Privacy & Legal

Notice of Privacy Practices

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. 

Our Privacy Promise

We understand the importance of handling your medical information with care. We are committed to protecting the privacy of your medical information. State and federal laws require us to make sure that your medical information is kept private. Federal law requires that we provide you with this Notice of Privacy Practices, which describes our legal duties and privacy practices with respect to your medical information and your legal rights with respect to our use and disclosure of your medical information. We are required by law to follow the terms of the Notice currently in effect. This Notice is effective September 23, 2013, and will remain in effect until it is changed or replaced. 

We reserve the right to change our privacy practices and the terms of this notice at any time, as long as the law allows. These changes will be effective for all medical information that we keep, including medical information we created or received before we made the changes. When we make a material change to our privacy practices, we will provide a copy of a new notice (or information about the changes to our privacy practices and how to obtain a new notice) in a mailing to members who are covered under our health plans at that time.

Uses and Disclosures of Medical Information

Treatment, Payment, Health Care Operations

We may use and disclose your medical information for purposes of treatment, payment and health care operations.

Treatment: We may disclose your medical information to a physician or other health care professional to help him or her provide your treatment. 

Payment: We may use or disclose your medical information for these and other activities related to payment:

• Paying claims from physicians, hospitals and other health care providers.
• Obtaining premiums.
• Issuing explanations of benefits to the named insured.
• Providing information to health care professionals or other entities that are bound by the federal Privacy Rules for their payment activities.

Health Care Operations: We may use or disclose your medical information in the normal course of conducting health care operations, including such activities as:

• Quality assessment and improvement activities.
• Reviewing the qualifications of health care professionals.
• Compliance and detection of fraud and abuse.
• Underwriting, enrollment and other activities related to creating, renewing or replacing a plan of benefits. We may not, however, use or disclose genetic information for underwriting purposes.
• Providing information to another entity bound by the federal Privacy Rules for its health care operations, in limited circumstances.

You and Your Family and Friends

We may use and disclose your medical information to communicate with you for purposes of customer service or to provide you with information you request. We may disclose your medical information to a family member, friend or other person to the extent necessary for him or her to assist with your health care or payment for your health care. Before we disclose your medical information to that person, we will give you a chance to object to us doing so. If you are not available, or if you are incapacitated or in an emergency situation, we may, in the exercise of our professional judgment, determine whether the disclosure would be in your best interest. We may also use or disclose your medical information to notify (or help notify, including identifying and locating) a family member, a personal representative or other person responsible for your care of your location, general condition or death.

Your Employer or Organization Sponsoring Your Group Health Plan 

We may disclose summary information and enrollment information to your employer (or other plan sponsor). Summary information is a summary of the claims history, claims expenses or types of claims that members of your group health plan have filed. The summary information will not include demographic information about you or others in the group health plan, but your employer or plan sponsor may be able to identify individuals from the summary information provided.

Disaster Relief

We may use or disclose your medical information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts. 

Public Benefit

We may use or disclose our members medical information as authorized by law for the following purposes that are in the public interest or benefit:

• As required by law.
• For public health activities, including disease and vital statistics reporting, child abuse reporting, FDA oversight, and to employers regarding work-related illness or injury.
• To report adult abuse, neglect or domestic violence.
• To health oversight agencies.
• In response to court and administrative orders and other lawful processes.
• To law enforcement officials in response to subpoenas and other lawful processes concerning crime victims, suspicious deaths, crimes on our premises, reporting crimes in emergencies and to identify or locate a suspect or other person.
• To coroners, medical examiners and funeral directors.
• To organ procurement organizations.
• To avert a serious threat to health or safety.
• In connection with certain research activities.
• To the military and to federal officials for lawful intelligence, counterintelligence and national security activities.
• To correctional institutions regarding inmates.
• As authorized by state workers compensation laws.

Your Authorization

You may give us written authorization to use your medical information or to disclose it to anyone for any purpose. You may revoke your authorization in writing at any time. However, this will not affect any uses and disclosures we made while your authorization was in effect. Without your written authorization, we will not use or disclose your medical information for any reason except those described in this notice.

Individual Rights

You have certain rights with respect to the medical information we maintain about you. To exercise any of these rights or to obtain more information about these rights (including any applicable fees), contact us using the information listed at the end of this notice. 

Access

You have the right to inspect or receive a paper or electronic copy of your medical information, with some exceptions. To inspect or receive your medical information, you must submit the request in writing. If you request to receive a copy of your records, we are allowed to charge a reasonable, cost-based fee. 

Disclosure Accounting

You have the right to request, in writing, a record of instances in which we (or our business associates) disclosed your medical information for purposes other than treatment, payment, health care operations, and as allowed by law. We will provide you with a record of such disclosures for up to the previous six years. If you request a record of disclosures more than once in a 12-month period, we may charge you a reasonable, cost-based fee for each additional request. 

Restriction

You have the right to request, in writing, that we place additional restrictions on our use or disclosure of your medical information. By law, we are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). Any agreement to additional restrictions will be made in writing and signed by a person authorized to make such an agreement for us. 

Confidential Communications

You have the right to request, in writing, that we communicate with you about your medical information by other means, or to another location. We are not required to agree to your request unless you state that you could be in danger if we do not communicate to you in confidence. In that case, we must accommodate your request if it is reasonable, if it specifies the other means or location, and if it permits us to continue to collect premiums and pay claims under your health plan. We will not be bound to your request unless our agreement is in writing.

Amendment

You have the right to request, in writing, that we amend your medical information. Your request must explain why we should amend the information. We may deny your request if we did not create the information you want amended and the person or entity that did create it is available, or we may deny your request for certain other reasons. If we deny your request, we will send you a written explanation. .

Notice of Breach

We are required to notify affected individuals following a breach of unsecured medical information. explanation.

