Language Assistance. TTY: 711 For language assistance in English call 0-000-000-0000 at no cost. (English) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj 0-000-000-0000. (Serbo-Croatian) Fii yo on heɓu xxxxx x xx yowitii e haala Pular noddee e oo numero ɗoo 0-000-000-0000. Njodi woo fawaaki on. (Sudanic-Fulfulde) Ukihitaji usaidizi katika lugha ya Kiswahili piga simu kwa 1-800-370-4526bila malipo. (Swahili) c2e. 2e u œ c2e 22v 2 c&u 2 zo _2c czv 2 c (cairyS-nairyssA) ., e o s 0-000-000-0000 ua22& c e o 2e c ą ª 3 o sª £c 6e o ḅ cş e´£co& 1-800-370-4526s ė ´ o& . ( ˇec c) (Telugu) สำ˚ หรับควำมช่วยเหลือทำงดำ้ นภำษำเป็ นภำษำไทย โทร 0-000-000-0000ฟรีไม่มีค่ำใชจ้ ่ำย (Thai) Kapau ‘oku fiema’u hā tokoni ‘i he lea faka-Tonga telefoni 0-000-000-0000 ‘o ‘ikai hā tōtōngi. (Tongan) Ren áninnisin chiakú ren (Kapasen Chuuk) kopwe kékkééri 1-800-370-4526nge esapw kamé ngonuk. (Trukese-Chuukese) (Dil) çağrısı dil yardım için. Hiçbir ücret ödemeden 0-000-000-0000. (Turkish) Щоб отримати допомогу перекладача української мови, зателефонуйте за безкоштовним номером 0-000-000-0000. (Ukrainian) )udrU( - t z1-800-370-4526 y y ~ Để được hỗ trợ xxxx xxx̃ bằng (xxxx xxx̃), hãy gọi miễn phí đến số 0-000-000-0000. (Vietnamese) (Yiddish) . אצפא jıפ "רפ0-000-000-0000 פıר א j א y yארפ ראפ Fún ìrànlọwọ xxxx xxx (Yorùbá) pe 0-000-000-0000 lái san owó kankan rárá. (Yoruba) Health Maintenance Organization (HMO) Evidence of Coverage Prepared exclusively for Contract holder: CITY OF ANAHEIM Contract holder number: 0849828 HMO agreement effective date: January 01, 2020 Product Name: HMO Underwritten by AETNA HEALTH OF CALIFORNIA INC. in the State of CALIFORNIA Welcome Thank you for choosing Aetna. This is your Evidence of Coverage, or EOC for short. It is one of three documents that together describe the benefits covered by your Aetna plan. This EOC will tell you about your covered benefits – what they are and how you get them. The second document is the schedule of benefits. It tells you how we share expenses for eligible health services and tells you about limits – like when your plan covers only a certain number of visits. The third document is the group agreement between Aetna Health of California Inc. (“Aetna”) and your contract holder. Ask your employer if you have any questions about the group agreement. Oh, and each of these documents may have amendments or riders attached to them. They change or add to the documents they’re part of. Where to next? Flip through the table of cont...
Language Assistance. Solicitor Firm shall not and shall assure its Agents shall not engage in any marketing, solicitation, or sales of SHP health care coverage products directed to persons with limited English proficiency(LEP) unless all such activities are conducted in the LEP individual’s preferred language, including but not limited to discussions, explanations, responses to questions, and the presentation of vital documents (subject to Section 12 of this Agreement (Advertisements and Collateral), including but not limited to coverage application forms, benefit summary matrices and key provisions of evidences of coverage, as defined by Section 1367.04 of the California Xxxx-Xxxxx Act and Section 1300.67.04 of Title 28 California Code of Regulations. Specifically, Solicitor Firm and its Agents acknowledge that SHP is subject to the Xxxx- Xxxxx Act requirements regarding the provision of interpreter services and written translations of vital documents, and Solicitor Firm and its Agents agree that if Solicitor Firm and its Agents are unable to provide LEP persons with language assistance services as required by the Xxxx Xxxxx Act, then Solicitor Firm shall and shall assure its Agents shall refer all such persons to the SHP sales department.
