Common use of Language Assistance Clause in Contracts

Language Assistance. TTY: 711 For language assistance in English call 0-000-000-0000 at no cost. (English) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj 0-000-000-0000 . (Serbo-Croatian) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj 0-000-000-0000. (Serbo-Croatian) Fii yo on heɓu xxxxx x xx yowitii e haala Pular noddee e oo numero ɗoo 0-000-000-0000. Njodi woo fawaaki on. (Sudanic-Fulfulde) Ukihitaji usaidizi katika lugha ya Kiswahili piga simu kwa 1-800-370-4526bila malipo. (Swahili) )cairyS-nairyssA( . 0-000-000-0000 0-000-000-0000 ( ) (Telugu) สำ หรับควำมช่วยเหลือทำงดำ้ นภำษำเป็ นภำษำไทย โทร 0-000-000-0000ฟรีไม่มีค่ำใชจ้ ่ำย (Thai) Kapau ‘oku fiema’u hā tokoni ‘i he lea faka-Tonga telefoni 0-000-000-0000 ‘o ‘ikai hā tōtōngi. (Tongan) Ren áninnisin chiakú ren (Kapasen Chuuk) kopwe kékkééri 1-800-370-4526nge esapw kamé ngonuk. (Trukese-Chuukese) (Dil) çağrısı dil yardım için. Hiçbir ücret ödemeden 0-000-000-0000. (Turkish) Щоб отримати допомогу перекладача української мови, зателефонуйте за безкоштовним номером 0-000-000-0000. (Ukrainian) )udrU( 0-000-000-0000 Để được hỗ trợ xxxx xxx̃ bằng (xxxx xxx̃), hãy gọi miễn phí đến số 0-000-000-0000. (Vietnamese) )Yiddish( 0-000-000-0000 Fún ìrànlọwọ xxxx xxx (Yorùbá) pe 0-000-000-0000 lái san owó kankan rárá. (Yoruba) ‌ Health Maintenance Organization (HMO) Evidence of Coverage Prepared exclusively for Contract holder: CITY OF ANAHEIM Contract holder number: 0849828 HMO agreement effective date: January 01, 2018 Product Name: HMO Underwritten by AETNA HEALTH OF CALIFORNIA INC. in the State of CALIFORNIA Welcome Thank you for choosing Aetna. This is your Evidence of Coverage, or EOC for short. It is one of three documents that together describe the benefits covered by your Aetna plan. This EOC will tell you about your covered benefits – what they are and how you get them. The second document is the schedule of benefits. It tells you how we share expenses for eligible health services and tells you about limits – like when your plan covers only a certain number of visits. The third document is the group agreement between Aetna Health of California Inc. (“Aetna”) and your contract holder. Ask your employer if you have any questions about the group agreement. Oh, and each of these documents may have amendments or riders attached to them. They change or add to the documents they’re part of. Where to next? Flip through the table of contents or try the Let’s get started! section right after it. Let's get started! section gives you a thumbnail sketch of how your plan works. The more you understand, the more you can get out of your plan. Welcome to your Aetna plan. Some hospitals and other providers do not provide one or more of the following services that may be covered under your plan that includes:  Family planning  Contraceptive services, including emergency contraception  Sterilization, including tubal ligation at the time of labor and delivery  Infertility treatments  Abortion Call your prospective provider or refer to Let’s get started! – How to contact us for help section, if you have any questions. Table of contents Welcome Page Let's get started 6 Some notes on how we use words 6 What your plan does – providing covered benefits 6 How your plan works – starting and stopping coverage 6 How your plan works while you are covered 6 How to contact us for help 8 Your member ID card 8 Who the plan covers 9 Who is eligible 9 When you can join the plan 9 Who can be on your plan (who can be your dependents) 9 Adding new dependents 10 Special times you and your dependents can join the plan 11 Medical necessity, referral and precertification requirements 12 Medically necessary, medical necessity 12 Referrals 12 Standing referrals 12 Second opinion 12 Precertification 13 Eligible health services under your plan 14

Language Assistance. TTYATENCIÓN: 711 For language assistance in English call 0-si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 000-000-0000 at no cost(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. (English) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj 0-Gọi số 000-000-0000 (TTY: 711). (Serbo-Croatian) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj 0-000-000-0000주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. (Serbo-Croatian) Fii yo on heɓu xxxxx x xx yowitii e haala Pular noddee e oo numero ɗoo 0-000-000-0000. Njodi woo fawaaki on. (Sudanic-Fulfulde) Ukihitaji usaidizi katika lugha ya Kiswahili piga simu kwa 1-800-370-4526bila malipo. (Swahili) )cairyS-nairyssA( . 0-000-000-0000 0-(TTY: 711) 번으로 전화해 주십시오. ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 000-000-0000 ( ) (Telugu) สำ หรับควำมช่วยเหลือทำงดำ้ นภำษำเป็ นภำษำไทย โทร 0-000-000-0000ฟรีไม่มีค่ำใชจ้ ่ำย (Thai) Kapau ‘oku fiema’u hā tokoni ‘i he lea faka-Tonga telefoni 0-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 ‘o ‘ikai hā tōtōngi(TTY: 711). (Tongan) Ren áninnisin chiakú ren (Kapasen Chuuk) kopwe kékkééri 1-800-370-4526nge esapw kamé ngonukУВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. (Trukese-Chuukese) (Dil) çağrısı dil yardım için. Hiçbir ücret ödemeden 0-000-000-0000. (Turkish) Щоб отримати допомогу перекладача української мови, зателефонуйте Телефонуйте за безкоштовним номером 0-000-000-0000. (Ukrainian) )udrU( 0-000-000-0000 Để được hỗ trợ xxxx xxx̃ bằng (xxxx xxx̃телетайп: 711). ប្រយ័ត្ន៖ បរើសិនជាអ្ន កនិយាយ ភាសាខ្មែ រ, hãy gọi miễn phí đến số 0-000-000-0000. (Vietnamese) )Yiddish( 0-បសវាជំនួ យខ្ននកភាសា បោយមិនគិត្ឈ្ន លួ គឺអាចមានសំរារ់រំបរអ្ន ក។ ចូ រ ទរូ ស័ព្ទ 000-000-0000 Fún ìrànlọwọ xxxx xxx (Yorùbá) pe 0TTY: 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 lái san owó kankan rárá(መስማት ለተሳናቸው: 711). XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 000-000-0000 (YorubaTTY: 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) ‌ Health Maintenance Organization (HMO) Evidence of Coverage Prepared exclusively for Contract holder: CITY OF ANAHEIM Contract holder number: 0849828 HMO agreement effective date: January 01, 2018 Product Name: HMO Underwritten by AETNA HEALTH OF CALIFORNIA INC. in the State of CALIFORNIA Welcome Thank you for choosing Aetna. This is your Evidence of Coverage, or EOC for short. It is one of three documents that together describe the benefits covered by your Aetna plan. This EOC will tell you about your covered benefits – what they are and how you get them. The second document is the schedule of benefits. It tells you how we share expenses for eligible health services and tells you about limits – like when your plan covers only a certain number of visits. The third document is the group agreement between Aetna Health of California Inc. (“Aetna”) and your contract holder. Ask your employer if you have any questions about the group agreement. Oh, and each of these documents may have amendments or riders attached to them. They change or add to the documents they’re part of. Where to next? Flip through the table of contents or try the Let’s get started! section right after it. Let's get started! section gives you a thumbnail sketch of how your plan works. The more you understand, the more you can get out of your plan. Welcome to your Aetna plan. Some hospitals and other providers do not provide one or more of the following services that may be covered under your plan that includes:  Family planning  Contraceptive services, including emergency contraception  Sterilization, including tubal ligation at the time of labor and delivery  Infertility treatments  Abortion Call your prospective provider or refer to Let’s get started! – How to contact us for help section, if you have any questions. Table of contents Welcome Page Let's get started 6 Some notes on how we use words 6 What your plan does – providing covered benefits 6 How your plan works – starting and stopping coverage 6 How your plan works while you are covered 6 How to contact us for help 8 Your member ID card 8 Who the plan covers 9 Who is eligible 9 When you can join the plan 9 Who can be on your plan (who can be your dependents) 9 Adding new dependents 10 Special times you and your dependents can join the plan 11 Medical necessity, referral and precertification requirements 12 Medically necessary, medical necessity 12 Referrals 12 Standing referrals 12 Second opinion 12 Precertification 13 Eligible health services under your plan 14'ਤੇ ਕਾਲ ਕਰੋ।

Language Assistance. TTY: 711 For To access language assistance in English services at no cost to you, call 0-000-000-0000 at no cost0000. (English) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj 0-000-000-0000 . (Serbo-Croatian) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj Para acceder a los servicios de idiomas sin costo, llame al 0-000-000-0000. (Serbo-CroatianSpanish) Fii yo on heɓu xxxxx x xx yowitii e haala Pular noddee e oo numero ɗoo 如欲使用免費語言服務，請致電 0-000-000-0000. Njodi woo fawaaki on. (Sudanic-Fulfulde0000。(Chinese) Ukihitaji usaidizi katika lugha ya Kiswahili piga simu kwa 1-800-370-4526bila malipo. (Swahili) )cairyS-nairyssA( . 