Your health details are really important pieces of information you want to protect. And so do we. We take it very personally. And we comply with the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which requires confidentiality of members’ protected and private health and medical information.
But we know there are times when you might need or want a family member or close friend to contact us about your coverage.
When those situations arise, you’ll need to give us permission to talk with anyone besides you. You can do that either in writing or verbally.
Employer Group plans, ASO, Dean Care Gold and Select, & AON Active Health Exchange member, please use the below form:
Authorization for disclosure (PDF)
Appointment of representative (PDF)
2024 Individual and Marketplace plans, please use the below forms:
Authorization for disclosure (PDF)
Appointment of representative (PDF)
You can also give us permission verbally by talking with one of our customer service representatives. In addition to letting us know if you want them to talk with us about your coverage, prior authorizations or claims, you’ll need to provide your:
Verbal permission isn’t a permanent solution and lasts for just 14 days. For a long-term solution, submit your written permission on our disclosure authorization form.
In certain circumstances, you may not be able to access your children’s information on the member portal. For certain services received by children, that information is not available to parents. And once your child turns 18, he or she must have their own individual account.
See related information:
If you're not sure what authorization is required for one of your family members to obtain access to insurance information or to speak about health insurance on behalf of another person, call our Customer Care Center at 866-514-4194 (TTY: 711).