Language Assistance. If you have questions about completing this application, please contact Xxxxxx Health Plus Member Services at 0-000-000-0000 (TTY 0-000-000-0000), Monday through Friday from 8 a.m. to 7 p.m. Xxxxxx Health Plus provides translation services and other language assistance services to you free of charge. If you are working with a broker, you may also call him or her for assistance. The broker who helped you read and complete this application must sign the application (see Section H). M-17-096 Section A – Enrollment Is the applicant an existing or former Xxxxxx Health Plus member? Yes No If Yes, please include your Subscriber ID here Enrollment Period Annual Open Enrollment Period Special Enrollment Period Qualifying Event Date (Please complete the Attestation Form for Qualifying Events for Special Enrollment included) Demographic Change Only Name Change Address Change Phone Number Change Enrollment or Change Type New Enrollment Subscriber Only Subscriber and Spouse/Domestic Partner Subscriber and Child(ren) Child Only Family: Subscriber, Spouse/Domestic Partner, Child(ren) Existing Subscriber Change Plan Add Dependent(s) Requested Effective Date Section A1 – Plan Details and Account Information Select the plan you would like Platinum Ml01 HMO* Gold Ml02 HMO* Silver Ml03 HMO* Bronze Ml04 HMO** Sections to Complete If you are applying for coverage for: • Yourself only (subscriber), complete Section B and Section E if applicable • Child only, complete Sections B, D and E If you are applying for any other coverage, complete Sections B and C and Section D if applicable If you are updating or changing name, address or phone, complete Section B for subscriber and Section C for dependents if applicable You need to select a primary care physician (PCP) for yourself and each covered family member. Please include your PCP's name and provider ID in Sections B and C. Section B – Subscriber Information Last Name First Name MI Gender Date of Birth M F Social Security Number (Required) Residential Address City State ZIP Home Phone Mobile Phone Work Phone Email Address Mailing Address (P.O. Box Accepted) same as residential City State ZIP Previous Name (If Any) Primary Spoken Language
Language Assistance. 39. EHPD shall ensure effective communication with and provide timely and meaningful access to police services to all members of the community, regardless of their national origin or limited ability to speak, read, write, or understand English. To achieve this outcome, EHPD shall:
Language Assistance. Customer agrees that if, on a monthly basis, calls -------------------- utilizing MCI Carrier Operator Services language MCI CONFIDENTIAL -4- assistance exceed XXXXXXXXXXXXXXXXXXXX, Customer shall pay two times the Tariff rate for all calls exceeding XXXXXXXXXXXXXXXXXXXX.
Language Assistance. The LOCAL AGENCY, its agents or subcontractors, shall provide language assistance designed to ensure meaningful access to services for persons with Limited English Proficiency pursuant to Title VI of the Civil Rights Act (42 U.S.C. ' 2000d et seq.) and 45 C.F.R. ' 80.3(b). Meaningful access means that the LOCAL AGENCY, its agents or subcontractors, and Limited English Proficiency person(s) can communicate effectively when services are being provided to Limited English Proficiency persons.
Language Assistance a. SCPD policy will require the following:
Language Assistance. The school district must ensure any be- havior agreement under this section is provided in a language the stu- dent and parents understand, which may require language assistance for students and parents with limited-English proficiency under Title VI of the Civil Rights Act of 1964. [Statutory Authority: RCW 28A.600.015, 28A.600.020 and 28A.600.010 through 28A.600.022, 28A.320.211. WSR 00-00-000, § 000-000-000, filed 7/30/18, effective 8/31/18.]
Language Assistance. If you are a person who is deaf or hard of hearing, , you can utilize the Michigan Relay Center (MRC) to reach your PIHP, CMHSP or service provider. Please call 7-1-1 and ask MRC to connect you to the number you are trying to reach. If you prefer to use a TTY, please contact [customer services] at the following TTY phone number: (number). If you need a sign language interpreter, contact the [customer services office] at (number) as soon as possible so that one will be made available. Sign language interpreters are available at no cost to you. If you do not speak English, contact the [customer services office] at (number) so that arrangements can be made for an interpreter for you. Language interpreters are available at no cost to you. [Note to PIHP: you should add in the handbook any other language assistance they have available] Accessibility and Accommodations In accordance with federal and state laws, all buildings and programs of the (PIHP name) are required to be physically accessible to individuals with all qualifying disabilities. Any individual who receives emotional, visual or mobility support from a qualified/trained and identified service animal such as a dog will be given access, along with the service animal, to all buildings and programs of the (PIHP name). If you need more information or if you have questions about accessibility or service/support animals, contact [customer services] at (phone number). If you need to request an accommodation on behalf of yourself or a family member or a friend, you can contact [customer services] at (phone). You will be told how to request an accommodation (this can be done over the phone, in person and/or in writing) and you will be told who at the agency is responsible for handling accommodation requests. [Note to PIHP: you may add additional information to this template. To accommodate multiple affiliates, CAs or provider networks, it is acceptable to format names and numbers in the most logical way] Template #7: Payment for Services If you are enrolled in Medicaid and meet the criteria for the specialty mental health and substance abuse services the total cost of your authorized mental health or substance abuse treatment will be covered. No fees will be charged to you. If you are a Medicaid beneficiary with a deductible (“spend-down”), as determined by the Michigan Department of Human Services (DHS), or an Adult Benefit Waiver enrollee you may be responsible for the cost of a portion of your services. [N...
