nondiscriminiation notice

Discrimination is against the law. Blue Shield of California Promise Health Plan follows State and Federal civil rights laws. Blue Shield of California Promise Health Plan does not unlawfully discriminate, exclude people, or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation..

Blue Shield of California Promise Health Plan provides:

  • Free aids and services to people with disabilities to help them communicate better,:
    • Qualified sign language interpreters
    • Written information in other formats (large print, audio, accessible electronic formats, and other formats)
  • Language services at no cost to people whose primary language is not English, such as:
    • Qualified interpreters
    • Information written in other languages

HOW TO FILE A GRIEVANCE

If you believe that Blue Shield of California Promise Health Plan has failed to provide these services or unlawfully discriminated in another way on the basis of race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation you can file a grievance with Blue Shield of California Promise Health Plan’s Civil Rights Coordinator. You can file a grievance by phone, in writing, in person, or electronically:

  • By phone: Contact Blue Shield of California Promise Health Plan’s Civil Rights
    Coordinator between 8 a.m. - 6 p.m., Monday – Friday by calling
    (844) 883-2233. Or, if you cannot hear or speak well, please call TYY/TDD 711.
  • In writing: Fill out a complaint form or write a letter and send it to:

    Blue Shield of California Promise Health Plan Civil Rights Coordinator
    601 Potrero Grande Dr.
    Monterey Park, CA 91755
  • In person: Visit your doctor’s office or Blue Shield of California Promise Health Plan and say you want to file a grievance.

OFFICE OF CIVIL RIGHTS - CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES

You can also file a civil rights complaint with the California Department of Health Care Services, Office of Civil Rights by phone, in writing, or electronically:

  • By phone: Call 916-440-7370. If you cannot speak or hear well, please call 711
    (Telecommunications Relay Service).
  • In writing: Fill out a complaint form or send a letter to:

    Deputy Director, Office of Civil Rights
    Department of Health Care Services
    P.O. Box 997413, MS 0009 Sacramento, CA 95899-7413

Complaint forms are available at http://www.dhcs.ca.gov/Pages/Language_Access.aspx.

Electronically: Send an email to CivilRights@dhcs.ca.gov.

OFFICE OF CIVIL RIGHTS - U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

If you believe you have been discriminated against on the basis of race, color, national origin, age, disability or sex, you can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights by phone, in writing, or electronically:

  • By phone: Call 1-800-368-1019. If you cannot speak or hear well, please call TTY/TDD
    1-800-537-7697.

 

Download the non-discrimination notice in other languages

Arabic (PDF, 108 KB) العربية Հայերեն Armenian (PDF, 82 KB)
ែខរ Cambodian (PDF, 101 KB) 繁體中文 Chinese (PDF, 163 KB)
Farsi (PDF, 90 KB) فارسی हिंदी Hindi (PDF, 69 KB)
Hmong Hmong (PDF, 43 KB) 日本語 Japanese (PDF, 138 KB)
한국어 Korean (PDF, 158 KB) ພາສາລາວ Laotian (PDF, 175 KB)
Mienh Mien (PDF, 40 KB) ਪੰਜਾਬੀ ਦੇ Punjabi (PDF, 61 KB)
Русский Russian (PDF, 71 KB) Español Spanish (PDF, 33 KB)
Tagalog Tagalog/Filipino (PDF, 42 KB) ภาษาไทย Thai (PDF, 74 KB)
Примітка українською (Ukrainian) (PDF, 95 KB) Tiếng Việt Vietnamese (PDF, 124 KB)

Free interpreter services and information in other languages

Blue Shield of California Promise Health Plan provides free language services to people whose primary language is not English.

Language assistance notice (PDF, 400KB)

English:
ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Call (855) 905-3825 [TTY: 711].

繁體中文 (Chinese):
注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 (855) 905-3825 [TTY:711]。

한국어 (Korean):
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. (855) 905-3825 [TTY: 711] 번으로 전화해 주십시오.

Русский (Russian):
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (855) 905-3825 (телетайп: 711).

