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Transcription:

Manhattan Hospitals Yale-New Haven Lenox Hill Lenox Health Greenwich Village Harlem Manhattan Eye, Ear & Throat Bellevue Metropolitan Montefiore Medical Centers Phelps Memorial Northern Westchester White Plains Greenwich Bridgeport North Central Bronx Lincoln Jacobi Glen Cove Syosset North Shore University Zucker Hillside Plainview Elmhurst LIJ Medical Center Cohen Children s LIJ Forest Nassau University Hills Queens Medical Center Woodhull Wyckoff Heights South Oaks Kings County LIJ Valley Stream Staten Island Maimonides University (North) Coney Island Huntington Southside Peconic Bay Medical Center Hospitals Staten Island University (South) For a searchable list of CareConnect s providers, visit CareConnect.com/providersearch Bellevue Hospital Center, 462 First Avenue, New York, NY 10016, P: 212-562-5555 Bridgeport Hospital, 267 Grant St, Bridgeport, CT 06610, P: 203-688-8412 Bridgeport Hospital, 226 Mill Hill Avenue, Bridgeport, CT 06610, P: 203-384-3235 Bridgeport Hospital, 1305 Post Road, Suite 105, Fairfield, CT 06824, P: 203-336-7305 Bridgeport Hospital, 95 Armory Road, Stratford, CT 06614, P: 203-384-3388 Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY 11235, P: 718 616-3000 Elmhurst Hospital Center, 79-01 Broadway, Elmhurst, NY, 11373, P: 718-334-4000 Glen Cove Hospital, 101 St. Andrews Lane, Glen Cove, NY 11542, P: 516-674-7540 Greenwich Hospital, 5 Perryridge Road, Greenwich, CT 06830, P: 203-688-8412 Harlem Hospital Center, 506 Lenox Avenue, New York, NY 10037, P: 212-939-1000 Huntington Hospital, 270 Park Avenue, Huntington, NY 11743, P: 631-351-2000 Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY 10461, P: 718-918-5000 Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, P: 718-245-3131 Lenox Health Greenwich Village, 30 Seventh Avenue, New York, NY 10011, P: 646-665-6000 Lenox Hill Hospital, 100 East 77th Street, New York, NY 10021, P: 212-434-2000 Lincoln Medical & Mental Health Center, 234 East 149th Street, Bronx, NY 10451, P: 718-579-5000 Long Island Jewish (LIJ) Forest Hills, 102-01 66th Road, Forest Hills, NY 11375, P: 718-830-4000 Long Island Jewish (LIJ) Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040, P: 718-470-7000 Long Island Jewish (LIJ) Valley Stream, 900 Franklin Avenue, Valley Stream, NY 11580, P: 516-256-6000 Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, P: 718-283-6000 Manhattan Eye, Ear & Throat Hospital, 210 East 64th Street, New York, NY 10021, P: 212-838-9200 Metropolitan Hospital Center, 1901 First Avenue, New York, NY 10029, P: 212-423-6262 Montefiore Medical Center - Montefiore Hospital, 111 East 210th Street, Bronx, NY 10467, P: 718-920-4321 Montefiore Medical Center - Wakefield Hospital, 600 East 233rd Street, Bronx, NY 10466, P: 718-920-9000 Montefiore Medical Center - Weiler Hospital, 1825 Eastchester Road, Bronx, NY 10461, P: 718-904-2000 Montefiore Medical Center - Westchester Square, 2475 Saint Raymonds Avenue, Bronx, NY 10461, P: 718-430-7300 Montefiore Mt. Vernon Hospital, 12 North Seventh Avenue, Mt. Vernon, NY 10550, P: 914-664-8000 Montefiore New Rochelle Hospital, 16 Guion Place, New Rochelle, NY 10801, P: 914-632-5000 Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, P: 516-572-0123

