• Your first accounting in any 12-month period is free. However, if you request an additional
accounting within 12 months of receiving your free accounting, we may charge you a fee. We
will inform you in advance of the fee and provide you with an opportunity to withdraw or
modify your request.
• You have a right to receive a paper copy of this notice upon request at any time. Your request
to exercise any of the above member rights must be in writing and be signed by you or your
representative. We may ask you to complete a form when making a request.
Changes to this Privacy Statement
We may from time-to-time change the contents of this notice and reserve the right to do so. If we
do so the new notice will be effective for all the member information maintained by us. Once
revised, we will provide the new notice to you by mail and post it on our Web site.
Who to Contact
If you have any questions about this notice or about how we use or share member information,
you may contact the HAP Privacy Officer by mail at:
Health Alliance Plan
ATTN: Privacy Officer
2850 W. Grand Boulevard, Detroit, MI 48202.
You may also call us at
. Or go to
, log in then select
& Receive Messages
If you believe your privacy rights have been violated, you may file a complaint with us by
contacting the Privacy Officer as noted above, or filing a grievance with the Client Services
Department. You may also notify the Secretary of the U.S. Department of Health and Human
Services of your complaint. We will not take any action against you for filing a complaint.