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إن كان لديك أو لدى شخص تساعده أسئلة بخصوص Delta Dental of Iowa، فلديك الحق في الحصول على المساعدة والمعلومات الضرورية بلغتك من دون أية تكلفة. للتحدث

.1-877-423-3582 x3 مع مترجم اتصل بـ

Chinese – 如果您，或是您正在協助的對象，有關於 Delta Dental of Iowa 方面的問題，您有權利免費以您的母語得到幫助和訊息。洽詢一位翻譯員，請致電 1-877-423-3582 x3

French – Si vous, ou quelqu’un que vous êtes en train d’aider, a des questions à propos de Delta Dental of Iowa, vous avez le droit d’obtenir de l’aide et l’information dans votre langue à aucun coût. Pour parler à un interprète, appelez 1-877-423-3582 x3.

German – Falls Sie oder jemand, dem Sie helfen, Fragen zum Delta Dental of Iowa haben, haben Sie das Recht, kostenlose Hilfe und Informationen in Ihrer Sprache zu erhalten. Um mit einem Dolmetscher zu sprechen, rufen Sie bitte die Nummer 1-877-423-3582 x3 an.

Hindi – यदि आपके, या आप द्ारा सहायता ककए जा रहे ककसी वयक्ति के Delta Dental of Iowa के बारे में प्रश्न हैं, तो आपके पास अपनी भाषा में मुफत में सहायता और सूचना प्राप्त करने का अधिकार है। ककसी िभुाषषए से बात करने के लिए 1-877-423-3582 x3 पर कॉि करें।

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Korean – 만약 귀하 또는 귀하가 돕고 있는 어떤 사람이 Delta Dental of Iowa에 관해서 질문이 있다면 귀하는 그러한 도움과 정보를 귀하의 언어로 비용 부담 없이 얻을 수 있는 권리가 있습니다. 그렇게 통역사와 얘기하기 위해서는 1-877-423-3582 x3로 전화하십시오.

Laotian – ຖ້າທ່ານ ຫຼື ຄົນທີ່ ທ່ານກໍາລັງຊ່ວຍເຫຼື ອ ມີ ຄໍ າຖາມກ່ຽວກັບDelta Dental of Iowa, ທ່ານມີ ສິ ດທີ່ ຈະໄດ້ຮັບການຊ່ວຍເຫຼື ອແລະຂໍ ້ ມູນຂ່າວສານທີ່ ເປັນພາສາຂອງທ່ານບໍ່ ມີ ຄ່າໃຊ້ຈ່າຍ. ເພ່ືອໂອ້ລົມກັບນາຍພາສາ,ໃຫ້ໂທຫາ 1-877-423-3582 x3.

Arabic – Pennsylvania Dutch: Wann du hoscht en Froog, odder ebber, wu du helfscht, hot en Froog baut Delta Dental of Iowa, hoscht du es Recht fer Hilf un Information in deinre eegne Schprooch griege, un die Hilf koschtet nix. Wann du mit me Interpreter schwetze witt, kannscht du 1-877-423-3582 x3 uffrufe.

Russian – Если у вас или лица, которому вы помогаете, имеются вопросы по поводу Delta Dental of Iowa, то вы имеете право на бесплатное получение помощи и информации на вашем языке. Для разговора с переводчиком позвоните по телефону 1-877-423-3582 x3.

Serbo-Croatian – Ukoliko Vi ili neko kome Vi pomažete ima pitanje o Delta Dental of Iowa, imate pravo da besplatno dobijete pomoć i informacije na Vašem jeziku. Da biste razgovarali sa prevodiocem, nazovite 1-877-423-3582 x3.

Spanish – Si usted, o alguien a quien usted está ayudando, tiene preguntas acerca de Delta Dental of Iowa, tiene derecho a obtener ayuda e información en su idioma sin costo alguno. Para hablar con un intérprete, llame al 1-877-423-3582 x3.

Tagalog – Kung ikaw, o ang iyong tinutulungan, ay may mga katanungan tungkol sa Delta Dental of Iowa, may karapatan ka na makakuha ng tulong at impormasyon sa iyong wika ng walang gastos. Upang makausap ang isang tagasalin, tumawag sa 1-877-423-3582 x3.

