HEALTH INSURANCE NOTICE OF PRIVACY PRACTICES
GLOBE LIFE AND ACCIDENT INSURANCE COMPANY
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.
This Notice gives you information required by the privacy provisions
of the Health Insurance Portability and Accountability Act of 1996 and
its implementing regulations (HIPAA Privacy Rules) about the duties and
privacy practices of American Income Life Insurance Company to protect
the privacy of your medical information that we maintain as an issuer of
health insurance policies that provide medical care benefits. We sent
this Notice to you because our records show that we provide health care
benefits to you under an individual or group health insurance policy
that provides medical care benefits.
This Notice applies to the designated health care components of
United American Insurance Company that use and disclose your medical
information to provide medical care benefits to you under health
insurance policies. We use the terms health and health care in this
Notice to refer to the medical care benefits we provide to you. This
Notice does not apply to the information that our non-health care
components maintain about you as an issuer of life, disability, accident,
indemnity or any other non-health insurance policy.
THE EFFECTIVE DATE OF THIS NOTICE IS APRIL 14, 2003. We are required
to follow the terms of this Notice until we replace it. We reserve the
right to change the terms of this Notice at any time. If we make changes
to this Notice, we will revise it and send a new Notice to all persons
to whom we are required to give the new Notice. We reserve the right to
make the new changes apply to all your medical information maintained by
us before and after the effective date of the new Notice.
Purposes for which We May Use or Disclose Your Medical Information
Without Your Consent or Authorization
We may use and disclose your medical information for the following
- Health Care Providers’ Treatment Purposes. For example, we may
disclose your medical information to your doctor, at the doctor’s
request, for your treatment by him.
- Payment. For example, we may use or disclose your medical
information to collect premiums, to pay claims for covered health
care services or to provide eligibility information to your doctor
when you receive treatment. We may also use and disclose your medical
information to another covered entity or health care provider for the
payment activities of the entity that receives your medical information.
- Health Care Operations. For example, we may use or disclose your
medical information (i) to conduct quality assessment and improvement
activities, (ii) for underwriting, premium rating, or other activities
relating to the creation, renewal or replacement of a contract of health
insurance, (iii) to authorize business associates to perform data
aggregation services, (iv) to engage in care coordination or case
management, and (v) to manage, plan or develop our business. We may
also disclose your medical information to another covered entity for
the limited health care operations activities and health care fraud
and abuse compliance activities of the entity that receives your
- Health Services. We may use your medical information to contact
you to give you information about treatment alternatives or other
health-related benefits and services that may be of interest to you.
We may disclose your medical information to our business associates
to assist us in these activities.
- As required by law. For example, we must allow the U.S. Department
of Health and Human Services to audit our records. We may also
disclose your medical information as authorized by and to the extent
necessary to comply with workers’ compensation or other similar laws.
- To Business Associates. We may disclose your medical information
to business associates we hire to assist us. Each of our business
associates must agree in writing to ensure the continuing
confidentiality and security of your medical information.
- To Plan Sponsor. If we provide health benefits to you under a
group health plan, we may disclose to the plan sponsor of your group
health plan, in summary form, claims history and other similar
information. Such summary information does not disclose your name or
other distinguishing characteristics. We may also disclose to the plan
sponsor the fact that you are enrolled in, or disenrolled from the
group health plan. We may disclose your medical information to the
plan sponsor for administrative functions that the plan sponsor
provides to the group health plan if the plan sponsor agrees in writing
to ensure the continuing confidentiality and security of your medical
information. The plan sponsor must also agree not to use or disclose
your medical information for employment-related activities or for any
other benefit or benefit plans of the plan sponsor.
We may also use and disclose your medical information
- To comply with legal proceedings, such as a court or administrative
order or subpoena.
- To law enforcement officials for limited law enforcement purposes.
- To a family member, friend or other person, for the purpose of
helping you with your health care or with payment for your health care,
if you are in a situation such as a medical emergency and you cannot
give your agreement to us to do this.
- To your personal representatives appointed by you or designated by
- For research purposes in limited circumstances.
- To a coroner, medical examiner, or funeral director about a
- To an organ procurement organization in limited circumstances.
- To avert a serious threat to your health or safety or the health
or safety of others.
- To a governmental agency authorized to oversee the health care
system or government programs.
- To federal officials for lawful intelligence, counterintelligence
and other national security purposes.
- To public health authorities for public health purposes.
- To appropriate military authorities, if you are a member of the
Potential Impact of State Law
In some situations, the HIPAA Privacy Rules do not preempt (or take
precedence over) state privacy laws that give you greater privacy
protections. As a result, the privacy laws of a particular state might
impose a privacy standard under which we will be required to operate
(for example, a state privacy law relating to disclosures of medical
information of minors).
Uses and Disclosures with Your Permission
We will not use or disclose your medical information for any other
purposes unless you give us your written authorization to do so. If you
give us written authorization to use or disclose your medical
information for a purpose that is not described in this Notice, then,
in most cases, you may revoke it in writing at any time. Your revocation
will be effective for all your medical information we maintain, unless
we have taken action in reliance on your authorization.
You may make a written request to us to do one or more of the
following concerning your medical information that we maintain:
- To put additional restrictions on our use and disclosure of your
medical information. We do not have to agree to your request.
- To communicate with you in confidence about your medical
information by a different means or at a different location than we
are currently doing. We do not have to agree to your request unless
such confidential communications are necessary to avoid endangering
you and your request continues to allow us to collect premiums and pay
claims. Your request must specify the alternative means or location.
Even though you requested that we communicate with you in confidence,
we may give subscribers cost information.
- To see and get copies of your medical information. In limited
cases, we do not have to agree to your request.
- To correct your medical information. In some cases, we do not have
to agree to your request.
- To receive a list of disclosures of your medical information that
we and our business associates made for certain purposes for the last
6 years (but not for disclosures before April 14, 2003).
- To send you a paper copy of this Notice if you received this
Notice by email or on the Internet.
If you want to exercise any of these rights described in this Notice,
please contact the Contact Office (below). We will give you the necessary
information and forms for you to complete and return to the Contact
Office. In some cases, we may charge you a nominal, cost-based fee to
carry out your request.
If you believe we have violated your privacy rights, you have the right
to complain to us or to the Secretary of the U.S. Department of Health
and Human Services. You may file a complaint with us at our Contact
Office (below). We will not retaliate against you if you choose to file
a complaint with us or with the U.S. Department of Health and Human
To request additional copies of this Notice or to receive more
information about our privacy practices or your rights, please contact
us at the following Contact Office:
Globe Life And Accident Insurance Company
Globe Life Center
Oklahoma City, OK 73184