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Notice of Non-Discrimination

Federal civil rights laws prohibit certain health programs and activities from discriminating on the basis of race, color, national origin, age, disability, or sex. The laws apply to health programs and activities that receive funding from the Federal government, are administered by a Federal agency or are offered on a public Health Insurance Marketplace. Health plans that are subject to the laws include Medicare Part D plans, Medicaid plans, health plans offered by issuers on Health Insurance Marketplaces, and certain employee health benefit plans. If you have questions about whether these Federal civil rights laws apply to your plan, please contact your health plan at the number in your benefit plan materials.

If your health plan is subject to these Federal civil rights laws, it complies with the laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex and does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Your health plan:

Provides appropriate aids and services, free of charge, when necessary to ensure that people with disabilities have an equal opportunity to communicate effectively with us, such as:

  • Auxiliary aids and services
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)

Provides language assistance services, free of charge, when necessary to provide meaningful access to people whose primary language is not English, such as:

  • Qualified interpreters
  • Information written in other languages

If you need these services, call Customer Care at the phone number on your benefit ID card.

If you believe these services have not been appropriately provided to you or you have been discriminated against on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail, fax, or email with your health plan’s Civil Rights Coordinator.

You may also contact Customer Care and we will direct your grievance to your health plan’s Civil Rights Coordinator:

Nondiscrimination Grievance Coordinator

PO BOX 6590, Lee’s Summit, MO 64064-6590
Phone: 1-866-526-4075
TTY: 1-800-863-5488
Fax: 1-855-245-2135
Email: nondiscrimination@cvscaremark.com

If you need additional help filing a grievance, your health plan’s Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail or phone at:

U.S. Department of Health and Human Services

200 Independence Avenue, SW
Room 509F, HHH Building
Washington, DC 20201
1-800-368-1019
1-800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Attention

Language assistance services, free of charge, are available to you. Call Customer Care at the number on your benefit ID card (TTY: 711).

All languages are also available as a downloadable PDF.

ENGLISH
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-866-322-0984 (TTY: 711).

SPANISH
ATENCIÓN: Si usted habla español, tenemos servicios de asistencia lingüística disponibles para usted sin costo alguno. Llame al 1-866-322-0984 (TTY: 711).

CHINESE
小贴士:如果您说普通话,欢迎使用免费语言协助服务。请拨 1-866-322-0984 (TTY: 711)。

VIETNAMESE
CHÚ Ý: Nếu quý vị nói tiếng Việt, thì có sẵn các dịch vụ trợ giúp ngôn ngữ miễn phí dành cho quý vị. Hãy gọi số 1-866-322-0984 (TTY: 711).

KOREAN
알림: 한국어를 하시는 경우 무료 통역 서비스가 준비되어 있습니다. 1-866-322-0984 (TTY: 711)로 연락주시기 바랍니다.

TAGALOG
Pansinin: Kung nagsasalita ka ng Tagalog, mga serbisyo ng tulong sa wika, nang walang bayad, ay magagamit sa iyo. Tawagan ang 1-866-322-0984 (TTY: 711).

RUSSIAN
ВНИМАНИЕ: Если вы говорите на русском языке, вам будут бесплатно предоставлены услуги переводчика. Звоните по телефону: 1-866-322-0984 (телетайп: 711).

ARABIC
.(مالحظة: إذا كنت تتحدث العربية، تتوفر خدمات المساعدة اللغوية مجان أجلك. اتصل بالرقم 0984-322-866-1 (من الهاتف النصي: 711

FRENCH CREOLE
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-866-322-0984 (TTY: 711).

FRENCH
ATTENTION : Si vous parlez français, des services gratuits d’interprétation sont à votre disposition. Veuillez appeler le 1-866-322-0984 (TTY: 711).

POLISH
UWAGA: Dla osób mówiących po polsku dostępna jest bezpłatna pomoc językowa. Zadzwoń pod numer 1-866-322-0984 (TTY: 711).

PORTUGUESE
ATENÇÃO: Se fala português, estão disponíveis serviços gratuitos de assistência linguística na sua língua. Telefone para 1-866-322-0984 (TTY: 711).

ITALIAN
ATTENZIONE: Se lei parla italiano, sono disponibili servizi gratuiti di assistenza linguistica nella sua lingua. Chiami 1-866-322-0984 (TTY: 711).

JAPANESE
お知らせ: 日本語での対応を望まれる方には、無料で通訳サービスをご利用になれま す。電話番号1-866-322-0984 (TTY: 711)までお問い合わせ下さい。

GERMAN
BITTE BEACHTEN: Wenn Sie Deutsch sprechen, stehen Ihnen unsere Dolmetscher unter der Nummer 1-866-322-0984 (TTY: 711) kostenlos zur Verfügung.

FARSI
.تماس بگیرید. تماس بگیرید (TTY: 711)   توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 0984-322-866-1-