We Value you as a customer and take your personal privacy seriously.  We will inform you of our policies for collecting, using, securing, and sharing nonpublic personal information (“customer information”) the first time we do business and every year that you are an Evergreen customer.

OUR PRIVACY PRINCIPLES

• We do not sell customer information.
• We do not provide customer information to persons or organizations outside our Evergreen family of companies who are doing business on our behalf, for their own marketing purposes.
• We contractually require any person or organization providing products or services to customers on our behalf to protect the confidentiality of Evergreen customer information.
• We do not share customer medical information with anyone within the Evergreen family of companies, unless you expressly authorize it, or unless it is permitted or required by law, or unless your insurance policy contract with us permits us to do so.
• We afford prospective and former customers the same protections as existing customers with respect to the use of personal information.
   

INFORMATION WE MAY COLLECT

We collect and use information we believe is necessary to administer our business, to advise you about our products and services, and to provide you with customer service.  We may collect and maintain several types of customer information needed for these purposes, such as those below.

Types of information we may collect and how we gather it:

• From you, information we receive from you on enrollment applications and other forms. This information includes:  name, address, phone number, social security number, age, date of birth, dependents, health history, etc.
• From your transactions with us, these transactions include claims, authorizations and referrals, and health care appointments.  The information we receive from these transactions includes services or procedures received, diagnosis made, prescriptions filled, providers seen, and payments made on your behalf.
• From non-insurance companies, such as your previous coverage and creditable coverage history.

HOW WE USE INFORMATION:  We use customer information we collect about members and former members within our affiliated organizations to administer and manage our health plans and provide care and service to our members.  Examples of how we use this information include enrollment, underwriting, providing medical and hospital care, care management, case management, care coordination, care improvement, claims payment, customer service, quality assurance, service improvement, utilization management, licensing, credentialing and accreditation.  We limit the sharing of your customer information with affiliates to those who need the information to provide you with care and service.

TYPES OF INFORMATION SHARING:  There are two types of information sharing – information sharing within Evergreen family of companies and information sharing outside Evergreen.  We do not sell customer information.  We do not provide customer information to persons or organizations outside Evergreen who are doing business on our behalf for their own marketing purposes.

DISCLOSING INFORMATION:  We will not disclose any information that we collect concerning you or your family members, except in situations where it is necessary to conduct our business.  Some of the disclosures that may be made without your prior approval are outlined below.  These include:

HEALTH CARE PROVIDERS:  We may disclose information to a physician, hospital, clinic, other health care provider, or peer review organization needing the information to perform a business, professional, or insurance function for Evergreen Health Plan of Georgia.

MARKETING PURPOSES:  We do not sell customer information.

STATE REGULATORY AUTHORITY:  We may provide information to the Georgia Departments of Insurance in connection with their regulator authority.  Information may be provided to other governmental or law enforcement authorities to prevent or prosecute fraud or other unlawful activities.

We will only disclose information that is necessary to accomplish the intended purpose of the information.  The preceding list describes some of the situations in which disclosures might be made.  These disclosures are not always or even frequently made.  However, in some situations they may be made.

PERSONAL INFORMATION:  You have the right to know the nature and substance of the information we have about you in our files.  You have the right to access information about yourself and may obtain a copy on request.  We are not required to give you access to information collected in condition with a claim or when the possibility of a lawsuit exists.

ADVERSE UNDERWRITING DECISIONS:  Include situations where coverage for individuals is offered with an exclusion or deletion rider, declined, terminated, or offered at a higher-than-standard rate.  You have the right to know the specific items of information and the sources of the information that support our underwriting decision.  Any medical records we may have will only be disclosed to a medical professional designated by you to retrieve such information.

CORRECTION, AMENDMENT, OR DELETION OF INFORMATION:  You may ask us to correct, amend, or delete information about you or your dependents in our files.  If we refuse to do so, you have the right to appeal our decision and to give us a concise statement indicating what you think to be the correct, relevant, or fair information and why you disagree with our decision.  We will put your statement in our file so that anyone reviewing your file will see it.  You do not have the right to changed information in your medical records.

Can I “opt out” of certain disclosures?

You may have received notices from other organizations that allow you to “opt out” of certain disclosures.  The most common type of disclosure that applies to “opt outs” is the disclosure of personal information to a non-affiliated company so that company can market its products or services to you.  As a health plan, we must follow many federal and state laws that prohibit us from making these types of disclosures.  Because we do not make disclosures that apply to “opt outs”, it is not necessary for you to complete an “opt out” form or take any action to restrict such disclosures.

We maintain physical, electronic, and organizational safeguards to protect customer information.  We continually review our policies and practices, monitor our computer networks, and test the strength of our security in order to help us ensure the safety of customer information.

Revisions:  We may amend this notice at any time and will inform you of changes as required by law.

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