Additional notices and information regarding your coverage and benefits:

• Grievance Process and Form

• Affirmative Statement

• Language Assistance Notice

• Rights & Responsibilities

• Annual Member Notice

• Continuity of Care

• Independent Medical Review

• Authorization Process

• Non-Discrimination Notice

• Privacy Practices

• Communicating Confidential Medical Information

• Deductible and Out-of-Pocket Accrual Balance Report Notice