Electronic Notice

You may request a written copy of this notice at any time or download it from our website.

Questions and Complaints

If you want more information about our privacy practices, or if you have questions or concerns, please contact us using the information below. 

If you believe we may have violated your privacy rights, you may submit a complaint to us using the contact information listed below. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with that address upon request.

We support your right to the privacy of your medical information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

Contact Information
Attn: Privacy Officer 
I 20 East @ Alpine Road (AC-200) Columbia, SC 29219

803-264-7258 (telephone)
803-264-7257 (fax)
 

Blue Cross and Blue Shield of South Carolina, together with its affiliates (collectively referred to as “Company” or “we”) is the owner of this website (this “Site”) and, makes the Site available to you.  

1.    General Terms

1.1.       In consideration for using this Site, you agree to these Terms of Use.  If you do not agree to these Terms of Use OR TO ANY PRIVACY POLICY CONTAINED OR REFERRED TO ON THIS SITE, do not use this Site.  By using this Site (other than to read these Terms of Use for the first time) or clicking on the words “Continue”, “Yes” or “I Agree” or any similar wording anywhere on this Site or as a requirement to access, download, or otherwise use the Site, you agree to comply with these Terms of Use.  Company reserves the right to change these Terms of Use from time to time and you hereby agree to such changes without further notice.  We suggest that you re-read the Terms of Use and any privacy policies contained on or referred to on this Site (“Privacy Policy” from time to time so that you stay informed as to any such changes.  In any event, by using this Site, you agree that you will be bound by the Terms of Use appearing on this Site at the time you are using this Site. Further, some Company services may require you to agree to additional terms and conditions that apply to the specific Company services. If you agree to those additional terms and conditions, then those additional terms and conditions also shall form a part of these Terms of Use.

1.2.       The right to use this Site is personal to you and is not transferable to any other person or entity.  You are responsible for protecting the confidentiality of your password and user name, if you have them. You may only use this Site to access information about you or your dependents.  Do not use this Site to access information about any other person, including a friend or family member.

1.3.       You acknowledge that this Site may experience service interruptions or events that are beyond Company’s control and that Company will not be responsible for any information you may lose while you are using this Site or when you transmit information to this Site via the Internet. 

1.4.       Your use of the Internet and this Site is solely at your own risk.  You may not share your login name, password or other credentials with a third party.  You agree to assume all risks associated with any usage, whether or not authorized, of your login name, password or other credentials or other information you share with or have access to on this Site and further release us from any and all claims, liabilities and damages, of whatever nature, related to this Site.

1.5.       You represent and warrant to us that you are age 18 or older. Use by those under the age of 18 is not authorized. This Site is not directed at children under the age of 13. Company does not knowingly permit registration or submission of personally identifiable information by anyone younger than 13 years of age.

2.    Information on this Site

2.1       Company has no legal duty to you to update information on this Site.  This means information on this Site may be out of date at any given time.  Company also may make improvements or changes to the information, products, or services described on this Site at any given time without notice.

2.2        Company has no legal duty to you to ensure that this Site is correct.  By using this Site, you agree not to hold Company liable for any inaccuracy of this information and you assume all the risks associated with its use.

2.3       We may modify, remove, or update information on this Site without notice.  Company may change or terminate any feature of this Site, including, but not limited to, content, hours of availability, and equipment needed for access or use.  Company may stop providing any information or category of information, may change or eliminate any transmission method, and may change transmission speeds or other aspects of this Site’s operation.  If we terminate your access to this Site, then this Agreement shall remain in full force and effect and shall survive as the governing terms of your access and use of the Site and Services prior to your termination.  Furthermore, we may modify or discontinue your access to any or all of this Site in our discretion at any time.

2.4      Depending on your status, you may have access to eligibility and benefits information through this Site. The information you obtain is not a guarantee of payment. Unless otherwise required by state law, any information you obtain regarding eligibility and benefits is not a guarantee of payment. Benefits are subject to all contract limits and member status on the date of service and other terms of your insurance policy or benefit plan. Also, nonpayment of premiums and other contractual limitations may result in denial of benefits or refunds.  You should always consult your insurance policy or benefit plan document about what your insurance policy or benefit plan covers.

Accumulated amounts such as deductibles may change as additional claims are processed. Deductible and out-of-pocket limits may not apply for all services under your benefit plan. The deductible and out-of-pocket status information is a standard calculation based on the limits for professional outpatient services performed in a hospital. If your benefit plan does not impose a limit for this service or includes different limits for other types of services, the actual amounts may vary.

The replacement deductible is for the deductible specific to the service type requested. This replaces the global deductible for this service type. Please contact Customer Service for additional information regarding benefits.

2.5       Nothing contained, expressed, or implied in this Site is intended as, nor shall be construed or understood as, medical advice.  No doctor-patient or other medical provider-patient relationship is established between Company and you by reason of your use of this Site or under any circumstances whatsoever.  The information in this Site is for general informational purposes only.  If you have questions about medical issues or health information arising from your use of this Site, you should contact your own health professional.

2.6       Confidentiality of Communications:  Communications that you post to this Site are not confidential. You are responsible for your own communications and the consequences of such posting. Some parts of this Site may allow you to post, or to e-mail to Company, materials or information ("Visitor Content"). Communications that you post to this Site are not confidential. You are responsible for your own communications and the consequences of such posting. You grant Company the unrestricted right to use or distribute, free of charge, any Visitor Content posted on this Site by you or anyone using your login information. COMPANY DOES NOT REPRESENT OR GUARANTEE THE TRUTHFULNESS, ACCURACY OR RELIABILITY OF ANY COMMUNICATIONS POSTED BY OTHER USERS OR ENDORSE ANY OPINIONS EXPRESSED BY OTHER USERS. ANY RELIANCE ON MATERIAL POSTED BY OTHERS IS AT YOUR OWN RISK.

