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Notice of Financial Privacy PracticeCIGNA HealthCare Limited-Benefit Medical Plans

Privacy Statements>Notice of Financial Privacy Practice

IMPORTANT: The following notice is designed to comply with the Gramm-Leach-Bliley Act regulations. A separate
notice designed to meet the requirements of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule was provided to your employees either prior to April 14, 2003 or at the time they enrolled.

PROTECTING YOUR EMPLOYEES’ CONFIDENTIALITY
Gramm-Leach-Bliley Privacy Notice for Group Policyholders

At CIGNA HealthCare, we’re committed to maintaining the confidentiality of your employees’ personal health and
fi nancial information (“personal information”). We have developed internal policies and procedures to comply with
our Confi dentiality Policy and with state and federal privacy laws. This notice answers some common questions about our confi dentiality policies.

HOW DO WE PROTECT YOUR EMPLOYEES PERSONAL INFORMATION

CIGNA HealthCare employees and organizations who act on behalf of CIGNA HealthCare are required to keep your employees’ personal information confi dential. Here’s what we
are doing to help ensure this policy is followed:
¦ We’ve established a CIGNA HealthCare privacy program office, which is responsible for monitoring our compliance
with confi dentiality policies and for educating CIGNA HealthCare employees on this important topic.
¦ Whenever possible, we provide only aggregate information that doesn’t identify any individual.
¦ If we need to share your employees’ personal information, we have policies and procedures that protect confidentiality.
¦ Our employees may not disclose personal information to other employees except when it is needed to conduct
CIGNA HealthCare operations.
¦ In accordance with the HIPAA Privacy Rule, we require business associates who receive personal information and act on our behalf or provide a service to us to sign an agreement in which they promise that they will use information only for the purposes for which it was provided.
¦ In some situations, we require a member’s written authorization before we disclose personal information. For example, we will not supply personal information to a potential employer with whom a member is seeking employment without the member’s signed authorization, and we will not supply personal information to another
company for its marketing purposes.
¦ We restrict access to personal information about our members to employees, service providers, and companies
that are involved in administering health care coverage and servicing our members. We maintain physical, electronic and procedural safeguards that comply with federal standards to guard the personal information of
our members.

WHAT TYPES OF PERSONAL INFORMATION DO WE RECEIVE?

We may receive personal information about your employees from you or from your employees at the time of
enrollment. We also receive personal information needed to administer your plan from your employees when they
submit a claim or pay a premium. In addition, other insurers may provide us with personal information to coordinate
benefi ts. Lastly, we receive personal information from health providers and premium payment histories from you or
from a bank. The information we receive includes personal health information as well as names, addresses and social
security numbers.

WHAT TYPES OF PERSONAL INFORMATION DO WE DISCLOSE, AND TO WHOM?

CIGNA HealthCare will not release confi dential information unless it is to administer the benefi ts plan or to support
CIGNA HealthCare programs or services, such as our care management and wellness programs. We may disclose personal health information or other types of information, including names addresses and social security numbers, to:
¦ Medical providers and plan sponsors
¦ Insurers that provide reinsurance or excess (stop loss) insurance to an employer or with whom we are coordinating benefits
¦ CIGNA HealthCare affi liated companies such as Intracorp, CIGNA Behavioral Health, Inc., CIGNA Dental companies
and CIGNA Tel-Drug companies 806801 09/06 ©2006 CIGNA
¦ Regulatory agencies such as departments of insurance and accreditation organizations such as the National
Committee for Quality Assurance
¦ Courts or attorneys who serve us with a subpoena
¦ Successor insurers or claim administrators who assume responsibility for administering your benefi t plan
“CIGNA” and “CIGNA HealthCare” refer to various operating subsidiaries of CIGNA Corporation. Products and services are provided by these operating subsidiaries and not by CIGNA
Corporation. These operating subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc. and its affi liates, CIGNA Behavioral Health, Inc., Intracorp, and HMO or
service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc.
¦ Companies that assist CIGNA HealthCare in recovering overpayments, paying claims or performing utilization
review services
¦ Other companies not affi liated with CIGNA HealthCare that provide services to us when disclosure is permitted
or required by law

You may contact our Privacy Offi ce at:

PO Box 55270
Phoenix, AZ 85078-5270
Telephone Number: 602.956.4200
Fax Number: 602.328.4035

Privacy Statements | Disclaimer Phone: 1-800-258-9260

CIGNA HealthCare
“CIGNA” and “CIGNA HealthCare” refer to various operating subsidiaries of CIGNA Corporation. Products and services are provided by these operating subsidiaries and not by CIGNA Corporation. These operating subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc. and its affiliates, CIGNA Behavioral Health, Inc., Intracorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc.