Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Appendix A - SAMPLE CLAUSES

Current through June 24, 2024
Licensees, including a group of financial holding company
				affiliates that use a common privacy notice, may use the following sample
				clauses, if the clause is accurate for each institution that uses the notice.
				(Note that disclosure of certain information, such as assets, income and
				information from a consumer reporting agency, may give rise to obligations
				under the federal Fair Credit Reporting Act, such as a requirement to permit a
				consumer to opt out of disclosures to affiliates or designation as a consumer
				reporting agency if disclosures are made to nonaffiliated third parties.)
A-1-Categories of information a licensee collects (all
				institutions)
A licensee may use this clause, as applicable, to meet the
				requirement of s.
				Ins
				25.15(1) (a) to describe the
				categories of nonpublic personal financial information the licensee collects.
Sample Clause A-1:
We collect nonpublic personal financial information about you
				from the following sources:
* Information we receive from you on applications or other
				forms;
* Information about your transactions with us, our affiliates
				or others; and
* Information we receive from a consumer reporting agency.
A-2-Categories of information a licensee discloses
				(institutions that disclose outside of the exceptions)
A licensee may use one of these clauses, as applicable, to
				meet the requirement of s. Ins.
				25.15(1)
				(b) to describe the categories of nonpublic
				personal financial information the licensee discloses. The licensee may use
				these clauses if it discloses nonpublic personal financial information other
				than as permitted by the exceptions in ss.
				Ins
				25.50,
				25.55, and
				25.60.
Sample Clause A-2, Alternative 1:
We may disclose the following kinds of nonpublic personal
				financial information about you:
* Information we receive from you on applications or other
				forms, such as [provide illustrative examples, such as "your name, address,
				social security number, assets, income, and beneficiaries"];
*Information about your transactions with us, our affiliates or
				others, such as [provide illustrative examples, such as "your policy coverage,
				premiums, and payment history"]; and
* Information we receive from a consumer reporting agency, such
				as [provide illustrative examples, such as "your creditworthiness and credit
				history"].
Sample Clause A-2, Alternative 2:
We may disclose all of the information that we collect, as
				described [describe location in the notice, such as "above" or "below"].
A-3-Categories of in formation a licensee discloses and
				parties to whom the licensee discloses (institutions that do not disclose
				outside of the exceptions)
A licensee may use this clause, as applicable, to meet the
				requirements of s.
				Ins
				25.15(1) (b), (c) and (d) to describe
				the categories of nonpublic personal financial information about customers and
				former customers that the licensee discloses and the categories of affiliates
				and nonaffiliated third parties to whom the licensee discloses. A licensee may
				use this clause if the licensee does not disclose nonpublic financial personal
				information to any party, other than as permitted by the exceptions in ss.
				Ins
				25.55 and
				25.60.
Sample Clause A-3:
We do not disclose any nonpublic personal financial
				information about our customers or former customers to anyone, except as
				permitted by law.
A-4-Categories of parties to whom a licensee discloses
				(institutions that disclose outside of the exceptions)
A licensee may use this clause, as applicable, to meet the
				requirement of s.
				Ins
				25.15(1) (c) to describe the
				categories of affiliates and nonaffiliated third parties to whom the licensee
				discloses nonpublic financial personal information. This clause may be used if
				the licensee discloses nonpublic financial personal information other than as
				permitted by the exceptions in ss.
				Ins
				25.50,
				25.55, and
				25.60, as well as when permitted by
				the exceptions in ss.
				Ins
				25.55 and
				25.60.
Sample Clause A-4:
We may disclose nonpublic financial personal information about
				you to the following types of third parties:
*Financial service providers, such as [provide illustrative
				examples, such as "life insurers, automobile insurers, mortgage bankers,
				securities broker-dealers, and insurance agents"];
*Non-financial companies, such as [provide illustrative
				examples, such as "retailers, direct marketers, airlines, and publishers"]; and
*Others, such as [provide illustrative examples, such as
				"non-profit organizations"].
We may also disclose nonpublic financial personal information
				about you to nonaffiliated third parties as permitted by law.
A-5-Service provider/joint marketing exception
A licensee may use one of these clauses, as applicable, to
				meet the requirements of s.
				Ins
				25.15(1) (e) related to the exception
				for service providers and joint marketers in s.
				Ins
				25.50. If a licensee discloses nonpublic personal
				financial information under this exception, the licensee shall describe the
				categories of nonpublic financial personal information the licensee discloses
				and the categories of third parties with which the licensee has contracted.
Sample Clause A-5, Alternative 1:
We may disclose the following information to companies that
				perform marketing services on our behalf or to other financial institutions
				with which we have joint marketing agreements:
*Information we receive from you on applications or other
				forms, such as [provide illustrative examples, such as "your name, address,
				social security number, assets, income, and beneficiaries"];
*Information about your transactions with us, our affiliates or
				others, such as [provide illustrative examples, such as "your policy coverage,
				premium, and payment history"]; and
*Information we receive from a consumer reporting agency, such
				as [provide illustrative examples, such as "your creditworthiness and credit
				history"].
Sample Clause A-5, Alternative 2:
We may disclose all of the information we collect, as
				described [describe location in the notice, such as "above" or "below"] to
				companies that perform marketing services on our behalf or to other financial
				institutions with whom we have joint marketing agreements.
A-6-Explanation of opt out right (institutions that
				disclose outside of the exceptions)
A licensee may use this clause, as applicable, to meet the
				requirement of s.
				Ins
				25.15(1) (f) to provide an
				explanation of the consumer's right to opt out of the disclosure of nonpublic
				personal financial information to nonaffiliated third parties, including the
				method(s) by which the consumer may exercise that right. The licensee may use
				this clause if the licensee discloses nonpublic personal financial information
				other than as permitted by the exceptions in ss.
				Ins
				25.50,
				25.55, and
				25.60.
Sample Clause A-6:
If you prefer that we not disclose nonpublic personal
				financial information about you to nonaffiliated third parties, you may opt out
				of those disclosures, that is, you may direct us not to make those disclosures
				(other than disclosures permitted by law). If you wish to opt out of
				disclosures to nonaffiliated third parties, you may [describe a reasonable
				means of opting out, such as "call the following toll-free number: (insert
				number)].
A-7-Confidentiality and security (all institutions)
A licensee may use this clause, as applicable, to meet the
				requirement of s.
				Ins
				25.15(1) (g) to describe its policies
				and practices with respect to protecting the confidentiality and security of
				nonpublic personal financial information.
Sample Clause A-7:
We restrict access to nonpublic personal financial information
				about you to [provide an appropriate description, such as "those employees who
				need to know that information to provide products or services to you"]. We
				maintain physical, electronic, and procedural safeguards that comply with
				federal regulations to guard your nonpublic personal financial information.