Company may review, remove or edit any Visitor Content at its discretion. COMPANY HAS NO RESPONSIBILITY AND ASSUMES NO LIABILITY FOR VISITOR CONTENT POSTED BY YOU OR BY ANY OTHER PARTY.

3.    Proprietary Rights

3.1       This Site and all contents posted on this Site are the exclusive property of Company or are licensed to Company for its use.  Company is the owner or licensee of the copyright in the entire content (including images, text, and look and feel attributes) of this Site and reserves all rights in that regard.  You may not post, link, or make other modifications to this Site or copy material from this Site without Company’s express written consent. 

3.2       Company does not transfer or grant any of its intellectual property or other rights to you, including any copyright, trademark, service mark or patent rights, all of which Company expressly reserves for itself.  You may not remove or change any copyright notice on any material on this Site.

3.3       (a) If you are an individual member, participant, or beneficiary, you may make reasonable use of this Site and content on this Site for your personal or household purposes.  If you are an individual who is participating in a wellness program administered in whole or in part by Company (“Wellness Program”), but are not otherwise a member, participant, or beneficiary of a policy or group health plan administered in whole or in part by Company, you may use the Site solely to participate in the Wellness Program. Regardless of the purposes for which the above language permits you to use this Site, you may not use content on this Site for any commercial purpose.  Also, you agree not to distribute, manipulate, create derivative works from, or use the information on this Site for any purpose other than as described above or as expressly authorized by Company.  You additionally acknowledge that you do not acquire any ownership rights by copying or downloading copyrighted material. 

(b)  If you are a health care provider who has patients who are entitled to health benefits through insurance provided by or any other health benefit plan administered by Company, you may use the provider designated portions of this site solely to the extent minimally necessary for your internal business purposes of managing payment by Company or its clients of claims for services covered by said plan and that are rendered by you to said patients.  You agree that this permission may not be sub-licensed or otherwise granted to any third party.  Furthermore, you agree not to distribute, manipulate, create derivative works from, or use the information on this Site other than as described above or as expressly authorized by Company in a writing signed by an officer of Company authorized to bind Company in the matter.  You acknowledge that you do not acquire any ownership rights by copying or downloading copyrighted material. 

(c)  If you are a group health plan client or plan sponsor of such a plan administered or insured by Company, you may use the Permitted Portions of this Site to the extent minimally necessary for the plan’s healthcare operations or payment purposes only regarding members, participants or other beneficiaries that are insured or administered by Company only.   The Permitted Portions of this Site shall be defined to be those portions of this Site designated as for group health plan clients or plan sponsors only.  You agree that this permission may not be sub-licensed or otherwise granted to any third party.  You agree not to distribute, manipulate, create derivative works from, or use the information on this Site for any purpose other than as described above or as expressly authorized by Company in a writing signed by an officer of Company authorized to bind Company in the matter.  You acknowledge that you do not acquire any ownership rights by copying or downloading copyrighted material.

(d)  Any usage by third parties other than as described in Section 3.3 (a), (b), or (c) above is prohibited.

(e)  You agree that you shall comply with all applicable laws, regulations or other government directives regarding your use. You agree that you do not have permission to use and will not use this Site: (i) to access any information for which you do not have the legal right to view; or (ii) to distribute or publish any defamatory statements, pornographic material, copyrighted, trademarked or other proprietary material. You may not submit or post any material or information which is illegal, obscene, threatening, defamatory, invasive of privacy, or infringing of proprietary rights of any person or entity, or which contains software viruses, corrupted data, cancel bots, commercial solicitations, or mass mailings or any form of "spam." You may not use a false e-mail address to impersonate any person or otherwise mislead as to the origin of any material or information you submit or post.

3.4       Any violation of this Agreement may result in copyright, trademark, or other intellectual property right infringement that may subject you to civil and/or criminal penalties.  This Site contains Company’s copyrighted material, trademarks, and other proprietary information, including, but not limited to, text, software, photos, video, graphics, music, and sound.  This content is protected by copyright as a collective work under the United States copyright laws.

4.    Security/Privacy; Other Websites; Information Sharing; Mobile Device Information Usage; Consent to Usage of Information; Email Usage; Cookies and Similar Technologies

4.1       Security/Privacy.  This Site has security/privacy measures in place to protect against the loss, misuse and alteration of the information under our control. While your Username and Password are used to initially recognize you as an enrolled member, some of the functions offered by this Site may require a higher level of validation and will use your member/group/provider/agent number and date of birth to allow access to these functions. We may also require multi-factor authentication and may send you a code via voice, text, or email (as chosen by you) that you will have to use to access the Site. We use your Internet Protocol (IP) address to help diagnose problems with our server, and to administer this Site. Your IP address is also used to help identify you and to help gather broad demographic information. Although we have security and privacy measures in place, we cannot guarantee that unauthorized third parties (including computer hackers) will not gain unauthorized access to your information or otherwise misuse the system. Use your own best judgment when sending information via the Internet to an email address or website or this Site. Email sent via the Internet may pass through private and public networks with varying levels of security. Some networks may have taken steps to secure email transmissions while others have not, thereby compromising the privacy and integrity of an email. An email may be copied, altered or destroyed.

