OUR PLEDGE TO YOU

FamilyCare is committed to maintaining the confidentiality of your personal medical information. Your personal doctor or health care provider may have different policies or notices regarding their use and disclosure of your medical information created by them. This Notice will tell you how we use information about you and when we can share that information with others. This also describes your rights with respect to your health information and how you can exercise these rights. This Notice applies to all of the medical records which we maintain.

We are required by law to:

• make sure that medical information that identifies you is kept private, except as specified in this Notice;
• give you this Notice of our legal duties and privacy practices with respect to medical information about you; and
• follow the terms of this Notice.

This Notice of Privacy Practices takes effect on April 14, 2003, and will remain in effect until we replace it. This Notice pertains to you and your covered dependents.

You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us at 1-866-798-2273 or TTY 1-800-735-2900.