Authorization To See More of Blue365
By clicking the "I AGREE" link, below, I authorize Florida Health
Care Plans to disclose to Blue Cross and Blue Shield Association ("BCBSA"):
- The fact that I am enrolled in a Florida Health Care Plans product and
my IP address.
This authorization does
not permit Florida Health Care Plans to disclose
any other information.
I understand that BCBSA needs to know I am enrolled in a Florida Health
Care Plans product to make discounts available to me.
Once I click on a link to visit BCBSA’s Blue365 web site, the fact
that I am enrolled in a Florida Health Care Plans product and my IP address
will be disclosed to BCBSA. Although Florida Health Care Plans will not
give BCBSA my name or any other information about me, I understand that
BCBSA’s Blue365 web site is not subject to federal health information
privacy laws and, therefore, could re-disclose the fact that I am enrolled
in a Florida Health Care Plans and my IP address (subject to its privacy
policies and any applicable state laws). I acknowledge that the Blue 365
web site includes products and services that are not health related.
This authorization is voluntary. Florida Health Care Plans will not condition
my enrollment in a health plan or eligibility or payment for benefits
on receiving this authorization. I revoke this authorization and it expires
immediately when I close the browser window after using the Blue 365 web
site. When I revoke this authorization, the revocation will
not affect any disclosure of the fact I am enrolled in a Florida Health Care
Plans product that Florida Health Care Plans made before the revocation.
BCBSA may receive payment from vendors under the Blue 365 program.
I have had full opportunity to read and consider the contents of this authorization.
I understand that, by clicking on the “I AGREE” Link, below,
I am confirming my authorization for the use and disclosure of information
about me, as described in this form.
I Agree |