4.2       Third Party Sites, Terms and Information Sharing.  As you navigate through this Site, you will be able to link to other sites for special offers or information. Please note that we provide these links for your convenience, but inclusion of the link does not imply endorsement by us. We do not guarantee any third party’s performance and do not guarantee any of the services or materials provided by any third party. The linked sites are not under our control and we are not responsible for the contents of any linked site or any link contained as a linked site. You may be required to accept a linked website’s separate terms and conditions in order to access such website. Some linked sites may provide particular, personalized services. For the linked site to provide this type of detailed information, it may be necessary for us to provide the linked site with specific information related to your personal information. Your acceptance of this Agreement constitutes your agreement that we may provide such linked sites with necessary personal information. Because we do not control the linked sites, we encourage you to understand the privacy policies of linked sites.  Obviously, we cannot be responsible for the privacy practices or the content of such websites. With regard to third party information, we do not endorse or otherwise recommend or approve any product or information located on or available through this Site.

4.3       Mobile Device Usage and Information.  You agree to the following:

(a)       Mobile usage includes any program or service accessed or used via your mobile device (e.g. a portable computer, iPad, iPhone, smart phone, smart watch, smart pad, or other such device) and the software modules operating within our mobile environment and appearing on your mobile device that provide you access to a variety of content and services.

(b)       We collect information for mobile usage, such as your device type and hardware IDs; the request type; your mobile carrier; your mobile carrier’s user ID; the content of your request; basic usage stats about your device; and use of our products and services. This information does not by itself identify you to us, though it may be unique or consist of or contain information that you consider personal.

If you use location-enabled products and services, such as Google Maps for mobile, you may be sending us location information. This information may reveal your actual location, such as GPS data, or it may not, such as when you submit a partial address to look at a map of the area.

Certain use of our products and services allows you to download and/or personalize the content you receive from us. For these products and services, we will record information about your downloads and preferences, along with any information you provide about yourself. If the product or service requires you to log in with a specific account, this information will be associated with your account.

(c)        All requests made via your mobile device must be sent through your mobile carrier's network and your mobile carrier may have access to it. For information regarding your mobile carrier's treatment of your information, please consult your mobile carrier's privacy policies.

4.4       Consent to Use Information Supplied; TCPA Consent.  In using this Site, you may supply or be requested to supply certain contact information, including, without limitation, your cell phone or other telephone number. You are not required to provide a cell or other telephone number to receive services from Company.  However, failure to provide the requested contact information may affect our ability to quickly communicate with you and the quality of your online and other electronic experiences with us.  Please be advised that we may use or share contact information provided by you as part of any services we provide with third parties for the purposes of providing this Site or any other services, products or benefits or for marketing purposes to the extent otherwise allowed by law.  This may include, without limitation, our use or our vendors’ or subvendors’ use of automatic telephone dialers or recorded or artificial voices to communicate with you at any telephone number, including, without limitation, any mobile or other mobile device numbers you have provided or any successor to such numbers, for the purposes of supplying any services, products or benefits or for marketing purposes.  Your providing any contact information to Company constitutes your consent, to the maximum extent allowed by law, to any usage by us or our vendors or subvendors of your personal information (including, without limitation, contact information such as email addresses, mobile or other device numbers) as referred to or otherwise stated in this Agreement and any Privacy Policy. 

4.5.      Consent to use of Email.  You agree Company may use any email address you supply to correspond with you regarding this Site, to provide any services, products, or benefits to you, your spouse or your dependents and to send other communications, including, without limitation, marketing communications, to you, your spouse or your dependents. Company also may retain this email address for such future use as Company may determine. Additionally, Company may send email responses to questions submitted to Company.  If you would like to update your personal information, you may do so either via the Site customer services functions or by calling the Customer Service department. If you are an individual member, participant, or beneficiary, to opt-out of receiving email communications or otherwise manage your contact information and/or preferences, please log into the Site, click on My Profile, then click on My Contact Information and My Contact Preferences.  If you are a health care provider, to opt-out of receiving email communications or otherwise manage your contact information and/or preferences, please contact us at 800-868-2510 . If you are a health plan client or plan sponsor, to opt-out of receiving email communications or otherwise manage your contact information and/or preferences, please contact your BlueCross account representative.

4.6       Consent to Delivery of Notices or Documents by Electronic Means.  In addition to Sections 4.4 and 4.5 above, but subject to the limitations and rights below, by supplying your contact information electronically, you affirmatively consent to the delivery of notices or other documents electronically. Please take notice of the following limitations and rights:

(a) You have a right to receive notices or other documents delivered to you in a paper or other non-electronic form at no additional cost;

(b) If you have consented to the receipt of notices or other documents by electronic means, then you may withdraw that consent at any time as indicated in section 4.5 above or subsection (e) below;

(c) The notices or other documents covered by this consent include, without limitation, the following:  enrollment documents, explanations of benefits, notices of cancellation or termination of benefits or coverage, grants or denials of claims, communications related to THE FILING AND payment of claims OR TO PLAN OR OTHER CONTRACTUAL LIMITATIONS, wellness program documents, disease management program documents, or any other documents or notices related in any way to your RELATIONSHIP WITH COMPANY OR YOUR health benefit or other insurance or benefit plan;

(d)  If you are an individual member, participant, or beneficiary, To obtain, at no additional cost, a PAPER copy of any notice or document delivered to you electronically, please CONTACT THE CUSTOMER SERVICE NUMBER ON THE BACK OF YOUR CARD.  OTHERWISE, TO OBTAIN SUCH PAPER COPIES, IF YOU ARE A HEALTH CARE PROVIDER, PLEASE CONTACT US AT 800-868-2510 , OR IF YOU ARE A HEALTH PLAN CLIENT OR PLAN SPONSOR, PLEASE CONTACT YOUR BLUECROSS ACCOUNT REPRESENTATIVE;

