Please read our Privacy Notice.

This statement describes the privacy standards and practices of the EnvisionRx Plus prescription drug plan by Envision Insurance Company (hereafter, "EnvisionRx Plus" or the "Plan"). The EnvisionRx Plus website is intended to provide you with access to various online information and tools to help you manage your prescription drug benefits. In order for EnvisionRx Plus to provide these services, there will be instances where EnvisionRx Plus will request personal information from you. As part of our commitment to protect your privacy, EnvisionRx Plus has provided this policy to explain how we use and protect your personal information gathered from you via this corporate website.

Sharing Information

EnvisionRx Plus is the sole collector and owner of this information and will not provide any identifiable personal information, including email addresses, to any third party, unless legally permitted to do so. In the course of maintaining your prescription drug benefit, personal information you provide on this website may be shared with other EnvisionRx Plus operations, your health plan, and other companies performing services on behalf of EnvisionRx Plus or your health plan.

How We Keep Your Information Secured

EnvisionRx Plus protects your transactions using a technology called Secure Socket Layer (SSL). Your sensitive information will automatically be encrypted before being sent over the internet. Encryption involves systematically scrambling numbers and letters so if someone managed to intercept that information they would not be able to make sense of it.

Collection and Use of Information

The EnvisionRx Plus website collects both personally identifiable and non-personally identifiable information.

Personally identifiable information is any data that can be used to identify an individual or their residence. This may include, without limitation, name, address and/or telephone number. Conversely, non-personally identifiable information is any data that cannot be directly associated with an individual.

Non-personally identifiable information can be used to show how many people visit the web-site, which pages they visited, how long they stay at the site, etc. This type of data is collected as an anonymous aggregate.

Cookies

No client-side cookies are used. No files or information are stored on the visitor's computer, and no information is captured from the visitor's computer. User session variables are used on the host server to store information about products selected for purchase. No personal information is ever captured.

Information Requested When Contacting EnvisionRx Plus

When you access the "Contact Us" area, you will be asked for personally identifiable information, including your name, email address, and postal address. You are voluntarily providing EnvisionRx Plus with this information so that we may respond/fulfill your information request.

External Links

EnvisionRx Plus may provide links to other sites that we believe offer our beneficiaries useful services and information. Since these sites are not under the control of EnvisionRx Plus, we cannot and do not make any representation or guarantee regarding the linked sites or their content. Providing these links does not constitute an endorsement by EnvisionRx Plus, and we cannot be responsible for the privacy policies or security procedures of the linked sites. We encourage you to review the privacy and security policies of any site you visit, as this policy is solely applicable to the EnvisionRx Plus web-site.

Consent

By visiting the EnvisionRx Plus website and using the services and features that we have made available to you, you hereby consent to our collection and use of the information in the manner we have described above where applicable. Any changes in our Privacy Policy will appear in this document.

Please read and review this notice carefully and thoroughly. It describes how prescription information about you MAY BE USED or DISCLOSED. This notice also will inform you on how to obtain this information.

EnvisionRx Plus requirements and responsibilities regarding your protected health information (PHI).

EnvisionRx Plus must comply with all HIPAA privacy provisions that protect beneficiaries’ (PHI). Be aware that a beneficiary’s PHI may be used for the purposes of health care related operations and the marketing of other products and services that are directly related to the Medicare endorsements. This regulation provides other restrictions that exceed the HIPAA privacy requirements that prevent a EnvisionRx Plus from seeking authorization from a beneficiary to utilize PHI for any other activity outside the immediate scope of the Medicare approved endorsement.

While EnvisionRx Plus retains certain rights to alter, include, or eliminate parts of the use of information, we will notify beneficiaries of any such changes. Please note EnvisionRx Plus is not permitted to use or release any (PHI) collected while operating the program for beneficiaries.

EnvisionRx Plus is dedicated to the protection of your PHI. We wish to make you aware of the use your PHI and to inform you of your rights and our obligations by law. We are required to do the following:

• Ensure all (PHI) remains private.
• Forward to you this notification explaining how EnvisionRx Plus may use and release your PHI.
• Notify you of your rights regarding your PHI.

We will not use or disclose any of your PHI to others without your written permission, except as described below.