Thai – หากคณุ หรอืคนที่คณุก�าลังช่วยเหลือมีค�าถามเกี่ยวกับ Delta Dental of Iowa คณุมีสิทธิที่จะไดร้บัความช่วยเหลือและข้อมูลในภาษาของคณุได้ โดยไม่มีคา่ใช้จ่าย พูดคยุกับล่าม โทร 1-877-423-3582 x3

Vietnamese – Nếu quý vị, hay người mà quý vị đang giúp đỡ, có câu hỏi về Delta Dental of Iowa, quý vị sẽ có quyền được giúp và có thêm thông tin bằng ngôn ngữ của mình miễn phí. Để nói chuyện với một thông dịch viên, xin gọi 1-877-423-3582 x3.

Required Federal Notice-Nondiscrimination and AccessibilityDelta Dental of Iowa complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. To review our full nondiscrimination notice go to www.deltadentalia.com/nondiscrimination.

Delta Dental of Iowa provides free language services to people whose primary language is not English. In addition, Delta Dental provides free services for people with disabilities such as auxiliary aids, written communication in other formats such as large print, audio or other formats. If you need these services, call 1-877-423-3582 x3, hearing impaired (TYY) call 1-888-287-7312.

Language Access Service

If you, or someone you’re helping, has questions about Delta Dental of Iowa, you have the right to get help and information in your language at no cost. To talk to an interpreter, call 1-877-423-3582 x3.

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يحوي هذا االشعار معلومات هامة. يحوي هذا االشعار معلومات مهمة بخصوص طلبك للحصول على التغطية من خالل Delta Dental of Iowa. ابحث عن التواريخ الهامة في هذا االشعار. قد تحتاج

التخاذ اجراء في تواريخ معينة للحفاظ على تغطيتك الصحية أو للمساعدة في دفع التكاليف. لك الحق .1-888- الوحصل لعا ىلمعولمتا اولعاسمدة بغلتك من كت أي نوـلدب لصتا .ةف يف 337-5159

Chinese – 本通知有重要的訊息。本通知有關於您透過 Delta Dental of Iowa 提交的申請或保險的重要訊息。請留意本通知內的重要日期。您可能需要在截止日期之前採取行動，以保留您的健康保險或者費用補貼。您有權利免費以您的母語得到本訊息和幫助。請撥電話字 1-888-337-5159。

French – Cet avis contient des informations importantes. Cet avis contient des informations importantes concernant votre demande ou la couverture offerte par Delta Dental of Iowa. Prenez note des dates butoirs indiquées dans le présent avis. Vous devrez peut-être effectuer certaines démarches dans les délais prévus pour conserver votre couverture santé ou l’aide financière à laquelle vous pouvez prétendre. Vous avez le droit d’obtenir ces informations et de recevoir de l’aide dans votre langue gratuitement. Appelez le 1-888-337-5159.

German – Diese Benachrichtigung enthält wichtige Informationen. Diese Benachrichtigung enthält wichtige Informationen bezüglich Ihres Antrags auf Krankenversicherungsschutz durch Delta Dental of Iowa. Suchen Sie nach wichtigen Terminen in dieser Benachrichtigung. Sie könnten bis zu bestimmten Stichtagen handeln müssen, um Ihren Krankenversicherungsschutz oder Hilfe mit den Kosten zu behalten. Sie haben das Recht, kostenlose Hilfe und Informationen in Ihrer Sprache zu erhalten. Rufen Sie an unter 1-888-337-5159.

Hindi – इस नोटिस में महत्वपूर्ण जानकारी है। इस नोटिस में आपके आवेदन या Delta Dental of Iowa के माधयम से बीमे के बारे में महतवपूर्ण जानकारी शाममल है। इस नोटिस में मुखय तारीखें देखें। अपना सवास्थय बीमा बनाए रखने या लागतों में मदद के मलए आपको कु छ ननश्चित समय-सीमाओं तक कार्णवाई करने की ज़रूरत हो सकती है। आपको कोई कीमत टदए बबना यह जानकारी और सहायता अपनी भाषा में प 1-888-337-5159 पर कॉल करें।

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Korean – 본 통지서에는 중요한 정보가 들어 있습니다. 즉 이 통지서는 귀하의 신청에 관하여 그리고 Delta Dental of Iowa을 통한 커버리지에 관한 정보를 포함하고 있습니다. 본 통지서에서 핵심이 되는 날짜들을 찾으십시오. 귀하는 귀하의 건강 커버리지를 계속 유지하거나 비용을 절감하기 위해서 일정한 마감일까지 조치를 취해야 할 필요가 있을 수 있습니다. 귀하는 이러한 정보와 도움을 귀하의 언어로 비용 부담 없이 얻을 수 있는 권리가 있습니다. 1-888-899-3747로 전화하십시오.

