Effective as of June 25, 2019
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.
Sidecar Health, Inc. (including our subsidiaries and affiliates, collectively, “Sidecar Health” or “We”) wants you to know that We recognize your desire to keep information about you and your family’s health personal. This notice describes how Sidecar Health will keep that information about you secure and confidential.
This Notice also explains your legal rights regarding your health information. "Health information" is information that is created for, or received by, Sidecar Health and identifies you and relates to your medical history or payment for medical services you receive. Sidecar Health will never sell your health information unless you have authorized us to do so.
Sidecar Health uses and discloses your health information for the normal business activities that the law sees as falling in the categories of treatment, payment and health care operations. Below We provide examples of those, although not every use or disclosure falling in these categories is listed:
We may disclose information to doctors, pharmacies, hospitals and other health care providers who take care of you to help coordinate your care. For example, We may use and disclose health information to help you find a provider, facility, pharmacy or service.
To help pay for your covered services, We may use and disclose personal information in a number of ways, including: to facilitate payment of premiums due us, to determine your coverage, and to process claims for health care services and products you receive from your health care providers.
We may use and disclose personal information during the course of running our business; that is, during operational activities such as providing services to our partner carrier that writes the policy, arranging for review of your claims, developing improved methods for payment of your claims, improving your health care coverage under Sidecar Health, or resolving a grievance you have about the health care services you received or could not receive. Sidecar Health will not use or disclose your genetic information for underwriting purposes.
We may be required to, or may choose to, limit the amount of health information We use or disclose about you for the purposes of treatment, payment or health care operations.
Sidecar Health may also use or disclose your health information to:
Sidecar Health has contracted with companies (deemed "business associates" under federal privacy rules) to help us provide our services to you. Sidecar Health requires these companies to provide us with assurances that they will safeguard your health information.
Sidecar Health may also use or disclose your health information to communicate with individuals involved in your care or payment for that care, such as family members and friends. You have the right to stop or limit this kind of disclosure by contacting us at firstname.lastname@example.org.
Federal and state laws may further limit our use or disclosure of your health information in certain areas. If any federal or state law gives you greater privacy protection, We will follow the stricter law.
In situations and for purposes other than those described above, Sidecar Health will ask for your written authorization before using or disclosing your health information. For example, if Sidecar Health would ever have psychotherapy notes related to you, We will need to obtain an authorization from you before Sidecar Health discloses those notes. Sidecar Health will obtain your authorization before We use your health information for marketing purposes.
You may revoke any authorization you provide to Sidecar Health, but Sidecar Health is unable to take back disclosures made in reliance on your authorization.
Sidecar Health is required by law to:
Sidecar Health reserves the right to change privacy practices and to make the new practices effective for all the information Sidecar Health maintains. Sidecar Health will provide you with a copy of the revised notice if that occurs.
Sidecar Health may elect not to destroy your health information when you terminate your coverage with Sidecar Health, consistent with Sidecar Health’s document retention policies. It may be necessary to use and disclose this information for the purposes described above even after your coverage terminates, although policies and procedures will remain in place to protect against inappropriate use or disclosure.
The federal privacy regulations give you the right to make certain requests regarding health information about you that is maintained by Sidecar Health. You may:
Contact us at email@example.com if you wish to exercise these rights.
If you believe that your privacy has been violated, you may file a complaint with Sidecar Health or with the Secretary of Health and Human Services. You will not be subject to retaliation or penalized for filing a complaint with Sidecar Health or with the Secretary.
To file a complaint with the Secretary of Health and Human Services, go to https://www.hhs.gov/hipaa/filing-a-complaint/complaint-process/index.html
To file a complaint with Sidecar Health or to receive more information contact:
Sidecar Health’s Privacy Officer
2381 Rosecrans Avenue, Suite 400
El Segundo, CA 90245
If you have questions regarding this Notice, please contact firstname.lastname@example.org.
Coverage is administered by Sidecar Health Insurance Solutions, LLC. This is only a brief description of the insurance coverage(s) available. The Policy contains reductions, limitations, exclusions, and termination provisions. Full details of the coverage are contained in the Policy. If there are any conflicts between this document and the Policy, the Policy shall govern in all cases. Insurance plans in Alabama, Georgia, and Texas are underwritten by United States Fire Insurance Company, 5 Christopher Way, 3rd Floor, Eatontown, NJ 07724. Insurance plans in Arkansas and Kentucky are underwritten by Sirius America Insurance Company, 140 Broadway, 32nd Floor, New York, NY 10005. Coverage under these plans is unavailable to applicants age 65 years or older.
Fixed indemnity insurance plans do not provide ACA-qualified Essential Health Benefits or Minimum Essential Coverage. You cannot receive a subsidy (premium tax credit and/or cost-sharing reduction) under the ACA in connection with your purchase of such a fixed indemnity insurance plan. Also, the termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period.
This is a limited benefits insurance plan and is not an expense incurred medical plan. The benefits provided under this plan are limited in nature and are not related to the costs you may incur for health care services. As a fixed indemnity insurance plan, this plan is exempt from many state and federal requirements that apply to other types of health benefit plans. This policy does not provide major medical expenses coverage, minimum essential coverage or essential health benefits.
†Comparison of premiums quoted to a 30-year-old person, with no pre-existing health conditions and residing in ZIP code 77002, for a standard policy administered by Sidecar Health and a Blue Advantage Plus BronzeSM plan issued by BlueCross BlueShield of Texas (as of April 18, 2019). Benefits are clearly labeled in the member portal and subject to your individual policy. New drugs and experimental procedures may not be covered by Sidecar Health. Please refer to your policy for exact coverage details.
‡Beck, Melinda. “How to Cut Your Health-Care Bill: Pay Cash” The Wall Street Journal,
www.wsj.com/articles/how-to-cut-your-health-care-bill-pay-cash-1455592277. Accessed 22 April 2019.