(e) If you are an individual member, participant, or beneficiary, To withdraw your consent to electronic receipt of notices and documents, please LOG IN TO THE SITE AND GO TO MY PROFILE, THEN MY CONTACT PREFERENCES TO SWITCH TO SWITCH FROM ELECTRONIC DELIVERY TO MAIL.  OTHERWISE, TO WITHDRAW YOUR CONSENT, IF YOU ARE A HEALTH CARE PROVIDER PLEASE CONTACT US AT 800-868-2510 , OR IF YOU ARE A HEALTH PLAN CLIENT OR PLAN SPONSOR, PLEASE CONTACT YOUR BLUECROSS ACCOUNT REPRESENTATIVE; and

(f) If you are an individual member, participant, or beneficiary, To update your contact information for the provision of electronic notices and documents, please LOG IN TO THE SITE AND GO TO MY PROFILE, THEN MY CONTACT INFORMATION.  Otherwise, TO UPDATE YOUR CONTACT INFORMTION, IF YOU ARE A HEALTH CARE PROVIDER Please CONTACT US AT 800-868-2510 , OR IF YOU ARE A HEALTH PLAN CLIENT OR PLAN SPONSOR, PLEASE CONTACT YOUR BLUECROSS ACCOUNT REPRESENTATIVE.

(g) FOR A LIST OF HARDWARE AND SOFTWARE REQUIREMENTS NECESSARY FOR ACCESSING AND RETAINING THESE ELECTRONIC NOTICES OR DOCUMENTS, PLEASE USE THE FOLLOWING LINK: 

https://www.MyHealthToolkit.com/web/nonsecure/alliances/Content/My+Health+Toolkit+Hardware+and+Software+Requirements

PLEASE NOTE THAT THESE REQUIREMENTS MAY CHANGE AND THAT YOU ARE RESPONSIBLE FOR MONITORING THEM FOR ANY CHANGES.

4.7       Cookies and Similar Technologies.  Technologies like cookies, pixels, device or other identifiers (collectively, "Cookies and similar technologies") may be used to deliver, secure, and understand products and services offered by Company. Cookies are small files that are placed on your browser or device by the website you are viewing or app you are using. You agree, to the maximum extent permitted by law, that Company may use cookies and similar technologies for any reasons in support of Company’s business, including, without limitation, for marketing purposes and for use with third parties.

4.8       Consent to Monitoring or Recording.  Through your usage of or interaction with this Site, you, to the maximum extent permitted by applicable law, (i) consent to Company (or any vendor or subvendor of Company) monitoring and recording any such usage or interaction, and any devices used directly or indirectly to achieve such interaction; and (ii) agree that this monitoring or recording may be used for security, customer service, training, or other business purposes.

5.    Limitation of Liability; Warranties

5.1       By using this Site, any programs or tools on the Site, and any third-party sites to which you may link through this Site you agree to (a) release Company from any and all claims, liabilities or damages related to such use and (b) accept all risks related to such use. 

5.2       You agree not to hold Company responsible for any damages or injury, whether for breach of contract, tortious behavior, negligence, or under any other cause of action, caused by any failure of performance, error, omission, interruption, deletion, defect, delay in operation or transmission, computer virus, communication line failure, theft or destruction, or unauthorized access to, alteration of, or use of records or information made available on (a) this Site, (b) any program or other tool available at this Site, or (c) any third-party site to which you may link through this Site.  Without limiting the foregoing, you specifically agree not to hold Company responsible for the defamatory, offensive, or illegal conduct of any third party using this Site.

5.3       All materials on this Site are provided as is, without warranty of any kind, either express or implied.  Company disclaims any and all express and implied warranties, including, but not limited to, the implied warranties of merchantability, fitness for a particular purpose, and non-infringement.

5.4       Company shall not be liable for any special, indirect, punitive, incidental, or consequential damages, including, without limitation, lost revenues or lost profits, that may result from the use of this Site, the materials posted on this Site, and links provided on this Site.

5.5       You agree to defend, indemnify, and hold harmless Company and its affiliates and respective directors, officers, employees, and agents, from and against all claims, damages, obligations, losses, liabilities, cost or debt, and expenses, including but not limited to reasonable attorneys’ fees, arising from (a) your use of and access to this Site and any link to a third-party’s site; (b) your violation of any provisions of these Terms of Use ; (c) your violation of any third-party’s right, including (without limitation) any copyright, property, or privacy right; or (d) any claim that content or information you submit causes damage to a third party.  This defense and indemnification obligation specifically will survive these Terms of Use and your use of this Site.

5.6       This Site is controlled and operated by the Company from offices in the United States.  Company makes no representation that materials provided on this Site are appropriate or available for use in other locations and access to them from locations in which their contents are illegal is prohibited.  Those who choose to access this Site from such other locations are responsible for compliance with applicable local laws.

6.    Disputes

6.1       By using this Site, you agree that any dispute or claim arising out of or in connection with (a) the Terms of Use, (b) any failure to perform under or breach or termination of the Terms of Use, or (c) your use of this Site or any link to a third-party site, or any products or services provided under or through this Site or any link to a third-party site, shall be brought solely and exclusively in a federal or state court of competent jurisdiction located in Richland County, South Carolina, and you hereby expressly and irrevocably consent to the jurisdiction and venue of such courts and waive any defenses to such jurisdiction, venue or convenience of forum.  These Terms of Use and legal issues arising out of, but not exclusive to the use of, this Site or any third-party sites are governed by and in accordance with the laws of the State of South Carolina (exclusive of its rules regarding conflicts of laws). 

6.2       You agree that any cause of action arising out of or related to this Site or your use of this Site must commence within one (1) year after the cause of action accrues.  Otherwise, such cause of action is permanently barred.

6.3       If any provision of these Terms of Use is determined to be invalid by a court of competent jurisdiction, such invalidity shall not affect the enforceability of any other provision of the Terms of Use and the remaining portions of these Terms of Use shall continue in full force and effect.

6.4       By using this Site, you agree that any claim, suit or dispute resolution proceeding will be conducted only on an individual basis and not in a class or representative action.