Laotian – ແຈ້ ງການສະບັ ບີນ້ ີມໍຂ້ ູມ ນໍສາຄັ ນ. ແຈ້ ງການສະບັ ບີນ້ ີມໍຂ້ ູມ ່ນີທໍສາຄັນກ່ ຽວກັ ການສະໝັ ກ ຫື ຼ ການຄຸ້ ມຄອງ ງທ່ ານໂດຍຜ່ ານ Delta Dental of Iowa. ່ເິບ ໍງກາ ົນດການໃນແຈ້ ງການສະບັ ບີນ້ , ເບ່ິ ໍງກາ ົນດການໃນແຈ້ ງການສະບັ ບີ ້ນ

ຍກໍ ານົ ດເວລາທ່ີ ແນ່ ນອນ ເພື່ ອຮັ ກສາການຄຸ້ ມຄອງສຸ ຂະພາບຂອງທ່ ານຫື ຼ ການຊ

່ ວ ຍເຫື ີ່ຼອທີມ ່ຄາໃຊ້ ່ຈາຍ. ທ ່ານມີ ິສ ່ີດທຈະໄດ້ ັຮ ໍບຂ ູ້ມນຂ່ າວສານນີ ້ ແລະການຊ່ ວຍເຫືຼ ອໃ ນພາສາຂອງທ່ ານໂດຍບ່ໍ ີມ ່ຄາໃຊ້ ່ຈາຍ. ໂທ 1-888-337-5159.

Arabic – Pennsylvania Dutch – Die Bekanntmaching gebt wichdichi Auskunft. Die Bekanntmaching gebt wichdichi Auskunft baut dei Application oder Coverage mit Delta Dental of Iowa. Geb Acht fer wichdiche Daadem in die Bekanntmachung. Es iss meeglich, ass du ebbes duh muscht, an beschtimmde Deadlines, so ass du dei Health Coverage bhalde kannscht, odder bezaahle helfe kannscht. Du hoscht es Recht fer die Information un Hilf in deinre eegne Schprooch griege, un die Hilf koschtet nix. Ruf yuscht selli Nummer uff: 1-888-337-5159.

Russian – Настоящее уведомление содержит важную информацию. Это уведомление содержит важную информацию о вашем заявлении или страховом покрытии через Delta Dental of Iowa. Посмотрите на ключевые даты в настоящем уведомлении. Вам, возможно, потребуется принять меры до определенного срока для сохранения страхового покрытия или помощи с расходами. Вы имеете право на бесплатное получение этой информации и помощь на вашем языке. Звоните по телефону 1-888-337-5159.

Bosnian/Croatian – U ovom obavještenju su sadržane važne informacije. U ovom obavještenju su sadržane važne informacije o Vašoj prijavi ili osiguranju preko Delta Dental of Iowa. Pogledajte nalaze li se u ovom obavještenju neki ključni datumi. Možda ćete morati poduzeti određenje radnje u datom roku kako biste i dalje zadržali svoje osiguranje ili pomoć pri plaćanju. Imate pravo da ove informacije, kao i pomoć, dobijete besplatno na svom jeziku. Nazovite 1-888-337-5159.

Spanish – Este Aviso contiene información importante. Este aviso contiene información importante acerca de su solicitud o cobertura a través de Delta Dental of Iowa. Preste atención a las fechas clave que contiene este aviso. Es posible que deba tomar alguna medida antes de determinadas fechas para mantener su cobertura médica o ayuda con los costos. Usted tiene derecho a recibir esta información y ayuda en su idioma sin costo alguno. Llame al 1-888-337-5159.

Tagalog – Ang Paunawa na ito ay naglalaman ng mahalagang impormasyon. Ang paunawa na ito ay naglalaman ng mahalagang impormasyon tungkol sa iyong aplikasyon o pagsakop sa pamamagitan ng Delta Dental of Iowa. Tingnan ang mga mahalagang petsa dito sa paunawa. Maaaring mangailangan ka na magsagawa ng hakbang sa ilang mga itinakdang panahon upang mapanatili ang iyong pagsakop sa kalusugan o tulong na walang gastos. May karapatan ka na makakuha ng ganitong impormasyon at tulong sa iyong wika ng walang gastos. Tumawag sa 1-888-337-5159.