Hospitals (continued) North Central Bronx Hospital, 3424 Kossuth Avenue, Bronx, NY 10467, 718-519-5000 North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, P: 516-562-3456 Northern Westchester Hospital, 400 East Main Street, Mount Kisco, NY 10549-3417, P: 914-666-1200 Nyack Hospital, 160 North Midland Avenue, Nyack, NY 10960, P: 845-348-2000 Peconic Bay Medical Center, 1300 Roanoke Ave, Riverhead, NY 11901, P: 631-548-6000 Phelps Memorial Hospital, 701 North Broadway, Sleepy Hollow, NY 10591, P: 914-366-3000 Plainview Hospital, 888 Old Country Road, Plainview, NY 11803, P: 516-719-3000 Queens Hospital Center, 82-70 164th Street, Jamaica, NY 11432, P: 718-883-3000 South Oaks Hospital, 400 Sunrise Highway, Amityville, NY 11701, P: 631-608-5610 Southside Hospital, 301 East Main Street, Bay Shore, NY 11706, P: 631-968-3000 Staten Island University Hospital (North Site), 475 Seaview Avenue, Staten Island, NY 10305, P: 718-226-9000 Staten Island University Hospital (South Site), 375 Seguine Avenue, Staten Island, NY 10305, P: 718-226-2000 Steven & Alexandra Cohen Children s Medical Center of NY, 269-01 76th Avenue, New Hyde Park, NY 11040, P: 516-470-7000 Syosset Hospital, 221 Jericho Turnpike, Syosset, NY 11791, P: 516-496-6400 White Plains Hospital Center, 41 East Post Road, White Plains, NY 10601, P: 914-681-0600 Woodhull Medical and Mental Health Center, 760 Broadway, Brooklyn, NY 11206, P: 718-963-8000 Wyckoff Heights Medical Center, 374 Stockholm Street, Brooklyn, NY 11237, P: 718-963-7272 Yale-New Haven Hospital, 20 York Street, New Haven, CT 06510, P: 203-688-4242 Yale-New Haven Hospital, 1450 Chapel Street, New Haven, CT 06511, P: 203-688-4242 Yale-New Haven Hospital, 1 Park Street, New Haven, CT 06510, P: 203-688-4242 Yale-New Haven Psychiatric Hospital, 184 Liverly Street, New Haven, CT 06510, P: 203-688-4242 Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY 11004, P: 516-470-7000 Imaging * Cardiac Imaging Services of Northern Westchester, 2013 Crompound Road, Mount Kisco, NY 10549-3417, P: 914-962-0200 Chappaqua Crossing, 480 Bedford Road, Mount Kisco, NY 10549, P: 914-666-1200 Northwell Health Imaging at Bay Shore, 440 East Main Street, Bayshore, NY 11706, P: 631-414-8000 Northwell Health Imaging at Garden City, 711 Stewart Avenue, Garden City, NY 11530, P: 516-321-3456 Northwell Health Imaging at Glen Cove, 10 Medical Plaza, Suite 106, Glen Cove, NY 11542, P: 516-674-0500 Northwell Health Imaging at Great Neck, 611 Northern Boulevard, Suite 250, Great Neck, NY 11021, P: 516-233-3456 Northwell Health Imaging at Great Neck, 935 Northern Boulevard, Suite 200, Great Neck, NY 11021, P: 516-829-4414 Northwell Health Imaging at Great South Bay, 620 Main Street, Islip, NY 11751, P: 631-439-7237 Northwell Health Imaging at Greenwich Village, 200 West 13th Street, 5th Floor, New York, NY 10011, P: 646-665-6700 Northwell Health Imaging at Smithtown, 226 Middle Country Road, Smithtown, NY 11787, P: 631-775-3456 Northwell Health Imaging at Syosset, 100 Lafayette Drive, Syosset, NY 11791, P: 516-622-3456 Northwell Health Imaging at the Center for Advanced Medicine, 450 Lakeville Road, New Hyde Park, NY 11042, P: 516-734-8600 Northwell Health Reichert Family Imaging at Huntington, 284 Pulaski Road, Greenlawn, NY 11740, P: 631-670-3456 Peconic Bay Medical Services, PC, 496 County Road, Building F1, Manorville, NY 11949, P: 631-405-3240 Phelps Hospital Radiology at Croton, 440 South