The Company will use and share protected health information of Insureds as necessary to carry out payment and health care operations as permitted by law. We are required by law to maintain the privacy of our Insureds’ protected health information and to provide Insureds with a Notice of our legal duties and privacy practices concerning their secure health information. We are required to abide by the terms of this Notice so long as it remains in effect. We reserve the right to change this Notice’s terms and make the new Notice effective for all protected health information maintained by us. Copies of any revised notices will be mailed to all Insureds then covered by the Company.
Uses and Disclosures of Your Protected Health Information
This section describes the uses and disclosures of your protected health information that we may make. More stringent laws may limit or prohibit the use or disclosure described below in some states. In those circumstances, the Company will conduct itself according to the stricter regulation.
- Your Authorization—Except as described in this Notice, we will not use or disclose your protected health information, including psychotherapy notes, without written authorization from you. In addition, the use or disclosure of psychotherapy notes, the use or disclosure of protected health information for marketing purposes, or the disclosure of protected health information in a manner that constitutes a sale requires your authorization. If you do authorize the Company to use or disclose your protected health information for another purpose, you may revoke your consent in writing at any time. If you revoke an authorization, the Company will no longer use or disclose your protected health information in the manner covered by that authorization, except to the extent that the Company has taken action in reliance on the authorization, or if the authorization was obtained as a condition of obtaining insurance coverage, the Company has the right to contest a claim under a policy or to contest the policy itself.
- Uses and Disclosures for Payment—The Company will use and disclose your protected health information as necessary and as permitted by law for payment purposes. For example, we may use information regarding your medical procedures and treatment to process and pay claims or determine whether services are covered under the Treatment program rider. The Company may also forward such information to another health plan, which may also have an obligation to process and pay claims on your behalf.
- Uses and Disclosures for Health Care Operations—The Company will use and disclose your protected health information as necessary and as permitted by law for our health care operations. This includes enrollment, underwriting, policy issuance, securing reinsurance, customer service, and other activities relating to the creation and servicing of your insurance coverage, compliance, auditing, rating, fraud and abuse detection, business management and general administrative activities, quality improvement, and assurance, and other functions related to the Treatment program rider. Such activities may involve using third parties that perform services for us. When we hire other parties to help us conduct our business, we require them to protect your protected health information. Further, we do not permit them to use or share your protected health information for any purpose other than their work on our behalf or as required by law. In addition, your Northwestern Mutual Financial Representative and others assisting your Financial Representative have access to the information they need to provide service to you.
- Be assured that the Company will not disclose any other protected health information to your employer without your written authorization.
- Family and Friends Involved in Your Care—With your approval, the Company may, from time to time, disclose your protected health information to designated family, friends, and others who are involved in your care or payment for your consideration. Such disclosures are limited to the information necessary to facilitate that person’s involvement in caring for you or paying for your care. If you are unavailable, incapacitated, or facing an emergency medical situation, and we determine that a limited disclosure may be in your best interest, we may share protected health information with such individuals without your approval. Suppose you have designated a person (i.e., secondary addressee) to receive information regarding payment of the premium on your substance use disorder treatment policy. In that case, we will inform that person when your premium has not been paid. We may also disclose limited protected health information to a public or private entity authorized to assist in disaster relief efforts for that entity to locate a family member or other person involved in some aspect of caring for you.
- Payment of Claims—We may contact you and/or your authorized representative to obtain or provide information on the payment of your claims.