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Reference
Appendix and Legal Notices
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO YOUR INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective September 23, 2013
This notice describes the ways your medical information
may be used and disclosed by the group health benefit
programs sponsored by Aflac (collectively the “Plan”).
The Plan is required by the Health Insurance Portability
and Accountability Act of 1996 (“HIPAA”) to maintain the
privacy of protected health information and to provide
you with this notice of the Plan’s legal duties and privacy
practices. This notice also provides information about
how you may access your health information. Please
review it carefully.
Protected health information (“PHI”) means individually
identifiable health information that is created or received by
the Plan that relates to your past, present or future physical
or mental health or condition; the provision of health care
to you; or the past, present or future payment for the
provision of health care to you; and that identifies you or for
which there is a reasonable basis to believe the information
can be used to identify you. In addition to HIPAA, special
protections under state or other federal law may apply to
the use or disclosure of your PHI. The Plan will comply
with other federal laws where they are more protective of
your privacy. If state law provides privacy protections that
are more stringent than those provided by HIPAA, the
Plan will maintain your PHI in accordance with the more
stringent state-law standard only to the extent the law is
not preempted by ERISA or other federal law.
In general, the Plan receives and maintains health infor-
mation only as needed for claims or Plan administration.
The primary source of your health information continues
to be the healthcare provider (for example, your doctor,
dentist or hospital) that created the records. Some health
benefits are provided through insurance where the Plan
sponsor does not have access to PHI. If you are enrolled
in any insured arrangements, you will receive a separate
privacy notice from the insurer. Please note that the
group health benefit programs covered by this notice are
part of an organized health care arrangement because
they are all sponsored by Aflac. This means that the
benefit programs may share your PHI with each other,
as needed, for the purposes of payment and health care
operations.
The Plan is required to operate in accordance with the
terms of this notice. The Plan reserves the right to change
the terms of this notice. If there is a material change to
the uses or disclosures, your rights or the Plan’s legal
duties or privacy practices, the notice will be revised and
you’ll receive a copy. The new provisions will apply to all
PHI maintained by the Plan, including information that
existed prior to revision.
Uses and Disclosures Permitted Without
Your Authorization or Consent
The Plan is permitted to use or disclose PHI without your
consent or authorization in order to carry out treatment,
payment or health-care operations. Information about
treatment
involves the care and services you receive
from a health-care provider. For example, the Plan may
use information about treatment of a medical condition
by a doctor or hospital. Information about
payment
involves activities by the Plan to provide coverage and
benefits. Payment activities include determinations of
eligibility and claims management. (For example, claims
are made for services you receive from a doctor.) The
Plan may use and disclose your PHI for
health care
operations
to make sure the Plan is well run, adminis-
tered properly and does not waste money. For example,
the Plan may use information about your claims to
project future benefit costs or audit the accuracy of its
claims processing functions. The Plan may also disclose
your PHI to undertake underwriting, premium rating and
other insurance activities relating to changing health
insurance contracts or health benefits. However, federal
law prohibits the Plan from using or disclosing PHI that is
genetic information (e.g. family medical history) for under-
writing purposes, which include eligibility determinations,
calculating premiums and any other activities related to
the creation, renewal or replacement of a health insurance
contract or health benefits. The Plan may contact you to
provide information about treatment alternatives or other
health-related benefits that may be of interest to you.
The Plan may disclose health information to the
Company, if the information is needed to carry out admin-
istrative functions of the Plan. In certain cases, the Plan,
insurers or HMOs may disclose your PHI to the Company.
