Privacy disclaimer statements

In the normal course of visiting the Harvard Pilgrim website, downloading information, or searching for our products or services, we (or a third party on our behalf) may gather and store certain information about your browsing activity automatically. We use this information to help us make the site more useful to visitors — to learn about the number of visitors to our site and the types of technology our visitors use. Unless specifically stated otherwise, no additional information will be collected about you.

We (or a third party on our behalf) may collect and store the following types of information about your browsing activity:  

• Your computer's IP address. (An IP address is a number that is automatically assigned to your computer whenever you go on the internet.)
• The domain from which you access the internet (for example, gmail.com, if you are connecting from a Google email account).
• The internet address of the website, if any, from which you came to our site.
• The date and time you arrived at our site and how long you spent visiting the site.
• The name and version of your computer's operating system and browser (this information is supplied automatically by your computer).
• What pages you visit within our website. 

Some pages on this website employ browser session "cookies." A cookie is a small piece of data that a website transfers to your computer's hard drive to allow the server to distinguish your session from that of others while you are connected. Requests to send cookies are not designed to collect information about you, but only about your browser session. The cookies make it easier for you to use the dynamic features of our website. The cookies and the information about your session are automatically destroyed shortly after you close your browser. The information is not permanently stored on your computer. We do not collect personal information about you except as described previously.

Harvard Pilgrim is committed to ensuring the privacy and confidentiality of our members' protected health information (PHI). We collect and disclose such information only according to our strict confidentiality policies and federal and state laws designed to maintain privacy, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. The HIPAA Privacy Rule took effect on April 14, 2003, and requires Harvard Pilgrim to provide its members with a Notice of Privacy Practices. The notice explains how we use information about our members and under what conditions we are permitted to share that information with others.

Unless otherwise permitted by HIPAA, we will not disclose to third parties that are not our vendors any identifying data, including name, mailing address, email address and phone number, unless you authorize such disclosure, or such disclosure is required by law. To ensure privacy of your data, never share your username and password with anyone. Be sure to consider the content of any questions, the location of your email account and who, besides yourself, may have access to it.

We collect personally identifiable data through our web services in the following ways:

• Through members' secure accounts
• Within "Contact Us" — Lets users tell us what they think about our website via email and is emailed directly to the web manager
• Via email sent directly to Member Services
• By HealthTrio, our partner that collects personally identifiable data and is covered under a business associate agreement

Security is a priority at Harvard Pilgrim. Appropriate measures are taken to protect the confidentiality, integrity and availability of information about our members, providers, employers, brokers and anyone else who may want to use our website.

Only authorized users are allowed to access protected health information (PHI). Harvard Pilgrim enforces a high level of protection for securing transmissions between a user's browser and this website. Content on this site is protected against unauthorized access.

Please be aware that communications sent using unencrypted email are not inherently secure. It is possible that they can be intercepted while in transit and read. Harvard Pilgrim cannot guarantee the confidentiality or security of any information you send to us over the internet when it is sent using unencrypted email. Harvard Pilgrim will not be responsible for any breach of confidentiality resulting from your use of unencrypted email transmission.

Harvard Pilgrim maintains a corporate email policy governing the use of email when communicating confidential and/or health information, which includes implementing reasonable and appropriate safeguards when communicating via email.

We periodically email well-being and benefit-related information to our members to help them make the most of their plan. Each time we send an email, the recipient is given the opportunity to opt out of receiving similar emails in the future.

Medical questions or concerns about your care or treatment should be directed to appropriate health care professionals. Harvard Pilgrim will not respond to requests for personal medical advice made through this website. If you require an immediate response to non-medical questions or problems, please call Member Services at (888) 888-4742 (TTY: 711).

Email forms on our site should not be used for confidential personal medical issues but for general topics or product questions. If you wish to discuss personal information related to Harvard Pilgrim services, you should call Member Services, and not use email. We will share your comments and questions with our member services coordinators and those employees most capable of addressing your questions and concerns, as covered under personal health information, above. Your email may not be encrypted and may be accessed and viewed by other internet users without your knowledge while in transit to us. See email security.

© 2022 Harvard Pilgrim Health Care, Inc. All rights reserved.

