Privacy Policy

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.

About This Notice

We understand that information about you is personal, and we are committed to protecting your privacy. In the normal course of business, we collect information and create records about you and the services we provide to you. We may collect information from other persons or entities, such as employers or health care providers, to provide our services to you.

Protected Health Information is information that could be used to identify you, and relates to (1) your past, present, or future physical or mental health or conditions, (2) the provision of health care to you, or (3) the past, present, or future payment for your health care.

We are required by law to maintain the privacy of Protected Health Information and to give you this Notice explaining our privacy practices. We are required to abide by the terms of the current version of this Notice.

How We Protect Your Privacy

To protect your privacy, we maintain physical, technical, and administrative safeguards. Only employees who are authorized and trained to handle Protected Health Information are given access to such information. Additional safeguards include password-protecting computers and locking filing cabinets that contain personal information.

How We May Use or Share Your Health Information

We may use and disclose your Protected Health Information without your authorization in the following circumstances:

• For Treatment: To provide treatment or services and to manage and coordinate your medical care, including sharing with referring or specialist physicians.
• For Payment: To obtain payment of premiums, pay providers for covered services, make coverage determinations, and coordinate benefits with other health plans.
• For Health Care Operations: For general business management, checking provider performance, cost-management activities, audits, and legal services.
• Communications: To contact you with information about alternative treatments or health-related benefits and services, or to remind you of appointments.
• Minors: To disclose Protected Health Information of minor children to their parents or guardians unless otherwise prohibited by law.
• Personal Representative: To treat a legal guardian or executor as if that person is you with respect to disclosures.
• As Required by Law: When required by international, federal, state, or local law.
• To Avert a Serious Threat to Health or Safety: When necessary to prevent a serious threat to your health or safety or to the health or safety of others.
• Business Associates: To business associates who perform functions on our behalf, provided they are under contract to protect the privacy of your information.
• Military, Workers' Compensation, Public Health, Law Enforcement, National Security: As permitted or required by applicable law in each case.
• Coroners, Medical Examiners, Organ Donations, Research: As permitted by law and subject to appropriate privacy protections.

Uses and Disclosures That Require Your Opportunity to Object

Individuals Involved in Your Care: We may disclose Protected Health Information to a person involved in your medical care or helping to pay for your care, to the extent relevant to that involvement. We will provide you an opportunity to object whenever we practicably can.

Disaster Relief: We may disclose your Protected Health Information to disaster relief organizations to coordinate your care or notify family and friends of your location or condition in a disaster.

Fundraising: We do not use or disclose Protected Health Information for fundraising purposes, but we are required to inform you that you would have the right to opt out of receiving fundraising communications.

Your Written Authorization is Required For

• Disclosures of any Protected Health Information for marketing purposes or any sale of Protected Health Information
• Use and disclosure of therapy notes maintained by us, except under certain limited circumstances
• Other uses and disclosures of Protected Health Information not covered by this Notice or the laws that apply to us

If you give us an authorization, you may revoke it at any time by submitting a written revocation to our Privacy Officer.

Special Protections

Special privacy protections apply to HIV-related information, alcohol and substance abuse, mental health, and genetic information. Please contact our Privacy Officer for information about the special protections that apply to these categories.

Your Rights Regarding Your Protected Health Information

• Right to Inspect and Copy: You have the right to inspect and copy Protected Health Information that may be used to make decisions about your care or payment for your care. We may charge a fee for copying.
• Right to an Electronic Copy: If your Protected Health Information is maintained electronically, you have the right to request an electronic copy or have it transmitted to another individual or entity.
• Right to Get Notice of a Security Breach: We are required to notify you within 60 days of discovering any breach of your Unsecured Protected Health Information.
• Right to Request Amendments: If you feel that Protected Health Information we have is incorrect or incomplete, you may ask us to amend it. Requests must be made in writing to the Privacy Officer.
• Right to an Accounting of Disclosures: You have the right to request a list of disclosures we made of your Protected Health Information for non-routine purposes. The first request in any 12-month period is free.
• Right to Request Restrictions: You have the right to request a restriction or limitation on how we use or disclose your Protected Health Information. We are not required to agree to your request.
• Out-of-Pocket Payments: If you paid out-of-pocket in full for a specific item or service, you have the right to request that we not disclose that information to a health plan for payment or operations purposes.
• Right to a Paper Copy: You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

How to Exercise Your Rights or File a Complaint

To exercise any of the rights described in this Notice, or if you believe your privacy rights have been violated, you may contact our Privacy Officer:

Privacy Officer
Imperial Health Plan of California, Inc. / Imperial Insurance Companies, Inc.
PO Box 60874
Pasadena, CA 91116
privacy@imperialhealthplan.com
1-800-838-8271 (Medicare) · 1-800-595-0619 (Individual & Family) · TTY: 711

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at ocrportal.hhs.gov or by calling 1-800-368-1019 (TTY: 1-800-537-7697). There will be no retaliation for filing a complaint.

Download this Notice

This Notice of Privacy Practices is also available as a PDF in English and Spanish. The PDF version is the CMS-accepted format.

• Privacy Policy — English (Medicare) PDF
• Privacy Policy — Español (Medicare) PDF

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all Protected Health Information that we maintain, including medical information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.