EmblemHealth Confidentiality Protocols for Domestic Violence Victims and Endangered Victims

Date Issued: 6/28/2013

Summary

New York State Insurance Law § 2612 governs the confidentiality protocols for domestic violence victims and endangered individuals. If any person covered under a group policy delivers to the insurer that issued the policy a valid order of protection against the policyholder or other person, then the insurer is prohibited from disclosing to the policyholder or other person the address and telephone number of the insured, or of any person or entity providing covered services to the insured for the duration of the order. EmblemHealth and its companies GHI and HIP shall accommodate a reasonable request for a covered individual to receive communications of claim-related information from the health insurer by an alternative means or at an alternative location, if the member delivers to the insured a valid order of protection against the policyholder or other person, or if the member indicates that they are a victim of domestic violence endangered by the disclosure of certain information to the policyholder.

Procedure to Make a Request

A member, the member’s legal representative or with regard to a child, the child’s parent or guardian, may make a request by calling EmblemHealth’s Customer Service department at the telephone number listed below or by writing to the Corporate Compliance department at the address herein. The person making the request must provide an alternative address, telephone number or other method of contact, and may be required to provide this information in writing.

Procedure to Revoke a Request

A member, the member’s legal representative or with regard to a child, the child’s parent or guardian, may revoke a request by submitting their request in writing to EmblemHealth’s Corporate Compliance department at the address indicated below.

Write to:

EmblemHealth
Corporate Compliance Department
P.O. Box 2878
New York, NY 10116-2878

Contact information

  • EmblemHealth members: 1-877-842-3625
  • GHI PPO members: 1-800-624-2414
  • HIP/HIPIC members: 1-800-447-8255
  • GHI HMO members: 1-877-244-4466

EmblemHealth Medicare members:

  • PPO: 1-866-557-7300
  • HMO: 1-877-344-7364
  • PDP (City of NY Retirees): 1-800-624-2414
  • PDP (Non-City of NY Retirees): 1-877-444-7241

If you have a hearing or speech impairment and use a TTY/TDD, please call 711.

New York State Domestic Violence and Sexual Violence Hotline:

  • English: 1-800-842-6906
  • Spanish: 1-800-942-6908
  • In NYC: 1-800-621- 4673 or dial 311
  • TTY: 1-866-604-5350

This document may be downloaded and posted in your offices.