The information posted on this website is protected by copyright and other intellectual property rights. It may be displayed, reformatted and printed for personal, non-commercial use only. Any copy of information obtained through the website must include the copyright notice. Removing or altering the copyright notice on any material on this website is prohibited. Use or misuse of Harvard Pilgrim's trademarks, service marks or logos is expressly prohibited and may violate state and federal law.

In order to administer your health care coverage, including paying for your health care services, we need to use and disclose your information in a number of ways. Harvard Pilgrim maintains and enforces company policies governing the use and disclosure of information, including only using or disclosing the minimum amount of information necessary for the intended purpose. The following are examples of the types of uses and disclosures we are permitted or required by federal law to make without your written authorization. Where state or other federal laws offer you greater privacy protections, we will follow the more stringent requirements.

For payment

Harvard Pilgrim may use or disclose your information for payment purposes to administer your health benefits, which may involve obtaining premiums, determination of eligibility, claims payment, and coordination of benefits. Examples include:

• Paying claims that were submitted to us by physicians and hospitals.
• Providing information to a third party to administer an employee- or employer-funded account, such as a Flexible Spending Account (“FSA”) or Health Reimbursement Account (“HRA”), or another benefit plan, such as a dental benefits plan.
• Performing medical necessity reviews.
• Sharing information with third parties for Insurance Liability Recovery (“ILR”) or subrogation purposes.

For health care operations

Harvard Pilgrim may use or disclose your information for operational purposes, such as care management, customer service, coordination of care, or quality improvement. Examples include:

• Assessing and improving the quality of service, care and outcomes for our members.
• Learning how to improve our services through internal and external surveys.
• Reviewing the qualifications and performance of physicians.
• Evaluating the performance of our staff, such as reviewing our customer service phone conversations with you.
• Seeking accreditation by independent organizations, such as the National Committee for Quality Assurance.
• Engaging in wellness programs, preventive health, early detection, disease management, health risk assessment participation initiatives, case management, and coordination of care programs, including sending preventive health service reminders.
• Providing you with information about a health-related product or service included in your plan of benefits.
• Using information for underwriting, establishing premium rates and determining cost sharing amounts, as well as administration of reinsurance policies. (Harvard Pilgrim will not use or disclose any genetic information it might otherwise receive for underwriting purposes.)
• Facilitating transition of care from and to other insurers, health plans or third-party administrators.
• Communicating with you about your eligibility for public programs, such as Medicare.
• Other general administrative activities, including data and information systems management, risk management, auditing, business planning, and detection of fraud and other unlawful conduct.

For treatment

Harvard Pilgrim may use and disclose your information for health care providers (doctors, dentists, pharmacies, hospitals, and other caregivers) to treat you. Examples include:

• Our care managers providing your information to a home health care agency to make sure you get the services you need after discharge from a hospital.
• Quality improvement programs, safety initiatives, and clinical reminders sent to your primary care provider.
• Disclosing a list of medications you’ve received using your Harvard Pilgrim coverage to alert your treating providers about any medications prescribed to you by other providers and help minimize potential adverse drug interactions.
• Receiving your test results from labs you use, from your providers, or directly from you, using the results to develop tools to improve your overall health, and sharing the results with providers involved in your care.

For other permitted or required purposes

The following are examples of the additional types of uses and disclosures Harvard Pilgrim is permitted or required by law to make without your written authorization:

• To you, your family, and others involved in your care when you are unavailable to communicate (such as during an emergency), when you are present prior to the disclosure and agree to it, or when the information is clearly relevant to their involvement in your health care or payment for health care.
• Sharing eligibility information and copayment, coinsurance, and deductible information for dependents with the subscriber of the health plan in order to facilitate management of health costs and Internal Revenue Service verification.
• To your Personal Representative (including parents or guardians of a minor, so long as that information is not further restricted by applicable state or federal laws) or to an individual you have previously indicated is your Designated Representative or is authorized to receive your information. Information related to any care a minor may receive without parental consent remains confidential unless the minor authorizes disclosure.
• To our business partners and affiliates. Harvard Pilgrim may contract with other organizations to provide services on our behalf. In these cases, Harvard Pilgrim will enter into an agreement with the organization explicitly outlining the requirements associated with the protection, use and disclosure of your information. The following corporate affiliates of Harvard Pilgrim designate themselves as a single affiliated covered entity and may share your information among them: Tufts Associated Health Maintenance Organization, Inc., Tufts Health Public Plans, Inc., Tufts Insurance Company, CarePartners of Connecticut, Inc., Point32Health Services, Inc. Group Health Plan, Harvard Pilgrim Health Care, Inc., Harvard Pilgrim Health Care of New England, Inc., and HPHC Insurance Company, Inc.
• To your plan sponsor, when sharing information used for enrollment, plan renewal, or plan administration purposes. This is your employer or the employer of your subscriber if you are enrolled through an employer. When sharing detailed information, your plan sponsor must certify that they will protect the privacy and security of your information and that the information will not be used for employment decisions.
• To government entities, such as the Centers for Medicare & Medicaid Services, the Health Connector, HealthSourceRI, or MassHealth, if you are enrolled in a government-funded plan.
• To provide information for health research to improve the health of our members and the community in certain circumstances, such as when an Institutional Review Board or Privacy Board approves a research proposal with protocols to protect your privacy, or for purposes preparatory to research.
• To comply with laws and regulations, such as those related to workers’ compensation programs.
• For public health activities, such as assisting public health authorities with disease prevention or control and pandemic response efforts.
• To report suspected cases of abuse, neglect, or domestic violence.
• For health oversight activities, such as audits, inspections, and licensure or disciplinary actions. For example, Harvard Pilgrim may submit information to government agencies such as the U.S. Department of Health and Human Services or a state insurance department to demonstrate its compliance with state and federal laws.
• For judicial and administrative proceedings, such as responses to court orders, subpoenas, or discovery requests.
• For law enforcement purposes, such as to help identify or locate a victim, suspect, or missing person.
• Disclosures to coroners, medical examiners, and funeral directors about decedents. Harvard Pilgrim may also disclose information about a decedent to a person who was involved in their care or payment for care, or to the person with legal authority to act on behalf of the decedent’s estate.
• To organ procurement organizations for cadaveric organ, eye, or tissue donation purposes, only after your prior authorization.
• To prevent a serious threat to your health or safety, or that of another person.
• For specialized government functions, such as national security and intelligence activities.
• Disclosures by employees for whistleblower purposes.

Other than the permitted or required uses and disclosures described above, Harvard Pilgrim will only use and disclose your information with your written authorization.

For example, we require your authorization if we intend to sell your information, use or disclose your information for marketing or fundraising purposes, or, in most cases, use or disclose your psychotherapy notes.

You may give us written authorization to use or disclose your information to any individual or organization for any purpose by submitting a completed authorization form. The form can be found at www.harvardpilgrim.org, or you may obtain a copy by calling Member Services at the phone number listed on your Harvard Pilgrim ID card. For members enrolled in a student health plan offered by HPHC Insurance Company and administered by UnitedHealthcare Student Resources, the form can be found at www.uhcsr.com.

You may revoke such an authorization at any time in writing, except to the extent we have already made a use or disclosure based on a previously executed authorization.

The following are examples of your rights under federal law with respect to your information. You may also be entitled to additional rights under state law.

Request a restriction

You have the right to request we restrict the way we use and disclose your information for treatment, payment, or health care operations, to individuals involved in your care, or for notification purposes, including asking that we not share your information for health research purposes. We are not, however, required by law to agree to your request.

Request confidential communications

You have the right to request we send communications to you at an address of your choice or that we communicate with you by alternative means. For example, you may ask us to mail your information to an address that is different than your subscriber’s address. We will accommodate reasonable requests.

Access your information and receive a copy

You have the right to access, inspect, and obtain a copy of your information maintained by Harvard Pilgrim (with certain exceptions). We have the right to charge a reasonable fee for the cost of producing and mailing copies of your information.

Amend your information

You have the right to request we amend your information if you believe it is incorrect or incomplete. We may deny your request in certain circumstances, such as when we did not create the information. For example, if a provider submits medical information to Harvard Pilgrim that you believe is incorrect, the provider will need to amend that information.

Receive an accounting of disclosures

You have the right to request an accounting of those instances in which we disclosed your information, except for disclosures made for treatment, payment, or health care operations, or for other permitted or required purposes. Your request must be limited to disclosures in the six years prior to the request. If you request an accounting more than once in a 12-month period, we may charge you a reasonable fee.