Riverside Avenue, Croton on Hudson, NY 10521, P: 914-269-1700 Phelps Hospital Radiology at Dobbs Ferry, 11-17 Ashford Avenue, Dobbs Ferry, NY 10522, P: 914-269-1991 Schlanger, Gottlieb, Partners Council Breast Imaging Center, 450 Lakeville Road, Lake Success, NY 11042, P: 516-734-8600 Staten Island University Hospital Center For Breast Imaging, 242 Mason Avenue, Staten Island, NY 10305, P: 718-226-1362 Staten Island University Hospital Verrazano Imaging, 256 Mason Avenue, Building A, Staten Island, NY 10305, P: 718-226-7758 The Bohlsen Womens Imaging Center at Great South Bay, 620 Main Street, Islip, NY 11751, P: 631-439-7237 Wyckoff Imaging Services, PC, 374 Stockholm Street, Brooklyn, NY 11237, P: 718-963-7676 Yorktown Imaging, 1940 Commerce Street, Suite 101, Yorktown Heights, NY 10598, P: 914-245-5200 Zilkha Radiology, PC, 369 East Main Street, Suite 18, East Islip, NY 11730, P: 631-277-1600 Zilkha Radiology, PC, 1161 Montauk Highway, West Islip, NY 11795, P: 631-277-1600

Laboratories * Bridgeport Hospital Blood Draw Station, 267 Grant Street, Bridgeport, CT 06610, P: 203-384-3386 Bridgeport Hospital Blood Draw Station, 4775 Main Street, Bridgeport, CT 06610, P: 203-373-1351 Bridgeport Hospital Blood Draw Station, 2600 Post Road, Southport, CT 06890, P: 203-256-5948 Bridgeport Hospital Blood Draw Station, 3115 Main Street, Stratford, CT 06614, P: 203-375-5490 Bridgeport Hospital Blood Draw Station, 15 Corporate Drive, Trumbull, CT 06611, P: 203-268-1413 Bridgeport Hospital Blood Draw Station, 5220 Park Ave, Trumbull, CT 06611, P: 203-373-0201 Dyker Labs, 1274 74th Street, Brooklyn, NY 11228, P: 718-256-6500 Montefiore Medical Arts Pavilion, 3400 Bainbridge Ave, Bronx, NY 10467, P: 718-920-7547 Montefiore Medical Park Lab Services, 1515 Blondell Ave, Bronx, NY 10461, P: 718-405-8250 Northwell Health Laboratories, 10 Medical Plaza, Suite 104, Glen Cove, NY 11542, P: 516-674-7906 Northwell Health Laboratories, 10 Nevada Drive, Lake Success, NY 11042, P: 516-719-1000 Northwell Health Laboratories, 110 E. 59th Street, 10th Floor, New York, NY 10022, P: 646-368-1472 Northwell Health Laboratories, 166 Hicksville Road, Bethpage, NY 11714, P: 516-520-2978 Northwell Health Laboratories, 175 Jericho Turnpike, Suite 304, Syosset, NY 11791, P: 516-802-3380 Northwell Health Laboratories, 180 East Main Street, Bay Shore, NY 11706, P: 631-206-1030 Northwell Health Laboratories, 180 East Pulaski Road, West Wing (lower level) Suite B, Huntington Station, NY 11746, P: 631-923-2750 Northwell Health Laboratories, 1895 Walt Whitman Road, Suite 304, Melville, NY 11747, P: 631-393-2838 Northwell Health Laboratories, 195 East Main Street, Huntington, NY 11743, P: 631-683-5410 Northwell Health Laboratories, 1991 Marcus Avenue, Suite M113, Lake Success, NY 11042, P: 516-442-2838 Northwell Health Laboratories, 210 East 64th Street, 4th Floor, New York, NY 10065, P: 212-605-3726 Northwell Health Laboratories, 222 Middle Country Road, Suite 211, Smithtown, NY 11787, P: 631-724-3516 Northwell Health Laboratories, 23-91 Bell Boulevard, Bayside, NY 11361, P: 718-631-4930 Northwell Health Laboratories, 285 Sills Road, Building 10, Suite B, Patchogue, NY 11772, P: 631-569-2905 Northwell Health Laboratories, 674 Central Avenue, Cedarhurst, NY 11516, P: 516-881-7448 Northwell Health Laboratories, 800 Northern Boulevard, Suite 5, Great Neck, NY 