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.
As used in this notice, “WE” and “OUR” refer to Kansas City Life Insurance Company, in its capacity as issuer of group dental and group vision plans (“plans”), which are covered by federal laws and regulations governing use and disclosure of personally identifiable health information (“protected health information” or “PHI”). The functions which are covered by these rules include: administration of Kansas City Life’s group dental and vision policies. “YOU” means a named insured of a group or individual health insurance policy, an enrollee in the health or dental benefit plan.
Administration of the Plans. All group dental and vision plans we issue are administered by third parties. These administrators are our business associates, as defined by the Health Insurance Portability and Accountability Act (“HIPAA”). All of our duties and responsibilities under HIPAA, as described below, also apply to our business associates. The Business Associates will notify us, and we will notify you, if there is a privacy breach of your unsecured PHI if you may be affected by the breach.
Our Duties. We are required by the Health Insurance Portability and Accountability Act of 1996 to maintain the privacy of your PHI and to provide you with this Notice of our privacy practices and legal duties. We must abide by the terms of this Notice. We reserve the right to change the terms of this notice and to make the new terms effective as to all of the PHI that we maintain about you. In that case we will provide you with a new Notice by mailing it to the address you have last provided us, or with your consent by sending it to you electronically.
Your Rights. You have a right to access, inspect and copy the PHI we maintain about you. We may impose a reasonable fee where permitted by law.
You have the right to request that we amend your PHI. We may deny your request if we did not create the PHI you want us to amend, or for other reasons. If we do not agree to amend your PHI as you request, you may submit a short statement of dispute and we will include it with your records.
You have the right to an accounting of disclosures we have made of your PHI to others after April 14, 2003, except for disclosures related to your treatment, payment or other health care operations. We may impose a reasonable fee if you make such a request more than once in any 12-month period.
You have the right to request that we place additional restrictions on our use or disclosure of your PHI. We are not required to agree to additional restrictions.
You have the right to request that we communicate with you in confidence about your PHI by providing us with an alternate means or location. You must inform us that this is required to avoid endangering you.
If we provide you this Notice by electronic means, you have the right to request a paper copy.
You may exercise any of the rights stated in this section of the Notice by making your request in writing and sending it to us, postage prepaid, at the address shown at the end of this Notice.
Where We Get Your PHI. We get most health history and treatment information from you or somebody you have authorized to provide it to us. For instance, we get medical information about you in order to pay a health insurance benefit or to pay providers of medical treatment.
Permitted Disclosures of Your PHI. We are allowed to use and disclose your PHI without your authorization as necessary to conduct or service our business or when disclosure is legally required. For instance, we may use and disclose your PHI as needed to pay claims, set premiums, reinsure policies and underwrite for health care coverage. If you are an enrollee of an employee dental or medical benefit plan, we may disclose limited PHI to your plan’s sponsor to permit the sponsor to perform plan administration functions. We may also disclose your PHI when we are required to do so by law (for instance, by subpoena, administrative order or discovery request), or as requested by the U.S. Department of Health and Human Services. Disclosures not described in this paragraph will be made only if you give us a written authorization. You may revoke your authorization at any time in writing.
We will not otherwise disclose your PHI to an affiliate or any third party who helps administer our business unless they agree in writing to maintain its confidentiality, use it only as intended and if feasible destroy it when no longer needed.
We do not sell your PHI or disclose it to anyone for purposes unrelated to our services.
We will comply with applicable health information privacy law of any state which is more stringent than and not pre-empted by federal law.
Complaints. If you want further information or have any questions about our privacy practices, please contact us using the information provided in this section. You also may submit a written complaint to the Secretary of the Department of Health and Human Services. We will not retaliate against you in any way if you file a complaint.
Contact: Privacy Official, Legal Department, Kansas City Life Insurance Company, P.O. Box 219139, Kansas City, MO 64121-9139. Or, telephone us at 800- 874-5254 ext. 8434.