Illinois Notice of Claim-Related Information

Under Section 355b of Illinois Code, we will accommodate a reasonable request by a covered person to receive claims-related information from us by alternate means or at an alternate location, if the information could endanger the covered person. We may require the request in writing, with a statement that such information could endanger the person making the request. Upon acceptance of the request, we will not disclose identifying information of the requestor, the health care provider, or the nature of the services provided, without the express consent of the person making the request.

You may exercise your right to make such a request, provide an alternate address, telephone number or other method of contact, or revoke a reasonable request by calling the toll-free phone number on your ID card; or mailing a written request to: Privacy Office, 7440 Woodland Drive, Indianapolis, IN 46278-1719.

Illinois Domestic Violence Helpline: (877) TO END DV; (877) 863-6338; (877) 863-6339 (TTY).

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