USI Affinity Collegiate Insurance Resources
ID Cards Benefits Claims Doctors Address Change


NOTICE OF PRIVACY PRACTICES

A federal law entitled the Gramm-Leach-Bliley Act (GLBA) requires firms to protect the privacy of consumers' non-public personal information. This law requires that we inform you about what type of information we collect or maintain, how we use it and to whom we may disclose this information.

Special Risk Consultants, Inc. (SRC) values you as a customer and the protection of your privacy is very important to us. To effectively administer the array of insurance plans offered to our customers, we may collect and share "non-public personal information" about you in accordance with applicable laws and regulations.

Non-public Personal Information we may Collect

Special Risk Consultants, Inc. collects nonpublic personal information about you from the following sources:

•  Information we receive from you or your plan sponsor via applications or other forms;

•  Information about your transactions with us, our affiliates or others;

•  Information we may receive electronically when you accesses our web site.

Non-public Personal Information we may Disclose

We do not disclose non-public personal information about our customers or former customers to anyone, except as otherwise permitted by law.

Other Security Procedures

We restrict access to non-public personal information about you to individuals or entities that are involved in providing services to you. We maintain safeguards (including internet security devices and hard document cross shredding) to protect non-public personal information.

Questions If you have any questions about this notice, our compliance with either the Gramm-Leach-Bliley Act (GLBA), or the Health Insurance Portability & Accountability Act (HIPAA), please contact us at:

Joseph C. Seufer, President J.Seufer@visitSRC.com

Special Risk Consultants, Inc.

172 Bechtel Road
Collegeville, PA 19426-2830
610/489-6100 . voice
610/489-9325 . fax
Privacy of Personal Information Statement