Language Assistance. Solicitor Firm shall not and shall assure its Agents shall not engage in any marketing, solicitation, or sales of SHP health care coverage products directed to persons with limited English proficiency(LEP) unless all such activities are conducted in the LEP individual’s preferred language, including but not limited to discussions, explanations, responses to questions, and the presentation of vital documents (subject to Section 12 of this Agreement (Advertisements and Collateral), including but not limited to coverage application forms, benefit summary matrices and key provisions of evidences of coverage, as defined by Section 1367.04 of the California Xxxx-Xxxxx Act and Section 1300.67.04 of Title 28 California Code of Regulations. Specifically, Solicitor Firm and its Agents acknowledge that SHP is subject to the Xxxx- Xxxxx Act requirements regarding the provision of interpreter services and written translations of vital documents, and Solicitor Firm and its Agents agree that if Solicitor Firm and its Agents are unable to provide LEP persons with language assistance services as required by the Xxxx Xxxxx Act, then Solicitor Firm shall and shall assure its Agents shall refer all such persons to the SHP sales department.
Language Assistance. If you have questions about completing this application, please contact Xxxxxx Health Plus Member Services at 0-000-000-0000 (TTY 0-000-000-0000), Monday through Friday from 8 a.m. to 7 p.m. Xxxxxx Health Plus provides translation services and other language assistance services to you free of charge. If you are working with a broker, you may also call him or her for assistance. The broker who helped you read and complete this application must sign the application (see Section H). M-17-096 Section A – Enrollment Is the applicant an existing or former Xxxxxx Health Plus member? Yes No If Yes, please include your Subscriber ID here Enrollment Period Annual Open Enrollment Period Special Enrollment Period Qualifying Event Date (Please complete the Attestation Form for Qualifying Events for Special Enrollment included) Demographic Change Only Name Change Address Change Phone Number Change Enrollment or Change Type New Enrollment Subscriber Only Subscriber and Spouse/Domestic Partner Subscriber and Child(ren) Child Only Family: Subscriber, Spouse/Domestic Partner, Child(ren) Existing Subscriber Change Plan Add Dependent(s) Requested Effective Date Section A1 – Plan Details and Account Information Select the plan you would like Platinum Ml01 HMO* Gold Ml02 HMO* Silver Ml03 HMO* Bronze Ml04 HMO** Sections to Complete If you are applying for coverage for: • Yourself only (subscriber), complete Section B and Section E if applicable • Child only, complete Sections B, D and E If you are applying for any other coverage, complete Sections B and C and Section D if applicable If you are updating or changing name, address or phone, complete Section B for subscriber and Section C for dependents if applicable You need to select a primary care physician (PCP) for yourself and each covered family member. Please include your PCP's name and provider ID in Sections B and C. Section B – Subscriber Information Last Name First Name MI Gender Date of Birth M F Social Security Number (Required) Residential Address City State ZIP Home Phone Mobile Phone Work Phone Email Address Mailing Address (P.O. Box Accepted) same as residential City State ZIP Previous Name (If Any) Primary Spoken Language
Language Assistance. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 000-000-0000 (TTY: 711).注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 000-000-0000（TTY：711）。 CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch xx xx trợ xxxx xxx miễn phí xxxx xxx bạn. Gọi số 000-000-0000 (TTY: 711). 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 000-000-0000 (TTY: 711) 번으로 전화해 주십시오. ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 000-000-0000 (телетайп: 711). PAUNAWA: Kung nagsasalita xx xx Tagalog, maaari kang gumamit ng mga serbisyo ng tulong xx xxxx nang walang bayad. Tumawag sa 000-000-0000 (TTY: 711). УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером 000-000-0000 (телетайп: 711). ប្រយ័ត្ន៖ បរើសិនជាអ្ន កនិយាយ ភាសាខ្មែ រ, បសវាជំនួ យខ្ននកភាសា បោយមិនគិត្ឈ្ន លួ គឺអាចមានសំរារ់រំបរអ្ន ក។ ចូ រ ទរូ ស័ព្ទ 000-000-0000 (TTY: 711)។ 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。000-000-0000（TTY:711）まで、お電話にてご連絡ください。 ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 000-000-0000 (መስማት ለተሳናቸው: 711). XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 000-000-0000 (TTY: 711). .)711 :مكبلاو مصلا فتاه مقر( 000-000-0000 مقرب لصتا .ناجملاب كل رفاوتت ةيوغللا ةدعاسملا تامدخ نإف ،ةغللا ركذا ثدحتت تنك اذإ :ةظوحلم ਧਿਆਨ ਧਿਓ: ਜੇ ਤੁਸੀਂ ਪੰ ਜਾਬੀ ਬੋਲਿੇ ਹੋ, ਤਾਂ ਭਾਸ਼ਾ ਧਵਿੱ ਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਿ ਹੈ। 000-000-0000 (TTY: 711) 'ਤੇ ਕਾਲ ਕਰੋ।
