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Single Vision Solutions & National Guardian Life Insurance Company

JOINT 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.

 

Single Vision Solutions and National Guardian Life Insurance Company are required by law to maintain the privacy of your health information and to provide you with notice of their legal duties and privacy practices with respect to your health information.  

 

How We May Use or Disclose Your Health Information

 

  1. Payment Functions. We may use or disclose health information about you to determine eligibility for plan benefits, obtain premiums, facilitate payment for the treatment and services you receive from health care providers, determine plan responsibility for benefits, and to coordinate benefits.
  1. Health Care Operations. We may use and disclose health information about you to carry out necessary insurance-related activities, including, but not limited to, underwriting, premium rating and other activities relating to plan coverage; conducting quality assessment and improvement activities; submitting claims for stop-loss coverage; conducting or arranging for medical review, legal services, audit services, and fraud and abuse detection programs.
  1. Required by Law. As required by law, we may use and disclose your health information.  We may disclose medical information pursuant to a court order in judicial or administrative proceedings; to report information related to victims of abuse, neglect, or domestic violence; or to assist law enforcement officials in their law enforcement duties.
  1. Public Health. As required by law, we may disclose your health information to public health authorities to prevent or control disease, injury or disability, or for other health oversight activities.
  1. Coroners, Medical Examiners and Funeral Directors. We may disclose your health information to coroners, medical examiners and funeral directors.  For example, this may be necessary to identify a deceased person.
  1. Organ and Tissue Donation. Your health information may be used or disclosed for cadaveric organ, eye or tissue donation purposes.
  1. Health and Safety. We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
  1. Government Functions. We may disclose your health information for military, national security, prisoner and government benefits purposes. 
  1. Worker’s Compensation. We may disclose your health information as necessary to comply with worker’s compensation or similar laws.
  1. Disclosures to Plan Sponsors. We may disclose your health information to the sponsor of your group health plan for purposes of administering benefits under the plan.

 

When We May Not Use or Disclose Your Health Information

Except as described in this Notice of Privacy Practices, we will not use or disclose your health information without written authorization from you.  If you do authorize us to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

 

Statement of Your Health Information Rights

 

  1. Right to Request Restrictions.  You have the right to request restrictions on certain uses and disclosures of your health information.  We are not required to agree to the restrictions that you request. 
  2. Right to Request Confidential Communications. You have the right to receive your health information through alternative means or at an alternative location.  We are not required to agree to your request.
  1. Right to Inspect and Copy. You have the right to inspect and copy your health information.  If you request a copy of the information, we may charge you a reasonable fee to cover the copy expense.
  1. Right to Request a Correction. You have a right to request that we amend your health information.  We are not required to change your health information.
  2. Right to Accounting of Disclosures.  You have the right to receive an accounting of disclosures of your health information.  We will provide one list per 12 month period free of charge; we may charge you for any additional lists requested within the same 12 month period.
  3. Right to Paper Copy.  You have a right to receive a paper copy of this Notice of Privacy Practices at any time.
  1. Right to Revoke Permission. You have the right to revoke your authorization to use or disclose your health information at any time, except to the extent that action has already been taken.

 

Our Obligations Under This Notice

We are required by law to:

  1. Maintain the privacy of your health information.
  2. Provide you with a notice of our legal duties and privacy practices with respect to your health information.
  3. Abide by the terms of this Notice.
  4. Provide you notice of a breach of any unsecured personal health information.
  5. Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed.
  6. Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
  7. Obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted by law, including psychotherapy notes, personal health information for marketing purposes, and information in instances constituting the sale of personal health information.

 

We reserve the right to amend this Notice of Privacy Practices at any time in the future and to make the new Notice provisions effective for all health information that we maintain.  Revised Notices will be distributed to you by mail. 

 

Complaints

If you believe your privacy rights have been violated, you may file a complaint with: 

 

Privacy Officer

Single Vision Solution

c/o SVS Vision Holding Company 

118 Cass Ave, Mt Clemens, MI 48043

Toll Free: 800.225.3095

 

You may also file a complaint with the Secretary of the Department of Health and Human Services.   We will not retaliate against you in any way for filing a complaint. 

 

Effective Date of This Notice: December 1, 2024.

National Guardian Life Insurance Company

Privacy Notice

 

Why We Collect and How We Use Information:

When you apply to any of our insurance companies for any product or service, you disclose to us a certain amount of Information about yourself. We collect only Information necessary or relevant to our business. We use the Information to evaluate, process and service your request for products and services and to offer you other NGL products or services.

 

Types of Information We Collect:

We collect most information directly from you on applications or from other communications with you during the application process.

