T3 Consortium, LLC's privacy policies include
guidelines and procedures relating to T3 Consortium, LLC's use
and disclosure of information about our customers and individuals
who visit our website. For information regarding our Online Privacy
Policy, Customer Privacy Policy, or HIPAA Notice of Privacy Practices
for Personal Health Information, please click on the appropriate
option.
HIPAA Notice of Privacy Practices for Personal
Health Information
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Dear Mynumi Group, LLC Health Insurance Customer:
This is your Health
Information Privacy Notice from Metropolitan Life Insurance
Company ("Mynumi Group,
LLC"). Please read it carefully. You have received this
notice because of your Health Insurance coverage with us that
is administered by either Kanawha Insurance Company, Marsh
Affinity group or Health Plan Services. Mynumi Group, LLC and
each member of the Mynumi Group, LLC family of companies (an "Affiliate")
strongly believe in protecting the confidentiality and security
of information we collect about you. This notice refers to
Mynumi Group, LLC by using the terms "us," "we," or "our."
This notice describes
how we protect the personal health information we have about
you which relates to your Mynumi Group, LLC Health insurance
coverage ("Personal
Health Information"), and how we may use and disclose
this information. Personal Health Information includes individually
identifiable information which relates to your past, present
or future health, treatment or payment for health care services.
This notice also describes your rights with respect to the
Personal Health Information and how you can exercise those
rights.
We are required to
provide this Notice to you by the Health Insurance Portability
and Accountability Act ("HIPAA"). For additional
information regarding our HIPAA Medical Information Privacy
Policy or our general privacy policies, please see the privacy
notices contained at our website, www.Mynumi Group, LLC.com.
You may submit questions to us there or you may write to
us directly at Mynumi Group, LLC, 241 Mountain Road, Springfield,
New Jersey 07081.
We are required by law to:
maintain the privacy of your Personal Health
Information; provide you this notice of our legal duties and
privacy practices with respect to your Personal Health Information;
and follow the terms of this notice. We protect your Personal
Health Information from inappropriate use or disclosure. Our
employees, and those of companies that help us service your
Mynumi Group, LLC Health Insurance, are required to comply
with our requirements that protect the confidentiality of Personal
Health Information. They may look at your Personal Health Information
only when there is an appropriate reason to do so, such as
to administer our products or services.
We will not disclose your Personal Health
Information to any other company for their use in marketing
their products to you. However, as described below, we will
use and disclose Personal Health Information about you for
business purposes relating to your Health Insurance coverage.
The main reasons for which we may use and
may disclose your Personal Health Information are to evaluate
and process any requests for coverage and claims for benefits
you may make or in connection with other health-related benefits
or services that may be of interest to you. The following describe
these and other uses and disclosures, together with some examples.
For Payment: We may use and disclose Personal
Health Information to pay for benefits under your Health Insurance
coverage. For example, we may review Personal Health Information
contained on claims to reimburse providers for services rendered.
We may also disclose Personal Health Information to other insurance
carriers to coordinate benefits with respect to a particular
claim. Additionally, we may disclose Personal Health Information
to a health plan or an administrator of an employee welfare
benefit plan for various payment-related functions, such as
eligibility determination, audit and review or to assist you
with your inquiries or disputes.
For Health Care Operations:
We may also use and disclose Personal Health
Information for our insurance operations. These purposes include
evaluating a request for Health Insurance products or services,
administering those products or services, and processing transactions
requested by you. We may also disclose Personal Health Information
to Affiliates, and to business associates outside of the Mynumi
Group, LLC family of companies, if they need to receive Personal
Health Information to provide a service to us and will agree
to abide by specific HIPAA rules relating to the protection
of Personal Health Information. Examples of business associates
are: billing companies, data processing companies, or companies
that provide general administrative services. Personal Health
Information may be disclosed to reinsurers for underwriting,
audit or claim review reasons. Personal Health Information
may also be disclosed as part of a potential merger or acquisition
involving our business in order to make an informed business
decision regarding any such prospective transaction.
Where Required by Law or for Public Health
Activities:
We disclose Personal Health Information when required by federal,
state or local law. Examples of such mandatory disclosures
include notifying state or local health authorities regarding
particular communicable diseases, or providing Personal Health
Information to a governmental agency or regulator with health
care oversight responsibilities. We may also release Personal
Health Information to a coroner or medical examiner to assist
in identifying a deceased individual or to determine the cause
of death.
To Avert a Serious Threat to Health or Safety:
We may disclose Personal Health Information to avert a serious
threat to someone's health or safety. We may also disclose
Personal Health Information to federal, state or local agencies
engaged in disaster relief as well as to private disaster
relief or disaster assistance agencies to allow such entities
to carry out their responsibilities in specific disaster
situations.
For Health-Related Benefits or Services:
We may use Personal Health Information to provide you with
information about benefits available to you under your current
coverage or policy and, in limited situations, about health-related
products or services that may be of interest to you.
For Law Enforcement or Specific Government
Functions:
We may disclose Personal Health Information in response to
a request by a law enforcement official made through a court
order, subpoena, warrant, summons or similar process. We may
disclose Personal Health Information about you to federal officials
for intelligence, counterintelligence, and other national security
activities authorized by law.