0-000-000-0000 0-000-000-0000 ( ) (Telugu) สำ หรับควำมช่วยเหลือทำงดำ้ นภำษำเป็ นภำษำไทย โทร 0-000-000-0000ฟรีไม่มีค่ำใชจ้ ่ำย (Thai) Kapau ‘oku fiema’u hā tokoni ‘i he lea faka-Tonga telefoni 0-000-000-0000 ‘o ‘ikai hā tōtōngi. (Tongan) Ren áninnisin chiakú ren (Kapasen Chuuk) kopwe kékkééri 1-800-370-4526nge esapw kamé ngonuk. (Trukese-Chuukese) (Dil) çağrısı dil yardım için. Hiçbir ücret ödemeden Afin d'accéder aux services langagiers sans frais, composez le 0-000-000-0000. (TurkishFrench) Щоб отримати допомогу перекладача української мовиPara ma-access ang mga serbisyo xx xxxx nang wala kayong babayaran, зателефонуйте за безкоштовним номером tumawag sa 0-000-000-0000. (UkrainianTagalog) )udrU( 0-000-000-0000 Để được hỗ trợ xxxx xxx̃ bằng (xxxx xxx̃), hãy gọi miễn phí đến số 0-000-000-0000. (VietnameseNavajo) )Yiddish( Um auf für Sie kostenlose Sprachdienstleistungen zuzugreifen, rufen Sie 0-000-000-0000 Fún ìrànlọwọ xxxx xxx an. (YorùbáGerman) pe Për shërbime përkthimi falas për ju, telefononi 0-000-000-0000. (Albanian) የቋንቋ አገልግሎቶችን ያለክፍያ ለማግኘት፣ በ 0-000-000-0000 lái san owó kankan ráráይደውሉ፡፡ (Amharic) )Arabic( .0-000-000-0000 مقرلا ىلع لاصتلاا ءاجرلا ،ةفلكت يأ نود ةيوغللا تامدخلا ىلع لوصحلل Անվճար լեզվական ծառայություններից օգտվելու համար զանգահարեք 0-000-000-0000 հեռախոսահամարով: (Armenian) Kugira uronke serivisi z’indimi atakiguzi, hamagara 0-000-000-0000 (Bantu) আপনাকে বিনামকূ যে ভাষা পবিকষিা পপকে হকয এই নম্বকি পেবযকNান েরুন: 0-000-000-0000। (Bengali) Ngadto maakses ang mga serbisyo sa pinulongan alang libre, tawagan sa 0-000-000-0000. (YorubaBisayan- Visayan) ‌ Health Maintenance Organization 0-000-000-0000 Per accedir a serveis lingüístics sense cap cost per vostè, telefoni al 0-000-000-0000. (HMOCatalan) Evidence of Coverage Prepared exclusively for Contract holderPara un hago' i setbision lengguåhi ni dibåtde para hågu, ågang 0-000-000-0000. (Chamorro) ᏩᎩᏍᏗ ᏚᏬᏂᎯᏍᏗ ᎤᏳᎾᏓᏛᏁᏗ Ꮭ ᎪᎱᏍᏗ ᏗᏣᎬᏩᎳᏁᏗ ᏱᎩ, ᏫᎨᎯᏏᎳᏛᏏ 0-000-000-0000. (Cherokee) Anumpa tohsholi I toksvli ya xxx xxxxx ho ish I paya hinla, I paya 0-000-000-0000. (Choctaw) Tajaajiiloota afaanii garuu bilisaa ati argaachuuf,bilbili 0-000-000-0000. (Cushite-Oromo) Voor gratis toegang tot taaldiensten, xxxx 0-000-000-0000. (Dutch) Pou jwenn sèvis lang gratis, rele 0-000-000-0000. (French Creole-Haitian) Για να επικοινωνήσετε χωρίς χρέωση με το κέντρο υποστήριξης πελατών στη γλώσσα σας, τηλεφωνήστε στον αριθμό 0-000-000-0000. (Greek) તમારે કોઇ જાતના ખર્ચ વિના ભાષાની સેિાઓની પહોર્ માટે, કોલ કરો 0-000-000-0000. (Gujarati) No ka walaʻau ʻxxx me xx xxxxxxxx ʻōlelo e kahea aku i kēia helu kelepona 0-000-000-0000. Kāki ʻole ʻia kēia kōkua nei. (Hawaiian) आपके लिए बिना ककसी कीमत के भाषा सेवाओं का उपयोग करने के लिए, 0-000-000-0000 पर कॉि करें। (Hindi) Xav tau kev pab txhais lus tsis muaj nqi them xxx koj, hu 0-000-000-0000. (Hmong) Iji nwetaòhèrè na ọrụ gasị asụsụ n'efu, kpọọ 0-000-000-0000. (Ibo) Tapno maaksesyo dagiti serbisio maipapan iti pagsasao xxx xxxx ti bayadanyo, tawagan ti 1-888-982- 3862. (Ilocano) Untuk mengakses layanan bahasa tanpa dikenakan biaya, hubungi 0-000-000-0000. (Indonesian) Per accedere ai servizi linguistici, senza alcun costo per lei, chiami il numero 0-000-000-0000 (Italian) 言語サービスを無料でご利用いただくには、0-000-000-0000 までお電話ください。