Language Assistance. 39. EHPD shall ensure effective communication with and provide timely and meaningful access to police services to all members of the community, regardless of their national origin or limited ability to speak, read, write, or understand English. To achieve this outcome, EHPD shall:
Language Assistance. Customer agrees that if, on a monthly basis, calls -------------------- utilizing MCI Carrier Operator Services language MCI CONFIDENTIAL -4- assistance exceed XXXXXXXXXXXXXXXXXXXX, Customer shall pay two times the Tariff rate for all calls exceeding XXXXXXXXXXXXXXXXXXXX.
Language Assistance. VDOC agrees to provide language translation services or other accommodations, as necessary, for incarcerated individuals who may not be able to otherwise access any of the written materials discussed in this section.
Language Assistance. If you are a person who is deaf or hard of hearing, , you can utilize the Michigan Relay Center (MRC) to reach your PIHP, CMHSP or service provider. Please call 7-1-1 and ask MRC to connect you to the number you are trying to reach. If you prefer to use a TTY, please contact [customer services] at the following TTY phone number: (number). If you need a sign language interpreter, contact the [customer services office] at (number) as soon as possible so that one will be made available. Sign language interpreters are available at no cost to you. If you do not speak English, contact the [customer services office] at (number) so that arrangements can be made for an interpreter for you. Language interpreters are available at no cost to you. [Note to PIHP: you should add in the handbook any other language assistance they have available] Accessibility and Accommodations In accordance with federal and state laws, all buildings and programs of the (PIHP name) are required to be physically accessible to individuals with all qualifying disabilities. Any individual who receives emotional, visual or mobility support from a qualified/trained and identified service animal such as a dog will be given access, along with the service animal, to all buildings and programs of the (PIHP name). If you need more information or if you have questions about accessibility or service/support animals, contact [customer services] at (phone number). If you need to request an accommodation on behalf of yourself or a family member or a friend, you can contact [customer services] at (phone). You will be told how to request an accommodation (this can be done over the phone, in person and/or in writing) and you will be told who at the agency is responsible for handling accommodation requests. [Note to PIHP: you may add additional information to this template. To accommodate multiple affiliates, CAs or provider networks, it is acceptable to format names and numbers in the most logical way] Template #7: Payment for Services If you are enrolled in Medicaid and meet the criteria for the specialty mental health and substance abuse services the total cost of your authorized mental health or substance abuse treatment will be covered. No fees will be charged to you. If you are a Medicaid beneficiary with a deductible (“spend-down”), as determined by the Michigan Department of Human Services (DHS), or an Adult Benefit Waiver enrollee you may be responsible for the cost of a portion of your services. [N...
Language Assistance. Customer agrees that if, on a monthly basis, calls utilizing MCI Carrier Operator Services language assistance exceed thirty percent (30%), Customer shall pay two times the Tariff rate for all calls exceeding thirty percent (30%).
Language Assistance. 10.3.1 The Sub-recipient must have sufficient Spanish-speaking staff to serve the Counties’ significant Spanish-speaking populations. Other language capacity appropriate to the potential youth job-seeker customer population will also be required. Additionally, key materials must be provided in Spanish and other appropriate languages in accordance with the DEDO- DWS WIOA Language Assistance plan.
Language Assistance a. SCPD policy will require the following:
