Notice of Privacy Practices

These notices* describe how health and payment information about you may be used and disclosed and how you can obtain access to this information.

PreferredOne Community Health Plan (PCHP)

• Notice of Privacy Practices – PCHP

PreferredOne Insurance Company (PIC)

• Notice of Privacy Practices – PIC

PreferredOne Administrative Services, Inc. (PAS)

• PreferredOne Administrative Services is a Third Party Administrator (TPA) providing administrative services to self-insured health plans and provides PPO network access and claims re-pricing services. If PAS is your TPA, please contact your employer’s health plan (e.g. Benefits Department) to obtain a copy of your health plan’s Notice of Privacy Practices. If you access a PAS network through your health care coverage, please contact your employer’s health plan, your insurer or your TPA.

*If you are unsure which Notice of Privacy Practices applies to you, please check your PreferredOne ID card to determine if you are enrolled in coverage through PAS, PIC or PCHP. If you need additional assistance, please contact the PreferredOne Customer Service team at (763) 847-4477 or toll-free at 1-(800)-997-1750.

PreferredOne HIPAA Authorization

• Authorization to Release Health Information