WPS needs your approval (called an “authorization”) to send marketing communications to you. “Marketing” means a communication about a product or service that encourages you to use that product or service and that is unrelated to your treatment, coordination of care, or plan benefits. With your approval, WPS will access and use individually identifiable information that is a part of your protected health information (PHI) including: your name, mailing address, date of birth, gender, group number, subscriber number, e-mail address, and/or phone number to reach you.
Providing approval is easy! Complete your marketing authorization selection in the member portal to allow marketing communications from WPS. When completed, this marketing authorization will allow Wisconsin Physicians Service Insurance Corporation (WPS or WPS Health Insurance), and/or its wholly owned subsidiaries, The EPIC Life Insurance Company (EPIC Specialty Benefits), and WPS Health Plan, Inc. (collectively “WPS Health Solutions”) to use the PHI listed above for us or third parties to contact you for marketing purposes via postal mail, email, or telephone.
You can revoke your marketing authorization at any time by entering an expiration date in the fields on the next page; by requesting an end date in the member portal form; or, by contacting us at wpsprivacyofficer@wpsic.com. WPS will track and process the revocation request in a timely manner. Note: Revocations are not applicable until processed by WPS and are not applicable to materials sent prior to processing of the request. In addition, WPS will not sell your contact information but it may be shared with our business-partners to communicate with you on behalf of WPS.
If you disagree with allowing the use of your PHI to contact you or you want to limit how WPS may contact you (via postal mail, email, or telephone), please deny the marketing authorization and WPS will honor your request. Please note: we will still contact you for treatment- or benefit-related communications, even if you do not consent to receive marketing materials.
We appreciate having you as a customer! Your decision to allow or deny the marketing authorization will not affect any of the services or benefits provided to you on WPS plans or policies. Completion of this form provides your electronic signature (accepted as a written signature and authorization) and documents the following: I have read the contents of this electronic form. I understand, agree and allow WPS Health Solutions to access and use my PHI as stated above. I also understand that I am providing the approval of my own free will. I understand that WPS Health Solutions does not require that I sign this form in order for me to receive treatment or payment, or for enrollment or being eligible for benefits. I have the right to withdraw or revoke this approval at any time by using any of the three documented methods. I understand that my withdrawing this approval will not affect any action taken before I do so. I am entitled to a record of my marketing authorization decision and it will be available in the member portal or by contacting wpsprivacyofficer@wpsic.com to request the record.