If you have been affected by the Los Angeles fires and need assistance, you may call customer service at 1-800-428-6337.

    • Impacted enrollees, may call for answers to questions, including loss of health       insurance identification cards, how to access health care, and any other related health       care questions.

    • ACN Group of California, Inc., will work with enrollees impacted by the state of       emergency or health emergency to find suitable access to care.

The Plan is implementing measures to:

    • Expedite timeframes for prior approval, pre-certifications, or referrals

    • Extend the timeframe of authorizations.

    • Allow enrollees to seek care from appropriate out-of-network providers if in-network       providers are unavailable due to the State of Emergency or if enrollees are displaced       outside their usual service area.

    • Ensures enrollees in these situations are not charged more than their standard in-       network cost-sharing amounts for such services

    • Extend deadlines for filing claims.

ACN Group of California, Inc. d/b/a OptumHealth Physical Health of California (Optum) complies with applicable civil rights laws and does not discriminate against, exclude, or treat individuals unfairly on the basis of race, color, national origin, ancestry, religion, marital status, age, disability, or sex (including pregnancy, sexual orientation, gender, and gender identity).

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.

We provide free aids and services to help you communicate with us. You can ask for interpreters and/or for communications in other languages or formats such as large print. We also provide reasonable modifications for persons with disabilities.

If you need these services, call the toll-free number 1-800-428-6337. (TTY 711).

If you believe that we failed to provide these services or discriminated in another way on the basis of race, color, national origin, ancestry, religion, marital status, age, disability, or sex (including pregnancy, sexual orientation, gender, and gender identity), you can send a complaint to the Civil Rights Coordinator:

Optum Civil Rights Coordinator 1 Optum Circle Eden Prairie, MN 55344 Optum_Civil_Rights@Optum.com

If you need help filing a complaint, call the toll-free number 1-888-445-8745. (TTY 711).

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

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

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

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

This notice is available at: myoptumhealthphysicalhealthofca.com

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 TDD (1-888-877-5379) 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, Inc. 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 Center at 1-888-466-2219.