Nondiscrimination statement
Discrimination is against the law. Liberty Dental Plan (“Liberty”) follows State and Federal civil rights laws. Liberty does not unlawfully discriminate, exclude people, or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation.
Liberty provides free aids and services to people with disabilities, and free language services to people whose primary language is not English, such as:
Qualified interpreters, including sign language interpreters
Written information in other languages and formats, including large print, audio, accessible electronic formats, etc.
If you need these services, please contact us between 8 a.m. to 5 p.m. PT by calling (888) 700-1093. Or, if you cannot hear or speak well, please call 877-855-8039.
How to file a grievance
If you believe that Liberty has failed to provide these services or unlawfully discriminated in another way on the basis of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation, you can file a grievance with Liberty’s Civil Rights Coordinator. You can file a grievance by phone, in writing, in person, or electronically:
By phone
Contact Liberty’s Civil Rights Coordinator, Monday through Friday, 8 a.m to 5 p.m PT by calling 888-700-1093. Or if you cannot hear or speak well, please call 877-855-8039.
In writing
Fill out a complaint form or write a letter and send it to: P.O. Box 26110, Santa Ana, CA 92799
In person
Visit your doctor’s office and say you want to file a grievance.
Electronically
Visit Liberty’s website at https://libertydentalplan-qa-dev.azurewebsites.net.
Office of Civil Rights – U.S. Department of Health and Human Services
If you believe you have been discriminated against on the basis of race, color, national origin, age, disability or sex, you can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights by phone, in writing, or electronically:
By phone
Call 800-368-1019. If you cannot speak or hear well, please call TTY/TDD 800-537-7697.
In writing
Fill out a complaint form or send a letter to:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
Electronically
Visit the Office for Civil Rights Complaint Portal here.