11021, P: 516-869-8462 Northwell Health Laboratories, 877 Stewart Avenue, Suite 15, Garden City, NY 11530, P: 516-280-3690 Northwell Health Laboratories, 95-25 Queens Boulevard, Rego Park, NY 11374, P: 718-925-6530 Staten Island University Hospital Laboratory, 17C Seguine Avenue, Staten Island, NY 10309, P: 718-967-6587 Staten Island University Hospital Laboratory, 2288 Hylan Boulevard, Staten Island, NY 10305, P: 718-987-4900 Staten Island University Hospital Laboratory, 11 Ralph Place, Suite 111A, Staten Island, NY 10304, P: 718-447-3155 Staten Island University Hospital Laboratory, 584 Forest Avenue, Staten Island, NY 10310, P: 718-226-5632 Staten Island University Hospital Laboratory, 78 Cromwell Avenue, Staten Island, NY 10305, P: 718-987-1352 Staten Island University Hospital Laboratory, 501 Seaview Avenue, Staten Island, NY 10305, P: 718-667-4072 The Health Center at Tremont, 1826 Arthur Avenue, Bronx, NY 10457, P: 718-918-8885 Transitions of Long Island, 1554 Northern Boulevard, Manhasset, NY 11030, P: 516-719-3700 Yale Physicians Building Blood Draw Station, 800 Howard Avenue, New Haven, CT 06510, P: 203-688-8412 Yonkers Patient Service Center, 6 Executive Plaza, Suite 282, Yonkers, NY 10701, P: 914-375-4861 Urgent Care CareMount Medical, PC, 185 Route 112, Brewster, NY 10509, P: 845-278-7000 CareMount Medical, PC, 1561 Ulster Avenue, Lake Katrine, NY 12449, P: 845-231-5600 CareMount Medical, PC, 225 Veterans Road, Yorktown Heights, NY 10598, P: 914-241-1050 CareMount Medical, PC, 30 Columbia Street, Poughkeepsie, NY 12601, P: 845-231-5600 CareMount Medical, PC, 360 North Bedford Road, Mount Kisco, NY 10549, P: 914-241-1050 CareMount Medical, PC, 600 Westage Bus Ctr Drive, Fishkill, NY 12524, P: 845-231-5600 CareMount Medical, PC, 6734 Route 9, Rhinebeck, NY 12572, P: 845-231-5600 Fairfield Urgent Care Center, 309 Stillson Road, Fairfield, CT 06825, P: 203-331-1924 Northwell Health/GoHealth Urgent Care (Amityville), 801 Broadway, Suite 100, Amityville, NY 11701, P: 516-784-4486 Northwell Health/GoHealth Urgent Care (Astoria), 37-01 Broadway, Astoria, NY 11103, P: 929-265-5990 Northwell Health/GoHealth Urgent Care (Bay Shore), 603B E Main Street, Bay Shore, NY 11706, P: 631-238-3064 Northwell Health/GoHealth Urgent Care (Bayside), 41-19 Bell Boulevard, Queens, NY 11361, P: 929-373-4480

Urgent Care (continued) Northwell Health/GoHealth Urgent Care (Bellmore), 2640 Merrick Road, Bellmore, NY 11710, P: 516-537-9064 Northwell Health/GoHealth Urgent Care (Chelsea), 225 W 23rd Street, New York, NY 10011, P: 212-897-1994 Northwell Health/GoHealth Urgent Care (Commack), 98 Jericho Turnpike, Commack, NY 11725, P: 631-387-4355 Northwell Health/GoHealth Urgent Care (Dobbs Ferry), 30 Livingston Avenue, Dobbs Ferry, NY 10522, P: 914-202-2944 Northwell Health/GoHealth Urgent Care (Dongan Hills), 1700 Hylan Blvd, Staten Island, NY 10305, P: 718-502-8425 Northwell Health/GoHealth Urgent Care (East 81st), 1555 1st Avenue, New York, NY 10028, P: 212-897-1995 Northwell Health/GoHealth Urgent Care (East Northport), 4199 Jericho Turnpike, East Northport, NY 11731, P: 631-238-3066 Northwell Health/GoHealth Urgent Care (Elwood), 1912 E Jericho Turnpike, East Northport, NY 11731, P: 631-238-3065 Northwell Health/GoHealth Urgent Care (Forest Hills), 102-29 Queens Blvd, Forest Hills, NY 11375, P: 718-502-9798 Northwell Health/GoHealth