(Japanese) 0-000-000-0000 무료 언어 서비스를 이용하려면 0-000-000-0000 번으로 전화해 주십시오. (Korean) M̀ dyi xxxx-xx xx xx ɖò ɓě dyi mɔuń nì Xxxxx xx, xxx, xx xx̀xx xxx xx: CITY OF ANAHEIM Contract holder number: 0849828 HMO agreement effective date: January 010-000-000-0000. (Kru-Bassa) )Kurdish( .0-000-000-0000 یەرامژ ەب ەکب یدنەويەپ ،ۆت ۆب نووچێت ێبەب نامز یرازوگتەمزخ ەب نتشيەگاڕێپسەد ۆب ເພອເ ຂົ້ າໃຊົ້ ການໍບິລການພາສາໂດຍື່ໍບເສຍຄື່ າຕື່ໍ ກັ ບທື່ ານ, 2018 Product Name: HMO Underwritten by AETNA HEALTH OF CALIFORNIA INCໃຫົ້ ໂທຫາເີບ 0-000-000-0000. in the State of CALIFORNIA Welcome Thank you for choosing Aetna(Laotian) कोणत्याही शल्कालशवाय भाषा सेवा प्राप्त करण्यासाठी, 0-000-000-0000 वर फोन करा. This is your Evidence of Coverage(Marathi) Nan etal nan jikin jiban ikijen Kajin ilo an ejelok onen xxx xxx, or EOC for shortkirlok 0-000-000-0000. It is one of three documents that together describe the benefits covered by your Aetna plan(Marshallese) Pwehn alehdi sawas en lokaia kan ni sohte pweipwei, koahlih 0-000-000-0000. This EOC will tell you about your covered benefits – what they are and how you get them(Micronesian- Pohnpeian) ដ=ើម្បីទទួលបានដេវាកម្មភាសាដ=លឥតគិតថ្លៃេម្រាប់ដោកអ្ន ក េូ ម្ដៅទូរេ័ព្ទដៅកាន់ដលខ 1-888- 982-3862។ (Mon-Khmer, Cambodian) ननिःशल् क भाषा सेवा प्राप्त गनन 0-000-000-0000मा टेलिफोन गनहु ोस ्। (Nepali) Të kɔɔr yïn wɛɛ̈ r de thokic ke cïn wëu kɔr keek tënɔŋ yïn. The second document is the schedule of benefitsKe cɔl kɔc ye kɔc kuɔny ne nɔmba 1-888-982- 3862. It tells you how we share expenses for eligible health services and tells you about limits – like when your plan covers only (Nilotic-Dinka) For tilgang til kostnadsfri språktjenester, ring 0-000-000-0000. (Norwegian) Um Schprooch Services zu griege mitaus Koscht, xxxx 0-000-000-0000. (Pennsylvania Dutch) )Persian-Farsi( .ديریگب سامت0-000-000-0000 هرامش اب ،ناگيار روط ەب نابز تامدخ ەب یسرتسد یارب Aby uzyskać dostęp do bezpłatnych usług językowych proszę zadzwonoć 0-000-000-0000 (Polish) Para acessar os serviços de idiomas sem custo para você, ligue para 0-000-000-0000. (Portuguese) ਤੁਹਾਡੇ ਲਈ ਬਿਨਾਂ ਬਿਸੇ ਿੀਮਤ ਵਾਲੀਆਂ ਭਾਸ਼ਾ ਸੇਵਾਵਾਂ ਦੀ ਵਰਤੋਂ ਿਰਨ ਲਈ, 0-000-000-0000 ‘ਤੇ ਫ਼ੋਨ ਿਰੋ। (Punjabi) Pentru a certain number of visitsaccesa gratuit serviciile de limbă, apelați 0-000-000-0000. The third document is the group agreement between Aetna Health of California Inc. (“Aetna”Romanian) and your contract holder. Ask your employer if you have any questions about the group agreement. OhДля того чтобы бесплатно получить помощь переводчика, and each of these documents may have amendments or riders attached to them. They change or add to the documents they’re part of. Where to next? Flip through the table of contents or try the Let’s get started! section right after it. Let's get started! section gives you a thumbnail sketch of how your plan works. The more you understand, the more you can get out of your plan. Welcome to your Aetna plan. Some hospitals and other providers do not