NONDISCRIMINATION NOTICE Blue Cross Blue Shield of Massachusetts complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity. It does not exclude people or treat them differently because of race, color, national origin, age, disability, sex, sexual orientation, or gender identity. If you believe that Blue Cross Blue Shield of Massachusetts has failed to provide Blue Cross Blue Shield these services or discriminated in another way on the basis of race, color, national of Massachusetts provides: origin, age, disability, sex, sexual orientation, • Free aids and services to people with or gender identity, you can 昀椀le a grievance disabilities to communicate effectively with the Civil Rights Coordinator by mail at Civil Rights Coordinator, Blue Cross with us, such as quali昀椀ed sign language Blue Shield of Massachusetts, interpreters and written information in other One Enterprise Drive, Quincy, MA 02171-2126; formats (large print or other formats). phone at 1-800-472-2689 (TTY: 711); • Free language services to people whose fax at 1-617-246-3616; or email at primary language is not English, such as [email protected]. quali昀椀ed interpreters and information written in other languages. If you need help 昀椀ling a grievance, the Civil Rights Coordinator is available to help you. If you need these services, call Member Service You can also 昀椀le a civil rights complaint at the number on your ID card. with the U.S. Department of Health and Human Services, Of昀椀ce for Civil Rights, online at ocrportal.hhs.gov; by mail at U.S. Department of Health and Human Services, 200 Independence Avenue, SW Room 509F, HHH Building, Washington, DC 20201; by phone at 1-800-368-1019 or 1-800-537-7697 (TDD). Complaint forms are available at hhs.gov. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross and Blue Shield Association. © 2024 Blue Cross and Blue Shield of Massachusetts, Inc., or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. 001651238 55-1487 (3/24)