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Health Information Privacy Model Act
Edition and licensing notes
Publisher. National Association of Insurance Commissioners (NAIC)
Status. NAIC model, © NAIC. Brief quotations under fair use; not the enacted law of any state until adopted.
What this document is
Health Information Privacy Model Act is a naic model law published by National Association of Insurance Commissioners (NAIC). It is one of the documents that insurance license exam questions are written from, including life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.
Sections cited in practice questions
Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.
- NAIC Model #55: Section 3 (Definitions)
““Covered person” means a policyholder, subscriber, enrollee, beneficiary, insured, certificateholder or other person covered by a policy, contract or agreement of insurance issued by a carrier.”
- NAIC Model #55: Section 6 (Notice of Policies)
“The carrier shall provide the notice to any person upon request, to covered persons at the time the policy is first delivered, and to all other individuals when requesting an authorization.”
- NAIC Model #55: Section 8 (Right to Amend)
“An individual who is the subject of protected health information has the right to amend the protected health information to correct any inaccuracies.”
- NAIC Model 55: Section 8B(2)(b) (Amend, Statement of Disagreement)
“File a concise statement of what the individual believes to be the correct information and the reasons why the individual disagrees with the denial. The carrier shall retain this statement filed by the individual with the protected health information.”
- NAIC Model 55: Section 14A (Right to Limit Disclosures)
“A carrier shall limit disclosure of information, including health information, about an individual who is the subject of the information if the individual clearly states in writing that disclosure to specified individuals of all or part of that information could jeopardize the safety of the...”
- NAIC Health Information Privacy Model Act § 11A(1)(a) (disclosure without authorization to a carrier handling a claim)
“A carrier may engage in the following activities with regard to protected health information without authorization in the following circumstances or as otherwise permitted by law: (1) Collect protected health information from or disclose protected health information to a carrier, provided that the...”
- NAIC Health Information Privacy Model Act § 10E (separate authorization for disclosure to an employer)
“A carrier shall obtain a separate authorization to disclose protected health information to an individual’s employer, including the employer’s designated risk manager, unless: (1) The protected health information is disclosed pursuant to the employer’s workers’ compensation program, to the extent...”
- NAIC Health Information Privacy Model Act § 6B (delivery of the notice of health information policies)
“The carrier shall provide the notice to any person upon request, to covered persons at the time the policy is first delivered, and to all other individuals when requesting an authorization. If subsequent policies are issued to the same insured, no additional notices are required to be included when...”
- NAIC Health Information Privacy Model Act § 7E, fees for providing protected health information
“The carrier may charge a reasonable fee for providing the protected health information requested and shall provide a detailed bill accounting for the charges. No charge shall be made for reproduction of protected health information requested for the purpose of supporting a claim, supporting an...”
- NAIC Health Information Privacy Model Act § 10F, contents of a marketing authorization request
“The request for authorization shall specify that the authorization shall remain valid for no more than twelve (12) months and may be revoked at any time. The request for authorization shall state that the terms and conditions of all insurance policies will not be affected in any way by a refusal to give authorization.”
- NAIC Health Information Privacy Model Act § 10J, limit on use by a recipient of protected health information
“A person who receives protected health information from a carrier shall not use the protected health information for any purpose other than the lawful purpose for which it was disclosed.”
- NAIC Health Information Privacy Model Act § 10G, revocation of an authorization
“An individual who is the subject of protected health information may revoke an authorization at any time, subject to the rights of any person who acted in reliance on the authorization prior to notice of revocation. A revocation of an authorization shall be in writing, dated and signed.”
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