ACN Group of California, Inc. d/b/a OptumHealth Physical Health of California (Optum) does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age or disability in its health programs or activities.

This statement is in compliance with the provisions of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Regulations of the U.S. Department of Health and Human Services issued according to these statutes at Title 45 Code of Federal Regulations Parts 80, 84, and 91.

If you believe that we have failed to provide these services or discriminated in another way on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age or disability, you can file a grievance by mail or email to the Optum Civil Rights Coordinator:

Optum� Civil Rights Coordinator 11000 Optum Circle Eden Prairie, MN 55344 Email: specialtynetworkstest@Optum.com

If you need help filing a grievance, please call toll-free 800-428-6337, TTY 711, Monday through Friday, 8:30 am � 5 pm PT.

United States Department of Health and Human Services � Office of Civil Rights

If you believe you have been discriminated against on the basis of race, color, national origin, age, disability, or sex, you can file a discrimination complaint directly with the U.S. Department of Health and Human services online, by phone, or mail:

Online: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

Phone: Toll-free 1-800-368-1019, 800-537-7697 (TDD)

Mail: U.S. Department of Health and Human Services
200 Independence Avenue, SW Room 509F, HHH Building
Washington, D.C. 20201

If you need more help, call the Department of Managed Health Care (DMHC) at 1-888-466-2219.

Department of Managed Health Care Review

The California Department of Managed Health Care is responsible for regulating health care service plans. If you have a grievance against your health plan, you should first telephone your health plan at (1-800-428-6337) or for TTY/TDD services call 1-888-877-5379 (voice), or 1-888-877-5378 (TTY) and use your health plan's grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. The Department also has a toll-free telephone number (1-888-466-2219) and a TDD line (1-877-688-9891) for the hearing and speech impaired. The department's internet website www.dmhc.ca.gov has complaint forms, IMR application forms and instructions online.

Language Assistance Services

You may be entitled to the following rights and services under California law which shall be available in the top 15 languages spoken by limited English-proficient individuals in California as determined by the State Department of Health Care Services.

Interpretation services and translated written materials are available to the member in the top 15 languages spoken by limited English-proficient individuals in California as determined by the State Department of Health Care Services. Appropriate auxiliary aids and services are also available to the member, including qualified interpreters for individuals with disabilities and information in alternate formats, when those aids and services are necessary to ensure an equal opportunity to participate for individuals with disabilities. These services will be provided free of charge in a timely manner upon request. To get help in your language, please call your health plan, ACN Group of California at: 800-428-6337/TTY: 711, Monday through Friday, 8:30 a.m. to 5:00 p.m. Pacific Time (PT). If you need more help, call the Department of Managed Health Care (DMHC) Help Line at 1-888-466-2219.