Notice of Nondiscrimination

Discrimination is Against the Law

Allina Health Aetna Insurance Company complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with 45 CFR § 92.101(a)(2)). Allina Health Aetna Insurance Company does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex. 

Allina Health Aetna Insurance Company:

• Provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as: 
   

  • Qualified sign language interpreters 

  • Written information in other formats (large print, audio, accessible electronic formats, other formats). 

• Provides free language assistance services to people whose primary language is not English, which may include: 
   

  • Qualified interpreters 

  • Information written in other languages. 

If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact 1-833-570-6671 ${tty}.

If you believe that Allina Health Aetna Insurance Company has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

Civil Rights Coordinator 

Attn: 1557 Coordinator 

CVS Pharmacy, Inc. 

1 CVS Drive, MC 2332,

Woonsocket, RI 02895

1-833-570-6671 ${tty}

Email: Coordinator1557@cvshealth.com

You can file a grievance in person or by mail, phone, or email. If you need help filing a grievance, the 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, D.C. 20201

1-800-368-1019, 800-537-7697 (TDD)

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

This notice is available at Allina Health Aetna Insurance Company website: https://www.allinahealthaetnamedicare.com.

Notice of Availability

TTY: 711

ENGLISH:

To access language services at no cost to you, call the number on your ID card.

AMHARIC:

እርስዎ ወጪ ሳያወጡ የቋንቋ አገልግሎቶችን ለመድረስ በመታወቂያ ካርድዎ (ID) ላይ ወዳለው ቁጥር ይደውሉ።

ARABIC:

للحصول على خدمات اللغة مجانًا، اتصل بالرقم الموجود على بطاقة العضوية الخاصة بك.

CHINESE:

如欲使用免費語言服務，請致電您 ID 卡上的電話號碼。

CUSHITE:

Tajaajila afaanii bilisaan argachuuf, lakkoofsa Waraqaa Eenyummeessaa (ID) keessan irra jiru irratti bilbilaa.

FRENCH:

Pour accéder gratuitement aux services linguistiques, appelez le numéro figurant sur votre carte d’identité.

FRENCH CREOLE:

Pou w jwenn aksè ak sèvis lang gratis pou ou, rele nimewo ki sou kat idantite w la.

GERMAN:

Um kostenlos auf Sprachdienste zuzugreifen, rufen Sie die Nummer auf Ihrem Ausweis an.

HAWAIIAN:

Inā ake ʻoe e ili mai no ke kōkua manuahi me ka unuhi, e kelepona ʻoe i ka helu ma kou kāleka ID.

HMONG:

Kom tau txais cov kev pab cuam txhais lus yam tsis sau nqi ntawm koj, thov hu rau tus xov tooj nyob ntawm koj daim npav ID.

ITALIAN:

Per accedere gratuitamente ai servizi linguistici, chiama il numero riportato sul tuo tesserino identificativo.

JAPANESE:

無料の言語サービスをご利用いただくには、ご自身のIDカードに記載されている番号 にお電話ください。

KAREN:

လၢကမၤန့ၢ် ကျိာ်တၢ်မၤစၢၤတၢ်မၤ လၢတလိၣ်လၢာ်ဘူၣ်လၢာ်စ့ၤ လၢနဂီၢ်အဂီၢ်, ကိးနီၣ်ဂံၢ် လၢအအိၣ် ဖဲန ID အဖီခိၣ်န့ၣ်တက့ၢ်.

KOREAN:

무료로 언어 서비스를 이용하려면 ID 카드에 적힌 전화번호로 전화하세요.

LAOTIAN:

ເພື່ອເຂົ້າເຖິງການບໍລິການພາສາໂດຍບໍ່ເສຍຄ່າໃຊ້ຈ່າຍໃດໆແກ່ທ່ານ, ໃຫ້ໂທຫາເບີທີ່ຢູ່ໃນບັດປະຈໍາຕົວຂອງທ່ານ.

MON-KHMER, CAMBODIAN:

ដើម្បីទទួលបានសេវាផ្នែកភាសាដោយមិនគិតថ្លៃពីអ្នកសូមទូរសព្ទទៅលេខដែលមាននៅលើកាតសម្គាល់ខ្លួនរបស់អ្នក។

PERSIAN:

برای دسترسی به خدمات زبانی رایگان، با شماره مندرج روی کارت ID خود تماس بگیرید.

POLISH:

Aby uzyskać bezpłatny dostęp do usług językowych, zadzwoń pod numer podany na karcie ID.

PORTUGESE:

Ligue para o número que está no seu cartão de identificação para receber assistência linguística gratuita.

RUSSIAN:

Чтобы получить бесплатные языковые услуги, позвоните по номеру телефона, указанному на вашей идентификационной карте.

SPANISH:

Para acceder a servicios de idiomas sin costo alguno, llame al número que figura en su tarjeta de identificación.

TAGALOG:

Upang ma-access ang mga serbisyo sa wika nang wala kang babayaran, tawagan ang numero sa iyong ID card.

VIETNAMESE:

Để truy cập dịch vụ ngôn ngữ miễn phí, hãy gọi đến số điện thoại trên thẻ ID của quý vị.