When Requested as Part of a Regulatory or
Legal Proceeding:
If you or your estate are involved in a lawsuit or a dispute,
we may disclose Personal Health Information about you in response
to a court or administrative order. We may also disclose Personal
Health Information about you in response to a subpoena, discovery
request, or other lawful process by someone else involved in
the dispute, but only if efforts have been made to tell you
about the request or to obtain an order protecting the Personal
Health Information requested. We may disclose Personal Health
Information to any governmental agency or regulator with whom
you have filed a complaint or as part of a regulatory agency
examination.
Other Uses of Personal Health Information:
Other uses and disclosures of Personal Health Information not
covered by this notice and permitted by the laws that apply
to us will be made only with your written authorization or
that of your legal representative. If we are authorized to
use or disclose Personal Health Information about you, you
or your legally authorized representative may revoke that
authorization, in writing, at any time, except to the extent
that we have taken action relying on the authorization or
if the authorization was obtained as a condition of obtaining
your Health Insurance coverage. You should understand that
we will not be able to take back any disclosures we have
already made with authorization.
Your Rights Regarding Personal Health Information
We Maintain About You:
The following are your various rights as
a consumer under HIPAA concerning your Personal Health Information.
Should you have questions about a specific right, please write
to the administrator of your Health Insurance coverage.
Right to Inspect and Copy Your Personal Health
Information:
In most cases, you have the right to inspect and obtain a copy
of the Personal Health Information that we maintain about you.
To inspect and copy Personal Health Information, you must submit
your request in writing to the applicable administrator. To
receive a copy of your Personal Health Information, you may
be charged a fee for the costs of copying, mailing or other
supplies associated with your request. However, certain types
of Personal Health Information will not be made available for
inspection and copying. This includes psychotherapy notes;
and also includes Personal Health Information collected by
us in connection with, or in reasonable anticipation of any
claim or legal proceeding. In very limited circumstances we
may deny your request to inspect and obtain a copy of your
Personal Health Information. If we do, you may request that
the denial be reviewed. The review will be conducted by an
individual chosen by us who was not involved in the original
decision to deny your request. We will comply with the outcome
of that review.
Right to Amend Your Personal Health Information:
If you believe that your Personal Health Information is incorrect
or that an important part of it is missing, you have the
right to ask us to amend your Personal Health Information
while it is kept by or for us. You must provide your request
and your reason for the request in writing, and submit it
to the applicable administrator listed above. We may deny
your request if it is not in writing or does not include
a reason that supports the request.
In addition, we may deny your request if
you ask us to amend Personal Health Information that: is accurate
and complete; was not created by us, unless the person or entity
that created the Personal Health Information is no longer available
to make the amendment; is not part of the Personal Health Information
kept by or for us; or is not part of the Personal Health Information
which you would be permitted to inspect and copy.
Right to a List of Disclosures:
You have the right to request a list of the
disclosures we have made of Personal Health Information about
you. This list will not include disclosures made for treatment,
payment, health care operations, for purposes of national security,
made to law enforcement or to corrections personnel or made
pursuant to your authorization or made directly to you. To
request this list, you must submit your request in writing
to the applicable administrator listed above. Your request
must state the time period from which you want to receive a
list of disclosures. The time period may not be longer than
six years and may not include dates before February 26, 2003.
Your request should indicate in what form you want the list
(for example, on paper or electronically). The first list you
request within a 12-month period will be free. We may charge
you for responding to any additional requests. We will notify
you of the cost involved and you may choose to withdraw or
modify your request at that time before any costs are incurred.
Right to Request Restrictions:
You have the right to request a restriction or limitation on
Personal Health Information we use or disclose about you
for treatment, payment or health care operations, or that
we disclose to someone who may be involved in your care or
payment for your care, like a family member or friend. While
we will consider your request, we are not required to agree
to it. If we do agree to it, we will comply with your request.
To request a restriction, you must make your request in writing
to the applicable administrator listed above. In your request,
you must tell us (1) what information you want to limit;
(2) whether you want to limit our use, disclosure or both;
and (3) to whom you want the limits to apply (for example,
disclosures to your spouse or parent). We will not agree
to restrictions on Personal Health Information uses or disclosures
that are legally required, or which are necessary to administer
our business.
Right to Request Confidential Communications:
You have the right to request that we communicate
with you about Personal Health Information in a certain way
or at a certain location if you tell us that communication
in another manner may endanger you. For example, you can ask
that we only contact you at work or by mail. To request confidential
communications, you must make your request in writing to the
applicable administrator listed above and specify how or where
you wish to be contacted. We will accommodate all reasonable
requests.
ADDITIONAL INFORMATION
Changes to This Notice: We reserve the right
to change the terms of this notice at any time. We reserve
the right to make the revised or changed notice effective for
Personal Health Information we already have about you as well
as any Personal Health Information we receive in the future.
The effective date of this notice and any revised or changed
notice may be found on the last page, on the bottom right hand
corner of the notice. You will receive a copy of any revised
notice from Mynumi Group, LLC by mail or by e-mail, but only
if e-mail delivery is offered by Mynumi Group, LLC and you
agree to such delivery.
Further Information:
You may have additional rights under other applicable laws.
For additional information regarding our HIPAA Medical Information
Privacy Policy or our general privacy policies, please write
us.
If you have questions relating to your current
coverage, please contact the administrator of your Health Insurance
coverage listed above.
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