California Consumer Privacy Act Request Form

Use this form to exercise your rights under the California Consumer Privacy Act (CCPA). This includes requesting access to your personal information and having that information deleted. Please note that you must be a California resident to use this form.

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Select the Right You Want to Exercise:

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Steps Program Basics


Why Participate: So, you and your covered spouse can earn $1 for each day you walk 8,000 or more steps up to 20 days a month. All incentives earned this way are deposited into your HSA.

How to Participate: Create your MotivHealth member account. Sync an eligible device (Garmin, Fitbit, or Apple) and walk your way to $1 a day.

Who’s Eligible: You, the policy holder and a covered spouse.

Rx Program Basics


Why Participate: Spending $200 or more on prescriptions each month? We can help you eliminate or significantly lower your out-of-pocket costs.

How to Participate: Simply call one of our Prescription Benefit Analysts:
(385) 247-1030

Who’s Eligible: You, the policyholder and your covered dependents.

Prompt Pay Program Basics


Why Participate: Save between $250-$3,000 on out-of-pocket costs on planned medical procedures.

How to Participate: Simply call us before your scheduling your procedure, and we'll help you find a participating Prompt Pay facility / provider.

Who's Eligible: You, the policyholder and your covered dependents.

Price Transparency Tool Basics


Why Participate: Lower your out-of-pocket costs by empowering yourself to take charge of your healthcare.

How to Participate: Our Price Transparency Tool is accessed via your member portal. Simply create your account and click "Find Care."

Who's Eligible: You, the policyholder and your covered dependents with member accounts can access this tool.