provide one or more of the following services that may be covered under your plan that includes:  Family planning  Contraceptive services, including emergency contraception  Sterilization, including tubal ligation at the time of labor and delivery  Infertility treatments  Abortion Call your prospective provider or refer to Let’s get started! – How to contact us for help section, if you have any questions. Table of contents Welcome Page Let's get started 6 Some notes on how we use words 6 What your plan does – providing covered benefits 6 How your plan works – starting and stopping coverage 6 How your plan works while you are covered 6 How to contact us for help 8 Your member ID card 8 Who the plan covers 9 Who is eligible 9 When you can join the plan 9 Who can be on your plan (who can be your dependents) 9 Adding new dependents 10 Special times you and your dependents can join the plan 11 Medical necessity, referral and precertification requirements 12 Medically necessary, medical necessity 12 Referrals 12 Standing referrals 12 Second opinion 12 Precertification 13 Eligible health services under your plan 14позвоните по телефону 1-888-982-

Language Assistance. TTY: 711 For To access language assistance in English services at no cost to you, call 0-000-000-0000 at no cost0000. (English) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj 0-000-000-0000 . (Serbo-Croatian) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj Para acceder a los servicios de idiomas sin costo, llame al 0-000-000-0000. (Serbo-CroatianSpanish) Fii yo on heɓu xxxxx x xx yowitii e haala Pular noddee e oo numero ɗoo 如欲使用免費語言服務，請致電 0-000-000-0000. Njodi woo fawaaki on. (Sudanic-Fulfulde0000。(Chinese) Ukihitaji usaidizi katika lugha ya Kiswahili piga simu kwa 1-800-370-4526bila malipo. (Swahili) )cairyS-nairyssA( . 0-000-000-0000 0-000-000-0000 ( ) (Telugu) สำ หรับควำมช่วยเหลือทำงดำ้ นภำษำเป็ นภำษำไทย โทร 0-000-000-0000ฟรีไม่มีค่ำใชจ้ ่ำย (Thai) Kapau ‘oku fiema’u hā tokoni ‘i he lea faka-Tonga telefoni 0-000-000-0000 ‘o ‘ikai hā tōtōngi. (Tongan) Ren áninnisin chiakú ren (Kapasen Chuuk) kopwe kékkééri 1-800-370-4526nge esapw kamé ngonuk. (Trukese-Chuukese) (Dil) çağrısı dil yardım için. Hiçbir ücret ödemeden Afin d'accéder aux services langagiers sans frais, composez le 0-000-000-0000. (TurkishFrench) Щоб отримати допомогу перекладача української мовиPara ma-access ang mga serbisyo xx xxxx nang wala kayong babayaran, зателефонуйте за безкоштовним номером tumawag sa 0-000-000-0000. (UkrainianTagalog) )udrU( 0-000-000-0000 Để được hỗ trợ xxxx xxx̃ bằng (xxxx xxx̃), hãy gọi miễn phí đến số 0-000-000-0000. (VietnameseNavajo) )Yiddish( Um auf für Sie kostenlose Sprachdienstleistungen zuzugreifen, rufen Sie 0-000-000-0000 Fún ìrànlọwọ xxxx xxx an. (YorùbáGerman) pe Për shërbime përkthimi falas për ju, telefononi 0-000-000-0000. (Albanian) የቋንቋ አገልግሎቶችን ያለክፍያ ለማግኘት፣ በ 0-000-000-0000 lái san owó kankan ráráይደውሉ፡፡ (Amharic) )Arabic( .0-000-000-0000 مقرلا ىلع لاصتلاا ءاجرلا ،ةفلكت يأ نود ةيوغللا تامدخلا ىلع لوصحلل Անվճար լեզվական ծառայություններից