ایرانی / فارسی (Persian/Farsi):
وجه: اگر شما انگلیسی، خدمات کمک زبان، رایگان صحبت می کنند، در دسترس شما هستند. پاسخ (855) 905-3825 [TTY: 711].

हिंदी (Hindi):
ध्यान दें: आप अंग्रेजी, भाषा सहायता सेवाओं, नि: शुल्क बोलते हैं, तो आप के लिए उपलब्ध हैं। कॉल (855) 905-3825 [TTY: 711]।

Hmoob (Hmong):
LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (855) 905-3825 [TTY: 711]

Español (Spanish):
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (855) 905-3825 [TTY: 711].

Tiếng Việt (Vietnamese):
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số (855) 905-3825 [TTY: 711].

Tagalog (Tagalog – Filipino):
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa (855) 905-3825 [TTY: 711].

زبان عربی (Arabic):
تنبيه: إذا كنت تتحدث خدمات المساعدة اللغوية، مجانا الإنكليزية وتتوفر لك. دعوة (855) 905-3825 [TTY: 711].

ພາສາລາວ (Laotian):
ສິ່ງສໍາຄັນ: ຖ້າທ່ານເວົ້າພາສາລາວແມ່ນມີບໍລິການຊ່ວຍເຫຼືອທາງດ້ານພາສາບໍ່ເສຍຄ່າໃຫ້ທ່ານ. ໂທຫາເບີ 1-855-905-3825 (TTY: 711), 8:00 ໂມງເຊົ້າ ຫາ 8:00 ໂມງແລງ, ເຈັດວັນຕໍ່ອາທິດ. ການໂທແມ່ນບໍ່ເສຍຄ່າ.

日本語 (Japanese):
注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。(855) 905-3825 [TTY: 711]まで、お電話にてご連絡ください。

ภาษาไทย (Thai):
ความสนใจ: ถ้าคุณพูดภาษาอังกฤษบริการให้ความช่วยเหลือภาษาฟรีมีให้คุณ โทร (855) 905-3825 [TTY: 711]

ਪੰਜਾਬੀ (Punjabi):
ਧਿਆਨ: ਜੇਕਰ ਤੁਹਾਨੂੰ ਦਾ ਅੰਗਰੇਜ਼ੀ, ਭਾਸ਼ਾ ਸਹਾਇਤਾ ਸੇਵਾ, ਮੁਫ਼ਤ ਗੱਲ ਕਰ, ਜੇ, ਤੁਹਾਡੇ ਲਈ ਉਪਲੱਬਧ ਹਨ. ਕਾਲ ਕਰੋ (855) 905-3825 [TTY: 711].

​ខ្មែរ (Cambodian/Khmer):
របយ័តន៖ េបើសិនជាអនកនិយាយ ភាសាែខមរ, េសវាជំនួយែផនកភាសា េដាយមិនគិតឈន លួ គឺអាចមានសំរាប់បំេរអី នក។ ចូ រ ទូរស័ពទ (855) 905-3825 (TTY: 711)។

Հայերեն (Armenian):
ՈՒՇԱԴՐՈՒԹՅՈՒՆ՝ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք (855) 905-3825 (TTY (հեռատիպ)՝ 711):

Українська (Ukrainian):
ЗВЕРНІТЬ УВАГУ! Якщо Ви розмовляєте українською, ми можемо запропонувати Вам безкоштовні послуги мовної підтримки. Телефонуйте 1-855-905-3825 (TTY: 711) з 8:00 до 20:00 без вихідних. Дзвінок безкоштовний.

Mienh (Mien):
TOV JANGX LONGX OC: Beiv taix meih gorngv Mienh waac nor, ninh mbuo gorn zangc duqv mbenc nzoih wang-henh nzie weih faan waac bun meih muangx maiv zuqc feix liuc cuotv zinh nyaanh. Douc waac lorx taux 1-855-905-3825 (TTY: 711), 8:00 diemv ziangh hoc lungh ndorm mingh taux 8:00 ziangh hoc lungh muonz, yietc norm liv baaiz se koi nzoih siec hnoi. Naaiv norm douc waac gorn se wang-henh longc maiv zuqc feix liuc cuotv zinh nyaanh.