Legal Disclosures Please view important state disclosures and notices below. New York Confidentiality for Domestic Violence Victims and Endangered Individuals Notice (NY Ins Law §2612; Reg 168)Illinois Confidentiality Protocols for Request and Receipt of Claim Information by Alternative Means (Insurance Law §2028)New Jersey Department of Insurance Contact Information New York Confidentiality for Domestic Violence Victims and Endangered Individuals Notice (NY Ins Law 2612; Reg 168) New York Insurance Law § 2612, with respect to all insurers regulated under the Insurance Law, including health maintenance organizations (“HMOs”), provides in relevant part that if any person covered by an insurance policy delivers to the insurer a valid order of protection against the policyholder or other person covered by the policy, then the insurer is prohibited for the duration of the order from disclosing to the policyholder or other person the address and telephone number of the insured, or of any person or entity providing covered services to the insured. If a child is a covered person, then the right established by this section may be asserted by the child’s parent or guardian. Effective January 1, 2013, Insurance Law § 2612 also requires a health insurer, as defined in that section, to accommodate a reasonable request made by a person covered by an insurance policy or contract to receive communications of claim-related information by alternative means or at alternative locations if the person clearly states that disclosure of the information could endanger the person. If a child is the covered person, then this right may be asserted by the child’s parent or guardian. Except with the express consent of the person making the request, a health insurer may not disclose to the policyholder: (1) the address, telephone number, or any other personally identifying information of the person who made the request or child for whose benefit a request was made; (2) the nature of the health care services provided; or (3) the name or address of the provider of the covered services. The New York State Department of Financial Services (“Department”) has promulgated 11 NYCRR 244 (Insurance Regulation 168), which requires insurers to develop and implement confidentiality protocols. For health insurers, this also must include written procedures by which a person may make a reasonable request to receive communications of claim-related information by alternative means or at alternative locations and procedures for revoking such a request. The Department also has drafted a model confidential communication request formthat a health insurer may require a person to submit when making a reasonable request. For further information on domestic violence services, you can contact the NYS Domestic and Sexual Violence Hotline by dialing 1-800-942-6906 or by accessing the website for the New York State Office for the Prevention of Domestic Violence at the following link: www.opdv.ny.gov/help/dvhotlines.html. Illinois Confidentiality Protocols for Request and Receipt of Claim Information by Alternative Means (Insurance Law §2028) Illinois Insurance Law §2028 requires health and accident insurers to establish protocols to protect individuals of domestic violence. Summary of the law If an insurer receives a valid order of protection from a victim of domestic violence against a policyholder, the insurer is prohibited from disclosing the address, telephone number and any other identifying information of the victim of domestic violence to the policyholder. Likewise, if an insurer receives a valid order of protection from an insured against another person covered by the group policy, the insurer is also prohibited from disclosing the address, telephone number and any other identifying information of the insured person covered by the order to the person against whom the order was issued. Insurers must accommodate a reasonable request by an insured who is a victim of domestic violence to receive communications of claim-related information by alternative means or at alternative locations if the person making the request clearly states that disclosure of all or part of the information could endanger the person. Requesting or revoking alternative contact information To request or revoke an alternative address, phone number or any other contact information please Contact Us for instructions as to how to submit a request along with a copy of your protection order. Additional information Contact the State of Illinois’s Domestic Violence Hotline to receive additional information on the state’s domestic violence resources: 877-863-6338 TTY (hearing or speech impaired): 877-863-6339 NJ Department of Insurance Contact Information New Jersey residents please view the following. For Complaints: Consumer Inquiry and Case Preparation Unit 20 West State Street PO Box 471 9th Floor Trenton, NJ 08625 Phone: (609) 292-7272 or 1(800) 446-7467 Fax: (609) 777-0508 www.state.nj.us/dobi/consumer.htm For Claims Complaints: Office of the Insurance Claims Ombudsman 20 West State Street PO Box 472 9th Floor Trenton, NJ 08625 Phone: (609) 292-7272 or 1(800) 446-7467 Fax: (609) 292-2431 www.state.nj.us/dobi/ombuds.htm Email: Ombudsman@dobi.state.nj.us