english language assistance services - · pdf fileenglish language assistance services ....

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English Language Assistance Services
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-552-2400. UFCW & Employers Trust, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. UFCW & Employers Trust does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
UFCW & Employers Trust:
Provides free aids and services to people with disabilities to communicate effectively with us, such as:
o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats,
other formats)
Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages
If you need these services, contact the Compliance Supervisor.
If you believe that UFCW & Employers Trust has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
UFCW & Employers Trust Attn: Compliance Supervisor P.O. Box 4100 Concord, CA 94524-4100
1-800-552-2400 Fax: 925-746-7549 [email protected]
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Compliance Supervisor is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
https://ocrportal.hhs.gov/ocr/portal/lobby.jsfhttp://www.hhs.gov/ocr/office/file/index.html

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Espaol (Spanish)
ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Llame al 1-800-552-2400. UFCW & Employers Trust, LLC cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. UFCW & Employers Trust no excluye a las personas ni las trata de forma diferente debido a su origen tnico, color, nacionalidad, edad, discapacidad o sexo.
Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que se comuniquen de manera eficaz con nosotros, como los siguientes:
o Intrpretes de lenguaje de seas capacitados. o Informacin escrita en otros formatos (letra grande, audio, formatos electrnicos accesibles,
otros formatos).
Proporciona servicios lingsticos gratuitos a personas cuya lengua materna no es el ingls, como los siguientes:
o Intrpretes capacitados. o Informacin escrita en otros idiomas.
Si necesita recibir estos servicios, comunquese con [Name of Civil Rights Coordinator].
Si considera que UFCW & Employers Trust no le proporcion estos servicios o lo discrimin de otra manera por motivos de origen tnico, color, nacionalidad, edad, discapacidad o sexo, puede presentar un reclamo a la siguiente persona:
Puede presentar el reclamo en persona o por correo postal, fax o correo electrnico. Si necesita ayuda para hacerlo, Compliance Supervisor, est a su disposicin para brindrsela.
Tambin puede presentar un reclamo de derechos civiles ante la Office for Civil Rights (Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de Salud y Servicios Humanos) de EE. UU. de manera electrnica a travs de Office for Civil Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por correo postal a la siguiente direccin o por telfono a los nmeros que figuran a continuacin:
1-800-368-1019, 800-537-7697 (TDD)
Puede obtener los formularios de reclamo en el sitio web http://www.hhs.gov/ocr/office/file/index.html.

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(Chinese)
1-800-552-2400. UFCW & Employers Trust, LLC UFCW & Employers Trust
o o
o o
Compliance Supervisor.
UFCW & Employers Trust
Compliance Supervisor
U.S. Department of Health and Human Services Office for Civil Rights Office for Civil Rights Complaint Portal https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
1-800-368-1019800-537-7697 (TDD)
http://www.hhs.gov/ocr/office/file/index.html

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Ting Vit (Vietnamese)
CH : Nu bn ni Ting Vit, c cc dch v h tr ngn ng min ph dnh cho bn. Gi s 1-800-999-1999. UFCW & Employers Trust, LLC tun th lut dn quyn hin hnh ca Lin bang v khng phn bit i x da trn chng tc, mu da, ngun gc quc gia, tui, khuyt tt, hoc gii tnh. UFCW & Employers Trust khng loi tr mi ngi hoc i x vi h khc bit v chng tc, mu da, ngun gc quc gia, tui, khuyt tt, hoc gii tnh.
Cung cp dch v h tr min ph cho nhng ngi khuyt tt giao tip vi chng ti c hiu qu, nh:
o Thng dch vin ngn ng k hiu nng lc o Thng tin bng vn bn cc nh dng khc (ch in ln, m thanh, nh dng in t c th
tip cn, cc nh dng khc)
Cung cp min ph cc dch v ngn ng cho nhng ngi c ngn ng chnh khng phi l ting Anh, nh:
o Thng dch vin nng lc o Thng tin c trnh by bng ngn ng khc
Nu bn cn nhng dch v ny, hy lin h Compliance Supervisor.
Nu bn tin rng UFCW & Employers Trust khng cung cp nhng dch v ny hoc phn bit i x theo cch khc da trn chng tc, mu da, ngun gc quc gia, tui, khuyt tt, hoc gii tnh, bn c th np n khiu ni vi:
Bn c th trc tip np n khiu ni hoc gi qua ng bu in, chuyn fax, hoc email. Nu bn cn tr gip np n khiu ni, Compliance Supervisor sn sng gip bn.
Bn cng c th np n khiu ni v dn quyn ln U.S. Department of Health and Human Services (B Y T v Dch V Nhn Sinh Hoa K), Office for Civil Rights (Vn Phng Dn Quyn) bng hnh thc in t qua Office for Civil Rights Complaint Portal, c trn trang https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, hoc qua ng bu in hoc bng in thoi ti:
1-800-368-1019, 800-537-7697 (TDD)
Cc mu khiu ni c trn trang http://www.hhs.gov/ocr/office/file/index.html.

5
(Korean)
: , . 1-800-999-1999 . UFCW & Employers Trust, LLC () , , , , . UFCW & Employers Trust () , , , , .
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o o ( , , , )
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the Compliance Supervisor .
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1-800-368-1019, 800-537-7697 (TDD)
http://www.hhs.gov/ocr/office/file/index.html .

6
Tagalog
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-800-552-2400. Sumusunod ang UFCW & Employers Trust, LLC sa mga naaangkop na Pampederal na batas sa karapatang sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian. Ang UFCW & Employers Trust ay hindi nagtatangi ng mga tao o hindi nagpapakita ng ibang pakikitungo dahil sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian. Ang UFCW & Employers Trust ay:
Nagbibigay ng mga libreng tulong at serbisyo sa mga taong may kapansanan upang mahusay silang makipag-ugnayan sa amin, gaya ng:
o Mga kwalipikadong interpreter ng sign language o Nakasulat na impormasyon sa iba pang mga format (malaking print, audio, mga naa-access na
electronic na format, iba pang mga format)
Nagbibigay ng mga

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