7.    Miscellaneous

7.1       Electronic Signature and Agreement.  You agree to conduct business through and electronic signature and electronic agreement and that the act of clicking the words “Continue” or “Yes” or “I agree” or any similar phrasing anywhere in using this Site is intended by both parties to be an electronic signature that has the same significance as a signature in ink and that both such signature and this Agreement are considered to be in writing to the maximum extent permitted by law. 

7.2       Except as stated in the next sentence, these Terms of Use constitute the entire agreement of the parties with respect to the subject matter hereof.  These Terms of Use are not intended to modify or limit any provisions in any Privacy Policies contained or referred to on this Site.  In the event of a conflict between this Agreement and any Privacy Policy, the broader stated use shall apply to the extent permitted by law.  If you wish to withdraw your consent to this usage of your information, please contact our Customer Service department.  No waiver by either party of any breach or default hereunder is a waiver of any preceding or subsequent breach or default. 

7.3       You agree that, if you experience any problems in using this Site or need to request assistance in using this Site, you should contact the following:  877-274-1715 .

7.4       This Agreement does not establish any relationship or partnership, joint venture, employment, franchise or agency between you and us.

7.5       If any provision of this Agreement is determined to be invalid or unenforceable, then all other provisions of this Agreement shall remain in full force and effect.  If any provision of this Agreement is determined to be invalid or unenforceable, then the court shall enforce this Agreement to the maximum extent allowed by law or equity.

Revised: May 22, 2023

Your privacy is important to us. Blue Cross Blue Shield of South Carolina, together with its subsidiaries and affiliates (collectively referred to as “Company” or “we”), protects your privacy on this website (the “Site”).This Website Privacy Policy is part of the Company’s Terms of Use (please access Terms of Use section). This notice describes the information we collect on this Site, how we use and disclose the information, and how we safeguard any information we collect when you visit this Site. Some pages on this Site may supplement this notice by describing privacy practices that apply to information on (or provided through)those pages.

The Information We Collect, Use, and Disclose

Information About Your Use of the Site: When you visit this Site, it automatically captures your domain name, the IP address of the Web page from which you enter the Site, the pages you visit on the Site, and the amount of time you spend on the Site. This information alone does not identify you to us. In addition, we collect information about the use of various features of the Site, such as the extent to which certain features are used and the links or information that users access. We use this information to better understand how the Site is used, to improve and expand the Site, and to enhance your and other users’ experience with the Site.

We also may use cookies, pixel tags, and similar technologies in order to assist your use of the Site and to monitor and manage the Site so that we can improve, revise, and add material to the Site.Cookies are small files that are placed on your browser or device by a website.Pixel tags (also called clear GIFs, web beacons, or pixels) are small blocks of code on a website that allow them to do things like read and place cookies and transmit information to us. We use cookies and similar technologies for a variety of reasons, such as allowing us to show you content and material that's most relevant to you, improving our products and services, and helping to keep our products and services secure. While specific names of the cookies and similar technologies that we use may change from time to time as we improve and update our products and services, they generally fall into the following categories of use: authentication, security, insights and measurements, and site features and performance. You may use your browser controls to refuse to allow cookies to be placed on your computer. Refusing cookies disables our ability to include information about your visit in regular monitoring of Site traffic and may impact the way the Site functions on your computer.

We may hire third-party contractors to monitor, evaluate, and help improve users’ experience on our website. These contractors may have access to the information described above, subject to contractual obligations to comply with privacy and security requirements.

Protected Health Information. The Site includes pages that give you the opportunity to provide us with personal information about yourself. You are not required to provide personal information to use the Site, but personal information is necessary for certain functions of the Site. Personal information you provide to us on this Site(“Protected Health Information”) is subject to the HIPAA Privacy Rule. When Company collects Protected Health Information on this Site, Company’s HIPAA Privacy Practices Notice (please view the Privacy Practices section), describes how the Protected Health Information may be used and disclosed and the rights you have with respect to the information.

Once you download Protected Health Information from the Site, it is your responsibility to safeguard the information. We are not responsible for any third party’s access to your Protected Health Information once you have downloaded it.

Privacy and Security

Company is committed to taking appropriate measures to protect your privacy against unauthorized disclosures. Company and its third-party web vendor use a variety of safeguards and techniques designed to protect the confidentiality,integrity, and (when appropriate) availability of your information. You should be aware, however, that website security technology changes rapidly and that any security system can be “hacked.” Accordingly, we cannot guarantee that these safeguards will ensure the safety of your information in all situations or that your information will not be intercepted while being transmitted to or by us over the Internet. In any event, Company is not responsible for (and not liable for) third parties’ illegal or criminal activity.

Third-Party Links

The Site may contain links to websites of third parties that you may access.These websites have their own privacy policies and we recommend that you review those policies before using those websites. We cannot control the information disclosed to or by these third-party websites or how that information is used and disclosed.

Children

The Site is not directed at children under the age of 13. Company complies with the Children’s Online Privacy Protection Act (“COPPA”) and does not knowingly permit registration or submission of Protected Health Information by anyone younger than 13 years of age without the consent of a parent or guardian. To best protect your child’s privacy, please carefully supervise your child’s access to the Internet and this Site. For more information on how to protect your child’s privacy, you can visit the Federal Trade Commission’s Kids privacy page, accessible via www.ftc.gov.

Changes to this Privacy Policy

Your use of this Site constitutes your acceptance of the terms of this Privacy Policy, as may be amended or revised by us from time to time. We may update this Privacy Policy, from time to time. We may advise you that changes have been made by posting a notice on this Site or through other means. The date of the latest revision will be noted at the beginning of this Privacy Policy,above. Please consult this Site and the Privacy Policy regularly for any changes.

