Page 44 - EPO_Member_Kit

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• We may share information relative to specialized government functions, such as military and
veteran activities, national security and intelligence activities, and protective services for the
President and others.
• We may report information on job-related injuries because of requirements of your state
worker compensation laws.
If one of the above reasons does not apply, we must get your written permission to use or disclose
your member information. If you give us written permission and change your mind you may revoke
your written permission at any time. The revocation will not apply to any information we have
already disclosed. We may ask you to complete a form when making a request. Once you give us
authorization to release your member information, we cannot guarantee that the person to whom
the information is provided will not disclose the information.
Your Member Rights
The following are your rights with respect to your member information. If you would like to
exercise the following rights, please contact us as described below, under “Who to Contact.”
• You have the right to ask us to restrict how we use or disclose your member information for
treatment, payment, or health care operations. You also have the right to ask us to restrict
member information that we have been asked to give to family members or to others who
are involved in your health care or payment for your health care. Please note that we are not
required to agree to these restrictions.
• You have the right to ask to receive confidential communications of information. For
example, if you believe that you would be harmed if we send your information to your
current mailing address (for example in situations involving domestic disputes or violence),
you can ask us to send the information by alternative means, for example, by fax or to an
alternative address. We will try to accommodate reasonable requests.
• You have the right to inspect and obtain a copy of member information that we maintain
about you. We may deny your request to inspect and copy your member information in
certain, limited circumstances. For example, we may deny your request if review of the
records could endanger you or another person. We may charge you a fee for copies. We will
inform you in advance of the fee and provide you with an opportunity to withdraw or modify
your request.
• You have the right to ask us to amend member information we maintain about you. We will
require that the information you provide be accurate. We are unable to delete any part of a
legal record, such as a claim submitted by your doctor. Please note that we are not required
to agree to a request to amend.
• You have the right to receive an accounting of certain disclosures of your member
information made by us during the six years prior to your request. Please note that we are
not required to provide you with an accounting of all disclosures we make. For example, we
are not required to provide you with an accounting of member information collected prior to
April 14, 2003; information disclosed or used for treatment, payment, and health care
operations purposes; or information disclosed to you or pursuant to your authorization.