Receive a copy of this Notice of Privacy Practices

You have the right to receive a paper copy of this notice from us at any time upon request.

Be notified of a breach

You have the right to be notified if there is a breach of your unsecured information by us or our business partners. We will provide you written notice via mail, unless we do not have up-to-date contact information for you. In these cases we will notify you by a substitute method, such as posting the notice on our public website.

You may exercise any of your privacy rights described above by contacting Member Services at the phone number listed on your Harvard Pilgrim ID card. In some cases, we may require you to submit a written request. Harvard Pilgrim will not require you to waive your rights as a condition of the provision of treatment, payment, enrollment in a health plan, or eligibility for benefits.

If you believe your privacy rights have been violated or you would like more information, you may send a question or complaint to:

Privacy Officer
Point32Health
1 Wellness Way
Canton, MA 02021

Or, you may call our Compliance Hotline at (877) 824-7123 or Member Services at the phone number listed on your Harvard Pilgrim ID card.

You also have the right to submit a complaint to the Secretary of the Department of Health and Human Services. You can find more information at www.hhs.gov/ocr.

Harvard Pilgrim will not take retaliatory action against you for filing a complaint.

THIS NOTICE IS EFFECTIVE SEPTEMBER 1, 2022, AND REPLACES THE VERSION DATED MARCH 15, 2022.

These Terms of Service govern the Harvard Pilgrim Health Care Chatbot portal (“Portal”). Before you use or access the Portal, you must carefully review these Terms of Service (the "Terms"). In addition, specific pages on our website or mobile application (the “Services”) may set out additional terms and conditions, all of which are incorporated by reference into these Terms. These Terms may be changed or updated at any time, but you can always find the most recent version here. If we make material changes to the Terms, we will notify you through our services or by other means. You should periodically check this page to make sure you are up to date.

By using the Portal, you indicate that you accept these Terms and that you agree to be bound by them. Acceptance of these Terms creates a binding contract between you and Harvard Pilgrim Health Care that you will use the Services only in a manner consistent with these Terms.

Responsibility of the Host

You understand that the Portal administrator/owner shall have the right, but not the obligation, to monitor, edit, move, delete or refuse to post any content, or part thereof, in order to determine and/or ensure compliance with these Terms, applicable law and any other operating rules that may be established by the administrator/operator from time to time.

The administrator/owner will manage access to the Portal, including, but not limited to, adding and removing users of the Portal, changing user’s settings, or responding, in a timely manner, to inquiries related to the Portal or its use.  The administrator/owner may, in its sole discretion, terminate or modify your access to the Portal. You may not use the Portal for illegal purposes or in a manner that infringes the rights of any third party, including but not limited to, defamation, violation of intellectual property laws, violation of antitrust or unfair competition laws, or violation of criminal laws.

The Portal is not intended to be used for medical diagnosis or treatment. The Portal should not be used for any such purpose. If you think that you are having a medical emergency, call 911 or the number for your local emergency service. 

The Portal is a computer program that mimics chatting with a person. The Portal responds to your questions through a pre-programmed knowledgebase to identify best fit related answers. The Portal is designed to be used by members enrolled in certain commercial products offered by Harvard Pilgrim Health Care. It is not intended for use by Medicare members, employers, health care providers or brokers. The Portal is not intended to answer your plan specific questions or any questions relating to your personal health information. The knowledgebase of the Portal should expand over time. Portal responses may not be accurate. Please see Limitation of Liability.²  

It is usually acceptable to include a link to an article, while copying and pasting the actual article may be in violation of copyright laws.

Rule 1: Do not use the Portal for illegal purposes, including but not limited to defamation, violation of intellectual property laws, violation of antitrust or unfair competition laws,³ or violation of criminal laws.  Do not use the Portal if you are under 18 years of age or the age of majority under applicable law. 

a. Copyright — Referring to an article or news item with typical reference citations, providing a brief quote, or offering a link to legitimate online published content is permissible; members should not post a full-text version of published material to the Portal. Not infrequently a member wants to tell others about an article or news item related to the issues discussed. However, sending the entire article, without the permission of the author or publisher, results in a prima facie case of copyright violation. While there can be defenses to a claim of copyright infringement where the purpose of copying is clearly not for commercial purposes (e.g. “fair use” or academic teaching exceptions), those defenses are complicated, have been construed differently in different jurisdictions and may not be applicable.

