HIPAA Privacy

Health Insurance Portability and Accountability Act (HIPAA) privacy information and forms are available to view and download. Our Notice of Privacy Practices describes our uses and disclosures of member information and outlines your individual privacy rights.

Questions? Please call 800.962.2242.

• HIPAA Notice of Privacy Practices
• Member Authorization Form
• Group Certification Form
• Group Health Plan Representatives Authorized to Receive Member Information
• Appeals Authorization Form for Traditional/Indemnity Lines of Business