Notice of Privacy Practices

If you are concerned that your privacy rights may have been violated, or you disagree with a decision we made about access to your records, you may contact our Privacy Office (listed below). You may also contact the Help Line at 1-888-881-8395. Finally, you may send a written complaint to the U.S. Department of Health and Human Services Office of Civil Rights. Our Privacy Office can provide you the address. Under no circumstance will you be penalized or retaliated against for filing a complaint.

Mail:
Avera Privacy Office
5300 S. Broadband Lane
Sioux Falls, SD 57108

Phone: 605-322-7801
Email: Avera.HIPAA@avera.org
Fax: 1-605-322-7810

Notice of Privacy Practices as of February 16, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Who will follow this notice?

  • Avera Health Plans, Inc.
  • Insurapath, Inc.
  • Lumapath Benefits Administrator, Inc.

Your Rights

You have the right to:

  • Get a copy of your health and claims records
  • Correct your health and claims records
  • Request confidential communication
  • Ask us to limit the information we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

  • Answer coverage questions from your family and friends
  • Provide disaster relief
  • Market our services and sell your information

Our Uses and Disclosures

We may use and share your information as we:

  • Help manage the health care treatment you receive
  • Run our organization
  • Pay for your health services
  • Administer your health plan
  • Help with public health and safety issues
  • Do research
  • Comply with the law
  • Respond to organ and tissue donation requests and work with a medical examiner or funeral director
  • Address workers’ compensation, law enforcement, and other government requests
  • Respond to lawsuits and legal actions

To the extent that we have your substance use disorder patient records, subject to 42 CFR part 2, we will not share that
information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a
subpoena.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice
will be available upon request, on our web site at Avera.org or AveraHealthPlans.com, and we will mail a
copy to you.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our
responsibilities to help you.

Get a copy of health and claims records

  • You can ask to see or get a copy of your health and claims records and other health information we have about you.
    Ask us how to do this.
  • We will provide a copy or a summary of your health and claims records, usually within 30 days of your request.
    We may charge a reasonable, cost-based fee.
  • You may also view your records through our portal system, and for assistance in establishing this you can contact the
    Avera portal helpline at 855-667-9704.

Ask us to correct health and claims records

  • You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to
    do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home, office, or mobile phone) or to send mail to a
    different address.
  • We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.

Ask us to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations.
  • We are not required to agree to your request, and we may say “no,” for example, if it could affect your care. If we
    agree to your request, we may still share this information in the event that you need emergency treatment.

Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date
    you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain
    other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a
    reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We
will provide you with a paper copy promptly.

Choose someone to act for you

  • If someone has authority to act as your personal representative, such as if someone has your medical power of
    attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health
    information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can file a complaint if you feel we have violated your rights by contacting the Avera Health Help Line at
    1-888-881-8395 or by contacting our Privacy Officer (listed below).
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending
    a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting
    https://www.hhs.gov/ocr/complaints/index.html.
  • We will not retaliate against you for filing a complaint.

Please submit all requests or appeals to our privacy office. Find our contact information at the bottom of this notice.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for
how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will
follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in payment for your care
  • Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your
information if we believe it is in your best interest. We may also share your information when needed to lessen a serious
and imminent threat to health or safety.

In these cases, you have both the right and choice to tell us to:

  • Marketing purposes
  • Sale of your information

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Help manage the health care treatment you receive

We can use your health information and share it with professionals who are treating you.
Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services.

Run our organization

  • We can use and disclose your information to run our organization and contact you when necessary.
  • We are not allowed to use genetic information to decide whether we will give you coverage and the price of that
    coverage. This does not apply to long term care plans.

Example: We use health information about you to develop better services for you

Pay for your health services

We can use and disclose your health information as we pay for your health services.
Example: We share information about you with your dental plan to coordinate payment for your dental work.

Administer your plan

We may disclose your health information to your health plan sponsor for plan administration.
Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to
explain the premiums we charge.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good,
such as public health and research. We have to meet many conditions in the law before we can share your information
for these purposes. And in all cases, if we have substance use disorder patient records about you, subject to 42 CFR part
2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or
proceedings against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

We can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Do research
We can use or share your information for health research.

Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and
Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests and work with a medical examiner or funeral director

  • We can share health information about you with organ procurement organizations.
  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.

In Minnesota, we can use and disclose medical information about you, as described immediately above, with your signed
consent.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your
    information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described in this notice unless you tell us we can in writing. If
    you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Notice of Organized Health Care (OHCA) Arrangement

Avera Health System (covering Iowa, Minnesota, Nebraska, North Dakota, and South Dakota), Avera Health Plan
Inc (covering Iowa, Minnesota, Nebraska, and South Dakota), Insurapath Inc (covering South Dakota), and Lumapath
Benefits Administrator Inc (covering Iowa, Minnesota, Nebraska, and South Dakota), participate in an Organized
Health Care Arrangement (OHCA) under the Health Insurance Portability and Accountability (HIPAA). This OHCA
allows the participating entities to share information about members and patients to promote the joint operations
allowed under HIPAA related to treatment, payment, and healthcare operations.