Federal law requires HMSA to provide you with this notice.

HMSA complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. HMSA does not exclude people or treat them differently because of things like race, color, national origin, age, disability, or sex.

Services that HMSA provides

Provides aids and services to people with disabilities 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 language services to people whose primary language is not English, such as:

• Qualified interpreters
• Information written in other languages
• If you need these services, please call 1-800-776-4672 toll-free. TTY 711.

How to file a discrimination-related grievance or complaint

If you believe that we’ve failed to provide these services or discriminated against you in some way, you can file a grievance in any of the following ways:

• Phone: 1-800-776-4672 toll-free
• TTY: 711
• Email: Compliance_Ethics@teenlifestyle.net
• Fax: 808-948-6414 on Oahu
• Mail: 818 Keeaumoku St., Honolulu, HI 96814

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

• Online: ocrportal.hhs.gov/ocr/portal/lobby.jsf
• Phone: 1-800-368-1019 toll-free; TDD users, call 1-800-537-7697 toll-free
• Mail: U.S. Department of Health and Human Services, 200 Independence Ave. SW., Room 509F, HHH Building, Washington, DC 20201

For complaint forms, please go to
hhs.gov/ocr/office/file/index.html.