b. Defamation and libel — In exchanges on the Portal and when referring to others, avoid personal attacks and characterizations that question a person’s motives or qualifications. Sometimes a robust debate about ideas spills over into attacks on the proponents or opponents of the ideas. Members need to be reminded that a false statement that harms someone's reputation can be actionable as libel.

c. Prohibited uses — By using the Portal, you agree not to submit, post, or transmit any material or otherwise engage in any conduct that:

• Is false, misleading or deceptive.
• Violates or infringes the rights of others including, without limitation, patent, trademark, trade secret, copyright, publicity, privacy or other proprietary rights;
• Allows you to gain unauthorized access to the Portal, or any account, computer system or network connected to the Portal, by means such as hacking, password mining or other illicit means;
• Is unlawful, threatening, abusive, harassing, defamatory, libelous, fraudulent, invasive of another’s privacy, tortious, or contains explicit or graphic descriptions or accounts of sexual acts;
• Victimizes, harasses, degrades, or intimidates an individual or group of individuals on the basis of religion, gender, sexual orientation, gender identity, race, ethnicity, age, or disability;
• Collects for marketing purposes any email addresses or other personal information that has been posted by other users of the Portal;
• Impersonates any person, business or entity, or falsely states or otherwise misrepresents your affiliation with any person, business or entity;
• Contains an unauthorized advertisement or solicitation that is “spammy” (in our sole discretion), or that otherwise detracts from the character or purpose of the Portal;
• Contains viruses or any other computer code, files or programs that interrupt, destroy or limit the functionality of any computer software or hardware or telecommunications equipment, or otherwise permit the unauthorized use of a computer or computer network;
• Encourages conduct that would constitute a criminal offense or that gives rise to civil liability or that otherwise encourages others to commit illegal activities or cause injury or property damage to any other person;
• Results in the posting or transmission of any message anonymously or under a false name;
• Permits any person to access, using your email address or account, any features of the Portal that may require registration; or
• Violates the Terms, any other policy posted on the Portal, or otherwise interferes with the use of the Portal by others (in our sole discretion).

Rule 2: Do not intentionally interfere with or disrupt other members, network services or network equipment. This includes distribution of unsolicited advertisement or chain letters, propagation of computer worms and viruses, and use of the network to make unauthorized entry to any other machine accessible via the Portal.

Rule 3: Do not use the Portal for commercial purposes. "Commercial" means communications whose primary purpose is to advance the business or financial interests of any person or entity, or otherwise to promote a financial transaction for the benefit of the author directly or indirectly. Examples of prohibited communications include advertisements for products or services or direct solicitations of members to purchase products or services.

Examples of messages that may be of financial benefit to members but are not prohibited because they do not inure to the financial benefit of the author include news of job listings or position openings, or discussion of professionally related products or services where the member conveying the information is not in the business of selling the products or services.

Rule 4: Do not use this Portal for any communication that could be construed in any way as support for or opposition to any candidate for a federal, state or local public office.

If you have any questions, concerns or problems with regard to the Portal, please feel free to contact us at the email or mailing address below.

Email: harvard_pilgrim_online@harvardpilgrim.org

Mailing Address:
Harvard Pilgrim Health Care
Digital Department
1 Wellness Way
Canton, MA 02021 

This website may contain links to other websites for your convenience. However, Harvard Pilgrim disclaims any responsibility for the content, information or the privacy and security protections or policies contained on those other websites, and does not exert any editorial or other control over those sites.

When we link to the sites of Harvard Pilgrim vendors where protected information (PHI) is collected on our behalf, those sites are required to safeguard information in accordance with HIPAA.

Harvard Pilgrim does not expressly or implicitly recommend or endorse the specific services or products referenced at other websites linked to Harvard Pilgrim's site, unless explicitly stated. The services, products, or providers on this site linked websites, or in listings of network doctors and hospitals may not be covered in your specific benefit package or included in your provider network. We offer this information to be comprehensive, but it is not linked to your benefits plan. You must consult your specific benefits plan materials, provider network or contact Member Services at (888) 333-4742 (for TTY service, call 711) if you have any questions.