օգտվելու համար զանգահարեք 0-000-000-0000 հեռախոսահամարով: (Armenian) Kugira uronke serivisi z’indimi atakiguzi, hamagara 0-000-000-0000 (Bantu) আপনাকে বিনামকূ যে ভাষা পবিকষিা পপকে হকয এই নম্বকি পেবযক ান েরুন: 0-000-000-0000। (Bengali) Ngadto maakses ang mga serbisyo sa pinulongan alang libre, tawagan sa 0-000-000-0000. (YorubaBisayan- Visayan) ‌ Health Maintenance Organization 0-000-000-0000 Per accedir a serveis lingüístics sense cap cost per vostè, telefoni al 0-000-000-0000. (HMOCatalan) Evidence of Coverage Prepared exclusively for Contract holderPara un hago' i setbision lengguåhi ni dibåtde para hågu, ågang 0-000-000-0000. (Chamorro) ᏩᎩᏍᏗ ᏚᏬᏂᎯᏍᏗ ᎤᏳᎾᏓᏛᏁᏗ Ꮭ ᎪᎱᏍᏗ ᏗᏣᎬᏩᎳᏁᏗ ᏱᎩ, ᏫᎨᎯᏏᎳᏛᏏ 0-000-000-0000. (Cherokee) Anumpa tohsholi I toksvli ya xxx xxxxx ho ish I paya hinla, I paya 0-000-000-0000. (Choctaw) Tajaajiiloota afaanii garuu bilisaa ati argaachuuf,bilbili 0-000-000-0000. (Cushite-Oromo) Voor gratis toegang tot taaldiensten, xxxx 0-000-000-0000. (Dutch) Pou jwenn sèvis lang gratis, rele 0-000-000-0000. (French Creole-Haitian) Για να επικοινωνήσετε χωρίς χρέωση με το κέντρο υποστήριξης πελατών στη γλώσσα σας, τηλεφωνήστε στον αριθμό 0-000-000-0000. (Greek) તમારે કોઇ જાતના ખર્ચ વિના ભાષાની સેિાઓની પહોર્ માટે, કોલ કરો 0-000-000-0000. (Gujarati) No ka walaʻau ʻxxx me xx xxxxxxxx ʻōlelo e kahea aku i kēia helu kelepona 0-000-000-0000. Kāki ʻole ʻia kēia kōkua nei. (Hawaiian) आपके लिए बिना ककसी कीमत के भाषा सेवाओं का उपयोग करने के लिए, 0-000-000-0000 पर कॉि करें। (Hindi) Xav tau kev pab txhais lus tsis muaj nqi them xxx koj, hu 0-000-000-0000. (Hmong) Iji nwetaòhèrè na ọrụ gasị asụsụ n'efu, kpọọ 0-000-000-0000. (Ibo) Tapno maaksesyo dagiti serbisio maipapan iti pagsasao xxx xxxx ti bayadanyo, tawagan ti 1-888-982- 3862. (Ilocano) Untuk mengakses layanan bahasa tanpa dikenakan biaya, hubungi 0-000-000-0000. (Indonesian) Per accedere ai servizi linguistici, senza alcun costo per lei, chiami il numero 0-000-000-0000 (Italian) 言語サービスを無料でご利用いただくには、0-000-000-0000 までお電話ください。(Japanese) 0-000-000-0000 무료 언어 서비스를 이용하려면 0-000-000-0000 번으로 전화해 주십시오. (Korean) M̀ dyi xxxx-xx xx xx ɖò ɓě dyi mɔuń nì Xxxxx xx, xxx, xx xx̀xx xxx xx: CITY OF ANAHEIM Contract holder number: 0849828 HMO agreement effective date: January 010-000-000-0000. (Kru-Bassa) )Kurdish( .0-000-000-0000 یەرامژ ەب ەکب یدنەويەپ ،ۆت ۆب نووچێت ێبەب نامز یرازوگتەمزخ ەب نتشيەگاڕێپسەد ۆب ເພື່ ອເ ຂົ້ າໃຊົ້ ການໍບິລການພາສາໂດຍື່ໍບເສຍຄື່ າຕ ກັ ບທື່ ານ, 2018 Product Name: HMO Underwritten by AETNA HEALTH OF CALIFORNIA INCໃຫົ້ ໂທຫາເີບ 0-000-000-0000. in the State of CALIFORNIA Welcome Thank you for choosing Aetna(Laotian) कोणत्याही शल्कालशवाय भाषा सेवा प्राप्त करण्यासाठी, 0-000-000-0000 वर फोन करा. This is your Evidence of Coverage(Marathi) Nan etal nan jikin jiban ikijen Kajin ilo an ejelok onen xxx xxx, or EOC for shortkirlok 0-000-000-0000. It is one of three documents that together describe the benefits covered by your Aetna plan(Marshallese) Pwehn alehdi sawas en lokaia kan ni sohte pweipwei, koahlih 0-000-000-0000. This EOC will tell you about your covered