Annual notices

As required by the Women's Health and Cancer Rights Act of 1998, your health insurance policy provides benefits for mastectomy-related services, including all stages of reconstruction and surgery to achieve symmetry between the breasts, prosthesis and complications resulting from a mastectomy, including lymphedema. This coverage is subject to the same deductibles, copayments, coinsurance, and limitations as applied to other medical and surgical benefits provided under your policy. If you have questions, please check your benefit booklet or call the number on the back of your member ID card.

Independent agents must satisfy the requirements of the Centers for Medicare and Medicaid Services and be authorized by Blue Cross NC to sell, solicit, and negotiate products and services. Blue Cross NC only recognizes independent agents who have satisfied these requirements as a customer’s Agent of Record. Blue Cross NC does not provide training or support services to unauthorized independent agents.

This notice applies to individual plans only. If you have an employer-sponsored plan, please check your benefit booklet for the most accurate information.

You have 90 business days from the date of the mailing of this notice or other communication of an adverse underwriting decision to write Blue Cross NC for a written explanation of the adverse underwriting decision. This written request should be mailed to:

Blue Cross NC Customer Service

PO Box 30016

Durham, NC 27702-3016

Or you can fax your request: 919-765-7149.

Within 21 business days from the date of receipt of such written request, Blue Cross NC will provide you with the following:

• The specific reason(s) for the adverse underwriting decision unless previously provided in the original notice; and
• The specific items of personal and privileged information that support the reason(s) provided; and
• Reference to the specific Plan provisions on which the determination is based.

If you feel that the information used for the adverse underwriting decision was incomplete or you wish to have the decision reconsidered, you may submit a written request outlining your concerns along with any supporting documentation. The request, along with this information, should be mailed to:

Blue Cross NC

Individual Risk Assessment Department

PO Box 2291

Durham, NC 27702-2291

This notice applies to individual plans only. If you have an employer-sponsored plan, please check your benefit booklet for the most accurate information.

Your rate is determined by your age, address, the health plan you selected, and smoking status. If you've indicated that you are a smoker, your rate has been updated.

In such a case, you'll have 90 business days from the date of the mailing of this notice or other communication of an adverse underwriting decision to contact Blue Cross NC for a written explanation of the adverse underwriting decision. This written request should be mailed to:

Blue Cross NC Customer Service

PO Box 30016

Durham, NC 27702-3016

Or you can fax your request: 919-765-7149.

Within 21 business days from the date of receipt of such written request, Blue Cross NC will provide you with the following:

• The specific reason(s) for the adverse underwriting decision unless previously provided in the original notice; and
• The specific items of personal and privileged information that support the reason(s) provided; and
• Reference to the specific Plan provisions on which the determination is based.

If you feel that the information used for the adverse underwriting decision was incomplete or you wish to have the decision reconsidered, you may submit a written request outlining your concerns along with any supporting documentation. The request, along with this information, should be mailed to:

Blue Cross NC

Individual Risk Assessment Department

PO Box 2291

Durham, NC 27702-2291

Individuals have the right to access and amend recorded information, also referred to as protected health information or PHI, that Blue Cross NC maintains about the individual. Within 30 business days of receipt of a written request to access or amend PHI, Blue Cross NC will:

• Inform the individual of the nature and substance of the PHI and permit the individual to see and copy the information as described in Blue Cross NC’s Notice of Privacy Practices; or
• Respond to a request to amend the information as described in Blue Cross NC’s Notice of Privacy Practices. Blue Cross NC will not generally amend, correct, or delete information if Blue Cross NC believes the information is true and correct.

Visit our notice of privacy practices page to learn more about these rights and how you may make a request to access or amend your information.

Find out how we adhere to all federal civil rights laws and ensure access to all.

Learn how your medical information may be used and disclosed.