. Be sure to provide all required information including your name, your
birthday, the policy number under which you are covered, the information you are
requesting be amended, and an explanation as to why you believe the information
is incorrect or incomplete. You have a right to an appeal if your request to an
amendment is denied. These rights will be explained to you if your request is
denied.
Disclosures: You have a right to an accounting of certain disclosures of your
information made by Healthy Ohio Cities and its Business Associates over the last six
(6) years (but not for disclosures made before April 14, 2003). Please use the
form provided under the Member Services Section at our web site,
www.medmutual.com to
submit your request for an Accounting of Disclosures of your records. Be sure to
provide all required information including your name, your birthday, the policy
number under which you are covered, and a statement explaining your specific
request.
Complaints: You have the right to complain if you believe your rights have been
violated. You may use the form provided under the Member Services Section at our
web site, www.medmutual.com
to submit your complaint. Please provide all required information including your
name, your birthday, the policy number under which you are covered, and an
explanation regarding your complaint in as much detail as possible. You may file
a complaint by contacting Customer Service at the telephone number on the back
of your identification card, if you wish not to send it in writing.
You also have the right to complain to the Secretary of the U.S. Department of
Health and Human Services, Hubert Humphrey Building, 200 Independence Avenue,
S.W., Washington, D.C. 20201. Federal law prohibits retaliation against you if
you chose to file a complaint.
Contact Information: If you have questions or would like an additional copy of
this notice, please contact Customer Service at the telephone number on the back
of your identification card.
Security Procedures
Healthy Ohio Cities takes the security of your information very seriously and has
established security standards and procedures to prevent unauthorized access to
customer information. We maintain physical, electronic and procedural safeguards
to guard your information. All authorized personnel within our organization who
deal with your information must abide by a confidentiality agreement.
Links to Other Sites
This site may contain links to other Web sites, even though you may still see
our logo; you are providing information to these other sites when you leave our
site. We will notify you when you are leaving our site. We are not responsible
for the privacy practices or the contents of such other Web sites. You should
review the posted statement at the sites you go to from our site.
E-Mail
All information and correspondence you share with us will be handled in the
strictest confidence. Please note that the email facilities on our Web site
(unlike those areas within the site) do not provide the same level of security.
For that reason, please do not email to communicate information to us that you
consider confidential. If you wish, you may contact us instead via telephone at
the Customer Service number located on your identification card.
Cookies and Other Methods of Collecting Information
Healthy Ohio Cities uses various methods to collect certain other kinds of
information that cannot be personally identified with you, including "cookies",
"referrers", IP addresses, and environment variables. A "cookie" is an element
of data that Healthy Ohio Cities can send to your browser, which may then store it on
your system. It can be used to provide you with a tailored user experience. The
Healthy Ohio Cities site uses cookies. We treat any personally identifiable
information with the same confidentiality as when you enrolled. You can set your
browser to notify you when you receive a cookie, giving you the chance to decide
whether or not to accept it. Healthy Ohio Cities does not require that you accept
cookies. A "referrer" is the information passed along by a web browser that
references the Web URL you linked from, and is automatically gathered by our Web
server. This information is used by Healthy Ohio Cities to identify broad demographic
trends that may be used to provide information tailored to your interests. You
will not be personally identified from this information.
Your computer uses IP addresses every time you are connected to the Internet.
Your IP address is a number that is used by computers on the network to identify
your computer so that data (such as the Web pages you request) can be sent to
you. Our Web server automatically gathers them. Healthy Ohio Cities will not use your
IP address to attempt to identify your personal information and you will remain
anonymous. System Information we gather includes time, type of Web browser being
used, the operating system/platform, and CPU speed. This information is sent
automatically by your Web browser when you are connected to a Web site and is
used by Healthy Ohio Cities only for broad demographic statistics. You will not be
personally identified from this information.
Effective Date
The effective date of this notice is April 14, 2003. Healthy Ohio Cities is required
to follow the terms of this notice until it is replaced. Healthy Ohio Cities reserves
the right to change this Privacy Statement at any time as allowed by law and
will notify you of any changes as required by law. Healthy Ohio Cities reserves the
right to make the changes apply to all information that it maintains.