Health Insurance Portability and Accountability Act (HIPAA)

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.

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.

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.

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.

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.

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.

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.

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:

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.

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.

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.

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 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.

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.

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

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.