THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice of Privacy Practices describes the practices of The Tri-County Bank, Tri-County Insurance Agency, and Tri-County Financial Center for safeguarding individually identifiable personal health information.

We are required by law to maintain the privacy of our customers' personal health information and to provide notice of our legal duties and privacy practices with respect to personal health information. We are required to abide by the terms of this Notice as long as it remains in effect. We reserve the right to change the terms of this Notice as necessary and to make the new Notice effective for all personal health information maintained by us.

Uses and Disclosures of Your Personal Health Information

Authorization. Except as explained below, we will not use or disclose your personal health information for any purpose unless you have signed a form authorizing a use or disclosure. Unless we have taken any action in reliance on the authorization, you have the right to revoke an authorization if the request for revocation is in writing and sent to: The Tri-County Bank, P.O. Box 10, Stuart, NE 68780-0010.

Disclosures for Applications and Claims. We may disclose your personal health information as necessary for insurance underwriting and claim adjustment. For instance, an insurance company involved in underwriting or claim adjustment may request your personal health information in our possession to assist them in underwriting your application or settling a claim.

Uses and Disclosures for Payment. We will use and disclose your personal health information as necessary for claim purposes. For instance, we may use your personal health information to assist you in filing a claim. We may also forward information to another insurer in order for it to process or pay claims on your behalf.

Uses and Disclosures for Insurance and Investment Operations. We will use and disclose your personal health information as necessary for insurance operations. For instance, we may use or disclose your personal health information for quality assessment and quality improvement, premium rating, conducting or arranging for medical review or compliance. We may also disclose your personal health information to another insurer company.

Other Health-Related Uses and Disclosures. We may contact you to provide reminders for appointments; or other health-related programs, products or services that may be available to you.

Information Received Pre-enrollment. We may request and receive from you and your health care providers personal health information prior to your application. We will use this information for application purposes only.

Business Associate. Certain aspects and components of our services are performed by outside people or organizations pursuant to agreements or contracts. It may be necessary for us to disclose your personal health information to these outside people or organizations that perform services on our behalf. We require them to appropriately safeguard the privacy of your personal health information.

Family, Friends and Personal Representatives. With your approval, we may disclose to family members, close personal friends, or another person you identify, your personal health information relevant to their involvement with your care or paying for your care. If you are unavailable, incapacitated or involved in an emergency situation, and we determine that a limited disclosure is in your best interests, we may disclose your personal health information without your approval. We may also disclose your personal health information to public or private entities to assist in disaster relief efforts.

Other Uses and Disclosures. We are permitted or required by law to use or disclose your personal health information, your authorization, in the following circumstances:

o For any purpose required by law;
o For public health activities (for example, reporting of disease, injury, birth, death or suspicion of child abuse or neglect);
o To a governmental authority if we believe an individual is a victim of abuse, neglect or domestic violence;
o For health oversight activities (for example, audits, inspections, licensure actions or civil, administrative or criminal proceedings or actions);
o For judicial or administrative proceedings (for example, pursuant to a court order, subpoena or discovery request);
o For law enforcement purposes (for example, reporting wounds or injuries or for identifying or locating suspects, witnesses or missing people);
o To coroners and funeral directors;
o For procurement, banking or transplantation of organ, eye or tissue donations;
o For certain research purposes;
o To avert a serious threat to health or safety under certain circumstances;
o For military activities if you are a member of the armed forces; for intelligence or national security issues; or about an inmate or an individual to a correctional institution or law enforcement official having custody; and
o For compliance with workers' compensation programs.

We will adhere to all state and federal laws or regulations that provide additional privacy protections. We will only use or disclose AIDS/HIV-related information, genetic testing information and information pertaining to your mental condition or any substance abuse problems as permitted by state and federal law or regulation.

Your Rights

Restrictions on Use and Disclosure of Your Personal Health Information. You have the right to request restrictions on how we use or disclose your personal health information. You also have the right to request restrictions on disclosures to family members. To request a restriction, you must send a written request to: The Tri-County Bank, P.O. Box 10, Stuart, NE 68780-0010.

Access to Your Personal Health Information. You have the right to a copy of your personal health information we maintain in your designated record. To request access to your information, you must send a written request to: The Tri-County Bank, P.O. Box 10, Stuart, NE 68780-0010.

Amendment of Your Personal Health Information. You have the right to request an amendment to your personal health information to correct inaccuracies. To request an amendment, you must send a written request to: The Tri-County Bank, P.O. Box 10, Stuart, NE 68780-0010.

Complaints. If you believe your privacy rights have been violated, you can send a written complaint to us at The Tri-County Bank, P.O. Box 10, Stuart, NE 68780-0010.

Products and Services sold, issued or contracted through the Tri-County Insurance Agency or any Company contracted through or represented by Tri-County Insurance Agency are:
* Not a deposit
* Not FDIC insured
* Not insured by any federal government agency (if applicable)
* Not guaranteed by the bank
* May go down in value (if applicable)
We are licensed for the state of Nebraska.