Notice of Privacy Practices

Your information. Your rights. Our responsibilities. 

Effective October 23, 2024

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.

We are required by law to:

• Maintain the privacy and security of your health information
• Provide you with this notice
• Comply with this notice
• Tell you if there’s any breach of your health information

For more information about any of our privacy practices, to exercise your privacy rights, or to file a complaint, contact our privacy officer at:

Affordable Health Insurance Agency, AHIA,
ATTN: Jennifer Jorrie, Compliance Director
3502 Paesano’s Pkwy, Ste 102
San Antonio, TX  78231

Phone: 1-855-380-2442 (TTY 711)
Email: compliance@ahiabenefits.com

Your rights

When it comes to your health information, you have certain rights.

This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your health information

• You can ask us for an electronic or paper copy of the health information we have about you. We may charge a reasonable, cost-based fee.
• We’ll provide a copy or summary of your health information within 30 days after you ask us in writing (or 60 if we need extra time).
• In certain cases we may deny your request, like if it might put someone in danger. If we deny your request, we’ll explain why and how you can appeal. 

Ask us to correct your health information

• You can ask us to correct any records you think are incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but if we do, we’ll tell you why in writing within 60 days.

Request confidential communications

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will consider all reasonable requests, and must say “yes” if you tell us you’d be in danger if we don’t.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information. 
• In most cases, we are not required to agree to your request, and we may say “no” if it would affect your care. If we do agree, we’ll follow your request (unless it’s an emergency).

Choose someone to act for you

• If you have given someone power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. Before we take any action, we’ll check that the person has this authority and can act for you. 

Get a copy of this privacy notice

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will provide it promptly.

File a complaint if you believe your privacy rights have been violated

• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• To file a complaint with us, send your complaint in writing to our Compliance Director using the contact information on the first page of this notice. 
• We will not retaliate against you for filing a complaint. 

Your choices

Whether we sell your information or use it for marketing

• We’ll never sell your information or use it for marketing unless you tell us in writing that we can. 
• This also applies to sharing your information for any other reason not included in this notice. 
• If you tell us we can, you may change your mind at any time — just let us know in writing.

How we use and share your health information

We typically use or share your health information in the following ways:

This includes sharing information with your health plan sponsor or those involved in your healthcare decision making for any of these purposes.

Determining your eligibility for a health care plan or premium help

• Tell you about other health plan options or health-related services that you may be qualified for or may interest you
• For audits, risk management, or compliance — note that we can’t use genetic information to determine whether you can enroll in a health plan or what your premium will be
• Work with other third-party services including, but not limited to, consultants, other  agents or agencies (and only if we have agreements that require them to follow the law and protect your information and your explicit consent.)

We are also allowed or required to share your information in other ways.

Comply with the law

• When local, state, or federal laws require us to share your information
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law

Respond to a legal action

• This includes legal actions like a lawsuit, court or administrative order, or subpoena

State and other federal laws may have stricter requirements than the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on how we use and share your health information. If any of these laws apply, we will follow them.

We may collect or receive information about you from other third parties when those third parties provide services to you. This includes when you use technology related to these services — see our internet privacy policy (this link stays here and only needs to point to the privacy policy above)for more details. Once we receive that information, we follow all the rules outlined above in terms of how we use, share, and protect it.

We can change the terms of this notice. 

If we do, the changes will apply to all information we have about you, starting on the new notice’s effective date. The new notice will be available on our website, you can contact our Compliance Director to get a copy.

This policy covers entities that have designated themselves as an “Affiliated Covered Entity” for purposes of compliance with federal privacy laws. An Affiliated Covered Entity is a group of health insurance agencies that sell health plans and/or healthcare and affiliated products under common ownership or control that designates themselves as a single entity for purposes of compliance with HIPAA.

Our Commitment to Compliance

Affordable Health Insurance Agency would like you to know that we take compliance seriously.

As an organization, we’re guided by the highest standards of ethics and integrity in delivering our commitment to our clients. Our mission is to treat our clients like family. To be successful and achieve our mission and goals as a health insurance agency, we must create a culture of compliance and trust, and live and work by the highest ethical standards. Our Code of Conduct is our foundation in achieving this environment and complying with the laws, regulations, and ethical standards that govern our business. Our Medicare Compliance Program is designed to meet and build upon the requirements for an effective compliance program which includes measures to prevent, detect and correct issues of non-compliance and Fraud, Waste, and Abuse (FWA) in all lines of the business that we support.

We expect everyone to report potential non-compliance including employees, Issuers, and first-tier, downstream and related entities (FDRs). We’ve adopted and enforce a zero-tolerance policy for retaliation or intimidation against anyone who reports suspected misconduct. You may also choose to remain anonymous. If you are an FDR and you use your own code of conduct or compliance policies, you must include a process for reporting all compliance and FWA issues that impact Affordable Health Insurance Agency.

Please feel free to contact our Compliance Director with any questions related to potential non-compliance or FWA.

How to report compliance concerns

To report suspected or detected noncompliance or potential FWA, call our Compliance and FWA Hotline at 855-380-2442 or report online at compliance@ahiabenefits.com.

Affordable Health Insurance Agency stores Member Communications electronically in our secure online systems. Affordable Health Insurance Agency is not liable for disclosures or breaches of confidential information caused by the client or any third party. Affordable Health Insurance Agency is not liable for improper disclosure of confidential information unless caused by Affordable Health Insurance Agency’s intentional gross misconduct.