The following Notice describes how information about you may be used and disclosed, as well as how you can obtain access to this information. Please review it carefully.
This Notice gives you information required by the privacy provisions of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (HIPAA Privacy Rules) about the duties and privacy practices of National Income Life Insurance Company (NILICO) to protect the privacy of your medical information that we maintain as an issuer of health insurance policies that provide medical care benefits. If you enroll in NILICO healthcare benefits, you will receive a copy of this Notice when our records indicate that we provide healthcare benefits to you under an individual health insurance policy.
This Notice applies to the designated healthcare components of National Income Life Insurance Company that use and disclose your medical information to provide medical care benefits to you under health insurance policies. We use the terms health and healthcare in this Notice to refer to the medical care benefits we provide to you. This Notice does not apply to the information that our non-healthcare components maintain about you as an issuer of life, disability, accident, indemnity, or any other non-health insurance policy.
The effective date of this Notice is April 14, 2003 and was last revised on September 23, 2013. We are required to follow the terms of this Notice until we replace it. We reserve the right to change the terms of this Notice at any time. If we make changes to this Notice, we will revise it and send a new Notice to all persons to whom we are required to give the new Notice. We reserve the right to make the new changes apply to all your medical information maintained by us before and after the effective date of the new Notice.
Purposes for which we may use or disclose your medical information without your consent or authorization include:
For example, we may disclose your medical information to your doctor, at the doctor's request, or for your treatment by your doctor.
For example, we may use or disclose your medical information to collect premiums, to pay claims for covered healthcare services, or to provide eligibility information to your doctor when you receive treatment. We may also use and disclose your medical information to another covered entity or healthcare provider for the payment activities of the entity that receives your medical information.
For example, we may use or disclose your medical information (i) to conduct quality assessment and improvement activities; (ii) or underwriting, premium writing, or other activities relating to the creation, renewal, or replacement of a contract of health insurance; (iii) to authorize business associates to perform data aggregation services; (iv) to engage in care coordination or case management; and (v) to manage, plan, or develop our business. We may also disclose your medical information to another covered entity for the limited healthcare operations and activities and healthcare fraud and abuse compliance activities of the entity that receives your medical information.
We may use your medical information to contact you to give you information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may disclose your medical information to our business associates to assist us in these activities.
For example, we must allow the U.S. Department of Health and Human Services to audit our records. We may also disclose your medical information as authorized by and to the extent necessary to comply with workers' compensation or other similar laws.
We may disclose your medical information to business associates we hire to assist us. Each of our business associates must agree in writing to ensure the continuing confidentiality and security of your medical information.
If we provide health benefits to you under a group health plan, we may disclose to the plan sponsor of your group health plan, in summary form, claims history, and other similar information. Such summary information does not disclose your name or other distinguishing characteristics. We may also disclose to the plan sponsor the fact that you are enrolled in, or disenrolled from the group health plan. We may disclose your medical information to the plan sponsor for administrative functions that the plan sponsor provides to the group health 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.
In some situations, the HIPAA Privacy Rules do not preempt (or take precedence over) state privacy laws that give you greater privacy protections. As a result, the privacy laws of a particular state might impose a privacy standard under which we will be required to operate (for example, a state privacy law relating to disclosures of medical information of minors).
We will need your written authorization for the use or disclosure of psychotherapy notes, marketing, and the sale of your protected health information. Other uses or disclosures not described in this notice require your written authorization to do so. If you give us written authorization to use or disclose your medical information for a purpose that is not described in this Notice, then, in most cases, you may revoke it in writing at any time. Your revocation will be effective for all your medical information we maintain, unless we have taken action in reliance on your authorization.
If you want to exercise any of these rights described in this Notice, please contact the Contact Office (below). We will give you the necessary information and forms for you to complete and return to the Contact Office. In some cases, we may charge you a nominal, cost-based fee to carry out your request.
If you believe we have violated your privacy rights, you have the right to complain to us or to the Secretary of the U.S. Department of Health and Human Services. You may file a complaint with us at our Contact Office (below). We will not retaliate against you if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
To request additional copies of this Notice or to receive more information about our privacy practices or your rights, please contact us at the following Contact Office:
National Income Life Insurance Company
PO Box 5009
Syracuse, NY 13220
Telephone: (315) 451-8180
National Income Life Insurance Company
c/o National Income Life Service Center
PO Box 2608
Waco, TX 76702
Telephone: (315) 451-8180