Member Rights, Responsibilities, and Privacy

• Health Information Exchange
• Member Rights and Responsibilities (PDF)
• Notice of Privacy Practices (PDF)
• Personal representative form (English) (PDF)
• Personal representative form (Spanish) (PDF)
• Report fraud, waste, or abuse

HIPAA Authorization

• HIPAA Authorization Letter and Form (English) (PDF)
• HIPAA Authorization Letter and Form (Spanish) (PDF)