Types of Information we could collect include, but not limited to:

  • name
  • address
  • age
  • Social Security number
  • beneficiary information
  • other insurance coverage
  • health information
  • financial information
  • occupation
  • hobbies
  • other personal characteristics

 

How We Disclose Your Information:

 

We also may keep information about your transactions with us:

  • types of products you buy
  • your premium amount
  • your account balances
  • your payment history

Additional Information is received from:

  • medical personnel
  • medical institutions
  • Medical Information Bureau (MIB, Inc.)
  • Other insurance companies
  • agents
  • employers
  • public records
  • consumer reporting agencies

Your Information as described above may be disclosed as permitted by law to our affiliates and nonaffiliated third parties. These disclosures include, but are not limited to the following purposes:

  • To assess eligibility for insurance, benefits or payments
  • To process and service your requests for our products and services
  • To collect premium, pay benefits and perform other claims administration
  • To print and mail communications from us such as policy statements
  • For audit or research purposes
  • To respond to requests from law enforcement authorities or other government authority as required by law
  • To resolve grievances
  • To find or prevent criminal activity, fraud, material misrepresentation or nondisclosure in connection with an insurance issue

 

NGL also may disclose your Information as permitted by law to our affiliates without prior authorization in order to offer you other NGL products or services. The law does not allow you to restrict such disclosures.

 

Except for the above disclosures or as authorized by you with respect to your Information, NGL does not share Information about our customers or former customers with nonaffiliated third parties. Further, when Information is disclosed to any nonaffiliated third parties as permitted by law, we require that they agree to our privacy standards. Please note that Information we get from a report prepared by an insurance support organization may be retained by that insurance support organization and used for other purposes.

 

Access to and Correction of Your Information:

You have the right to access and correct your Information that we have on file. Generally, upon your written request, we will make your Information available for your review. Information collected in connection with or in anticipation of a claim or legal proceeding need not be disclosed to you.

If you notify us that your Information should be corrected, amended or deleted, we will review it. We will either make the requested change or explain our refusal to do so. If we do not make the requested change, you may submit a short written statement of dispute, which we will include in any future disclosure of Information. For a more detailed explanation of these rights to access and correction, please send us a written request.

 

Massachusetts Policyholders: You will be notified in writing of any adverse underwriting decisions, including the specific reason the adverse decision was made.


How We Protect Your Information:

NGL has developed strong security measures to guard the Information of our customers.

We restrict access to your Information to designated personnel or service providers who administer or offer our products or services, or who may be responsible for maintaining Information security practices.

We maintain physical, electronic and procedural safeguards that comply with applicable laws to protect your Information.

Please keep a copy of this notice with your important papers. Additional copies of this notice are available upon written or verbal request. This notice is also available on NGL’s website, www.nglic.com.

 

NGLPN National Guardian Life Insurance Company (NGL) 10/24

 

Appendix A

Privacy Information for California Residents

Last updated October 2024

This Appendix discusses how National Guardian Life Insurance Company (“we,” “us,” or “our”) collects personal information of California residents. This Appendix applies solely to individuals who reside in the State of California (“consumers” or “you”). This Appendix complies with the California Consumer Privacy Act of 2018 (“CCPA”) and any terms defined in the CCPA have the same meaning when used in this Appendix. This Appendix does not apply to personal information outside the scope of the CCPA, including without limitation:

  • Personal information collected, processed, sold, or disclosed pursuant to the Gramm- Leach-Bliley Act, and implementing regulations, or the California Financial Information Privacy Act.
  • Personal information bearing on a consumer’s credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living as set forth in the Fair Credit Reporting Act.
  • Personal health information collected, processed, or disclosed pursuant to the Health Insurance Portability and Accountability Act.

 

National Guardian Life Insurance Company as a Service Provider

When we act as a service provider for our customers, we collect personal information on behalf of our customers subject to our contractual obligations. When we act as a service provider, we follow the instructions of our customer on how to process personal information on our customer’s behalf. The provisions of this Appendix do not apply to the personal information that we process on behalf of our business customers.

 

What Personal Information We Collect and How We Share it

The below chart lists the categories of personal information that we may collect and have collected in the past 12 months and how we share such information. We will share personal information with parties to whom you have directed or authorized us to share with.

Categories of Personal Information

Categories of Service Providers and Third Parties

with whom Personal Information is Shared

Identifiers. This may include a real name, alias, address, email address, phone number, Social Security number, driver’s license number, online identifier, IP address, account username and password, job title, or other similar identifiers.

Entities that we are required to share with pursuant to law or for legal proceedings; service providers; our affiliates and business partners; data analytics providers; prospective purchasers of our business; and outside auditors and lawyers.

 

Internet and network information. This may include information on your interaction with a website, application, or advertisement, such as browsing history and how you use your account.

Entities that we are required to share with pursuant to law or for legal proceedings; service providers; our affiliates and business partners; and data analytics providers.

Device information. This may include the operating system of your device, device identifier, the type of device you are using, or your

geolocation information.

Entities that we are required to share with pursuant to law or for legal proceedings; service providers; and data analytics providers.

Other information you submit to us. This may include requests or communications you submit to us, including emails, ratings, or customer service call recording.

Entities that we are required to share with pursuant to law or for legal proceedings; service providers; our affiliates and business partners; prospective purchasers of our business; and outside auditors and lawyers.

Research or survey information. This may include survey results, social media data, and other information about your participation in consumer research.