Notice for Users Outside of the United States

You should be aware that the United States and other countries have not harmonized their privacy regulations. Because the Site is intended specifically for users in the United States, we have written this Privacy Policy to satisfy requirements of the laws of the United States. By using the Site and the services available on this Site, you agree to the level of privacy protection set out in this Privacy Policy.

Contact Us

To contact us regarding this policy and our related privacy practices, please contact us at:

Attn: Privacy Officer 
I 20 East @ Alpine Road (AC-200) Columbia, SC 29219

803-264-7258 (telephone)
803-264-7257 (fax)

If you believe we or any company associated with us has misused any of your information please contact us immediately and report such misuse.

Summary of the South Carolina Life and Accident and Health Insurance Guaranty Association Act and Notice Concerning Coverage Limitations and Exclusions

Residents of South Carolina who hold life insurance, annuities, or health insurance policies should know that the insurance companies and health maintenance organizations (HMOs) licensed in this state to write these types of insurance are required by law to be members of the South Carolina Life and Accident and Health Insurance Guaranty Association (SCLAHIGA). The purpose of SCLAHIGA is to assure that policyholders will be protected, within limits, in the unlikely event that a member insurer becomes financially unable to meet its obligations. If this happens, SCLAHIGA will assess its other member insurance companies for the money to pay the claims of insured persons who live in this state and, in some cases, to keep coverage in force. However, the valuable extra protection provided by these insurers through SCLAHIGA is limited. Consumers should shop around for insurance coverage and exercise care and diligence when selecting insurance coverage.

Disclaimer
Under South Carolina law, the South Carolina Life and Accident and Health Insurance Guaranty Association (SCLAHIGA) may provide coverage of certain direct life insurance policies, accident and health insurance policies, annuity contracts and contracts supplemental to life, accident and health insurance policies and annuity contract claims (covered claims) if the insurer becomes impaired or insolvent. South Carolina law does not require the SCLAHIGA to provide coverage for every policy. COVERAGE MAY NOT BE AVAILABLE FOR YOUR POLICY.

Coverage is generally conditioned upon residence in this state. Other conditions that may preclude or exclude coverage are described in this notice. Even if coverage is provided, there are significant limits and exclusions. Please read the entire notice for further details on limitations and exclusions.

Insurance companies and insurance agents are prohibited by law from using the existence of the SCLAHIGA or its coverage to sell you an insurance policy. You should not rely on the availability of coverage under SCLAHIGA when selecting an insurer. The South Carolina Life and Accident and Health Insurance Guaranty Association or the Department of Insurance will respond to any questions you may have which are not answered by this document.

If you think the law has been violated, you may file a written complaint with the SCLAHIGA or the South Carolina Department of Insurance at the addresses listed below

South Carolina Life and Accident and Health Insurance Guaranty Association
Attention: Executive Director
P.O. Box 8625 Columbia, SC 29202

South Carolina Department of Insurance 
Attention: Office of Consumer Services 1201 Main Street, Suite 1000
Columbia, SC 29201 Electronic complaint submission via www.doi.sc.gov

Please attach copies of all pertinent documentation. You may submit a written complaint or a complaint electronically to the Department through submission of the electronic form on the Department's website at www.doi.sc.gov. You should receive a response to your complaint within 10 days.
 
This safety-net coverage is provided for in the South Carolina Life and Accident and Health Insurance Guaranty Association (SCLAHIGA) Act (the Act). The following summary of the Act's coverages, exclusions and limits does not cover all provisions of the Act; nor does it in any way change  any person's rights or  obligations under  the Act or the rights or obligations of the SCLAHIGA.

COVERAGE
Generally, individuals will be protected by the SCLAHIGA if they live in this state and hold a covered life, accident, health or annuity policy, plan or contract issued by an insurer (including a health maintenance organization) authorized to conduct business in South Carolina. The beneficiaries, payees or assignees of insured persons may also be protected if they live in another state unless circumstances described under the Act exclude coverage.

EXCLUSIONS FROM COVERAGE
Persons who hold a covered life, accident, health or annuity policy, plan or contract are r1ot protected by SCLAHIGA if:

• They are eligible for protection under the laws of another state (This may occur when the insolvent insurer was incorporated in another state whose guaranty association protects insureds who live outside that state.);
• The insurer was not authorized to do business in this state; or
• They acquired rights to receive payments through a structured settlement factoring agreement.

SCLAHIGA also does not provide coverage for:

• A portion of a policy or contractor part there of not guaranteed by the member insurer, or  under which the risk is borne by the policy or contract owner;
• A policy or contract of reinsurance, unless assumption certificates have been issued;
• Interest rate or crediting rate yields or similar factors employed in calculating value changes that exceed an average rate;
• Any policy or contract issued by assessment mutuals, fraternals, and nonprofit hospital and medical service plans;
• Benefits payable by an employer, association or other person under: (a) a multiple employer welfare arrangement; (b) a minimum premium group insurance plan; (c) a stop-loss group insurance plan; or (d) an administrative services contract;
• A portion of a policy or contract to the extent that it provides for (a) dividends or experience rating credits; (b) voting rights; or (c) payment of any fees or allowances to any person, including the policy or contract owner, in connection with the service to or administration of the policy or contract;
• A portion of a policy or contract to the extent that the assessments required by Section 38-29-80 with respect to the policy or contract are preempted by federal or state law;
• An obligation that does not arise under the express written terms of the policy or contract issued by the member insurer to the enrollee, certificate holder, contract owner or policy owner, including without limitation: (a) Claims based on marketing materials; (b) Claims based on side letters, riders or other documents that were issued by the member insurer without meeting applicable policy or contract form filing or approval requirements; (c) Misrepresentations of or regarding policy or contract benefits; (d) Extra-contractual claims; or (e) A claim for penalties or consequential or  incidental damages;
• An unallocated annuity contract;
• A policy or contract providing any hospital, medical, prescription drug or other health care benefits pursuant to Medicare Part C or D or Medicaid; or
• Interest or other changes in value to be determined by the use of an index or other external references but which have not been credited to the policy or contract or as to which the policy or contract owner's rights are subject to forfeiture, as of the date the member insurer becomes impaired or insolvent insurer, whichever is earlier.

