Privacy

We are required by law to provide you with this notice. This notice informs you of your rights about the privacy of your personal information and how we may use and share your personal information. We will make sure that your personal information is only used and shared in the manner described.

We may, at times, update this notice. Changes to this notice will apply to the information that we already have about you as well as any information that we may receive or create in the future. You may request a copy of your privacy rights at any time.

Information We Collect

We collect enrollment and other information. Examples include your name, address, phone number, social security number, date of birth, marital status, and employment information. We also receive information from health care providers and others about you. Examples include the health care services you receive. This information may be in the form of health care claims and encounters, medical information, or a service request. We may receive your information in writing, by telephone or electronically.

Protecting Your Personal Information

Keeping your information safe is one of our most important duties. We limit access to your personal information to those who need it. We maintain appropriate safeguards to protect it. For example, we protect access to our buildings and computer systems. Our Privacy Office also assures the training of our staff on our privacy and security policies.

Sharing Your Information

To properly service your benefits, we may use and share your personal information for:

Treatment: To health care providers for coordination and management of your care. Providers include physicians, hospitals, and other caregivers who provide services to you.

Payment: To determine your eligibility, coordinate care, review medical necessity, pay claims, obtain external review and respond to complaints. For example, we may use information from your health care provider to help process your claims. We may also use and share your personal information to obtain payment from others that may be responsible for such costs.

Health Care Operations: Operations include quality improvement activities; responses to your questions, grievance or external review programs. This may also include general administrative activities such as detection and investigation of fraud; auditing; underwriting and rate setting; securing and servicing reinsurance policies.

Health care oversight and law enforcement: To comply with federal or state oversight agencies. These may include your state Department of Insurance or the US Department of Labor.

Legal proceedings: To comply with a court order or other lawful process.

Treatment options: To inform you about treatment options or health related benefits or services.

Others involved in your health care: To a relative, such as your spouse, close personal friend, or others who we have verified are involved in your care or payment for that care. For example, we may mail explanations of benefits paid to the subscriber. Your family may also have access to such information on our web sites. Also, if a family member calls with knowledge of your claim, we may confirm certain information about it. If you do not want this information to be shared, please tell us in writing.

Personal representatives: To people you have authorized or those having a relationship that gives them the right to act on your behalf. Examples include parents of an unemancipated minor or those having a Power of Attorney.

Business associates: To persons providing services to us, and who assure us that they will protect the information. Examples include those companies providing your Vision and health insurance benefits. 

Other situations: We also may share personal information in certain public interest situations. Examples include protecting victims of abuse or neglect; preventing a serious threat to health or safety; or informing military or veteran authorities if you are an armed forces member. We may also share your information with coroners; for worker's compensation; for national security and as required by law.

We may limit the amount of information we share about you as required by law. Our privacy policies will always reflect the most protective laws that apply.

Your Rights

The federal Privacy Rule provides you with certain rights. These rights are effective as of April 14, 2003. You must notify us in writing to exercise these rights.

Requesting restrictions: You can request a restriction on the use or sharing of your health information for treatment, payment or health care operations. However, we may not agree to a requested restriction.

Confidential communications: You can request that we communicate with you about your health and related issues in a certain way, or at a certain location. For example, you may ask that we contact you by mail, rather than by telephone, or at work, rather than at home. We will accommodate reasonable requests.

Access and copies: You can inspect and obtain a copy of certain health information. We may charge a fee for the costs of copying, mailing, labor and supplies related with your request. We may deny your request to inspect or copy in some situations. In some cases denials allow for a review of our decision. We will provide you this information free of charge, unless we already provided this to you within the same 12-month period. We will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

Amendment: You may ask us to amend your health information if you believe it is incorrect or incomplete. You must provide us with a reason that supports your request. We may deny your request if the information is accurate or as otherwise allowed by law.

Accounting of disclosures: You may request a report of certain times we have shared your information. Examples include, sharing your information in response to court orders or with government agencies that license us. All requests for an accounting of disclosures must state a time period that may not include a date earlier than 6 years prior to the date of the request and may not include dates before April 14, 2003. We will provide you with the list free of charge, unless we already provided you with a list within the same 12-month period. We will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

Contact Us

Please contact the Health Plan Privacy Officer to find out how to exercise any of your rights listed in this notice, or if you have any questions about this notice.

Privacy Office, Penn State University, 120 S. Burrows Street, Suite 333E State College, PA 16801 (814) 863-3049
 
If you believe we have not followed the terms of this notice, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.

To contact us, please follow the complaint, grievance or appeal process in your benefit documents.
For purposes of this notice, the pronouns "we", "us" and "our" refers to The Pennsylvania State University and its affiliated companies, including Highmark, and National Vision Administrators, Inc. (NVA); these entities will abide by the privacy practices described in this Notice.