2018 Aflac Incorporated Benefits Guide

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• For activities deemed necessary by military command
authorities, if you are in the armed forces.
• To comply with workers’ compensation or similar laws.
• To the Secretary of the Department of Health and Human
Services, if required by law, to investigate or determine the
Plan’s compliance with the law.
USES AND DI SCLOSURES REQUIRING
AUTHORI ZAT ION
Uses and disclosures other than those listed will be made
only with your written authorization. Types of uses and
disclosures requiring authorization include use or disclosure of
psychotherapy notes (with limited exceptions); use or disclosure
for marketing purposes (with limited exceptions); and use or
disclosure that constitutes the sale of your PHI.
If you authorize a use or disclosure, you have the right to revoke
that authorization. Your decision to revoke an authorization must
be timely, submitted in writing and delivered to the Benefits
Manager. Your authorization revocation will apply only to future
disclosures of PHI. Once the Plan has taken action with respect
to your authorization, the authorization can no longer be revoked
for PHI already released.
PROTECTED INFORMATION
The privacy of health information that can be used to identify
you or provides information about you is protected. Not all
health information is protected. Health information that doesn’t
identify you or cannot be used to identify you is not protected. In
addition, the protections described in this notice do not apply to
health information that Aflac can have under applicable law (e.g.,
the Family and Medical Leave Act, the Americans with Disabilities
Act, workers’ compensation laws, federal and state occupational
health and safety laws, and other state and federal laws) or that
Aflac properly can get for employment-related purposes through
sources other than the Plan and that is kept as part of your
employment records (e.g., pre-employment physicals,
drug testing, fitness-for-duty examinations, etc.).
INDIVIDUAL RIGHTS
You have the following rights:
You may request restrictions on certain uses and
disclosures of your PHI.
You may request a restriction on use or disclosure for the
purposes of treatment, payment or health care operations.
Your request must be in writing. The Plan is not required to
agree to this restriction if it would prevent the Plan from carrying
out payment or health care operations. Even if the Plan agrees
to your request for restriction, there are exceptions. For example,
if you need emergency treatment, restricted information may be
used or disclosed if it is needed for your treatment. Additionally,
there are certain instances in which uses and disclosures cannot
be restricted. For example, if disclosure is required by law, a
restriction would not apply. You may terminate any restriction
that you have requested. The Plan may terminate any restriction
it agreed to without your approval. A termination by the Plan will
affect only new information – in other words, information created
or received by the Plan after the termination.
You may also request that your health care provider not disclose
your PHI to the Plan for a health care item or service if you have
paid for the item or service out-of-pocket in full. Please note that
if your health care provider does not disclose the item or service
to the Plan, the amount you paid for the item or service will
not count toward your annual deductible or any out-of-pocket
maximums under the Plan. The provider may also charge you
the out-of-network rate for the item or service.
You have a right to receive confidential (alternative)
communications of PHI.
You may request that PHI be communicated to you at an
alternate address or by alternate means if your request clearly
states that you could be endangered by disclosure of all or part
of your PHI. Your request must be made in writing and must
specify an alternate address or method of contact. The Plan
will accommodate reasonable requests.
You have the right to access or copy your PHI.
You have a right to inspect and copy certain PHI maintained
by the Plan. Remember that your health care provider has the
most complete records of your health care, including information
the Plan does not have, use or maintain. We recommend that
you contact your provider to review your health information.
If you want to see the information maintained by the Plan,
you must make the request in writing to the Aflac Benefits
Manager. The Plan may charge a cost-based fee for supplies,
labor and postage. If you ask for a summary or explanation of
your personal health information, the Plan may charge you for
the cost of preparing the summary or explanation. Your right
of access is limited. For example, you do not have the right of
access to psychotherapy notes, to information used in judicial or
administrative proceedings or to information that is subject to the
federal Privacy Act or under a promise of confidentiality.
How to Apply for
Aflac Coverage