Language Assistance. Si usted, o alguien a quien usted está ayudando, tiene preguntas acerca de Alliant Health Plans, tiene derecho a obtener ayuda e información en su idioma sin costo alguno. Para hablar con un intérprete, llame al (000) 000-0000. Xxx xxx vị , hay người mà xxx vị đang giúp đỡ, có câ u hỏi về Al liant Health Plans, xxx vị sẽ có xxxxx được giúp và có thêm thông tin bằng xxxx xxx xxx xxxx miễn phí. Để nói chuyện với một thông dịch xxxx, xxx gọi (000) 000-0000. 만약 귀하 또는 귀하가 돕고 있는 어떤 사람이 Alliant Health Plans 에 관해서 질문이 있다면 귀하는 그러한 도움과 정보를 귀하의 언어로 비용 부담없이 얻을 수 있는 권리가 있습니다. 그렇게 통역사와 얘기하기 위해서는(000) 000-0000 로 전화하십시오. 如果您，或是您正在協助的對象，有關於[插入SBM項目的名稱Alliant Health Plans ]方面的問題，您有權利免費以您的母語得到幫助和訊息 。洽詢一位翻譯員，請撥電話 [在此插入數字(000) 000-0000。 તમને િવના �લ્ૂ યે તમાર� ભાષામાં મદદ અને મા�હતી મેળવવાનો અિધકાર છે. આરોગ્ય વીમા વ્યાપારબ�ર િવશે �ુ ભાિષયા સાથે �જરાતીમાં વાતચીત કરવા, કૉલ કરો (000) 000-0000. Si vous, ou quelqu'un que vous êtes en train d’aider, a des questions à propos de Alliant Health Plans, vous avez le droit d'obtenir de l 'aide et l 'i nformation dans votre langue à aucun coût. Pour parler à un interprète, appelez (000) 000-0000. እእእእእእእእ እእእእ እእእእእእእእእእእ እእAlliant Health Plansእእእ እእእእእ እእ እእእ እእእእእ እእእ እእእእእ እእእ እእእእእ እእእ እእእእእ እእእእእእእ እእ እእእእእእእ(000) 000-0000 እእእእእ यिद आपके ,या आप द्वारा सहायता ककए जा रहे ककसी ��त के Alliant Health Plans के बारे म� प्र� ह� ,तो आपके पास अपनी भाषा म� मु� म� सहायता और सूचना प्रा� करने का अिधकार है। ककसी भाषषए से बात करने के िलए, (000) 000-0000 पर कॉ कर� । Si oumenm xxxx xxx moun w ap ede gen kesyon konsènan Alliant Health Plans, se dwa w pou resevwa asistans ak enfòmasyon xxx xxxx ou pale a, san ou pa gen pou peye pou sa. Pou pale avèk yon entèprèt, rele nan (000) 000-0000. Если у вас или лица, которому вы помогаете, имеются вопросы по поводу Alliant Health Plans, то вы имеете право на бесплатное получение помощи и информации на вашем языке. Для разговора с переводчиком позвоните по телефону (000) 000-0000. إ ن كا ن لد يك أ و لد ى شخصتسا عد ه أ سئلة بخصوصAl liant Health Plans ، فلد يكا لحق في ا لحصول على ا لم سا عد ة وا لم علوم ا تا لضرورية بلغتك من د ون ا ية تكلفة . للتحد ثمع م ترجم ا تصل ب(000) 000-0000. Se você, ou alguém a quem você está ajudando, tem perguntas sobre o Alliant Health Plans, você tem o direito de obter ajuda e informação em seu idioma e sem custos. Para falar com um intérprete, ligue para (000) 000-0000. ا گر شم ا ، يا کسیکە شم ا بە ا و کم کم يکنيد ، سوا ل در م ورد Alliant Health Plans، د ا شتە با شيد حق ا ين را د ا ريد ...
