This notice is required by law to tell you how MWG International protects the confidentiality of your health care information in our possession. Protected Health Information (PHI) is defined as any individually identifiable information regarding a patient’s medical/dental history; mental or physical condition; or treatment. Some examples of PHI include your name, address, telephone and/or fax number, email address, social security number or other identification number, date of birth, date of treatment, treatment records, x-rays, enrollment and claims records. MWG International receives, uses and discloses your PHI to administer your benefit plan or as permitted or required by law. Any other disclosure of your PHI is prohibited.
We must follow the privacy practices that are described in this notice. However, we may change this notice and make the new notice effective for all of your PHI that we maintain. If we make any substantive changes to our privacy practices, we will promptly change this notice and redistribute to you within 60 days of the change to our practices. You may also request a copy of this notice from the privacy official at the plan headquarters that provides your benefits (refer to the Contact section at the end of this notice). You should receive a copy of this notice at the time of enrollment in an MWG International program, and we will notify you of how you can receive a copy of this notice every three years.
We are permitted to use or disclose your PHI without your prior authorization for the following purposes. These permitted uses and/or
disclosures include disclosures to you, uses and/or disclosures for purposes of health care treatment, payment of claims, billing of premiums,
and other health care operations. We may disclose PHI to third parties that perform services for MWG International in the administration of
your benefits. These parties are required by law to sign a contract agreeing to protect the confidentiality of your PHI. Your PHI may be disclosed
to an affiliate that performs services for MWG International in the administration of your benefits. These affiliates have implemented privacy policies and procedures and comply with applicable federal and state law.
We are also permitted to use and/or disclose your PHI to comply with a valid authorization, to notify or assist in notifying a family member, another person, or a personal representative of your condition, to assist in disaster relief efforts, and to report victims of abuse, neglect, or domestic violence. Other permitted uses and/or disclosures are for purposes of health oversight by government agencies, judicial, administrative, or other law enforcement purposes, information about decedents to coroners, medical examiners and funeral directors, for research purposes, for organ donation purposes, to avert a serious threat to health or safety, for specialized government functions such as military and veterans activities, for workers compensation purposes, and for use in creating summary information that can no longer be traced to you.
Additionally, with certain restrictions, we are permitted to use and/or disclose your PHI for fundraising and underwriting (although we are prohibited from using or disclosing any genetic information for these underwriting purposes). We are also permitted to incidentally use and/or disclose your PHI during the course of a permitted use and/or disclosure, but we must attempt to keep incidental uses and/or disclosures to a minimum. We use administrative, technical, and physical safeguards to maintain the privacy of your PHI, and we must limit the use and/or disclosure of your PHI to the minimum amount necessary to accomplish the purpose of the use and/or disclosure.
Such activities may include but are not limited to: processing your claims, collecting enrollment information and premiums, reviewing the quality of health care you receive, providing customer service, resolving your grievances, and sharing payment information with other insurers.
Additional examples include the following:
We are required to disclose your PHI to you or your authorized personal representative (with certain exceptions), when required by the U. S. Secretary of Health and Human Services to investigate or determine our compliance with law, and when otherwise required by law. MWG International must disclose your PHI without your prior authorization in response to the following:
MWG International will not use or disclose your PHI without your prior authorization if the law requires your authorization. You can later revoke that authorization in writing to stop any future use and disclosure. The authorization will be obtained from you by MWG International or by a person requesting your PHI from MWG International.
You have the right to request an inspection of and obtain a copy of your PHI. You may access your PHI by contacting MWG International at the addresses listed below. You must include (1) your name, address, telephone number and identification number and (2) the PHI you are requesting. MWG International may charge a reasonable fee for providing you copies of your PHI. MWG International will only maintain that PHI that we obtain or utilize in providing your health care benefits. Most PHI, such as treatment records or X-rays, is returned by MWG International to the provider after we have completed our review of that information. You may need to contact your health care provider to obtain PHI that MWG International do not possess.
You may not inspect or copy PHI compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, or PHI that is otherwise not subject to disclosure under federal or state law. In some circumstances, you may have a right to have this decision reviewed. Please contact MWG International at the addresses listed below if you have questions about access to your PHI.
You have the right to request a restriction of your PHI. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.
You have the right to correct or update your PHI. This means that you may request an amendment of PHI about you for as long as we maintain this information. In certain cases we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. If your PHI was sent to us by another, we may refer you to that person to amend your PHI. For example, we may refer you to your provider to amend your treatment chart. Please contact MWG International at the addresses listed below if you have questions about amending your PHI.
You have the right to request or receive confidential communications from us by alternative means or at a different address. We will agree to a reasonable request if you tell us that disclosure of your PHI could endanger you. You may be required to provide us with a statement of possible danger, a different address, or another method of contact or information as to how payment will be handled. Please make this request in writing to MWG International at the addresses listed below.
You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI. This right does not apply to disclosures for purposes of treatment, payment, or health care operations or for information we disclosed after we received a valid authorization from you. Additionally, we do not need to account for disclosures made to you, to family members or friends involved in your care, or for notification purposes. We do not need to account for disclosures made for national security reasons or certain law enforcement purposes, disclosures made as part of a limited data set, incidental disclosures, or disclosures made prior to April 14, 2003. Please contact MWG International at the addresses listed below if you would like to receive an accounting of disclosures or if you have questions about this right. You have the right to get this notice by email.
You have the right to get a copy of this notice by email. Even if you have agreed to receive notice via email, you also have the right to request a paper copy of this notice.
Except as explained below, we restrict access to nonpublic personal information about an individual to our employees who need to know what information to provide products or services to that person. We maintain physical, electronic, and procedural safeguards that comply with federal and state regulations to guard nonpublic personal information.
We collect nonpublic personal information about you we receive from you on applications or other forms and information about your transactions with us, our affiliates or others.
We may disclose all the information we collect as described above.
We may share this information with affiliated companies and nonaffiliated third parties to perform services or functions on our behalf but otherwise we do not disclose any nonpublic personal information about our customers or former customers to anyone, except as permitted by law. When we make disclosures or nonpublic personal information, except for those disclosures permitted by law, we require non-affiliated third parties to protect the confidentiality of such information and to use it solely for the purpose for which we disclosed the information.
If you want more information about our privacy practices or have questions or concerns, please contact us using the information at the end of this notice.
You may complain to us or to the U. S. Secretary of Health and Human Services if you believe that MWG International have violated your privacy rights. You may file a complaint with us by notifying MWG International at the addresses listed below. We will not retaliate against you for filing a complaint. We support your right to the privacy of your medical information.
You may contact MWG International at the addresses and telephone numbers listed below for further information about the complaint process or any of the information contained in this notice.
Attn: Privacy Contact
Post Office Box 16708
Jackson, MS 39236-6708
This notice is effective on and after XX.XX.2015.