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 1. Home
 2. ›About Us
 3. ›Privacy Center
 4. ›Notice of Privacy Practices

Interoperability support Notice of Privacy Practices Online Privacy Statement
Online Terms & Conditions SMS/Texting Terms and Conditions


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.

This Notice is effective as of September 23, 2013.

The last revision date is July 2024.

When we use the term "Customer Information," we are referring to financial or
health information that is "nonpublic," including any information from which a
judgment could possibly be made about you. When we use the term "Protected
Health Information" or "PHI," we are referring to individually identifiable
oral, written and electronic information concerning the provision of, or payment
for, health care to you. We refer to Customer Information and PHI collectively
as "Private Information."

For purposes of this Notice, "Horizon" and the pronouns "we," "us" and "our"
refer to all of the HMO and licensed insurer affiliates of Horizon Healthcare
Services, Inc. d/b/a Horizon Blue Cross Blue Shield of New Jersey, including the
entities listed on the last page of this Notice. These entities have been
designated as a single affiliated covered entity for federal privacy purposes,
unless otherwise noted.

HIPAA generally does not preempt other state and federal laws that give
individuals greater privacy protections. As a result, if any state or federal
privacy law requires us to give you more privacy protections, then we must
follow that law in addition to HIPAA.

When it comes to your Private Information, you have certain rights. To exercise
any of these rights, call Member Services at the phone number on the back of
your member ID card.


COLLECTION AND PROTECTION


WHAT PRIVATE INFORMATION WE COLLECT

In providing your health coverage, we collect Private Information, which may
include identifiable information (such as your name, address, phone number or
member identification number), medical information, or information about race,
ethnicity, language, gender identity or sexual orientation, from the following
sources:

 * Information we receive from you or your subscriber on applications, other
   forms or websites we sponsor.
 * Information we obtain from your transactions with us, our affiliates or
   others, such as health care professionals.
 * Information we receive from consumer reporting agencies or others, such as
   Medicare, state regulators and law enforcement agencies.
 * Information we obtain from other third party sources and publicly available
   sources


HOW WE PROTECT PRIVATE INFORMATION

Our employees are trained on the need to maintain your Private Information in
the strictest confidence. They agree to be bound by that promise of
confidentiality and are subject to disciplinary action if they violate that
promise. We also maintain appropriate administrative, technical and physical
safeguards to reasonably protect your Private Information.


YOUR RIGHTS


WHEN IT COMES TO YOUR PRIVATE INFORMATION, YOU HAVE CERTAIN RIGHTS

To exercise any of these rights, call Member Services at the phone number on the
back of your member ID card. You have the right to:

 * GET A COPY OF YOUR HEALTH AND CLAIMS RECORDS
   
   You can ask to see or get a copy of your health and claims records and other
   Private Information we have about you. We will provide a copy or a summary of
   your health and claims records, usually within 30 days of your request. We
   may charge a reasonable, cost-based fee.

 * ASK US TO CORRECT HEALTH AND CLAIMS RECORDS
   
   You can ask us to correct your health and claims records if you think they
   are incorrect or incomplete. We may say "no" to your request, but we will
   tell you why in writing within 60 days and advise you of your right to file a
   statement of rebuttal.

 * REQUEST CONFIDENTIAL COMMUNICATIONS
   
   You can ask us to contact you in a specific way (for example, home or office
   phone) or to send mail to a different address. We will consider all
   reasonable requests, and must say "yes" if you tell us you would be in danger
   if we do not. A verbal request may be considered, but must be followed up in
   writing.

 * ASK US TO LIMIT WHAT WE USE OR SHARE
   
   You can ask us not to use or share certain Private Information for treatment,
   payment or our operations. We are not required to agree to your request and
   we may say "no" if it would affect your care.

 * GET A LIST OF THOSE WITH WHOM WE HAVE SHARED PRIVATE INFORMATION
   
   You can ask for a list (accounting) of the times we have shared your Private
   Information for six years prior to the date you ask, whom we shared it with
   and why. We will include all the disclosures except for those about
   treatment, payment and health care operations, and certain other disclosures
   (such as disclosures to you or authorized by you). We will provide one
   accounting a year for free, but will charge a reasonable, cost-based fee if
   you ask for another one within 12 months.

 * GET A COPY OF THIS NOTICE
   
   You can ask for a paper copy of this Notice at any time, even if you have
   agreed to receive the Notice electronically. We will provide you with a paper
   copy promptly.

