Our Duties:
We must maintain the privacy of your Personal Information and give you this notice of our privacy practices and legal duties. We must abide by the terms of this notice, but we may change the terms hereof and make any new provisions effective as to all Personal Information we maintain about you. We will mail you a revised notice if we make changes.

Your Rights:
You have a right to know how we may use or disclose your Personal Information. This notice informs you of those uses and
disclosures.

There are certain uses and disclosures of your Personal Information that we are permitted or required to make by law without your
permission. We must obtain your permission first for all other uses and disclosures. You also have the right to:

• Request that we place additional restrictions on our uses and disclosures of your Personal Information, but we are not obligated to agree to any such additional restrictions.
• Access, inspect and copy the Personal Information we maintain in our files about you, and the right to have us correct or amend any information that we created in error. All such requests should be sent to the contact person and address provided on the back of this
  brochure.
• Receive an accounting of the disclosures of your Personal Information that we make for purposes other than activities related to your treatment, or our payment functions or other health care operations.
• Request that you receive communications of Personal Information in a confidential manner.

Information We Collect:
We collect from the following sources nonpublic Personal Information that:

• You provide us in conversations and on applications and other forms that you complete.
• We obtain as a result of our transactions with you.
• We obtain from the Department of Motor Vehicles or other consumer reporting agencies.
• We receive from entities such as health care providers or other insurance companies, in order to service your policy or carry out other insurance-related needs.
• We obtain from your medical records or from medical professionals.

Information We May Use and Disclose:
We do not disclose non-public Personal Information about you to affiliated or nonaffiliated third parties, except as authorized by law. We may use or disclose your Personal Information without your permission for the following purposes:

• For health care providers to provide you with treatment.
• To carry out activities relating to reimbursing you for the provision of health care, obtaining premiums, determining coverage, and providing benefits under the policy of insurance that you are purchasing. Such functions may include reviewing health care services with respect to medical necessity,
  coverage under the policy, appropriateness of care, or justification of charges.
• To carry out certain limited activities relating to your health insurance benefits, including reviewing the competence or qualifications of health care professionals and conducting quality assessments, and with respect to self-insured plans, placing contracts for stop-loss insurance.
• For other purposes permitted or required by law, including:
  
  • Compliance with workers’ compensation or other no-fault laws.
  • Compliance with a court order or in the course of any judicial or administrative proceeding .

All other uses or disclosures of your Personal Information will be made only with your written permission, which may be revoked by you at any time in writing.

With respect to all self-insured plans, we may make disclosures of Personal Information to plan sponsors pursuant to the restrictions
imposed on the plan sponsors in the plan document.

Our Practices Regarding Confidentiality and Security:
Except as authorized by law, we restrict access to nonpublic Personal Information about you to those employees who need to know that information in order to provide products or services to you. We maintain physical, electronic, and procedural safeguards that
comply with federal regulations to guard your nonpublic Personal Information.

This notice describes how personal information about you, including financial and personal health information (collectively, Personal Information), may be used and disclosed and how you may get access to this Personal Information. It also tells you how we safeguard your Personal Information and protect your privacy rights.

Please be aware that Hamilton Brewart Insurance does not disclose Personal Information about you to third parties whose sole use of the information is to market a product or service. We recognize that the fundamental component of the broker/insured customer relationship is trust. Hamilton Brewart Insurance is committed to keeping your information secure and confidential.

Our Policy Regarding Dispute Resolution:
Any controversy or claim arising out of or relating to our privacy policy, or the breach thereof, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof.

Complaints About Misuse of Personal Information:
If you believe that your rights, with respect to our protection of your Personal Information, have been violated, you may file a complaint with us by submitting a complaint in writing that includes as many
details (such as names and dates) as possible. You may also complain directly to the Secretary of Health and Human Services.

Contact Person for Filing Complaint or Obtaining Further Information:
Please direct any complaints or requests to:

Derek Brewart
President
Hamilton Brewart Insurance
1282 W. Arrow Highway
Upland, California 91786