Privacy Notice

Privacy Notice

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HIPAA (1996) sets privacy standards.  Individuals covered by a health plan receive a Privacy Practices Notice.

Trophy Insurance Agency is mandated by federal and state law to provide a Privacy Practices Notice to plan members. The notice describes how Trophy Insurance Agency uses and discloses member health and financial information.  This notice differs from the website Privacy Statement.

For Group, Individual, and Medicare Plan Members:

For Medicaid Plan Members:

Privacy Forms

Individuals have specific rights related to privacy. A privacy form is needed to exercise these rights.  Options include:

Print out a form. Complete and sign, then mail it to the address listed on the form.

Request to have a certain form sent to you. Contact customer service using the number on your member ID card.

For Group, Individual, and Medicare Plan Members: Standard Authorization Form with Instructions

For Medicaid Plan Members:

Privacy Questions or Concerns

Questions or concerns about privacy rights can be addressed as follows:

Call:1-713-907-9391

Write to:

Trophy Insurance Agency        103 Sandy Lane, Huffman, Texas, 77336