Notice of Privacy Practices
Effective Date: August 20, 2025

This Notice describes how your medical information may be used and disclosed and how you can get access to this information. Please review it carefully.

Our Responsabilities

Plan de Salud Menonita is required by law to:

• Maintain the privacy and security of your Protected Health Information (PHI).
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your PHI.
• Follow the duties and privacy practices described in this Notice.
• Not use or share your information other than as described here unless you tell us in writing that we can. You may revoke that permission at any time.

Your Rights

You have the right to:

• Access your records: Request to see or get a copy of your health and claims records.
• Request corrections: Ask us to correct information you believe is incorrect or incomplete.
• Request confidential communications: Ask us to contact you in a specific way (for example, at work or by mail).
• Limit what we use or share: Request restrictions on certain uses and disclosures of your PHI (in compliance with current policies and applicable rules and regulations).
• Get a list of disclosures: Request a list (accounting) of disclosures we have made of your PHI. • Receive a copy of this Notice: You can request a paper copy of this Notice at any time.
• Designate a representative: 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 PHI.

Your Choices

You have the right to tell us how we may share information in certain situations. For example, you can choose to:

• Share information with family, close friends, or others involved in your care.
• Share information in disaster relief situations.
• Share information for marketing or fundraising communications.

Important: We must obtain your written permission before we use or disclose your PHI for most marketing purposes, the sale of your information, or certain sensitive information (such as psychotherapy notes).

Uses and Disclosures Without Your Authorization

We may use or share your PHI for purposes such as:

• Treatment – To coordinate your care with providers.
• Payment – To process your claims and determine coverage.
• Health Care Operations – To improve our programs and services. We may also share your information when required by law, including:
• With public health authorities (for disease reporting, child abuse, etc.). With health oversight agencies for audits, investigations, and compliance.
  • With law enforcement and in response to court orders or subpoenas.
  • To prevent or lessen a serious and imminent threat to health or safety.
  • For workers’ compensation or other government programs. •
  • We may not use or disclose PHI related to reproductive health care that is lawfully obtained and provided, unless required by law.
  • We will not share reproductive health PHI with law enforcement or state officials investigating reproductive health care that is legally protected.
• We may not use or disclose PHI related to reproductive health care that is lawfully obtained and provided, unless required by law.
• We will not share reproductive health PHI with law enforcement or state officials investigating reproductive health care that is legally protected.

This new protection ensures your reproductive health information remains confidential and safeguarded.

Our Duties

• We are required by law to maintain the privacy of your PHI. •
• We will notify you if your unsecured PHI is ever compromised in a breach.
• We will not use or disclose your PHI in ways not described in this Notice unless you provide written authorization.

Changes to This Notice

We may change this Notice at any time. The revised Notice will apply to all PHI we maintain. If we make significant changes, we will:

• Post the updated Notice on our website.
• Provide the revised Notice upon request

Questions or Complaints

If you have questions, need to exercise your rights, or believe your privacy rights have been violated, contact:

Plan de Salud Menonita, Inc – Privacy Officer

• #400 Ave. Américo Miranda | Edificio Alianza COSVI, Piso 3 | San Juan, PR 00927
• 787-625-1380

If you suspect fraud or abuse, please report it to:

• 1-844-335-2864
• www.planmenonita.ethicspoint.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

© Plan de Salud Menonita. All rights reserved.