 * CHOOSE SOMEONE TO ACT FOR YOU
   
   If you have given someone medical power of attorney or if someone is your
   legal guardian, that person can exercise your rights and make choices about
   your Private Information. We will confirm the person has this authority and
   can act for you before we take any action.

 * FILE A COMPLAINT IF YOU FEEL YOUR RIGHTS ARE VIOLATED
   
   You can complain if you feel we have violated your rights by calling the
   Member Services phone number on the back of your member ID card. We will not
   retaliate against you for filing a complaint.
   * You can file a complaint with our Privacy Office by sending a letter to:
     Horizon BCBSNJ
     Attn: Privacy Office, PP-16F
     Three Penn Plaza East
     Newark, NJ 07105-2200
     
     Or calling 1-800-658-6781
   * You can file a complaint with the U.S. Department of Health and Human
     Services Office for Civil Rights by sending a letter to: 200 Independence
     Avenue, S.W. Washington, D.C. 20201 Or calling 1-877-696-6775 Or visiting
     www.hhs.gov/ocr/privacy/hipaa/complaints/


YOUR CHOICES


FOR CERTAIN PRIVATE INFORMATION, YOU CAN TELL US YOUR CHOICES ABOUT WHAT WE
SHARE.

If you have a clear preference for how we share your Private Information in the
situations described below, talk to us. Tell us what you want us to do and we
will follow your instructions.

 * • YOU HAVE BOTH THE RIGHT AND CHOICE TO TELL US TO:
   
   * Share information with the subscriber, your family, close friends or others
     involved in payment for your care.
   * Share information in a disaster relief situation.
   
   If you are not able to tell us your preference (for example, if you are
   unconscious), we may share your information if we believe it is in your best
   interest. We may also share your information when needed to lessen a serious
   and imminent threat to health or safety.

 * WE NEVER SHARE YOUR PRIVATE INFORMATION, UNLESS YOU GIVE US PRIOR WRITTEN
   PERMISSION, FOR THE FOLLOWING PURPOSES:
   
   * Marketing purposes
   * Sale of your Private Information
   * Psychotherapy notes
   
   If you give us your authorization, you are permitted to revoke that
   authorization at any time in writing. We will honor your revocation once it
   is processed, except to the extent that we have taken action in reliance upon
   your original authorization or the authorization was obtained as a condition
   of obtaining coverage. If you are not able to tell us your preference (for
   example, if you are unconscious), we may share your information if we believe
   it is in your best interest. We may also share your information when needed
   to lessen a serious and imminent threat to health or safety.


HOW WE TYPICALLY USE OR SHARE YOUR PRIVATE INFORMATION

We typically use or share your Private Information in the following ways:


 * HELP MANAGE THE HEALTH CARE TREATMENT YOU RECEIVE
   
   We can use your Private Information and share it with professionals who are
   treating you.
   
   Example: A doctor sends us Private Information about your diagnosis and
   treatment plan so we can arrange additional services.


 * RUN OUR ORGANIZATION
   
   We can use and disclose your Private Information to run our organization and
   contact you when necessary. We use Private Information for case management
   and care coordination, utilization review, quality assessment and
   improvement, network provider credentialing, population-based research to
   improve health or reduce health care costs, and contacting providers and
   members with information about treatment alternatives.
   
   We may also use your Private Information for other health care operations
   activities including compliance and auditing activities, evaluating provider
   performance, underwriting and other rate-setting activities, formulary
   development, information systems management, fraud and abuse detection (by
   ourselves or for other plans or providers), facilitation of a sale, transfer,
   merger or consolidation of all or part of Horizon BCBSNJ and/or its
   affiliated companies with another entity (including due diligence related to
   the transaction), customer service and general business management, among
   others.
   
   Example: We may use and disclose Private Information to remind you about the
   availability or value of preventive care or of a disease management program.


 * ADMINISTER YOUR PLAN
   
   If you are a participant or beneficiary of a self-funded group health plan,
   we may use and disclose your Private Information as described in this Notice.
   However, our use or disclosure is dictated by an arrangement with your
   employer (or other sponsor of your benefits plan) or that plan itself.
   
   That plan may use and disclose your Private Information differently than is
   described here. With respect to your individual rights, you should ask your
   plan administrator how to exercise those rights, along with any other
   questions you may have regarding your plan's privacy policies and practices.
   This Notice also applies to Horizon BCBSNJ's employee health benefit plan.


 * TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS
   
   We may use and disclose your Private Information for another covered entity's
   treatment, payment and health care operations purposes. In addition, we are
   permitted to disclose Private Information to other covered entities so they
   can conduct certain aspects of their health care operations. We may also
   disclose it for purposes of their fraud and abuse detection or compliance. We
   will only disclose Private Information to another covered entity for these
   purposes if that covered entity has or had a relationship with you.


 * DISCLOSURES TO INDIVIDUALS INVOLVED IN CARE OR PAYMENT
   
   Under certain circumstances, we may disclose certain Private Information to a
   person, such as the subscriber, a family member or a friend, who is involved
   in your care or payment for that care.


 * ADDITIONAL REASONS FOR DISCLOSURE
   
   We may also use or disclose Private Information to:
   
   * A certificate holder or subscriber of your coverage, if it is information
     regarding the status of an insurance transaction, as permitted by law.
   * Military authorities, if you are or were a member of the armed forces.
   * Plan sponsor employees designated by the plan administrator as assisting in
     plan administration.
   * Conduct marketing-type activities, either through ourselves or through
     other companies on our behalf, with a valid authorization.
   * Inform you of health-related products or services that are included in or
     add value to your plan of benefits.
   * Engage in face-to-face marketing communication.
   * Distribute promotional gifts of nominal value.


OTHER WAYS WE USE OR SHARE YOUR PRIVATE INFORMATION

We are allowed or required to share your Private Information in other ways;
usually in ways that contribute to the public good, such as public health and
research. We have to meet many conditions in the law before we can share your
Private Information for these purposes:


 * HELP WITH PUBLIC HEALTH AND SAFETY ISSUES
   
   We can share Private Information about you for certain situations such as:
   
   * Preventing diseases
   * Helping with product recalls
   * Reporting adverse reactions to medications
   * Reporting suspected abuse, neglect or domestic violence
   * Preventing or reducing a serious threat to anyone's health or safety


 * RESEARCH
   
   We can use or share your Private Information for health research.


 * COMPLY WITH THE LAW
   
   We will share Private Information about you if state or federal laws require
   it, including with the Department of Health and Human Services if it wants to
   see that we are complying with federal privacy law.


 * RESPOND TO ORGAN AND TISSUE DONATION REQUESTS AND WORK WITH A MEDICAL
   EXAMINER OR FUNERAL DIRECTOR
   
   We can share Private Information about you with entities that handle
   procurement, banking, or transplantation of organs, eyes, or tissue to
   facilitate donation and transplantation.
   
   We can share Private Information with a coroner or medical examiner for the
   purposes of identifying a deceased person, determining a cause of death or
   other duties, as authorized by law. We can share Private Information with a
   funeral director when an individual dies.


 * ADDRESS WORKERS' COMPENSATION, LAW ENFORCEMENT AND OTHER GOVERNMENT REQUESTS
   
   We can use or share Private Information about you:
   
   * For workers' compensation claims
   * For law enforcement purposes or with a law enforcement official
   * With health oversight agencies for activities authorized by law
   * For special government functions such as military, national security and
     presidential protective services


 * RESPOND TO LAWSUITS AND LEGAL ACTIONS
   
   We can share Private Information about you in response to a court or
   administrative order, or in response to a subpoena.


 * FOR USE BY BUSINESS ASSOCIATES
   
   We can share Private Information about you to our business associates (BAs)
   that perform functions on our behalf or provide us with services if the
   Private Information is necessary for such functions or services. Our BAs are
   legally and contractually required to protect the privacy of your
   information, and are only permitted to use and disclose such information as
   set forth in our contract and as permitted by federal law.


 * CORPORATE GOVERNANCE MATTERS
   
   We can share Private Information about individual policyholders to Horizon
   Mutual Holdings, Inc. to inform policyholders of their governance rights as
   Members of Horizon Mutual Holdings, Inc.


 * OTHER
   
   Please note that we will limit the disclosure of certain highly confidential
   information in accordance with laws governing the special nature of the
   information (e.g., HIV/AIDS, substance abuse, mental health, sexually
   transmitted diseases and genetic information). We are prohibited from using
   and disclosing your genetic information for underwriting purposes. Also,
   where a state permits minors of a certain age or status to seek treatment
   without parental consent, information that would normally be provided to our
   customers may be limited.
   