EnvisionRx Plus may utilize and release your PHI in the following ways:

• To pharmacists for treatment reasons, such as managing or coordinating your care through their knowledge of knowing what your prescriptions are to avoid dangerous drug interactions.
• For reimbursement or payment purposes to your pharmacy for dispensing your prescriptions to you or to collect payment from you or the government for the prescription drugs you receive. Also, a review of your enrollment form may be necessary to determine if you qualify for governmental assistance or discounts offered.
• For our health care organization to improve the quality and service of the EnvisionRx Plus program. This may include educational and wellness programs about medications you may be taking, customer care related matters to improve performance, medicine refill reminders, and to evaluate and improve the performance of our providers.
• For health plans or providers who are reimbursed for their services, including pharmacies that bills another payer or a health plan for your treatment and or improvement requirements.
• For certain contractors who assist us with the operation of the Plan regarding enrollment, outreach materials, educational programs, or accounting agencies for auditing purposes.

We will require all contractors to agree in writing that they must protect your PHI that they receive to perform their required services.

We may use or release your PHI to contact you about certain products or services offered as part of the EnvisionRx Plus program, which may include prescription refill reminders, alternative treatment options that may be beneficial to you and other health and wellness programs that may be of benefit or of interest to you.

Under no circumstances will your PHI be used to contact you about any product or service not offered by EnvisionRx Plus.

There are other circumstances in which your PHI may be disclosed if certain circumstances apply. This includes, without limitation:

• To a close friend or family member who is actively involved in your care or to an individual who helps or assists you in payment of care and must be informed since you may be unable to, do not object to, or are involved a disaster relief matter that requires notification as to your medical status, condition, and/or location.
• To governmental agencies for oversight committees, compliance, civil rights issues, fraud and abuse investigations, abuse, neglect, and domestic violence.
• To comply with law enforcement officials relating to criminal or civil matters, assist with workers' compensation matters, to coroner, medical examiners, and funeral directors, and to public health authorities to prevent, avoid, or control diseases of a communicable nature.
• To organizations engaged in organ procurement transplants or to assist in facilitating donations or transplantations. To avoid a major threat to your general health and safety in addition to others around you, appropriate military personnel in select circumstances should you be in armed forces or a military member, federal officials for intelligence and protection of our legislative, executive, and judicial branches of government, and correctional institutions and law enforcement officials if you are imprisoned. All of the above are under special and certain circumstances.
• As required by local, state, or federal law.

Your (PHI) Rights

You have certain rights related to your PHI as described below. To exercise any of these rights, you must send a request in writing with any additional information you feel is necessary, including your card identification to:

Envision Insurance Company
Attention: Privacy Officer
2181 E. Aurora Road, Suite 201
Twinsburg, OH 44087

Right to Inspect and Copy (PHI) About You

You have every right to inspect and copy PHI that is maintained about you. You may request a copy of the PHI and you may be charged to cover the cost of copying and mailing. Please note that we may deny such a request, but you have the right to request a review of the denial.

Amending your PHI

If it is your belief that your PHI is incomplete, inaccurate, or incorrect, you have the right to request it be amended. In such a request, you must also include the version(s) that support the amendment. If EnvisionRx Plus did not create the PHI, it is requested that you explain why you believe the party who created it is no longer available to amend the change. Your request may be denied, but you have the right to submit a record disagreeing with the denial and it will be linked to the relevant information in question.

Right to Account for PHI Disclosures

You may request a list of certain non-routine disclosures about your PHI. You must identify the time frame requested, and you will be charged to cover costs of producing this information if you request an accounting of the PHI more than once in any twelve (12) month period.

Your Right to Restrict PHI About You

You have the right to request a restriction on how EnvisionRx Plus uses or releases PHI about you regarding payment, treatment, or other health related operations. Furthermore, you have the right to request a restriction on information to be disclosed about you to the person or family member involved in your care. Such a request must specify what information should be restricted and in what way. Please note that we are not required to comply with the request.

Permission to Copy this Notice in Paper

You may make a paper copy of this notice at any time. As a reminder, EnvisionRx Plus will not disclose your PHI for any other reason than those described in this notice without your written permission or authorization.

Right to File Complaints

Should you believe your privacy rights have been violated, you have the right to file a grievance or complaint to EnvisionRx Plus or to the Secretary of the Office of Civil Rights. See www.hhs.gov/ocr/hipaa/. If you wish to file a grievance or complaint with us, please do so by writing to the address below or contact Member Services toll free: 1-866-250-2005, (TTY/TDD users 711).

Changes in This PHI Notification

EnvisionRx Plus reserves the right to modify, update, or change this notification as it related to PHI at any time in the future. EnvisionRx Plus will have a copy of the most up to date notice on website at www.envisionrxplus.com. For past copies of the notification, please send your written request to:

Envision Insurance Company
Attention: Privacy Officer
2181 E. Aurora Road, Suite 201
Twinsburg, OH 44087

Effective Date

This notice is effective October, 2006.