Thai – ประกาศน้ีมีข้อมูลส�าคญั ประกาศน้ีมีข้อมูลที่ส�าคญัเกี่ยวกับการการสมัคร หรอืขอบเขตประกันสุขภาพของคณุผ่าน Delta Dental of Iowa ดกู�าหนดการ ในประกาศน้ี คณุอาจจะตอ้งด�าเนินการภายในก�าหนดระยะเวลาที่แน่นอนเพื่อ จะรักษาการประกันสุขภาพของคุณหรือการช่วยเหลือที่มีค่าใช้จ่าย คุณมีสิทธิ ที่จะได้รับข้อมูลและความช่วยเหลือนี้ในภาษาของคุณโดยไม่มีค่าใช้จ่าย โทร 1-888-337-5159.

Vietnamese – Thông báo này cung cấp thông tin quan trọng. Thông báo này có thông tin quan trọng bàn về đơn nộp hoặc hợp đồng bảo hiểm qua chương trình Delta Dental of Iowa. Xin xem ngày then chốt trong thông báo này. Quý vị có thể phải thực hiện theo thông báo đúng trong thời hạn để duy trì bảo hiểm sức khỏe hoặc được trợ trúp thêm về chi phí. Quý vị có quyền được biết thông tin này và được trợ giúp bằng ngôn ngữ của mình miễn phí. Xin gọi số 1-888-337-5159.

Required Federal Notice-Nondiscrimination and AccessibilityDelta Dental of Iowa complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. To review our full nondiscrimination notice go to www.deltadentalia.com/nondiscrimination.

Delta Dental of Iowa provides free language services to people whose primary language is not English. In addition, Delta Dental provides free services for people with disabilities such as auxiliary aids, written communication in other formats such as large print, audio or other formats. If you need these services, call 1-888-337-5159, hearing impaired (TYY) call 1-888-287-7312.

Language Access Service

This Notice has Important Information. This notice has important information about your application or coverage through Delta Dental of Iowa. Look for key dates in this notice. You may need to take action by certain deadlines to keep your health coverage or help with costs. You have the right to get this information and help in your language at no cost. Call 1-888-337-5159.

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Benefit Frequencies are determined by calendar year. Benefit Allowances provide no remaining balance for future use within the same Benefit Frequency.

See the SERVICES NOT COVERED and NOTIFICATION/DOCUMENTATION REQUIREMENTS sections of this Policy for additional information.

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Have you heard?

1 I N 9 AM ER I C AN S HA S H E AR I N G LOS S . 1

Did you know there’s a connection between hearing and vision loss?2 In fact, mature adults and diabetics are likely to experience both sensory impairments.3

9 5% O F H E AR I N G LOS S C AN B E TR E ATED WITH H E AR I N G A I DS . 2

And because we care about your total health and wellness, your DeltaVision® plan includes access to affordable hearing care discounts through Amplifon - the world’s largest distributor of hearing aids and services.

YO U R H E AR I N G D ISCO U NT TH RO U G H AM PLI FO N I N C LU D E S:

• 40% off hearing exams at thousands of convenient locationsnationwide

• Discounted, set pricing on thousands of hearing aids, includingthose with the newest, most advanced technology

• Low price guarantee - if you find the same product at a lowerprice elsewhere, Amplifon will beat it by 5%

• 60-day hearing aid trial period with no restocking fees

• Free batteries for 2 years with initial purchase

• 3-year warranty plus loss and damage coverage

Call 1-844-526-5432 to find a hearing care provider near you and schedule a hearing exam today. You can also visit www.deltadentalia.com/fb to learn more.

PDF-1610-R-644

1 AmplifonUSA.com/hearing-loss-information2 Association Between Vision and Hearing Impairments and their Combined Effects on Quality of Life, October 1, 2006, Vol 124, No. 10, http://archopht.jamanetwork.com/article.aspx?articleid=418658 3 Health Day, U.S. News: http://health.usnews.com/heath-news/news/articles/2012/11/16/hearing-loss-tied-to-diabetes-in-study

H E A R I N G D I S CO U N T

DeltaVision is underwritten by Veratrus Benefit Solutions, Inc.,a wholly owned subsidiary of Delta Dental of Iowa, utilizing the EyeMed Vision Care Insight network.

fb-dental-vision-cert.pdffarm bureau py2020 delta dental_final workingDeltaVision Preferred 10_10 201704-09122018-clean update 10_1_19

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