   It may be necessary to use or disclose your Private Information as described
   in this Notice even after coverage has terminated. In addition, it may be
   infeasible to destroy your Private Information. Thus, we do not necessarily
   destroy it upon termination of your coverage. However, any Private
   Information we keep must be kept secure and private, and used only for
   permissible purposes. In cases involving Private Information of deceased
   persons, Horizon must comply with HIPAA with regard to protecting the Private
   Information for a period of 50 years following the death of the individual.

For more information:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html


OUR RESPONSIBILITIES

 * We are required by law to maintain the privacy and security of your Private
   Information.
 * We will let you know promptly if a breach occurs that compromises the privacy
   or security of your Private Information.
 * We must follow the duties and privacy practices described in this Notice, and
   give you a copy of it.
 * We will not use or share your Private Information other than as described
   here, unless you tell us we can in writing. If you tell us we can, you may
   change your mind at any time. Let us know in writing if you change your mind.

For more information:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html


CHANGES TO THE TERMS OF THIS NOTICE

Horizon BCBSNJ and its affiliated companies reserve the right to change the
terms of this Notice, and the changes will apply to all Private Information we
have about you. Our policies may change as we periodically review and revise
them. The new Notice will be available upon request, on our website, and we will
send a copy to you if the changes are material.

This Notice is effective as of September 23, 2013.

The last revision date is July, 2024.


THIS NOTICE OF PRIVACY PRACTICES APPLIES TO THE FOLLOWING ORGANIZATIONS

The Horizon Blue Cross Blue Shield of New Jersey-affiliated companies, all of
which are independent licensees of the Blue Cross and Blue Shield Association,
are:

Horizon Healthcare Services, Inc. d/b/a/ Horizon Blue Cross Blue Shield of New
Jersey
Horizon Healthcare of New Jersey, Inc. d/b/a Horizon NJ Health
Horizon Healthcare Dental, Inc.
Horizon Insurance Company
Healthier New Jersey Insurance Company d/b/a Braven Health
Horizon Casualty Services, Inc.*
Horizon Mutual Holdings, Inc.*

* These affiliates are not covered entities subject to the federal privacy
rules.

Health care providers in Horizon BCBSNJ's provider network may participate with
Horizon BCBSNJ in an organized system of care, referred to as an "organized
health care arrangement." Horizon BCBSNJ and these providers may exchange your
Private Information as necessary to carry out treatment, payment and health care
operations relating to the organized health care arrangement.

Spanish (Español): Para ayuda en español, llame al 1-855-477-AZUL (2985).
Chinese (中文): 如需中文協助, 請 致電 1-800-355-BLUE (2583).

The Blue Cross® and Blue Shield® names and symbols are registered marks of the
Blue Cross and Blue Shield Association. The Horizon® name and symbols are
registered marks of Horizon Blue Cross Blue Shield of New Jersey. © 2021 Horizon
Blue Cross Blue Shield of New Jersey. Three Penn Plaza East, Newark, New Jersey
07105. Privacy Office, Three Penn Plaza East, PP-16F Newark, NJ 07105-2200.
EC005810 (0620)


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This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is
not New Jersey’s Health Insurance Marketplace. This website does not display all
Qualified Health Plans available through Get Covered NJGet Covered NJ opens a
dialog window‌. To see all available Qualified Health Plan options, go to the
New Jersey Health Insurance Marketplace at Get Covered NJGet Covered NJ opens a
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Products and services are provided by Horizon Blue Cross Blue Shield of New
Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven
Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of
the Blue Cross Blue Shield Association. Communications may be issued by Horizon
Blue Cross Blue Shield of New Jersey in its capacity as administrator of
programs and provider relations for all its companies. The Blue Cross® and Blue
Shield® name and symbols are registered marks of the Blue Cross Blue Shield
Association. The Horizon® name and symbols are registered marks of Horizon Blue
Cross Blue Shield of New Jersey. The Braven Health℠ name and symbols are service
marks of Braven Health.

Information in Other Languages

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Family of Companies

 * Horizon BCBSNJ Dental
 * Horizon Casualty Services
 * Horizon NJ Health

Additional Links

 * About Us
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 * Notice of Non-Discrimination
   
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 * Clinical Decision Making Criteria

® 2024 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East,
Newark, New Jersey 07105.

Applicable Products:Commercial PPO/EPO &Exchange POS/EPO ‌ Applicable Products:
Commercial HMO & POS‌

Please note that these forms are to be used by Federal Employee Program Members
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