Pacific Life Insurance Company on behalf of itself and its subsidiaries including Pacific Life & Annuity Company provide this Notice of Privacy Practices (“NPP”) for dental and vision plans covered by the Health Insurance and Portability Accountability Act (“HIPAA”).
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 HIPAA Notice of Privacy Practices (the “Notice”) contains important information regarding your health information. You also have the right to receive a paper copy of this Notice and may ask us to give you a copy of this Notice at any time. If you received this Notice electronically, you are entitled to a paper copy of this Notice. If you have any questions about this Notice, please contact the person listed in Part 8, below.
We understand that health information about you and your health is personal. We are committed to protecting medical information about you and will use it to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request of it.
We are required by law to abide by the terms of this Notice to:
1. How We May Use and Disclose Health Information About You.
HIPAA generally permits the use and disclosure of your health information without your permission for purposes of health care treatment, payment activities, and health care operations. These uses and disclosures are more fully described below. Please note that this Notice does not list every use or disclosure; instead, it gives examples of the most common uses and disclosures.
OTHER PERMITTED USES AND DISCLOSURES
Uses and disclosures other than those described in this Notice will require your written authorization. Your written authorization is required for: most uses and disclosures of psychotherapy notes; uses and disclosures of PHI for marketing purposes; and disclosures that are a sale of PHI. You may revoke your authorization at any time, but you cannot revoke your authorization if PL has already acted on it.
The Privacy laws of a particular state or other federal laws might impose a more stringent privacy standard. If these more stringent laws apply and are not superseded by federal preemption rules, we will comply with the more stringent law.
2. Your Rights Regarding Medical Information About You.
You have the following rights regarding medical information that we maintain about you:
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. If PL does not maintain the health information, but know where it is maintained, you will be informed of where to direct your request.
You also must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend any of the following information:
- Information that is not part of the health information kept by or for PL.
- Information that was not created by us, unless the person or entity that created the information is no longer available to make the amendment.
- Information that is not part of the information which you would be permitted to inspect and copy.
- Information that is accurate and complete.
To request this list or accounting of disclosures, you must submit your request, which shall state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, paper or electronic). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
We are not required to agree to your request. If PL does agree to a request, a restriction may later be terminated by your written request, by agreement between you and PL (including orally), or unilaterally by the PL for health information created or received after PL have notified you that they have removed the restrictions and for emergency treatment.
To request restrictions, you must make your request in writing and must tell us the following information:
- What information you want to limit.
- Whether you want to limit our use, disclosure, or both.
- To whom you want the limits to apply (for example, disclosures to your spouse).
We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
You must make any of the requests described above, to the person listed in Part 8, below.
3. Breach Notification.
Pursuant to changes to HIPAA required by the Health Information Technology for Economic and Clinical Health Act of 2009 and its implementing regulations (collectively, “HITECH Act”) under the American Recovery and Reinvestment Act of 2009 (“ARRA”), this Notice also reflects federal breach notification requirements imposed on PL in the event that your “unsecured” protected health information (as defined under the HITECH Act) is acquired by an unauthorized party.
We understand that medical information about you and your health is personal and we are committed to protecting your health information. Furthermore, we will notify you following the discovery of any “breach” of your unsecured protected health information as defined in the HITECH Act (the “Notice of Breach”).
Your Notice of Breach shall be provided without unreasonable delay and in no case later than 60 days following the discovery of a breach and shall include, to the extent possible:
Additionally, for any substitute Notice of Breach provided via web posting or major print or broadcast media, the Notice of Breach shall include a toll-free number for you to contact us to determine if your protected health information was involved in the breach.
4. Changes to This Notice.
We can change the terms of this Notice at any time. If we do, the new terms and policies will be effective for all of the health information we already have about you as well as any information we receive in the future. We will provide you a copy of the revised notice.
If you believe your privacy rights have been violated, you may file a complaint with PL or with the Secretary of the Department of Health and Human Services. To file a complaint with PL, contact the person listed in Part 8, below. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.
6. Other Uses of Health Information.
Other uses and disclosures of health information that are not covered by this Notice or the laws that apply to us will be made only with your written permission. If you grant us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we may be required to retain our records related to your benefit determinations and enrollment.
7. Effective Date.
The effective date of this Notice is 11/7/2023.
8. Contact Information.
All correspondence relating to the contents of this Notice should be directed as follows:
Attn: Privacy Officer
Pacific Life Privacy Office
700 Newport Center Drive, Newport Beach, CA 92660
Telephone toll free at (877) 722-7848
E-mail at CorpCompliancePrivacy@PacificLife.com