Entities that we are required to share with pursuant to law or for legal proceedings; service providers; our affiliates and business partners; prospective purchasers of our business; and outside auditors and lawyers.

Inferences we draw about you. This may include information about your preferences, characteristics, predispositions, behavior, or other

trends that help us identify which products you may be interested in.

Entities that we are required to share with pursuant to law or for legal proceedings; service providers; our affiliates and business partners; and data analytics providers.

 

How We Use Personal Information

We may use personal information in the following ways:

  • To provide you with information, products, or services;
  • To improve our services and products;
  • To secure and monitor our websites;
  • For audit or research purposes;
  • To resolve grievances;
  • To find or prevent criminal activity, fraud, material misrepresentation or nondisclosure in connection with an insurance issue;
  • To respond to requests from law enforcement or other government authorities as required by law; or
  • For our own legal obligations and business needs.

 

Sale of Personal Information

CCPA defines a “sale” of personal information broadly to include more than exchanges for monetary purposes. A sale can include personal information shared with a third party for “valuable consideration,” or information shared with a third party (even if they are performing services on our behalf) if they are permitted to use the information for their own purposes.

We do not and have not sold any personal information in the previous 12 months.

 

California Residents’ Rights and Choices

The CCPA provides California residents with specific rights regarding their personal information, described below. Below are your CCPA rights and how to exercise those rights.

  • Access to Specific Information and Data Portability Rights (“Right to Know”)

You have the right to request that we disclose certain information to you about our collection and use of your personal information over the past 12 months. You could request:

  • The categories of personal information we collected about you;
  • The categories of sources of the personal information we collected about you;
  • Our business or commercial purpose for collecting that personal information;
  • The categories of third parties with whom we share that personal information; or
  • The specific pieces of personal information we collected about you.
  • Deletion Request Rights (“Right to Deletion”)

You have the right to request that we delete some or all of the personal information that we have collected from you and retained, subject to a number of exceptions. We are not required to delete personal information that is: (a) necessary to complete a transaction with you or for warranty or product recalls; (b) used for security purposes, to prevent fraud, to fix errors, or to comply with law; (c) reasonable for us to use for internal purposes given our relationship with you; or (d) compatible with the context in which you provided the information. The list of exceptions above is not exhaustive, and we may also deny a deletion request as otherwise permitted by law.

 

Exercising Your Rights

To exercise your rights described above, please submit a verifiable consumer request to us by either:

  • Calling us at 800.548.2962.
  • Request a form to be completed by writing to us at:
    • National Guardian Life Insurance Company Mailing Address: 123 Town Square Place PMB 748
    • Jersey City, NJ 07310

Only you, or a person or entity that you authorize to act on your behalf, may make a verifiable consumer request related to your personal information. You may also make a verifiable consumer request on behalf of your minor child. If you are making a request on behalf of another person, you must provide written legal documentation that you are authorized to act on behalf of that individual.

 

You may only make a verifiable consumer request for access or data portability twice within a 12-month period. The verifiable consumer request must:

  • Provide sufficient information that allows us to reasonably verify you are the person about whom we collected personal information or an authorized representative; and
  • Describe your request with sufficient detail that allows us to properly understand, evaluate, and respond to it.

 

We may not be able to fulfill your request or provide you with personal information if we cannot verify your identity or authority to make the request and confirm the personal information relates to you. To verify your identity, we may request up to three pieces of personal information about you, and we reserve the right to take additional steps, as necessary, to verify your identity if we have reason to believe a request is fraudulent.

 

Response Timing and Format

We endeavor to respond to a verifiable consumer request within 45 days of its receipt. If we require more time (up to 90 days), we will inform you of the reason and extension period in writing.

 

Any disclosures we provide will only cover the 12-month period preceding the date we received your verifiable consumer request. The response we provide will also explain the reasons we cannot comply with a request, if applicable. For data portability requests, we will select a format to provide your personal information that is readily useable and should allow you to transmit the information from one entity to another entity without hindrance.

We do not charge a fee to process or respond to your verifiable consumer request unless it is excessive, repetitive, or manifestly unfounded. If we determine that the request warrants a fee, we will tell you why we made that decision and provide you with a cost estimate before completing your request.

 

Non-Discrimination

You have the right to not be discriminated against for exercising any of your CCPA rights. Unless permitted by the CCPA, we will not:

  • Deny you goods or services;
  • Charge you different prices or rates for goods or services, including through granting discounts or other benefits, or imposing penalties;
  • Provide you a different level or quality of goods or services; or
  • Suggest that you may receive a different price or rate for goods or services or a different level or quality of goods or services.

 

Other California Privacy Rights

California’s “Shine the Light” law (Civil Code Section § 1798.83) permits users of our Website that are California residents to request certain information regarding our disclosure of personal information to third parties for their direct marketing purposes. To make such a request, please contact us through the information provided above.

Patient Forms

To submit your patient form online, please enter the city, address or zip code of the office you have your appointment scheduled at, or scroll and select the office from the list below.