HIPAA Notice and Privacy Forms

HIPAA Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please note: this notice is intended for our fully insured/premium members. Those members of a self-funded plan should obtain a plan from your employer/group health plan.

Notice of Privacy Practices 


Privacy — Contact Us

If you are concerned that your privacy rights have been violated, you may let us know by calling the number on the back of your member identification (ID) card. If you do not have an ID card and have a privacy concern you can reach us by calling 877-361-7594.

Written communications can be sent to:
Director, Privacy Office
P.O. Box 804836
Chicago, IL 60680-4110


Privacy Forms


Privacy and Your Health Information 

Your Health Information Privacy Rights