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Broker Service Center - Call (800) 474-4467
7440 Woodland Drive
Indianapolis, IN 46278
FAX: (801) 478-5460
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California Comprehensive State Privacy Law Web Form
If you are a resident of
California
, you may use this form to exercise your right to access, delete, correct, or restrict the sharing of your information or alleging discrimination based on exercising a prior right request, if permitted by law.
State of Residence (CA)
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Full Name
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Email Address
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NPN
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CA License Number
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Please indicate your relationship with us:
Broker/Agent
Current Employee
Prospective Hire
Former Broker/Agent
Former Employee
Other
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Please specify your request:
Request access to my Personal Information (information about the categories of Personal Information collected)
Request deletion of my Personal Information
Request correction of my Personal Information
Request a copy of my Personal Information (a data portability request)
Do not share or sell my Personal Information
Alleged discrimination based on prior right request
Appeal the denial of a prior rights request
Required
Most products and services are underwritten by Golden Rule Insurance Company or Oxford Health Insurance, Inc.
References to UnitedHealthcare pertain to each individual company or other UnitedHealthcare affiliated companies.
Administrative services are provided by United Healthcare Services, Inc.
UnitedHealthOne is a brand name that represents a portfolio of insurance options for individuals and families.
All products require separate applications. Separate policies or certificates are issued. Medical plans are medically underwritten– see the product brochures and applications.
Product availability varies by state.
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