benefits – what they are and how you get them(Micronesian- Pohnpeian) ដ ើម្បីទទួលបានដេវាកម្មភាសាដ លឥតគិតថ្លៃេម្រាប់ដោកអ្ន ក េូ ម្ដៅទូរេ័ព្ទដៅកាន់ដលខ 1-888- 982-3862។ (Mon-Khmer, Cambodian) ननिःशल् क भाषा सेवा प्राप्त गनन 0-000-000-0000मा टेलिफोन गनहु ोस ्। (Nepali) Të kɔɔr yïn wɛɛ̈ r de thokic ke cïn wëu kɔr keek tënɔŋ yïn. The second document is the schedule of benefitsKe cɔl kɔc ye kɔc kuɔny ne nɔmba 1-888-982- 3862. It tells you how we share expenses for eligible health services and tells you about limits – like when your plan covers only (Nilotic-Dinka) For tilgang til kostnadsfri språktjenester, ring 0-000-000-0000. (Norwegian) Um Schprooch Services zu griege mitaus Koscht, xxxx 0-000-000-0000. (Pennsylvania Dutch) )Persian-Farsi( .ديریگب سامت0-000-000-0000 هرامش اب ،ناگيار روط ەب نابز تامدخ ەب یسرتسد یارب Aby uzyskać dostęp do bezpłatnych usług językowych proszę zadzwonoć 0-000-000-0000 (Polish) Para acessar os serviços de idiomas sem custo para você, ligue para 0-000-000-0000. (Portuguese) ਤੁਹਾਡੇ ਲਈ ਬਿਨਾਂ ਬਿਸੇ ਿੀਮਤ ਵਾਲੀਆਂ ਭਾਸ਼ਾ ਸੇਵਾਵਾਂ ਦੀ ਵਰਤੋਂ ਿਰਨ ਲਈ, 0-000-000-0000 ‘ਤੇ ਫ਼ੋਨ ਿਰੋ। (Punjabi) Pentru a certain number of visitsaccesa gratuit serviciile de limbă, apelați 0-000-000-0000. The third document is the group agreement between Aetna Health of California Inc. (“Aetna”Romanian) and your contract holder. Ask your employer if you have any questions about the group agreement. OhДля того чтобы бесплатно получить помощь переводчика, and each of these documents may have amendments or riders attached to them. They change or add to the documents they’re part of. Where to next? Flip through the table of contents or try the Let’s get started! section right after it. Let's get started! section gives you a thumbnail sketch of how your plan works. The more you understand, the more you can get out of your plan. Welcome to your Aetna plan. Some hospitals and other providers do not provide one or more of the following services that may be covered under your plan that includes:  Family planning  Contraceptive services, including emergency contraception  Sterilization, including tubal ligation at the time of labor and delivery  Infertility treatments  Abortion Call your prospective provider or refer to Let’s get started! – How to contact us for help section, if you have any questions. Table of contents Welcome Page Let's get started 6 Some notes on how we use words 6 What your plan does – providing covered benefits 6 How your plan works – starting and stopping coverage 6 How your plan works while you are covered 6 How to contact us for help 8 Your member ID card 8 Who the plan covers 9 Who is eligible 9 When you can join the plan 9 Who can be on your plan (who can be your dependents) 9 Adding new dependents 10 Special times you and your dependents can join the plan 11 Medical necessity, referral and precertification requirements 12 Medically necessary, medical necessity 12 Referrals 12 Standing referrals 12 Second opinion 12 Precertification 13 Eligible health services under your plan 14позвоните по телефону 1-888-982-