Health Net Dental Nondiscrimination Notice

Discrimination is against the law. Health Net Dental follows State and Federal civil rights laws. Health Net Dental 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.

Health Net Dental provides:

• Free aids and services to people with disabilities to help them communicate better, such as:
  • Qualified sign language interpreters
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)
• Free language services to people whose primary language is not English, such as:
  • Qualified interpreters
  • Information written in other languages

If you need these services or to request this document in an alternative format, contact Health Net Dental between 8:00 a.m. and 5:00 p.m. Monday through Friday by calling 1-877-550-3868 (Sacramento) or 1-800-977-7307 (Los Angeles). If you cannot hear or speak well, please call TTY: 711.

How to File a Grievance

If you believe that Health Net Dental has failed to provide these services or unlawfully discriminated in another way on the basis 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, you can file a grievance with Health Net Dental. You can file a grievance by phone, in writing, in person, or electronically:

• By phone: Call Health Net Civil Rights Coordinator between 8:00 a.m. and 5:00 p.m. Monday through Friday at 1-866-458-2208. Or, if you cannot hear or speak well, please call TTY: 711.
• In writing: Fill out a complaint form or write a letter and send it to:
  Health Net Civil Rights Coordinator
  PO Box 9103, Van Nuys, CA 91409-9103
  
• In person: Visit your doctor's office or Health Net Dental and say you want to file a grievance.
• Electronically: Visit Health Net Dental's website.

Office of Civil Rights – California Department of Health Care Services

• 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
  Office of Civil Rights
  P.O. Box 997413, MS 0009
  Sacramento, CA 95899-7413
  
  Complaint forms are available.
  
• 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.
• In writing: Fill out a complaint form or send a letter to:
  U.S. Department of Health and Human Services
  200 Independence Avenue SW
  Room 509F, HHH Building
  Washington, DC 20201
  
  Complaint forms are available.
  
• Electronically: Visit the Office for Civil Rights Complaint Portal.

Nondiscrimination Notices