LIMITS ON AMOUNTS OF COVERAGE
The South Carolina Life and Accident and Health Insurance Guaranty Association Act also limits the amount that SCLAHIGA is obligated to pay for covered claims. The benefits for which SCLAHIGA may become liable shall in no event exceed the lesser of the following:

• With respect to one life, regardless of the number of policies or contracts: $300,000 in life insurance death benefits, or not more than $300,000 in net cash surrender and net cash withdrawal values for life insurance;
• For health insurance benefits: (a) $300,000 for coverages not defined as disability income insurance or health benefit plans or long- term care insurance, including any net cash surrender and net cash withdrawal values; (b) $300,000 for disability income insurance; (c) $300,000 for long-term care insurance; (d) $500,000 for health benefit plans; or
• $300,000 in the present value of annuity benefits, including net cash surrender and net cash withdrawal values.
   

Surprise Billing Protection

Transparency in Coverage

App Privacy Policy

Your privacy is important to us. BlueChoice HealthPlan of South Carolina, Inc., together with its parent company and affiliates (collectively referred to as “Company” or “we”), protects your privacy on this App. This App Privacy Policy is part of the Company’s Terms of Use. This notice describes the information we collect on this App, how we use and disclose the information, and how we safeguard any information we collect when you visit this App. Some pages on this App may supplement this notice by describing privacy practices that apply to information on (or are provided through) those pages.

The Information We Collect, Use and Disclose
Information About Your Use of the App: When you visit this App, it automatically captures your domain name, the IP address of the webpage from which you enter the App, the pages you visit on the App and the amount of time you spend on the App. This information alone does not identify you to us. In addition, we collect information about the use of various features of the App, such as the extent to which certain features are used and the links or information users access. We use this information to better understand how the App is used, to improve and expand the App, and to enhance your and other users’ experience with the App.

We also may use cookies, pixel tags and similar technologies in order to assist your use of the App and to monitor and manage the App so we can improve, revise and add material to the App. Cookies are small files that are placed on your browser or device by an app. Pixel tags (also called clear GIFs, web beacons or pixels) are small blocks of code on an app that allow them to do things like read and place cookies and transmit information to us. We use cookies and similar technologies for a variety of reasons, such as allowing us to show you content and material that's most relevant to you, improving our products and services, and helping to keep our products and services secure. While specific names of the cookies and similar technologies we use may change from time to time as we improve and update our products and services, they generally fall into the following categories of use: authentication, security, insights and measurements, and app features and performance. You may use your browser controls to refuse to allow cookies to be placed on your computer. Refusing cookies disables our ability to include information about your visit in regular monitoring of App traffic and may impact the way the App functions on your computer.

We may hire third-party contractors to monitor, evaluate and help improve users’ experience on our App. These contractors may have access to the information described above, subject to contractual obligations to comply with privacy and security requirements.

Protected Health Information. We will treat all information described in the next paragraph as protected health information, subject to the HIPAA Privacy Rule. The Company’s HIPAA Privacy Practices Notice, which you may access here, describes how protected health information may be used and disclosed and the rights you have with respect to the information.  

The App has access to eligibility information about you in the Company’s records when you download the App. In addition, the App includes pages that give you the opportunity to (i) provide us with personal information about yourself and (ii) grant the App access to information collected by other Apps you may use. To use the App, you do not need to provide personal information or grant us access to information in other Apps. But that information may be necessary for certain functions of the App.  

Privacy and Security

Company is committed to taking appropriate measures to protect your privacy against unauthorized disclosures. Company and its third-party web vendor use a variety of safeguards and techniques designed to protect the confidentiality, integrity and (when appropriate) availability of your information. You should be aware, however, that app security technology changes rapidly and that any security system can be “hacked.” Accordingly, we cannot guarantee that these safeguards will ensure the safety of your information in all situations or that your information will not be intercepted while being transmitted to or by us over the internet. In any event, Company is not responsible for (and not liable for) third parties’ illegal or criminal activity.

Third-Party Links

The App may contain links to websites (or “sites”) or apps of third parties you may access. These sites or apps have their own privacy policies, and we recommend you review those policies before using those sites or apps. We cannot control the information disclosed to or by these third-party sites or apps or how that information is used and disclosed.

Children

The Site is not directed at children under the age of 13. Company complies with the Children’s Online Privacy Protection Act (COPPA) and does not knowingly permit registration or submission of protected health information by anyone younger than 13 years of age without the consent of a parent or guardian. To best protect your child’s privacy, please carefully supervise your child’s access to the internet and this Site. For more information on how to protect your child’s privacy, you can visit the Federal Trade Commission’s Kids’ Privacy page, accessible via www.ftc.gov.

Changes to This Privacy Policy
Your use of this Site constitutes your acceptance of the terms of this Privacy Policy as amended or revised by us from time to time. We may update this Privacy Policy. We may advise you that changes have been made by posting a notice on this Site or through other means. The date of the latest revision will be noted at the beginning of this Privacy Policy, above. Please consult this Site and the Privacy Policy regularly for any changes.

Notice for Users Outside of the United States

You should be aware that the United States and other countries have not harmonized their privacy regulations. Because the Site is intended specifically for users in the United States, we have written this Privacy Policy to satisfy requirements of the laws of the United States. By using the Site and the services available on this Site, you agree to the level of privacy protection set out in this Privacy Policy.