Authorization to See More of Blue365^®         

By clicking the “I AGREE” button, below, I authorize BlueCross BlueShield of South Carolina to disclose to the Blue Cross and Blue Shield Association (“BCBSA”):   

• The fact that I am enrolled in a BlueCross BlueShield of South Carolina product and my IP address.

This authorization does not permit BlueCross BlueShield of South Carolina to disclose any other information. 

I understand that BCBSA needs to know I am enrolled in a BlueCross BlueShield of South Carolina product to make discounts available to me.

Once I click on a link to visit BCBSA’s Blue365 website, the fact that I am enrolled in a BlueCross BlueShield of South Carolina product and my IP address will be disclosed to BCBSA. Although BlueCross BlueShield of South Carolina will not give BCBSA my name or any other information about me, I understand that BCBSA’s Blue365 website is not subject to federal health information privacy laws and, therefore, could re-disclose the fact that I am enrolled in a BlueCross BlueShield of South Carolina product and my IP address (subject to its privacy policies and any applicable state laws). I acknowledge that the Blue365 website includes products and services that are not health related.  

This authorization is voluntary. BlueCross BlueShield of South Carolina 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 Blue365 website. When I revoke this authorization, the revocation will not affect any disclosure of the fact I am enrolled in a BlueCross BlueShield of South Carolina product that BlueCross BlueShield of South Carolina 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” button, below, I am confirming my authorization for the use and disclosure of information about me, as described in this form.

I AGREE