Urgent Care (Gramercy), 176 Third Ave, New York, NY 10003, P: 646-863-0464 Northwell Health/GoHealth Urgent Care (Great Kills), 125 Greaves Lane, Staten Island, NY 10306, P: 718-502-8763 Northwell Health/GoHealth Urgent Care (Greenwich Village), 41 East 8th Street, New York, NY 10003, P: 212-897-1991 Northwell Health/GoHealth Urgent Care (Hampton Bays), 80 East Montauk Highway, Hampton Bays, NY 11946, P: 631-604-4022 Northwell Health/GoHealth Urgent Care (Huntington Station), 19 West Jericho Turnpike, Huntington Station, NY 11746, P: 631-604-4023 Northwell Health/GoHealth Urgent Care (LeFrak City), 58-28 99th Street, Corona, NY 11368, P: 718-502-9867 Northwell Health/GoHealth Urgent Care (Levittown), 3631 Hempstead Turnpike, Levittown, NY 11756, P: 516-558-9860 Northwell Health/GoHealth Urgent Care (Lynbrook), 683 Sunrise Highway, Lynbrook, NY 11563, P: 516-441-2155 Northwell Health/GoHealth Urgent Care (Massapequa), 5165 Merrick Rd, Massapequa, NY 11762, P: 516-858-3724 Northwell Health/GoHealth Urgent Care (New Dorp), 2590 Hylan Boulevard, Staten Island, NY 10306, P: 718-502-9879 Northwell Health/GoHealth Urgent Care (New Rochelle), 77 Quaker Ridge Road, New Rochelle, NY 10804, P: 914-266-3104 Northwell Health/GoHealth Urgent Care (Plainview), 377 S. Oyster Bay Road, Plainview, NY 11803, P: 516-537-9061 Northwell Health/GoHealth Urgent Care (Ridgewood), 55-05 Myrtle Ave, Ridgewood, NY 11385, P: 718-502-9063 Northwell Health/GoHealth Urgent Care (Rockville Centre), 243 Merrick Road, Rockville Centre, NY 11570, P: 516-537-9063 Northwell Health/GoHealth Urgent Care (Roslyn), 1033 Northern Blvd, Roslyn, NY 11576, P: 516-473-0782 Northwell Health/GoHealth Urgent Care (Smithtown), 1 Miller Place, Suite C, Smithtown, NY 11787, P: 631-604-4024 Northwell Health/GoHealth Urgent Care (Syosset), 103 Jackson Ave, Syosset, NY 11791, P: 516-537-9062 Northwell Health/GoHealth Urgent Care (Tarrytown), 650 White Plains Road, Tarrytown, NY 10591, P: 914-266-3102 Northwell Health/GoHealth Urgent Care (Upper West Side), 199 Amsterdam Ave., New York, NY 10023, P: 212-721-4200 Northwell Health/GoHealth Urgent Care (West 100th), 2628 Broadway., New York, NY 10025, P: 212-897-1992 Northwell Health/GoHealth Urgent Care (West Islip), 434 Union Blvd., West Islip, NY 11795, P: 631-238-3067 Northwell Health/GoHealth Urgent Care (Williamsburg), 145 Kent Avenue, Brooklyn, NY 11249, P: 347-801-2136 Northwell Health/GoHealth Urgent Care (Yorktown Heights), 28 Triangle Center, Yorktown Heights, NY 10598, P: 914-266-3103 ProHealth Urgent Care (Pediatric), 1167 Wantagh Avenue, Wantagh, NY 11793, P: 516-900-1201 ProHealth Urgent Care, 555 North Broadway, Jericho, NY 11753, P: 516-597-5070 ProHealth Urgent Care, 250 South Service Road, Roslyn Heights, NY 11577, P: 516-622-6000 ProHealth Urgent Care, 1049 Morris Park Avenue, Bronx, NY 10456, P: 929-777-9082 ProHealth Urgent Care, 1074 Old Country Road, Plainview, NY 11803, P: 516-622-6000 ProHealth Urgent Care, 132-01 14th Avenue, College Point, NY 11356, P: 917-285-2156 ProHealth Urgent Care, 254-61 Nassau Boulevard, Little Neck, NY 11362, P: 917-563-1660 ProHealth Urgent Care, 330 Court Street, Brooklyn, NY 11231, P: 718-625-1600 ProHealth Urgent Care, 148 Merrick Road, Amityville, NY 11701, P: 631-842-4102 ProHealth Urgent Care, 4954 Merrick Road, Massapequa Park, NY 11762, P: 516-308-7255 ProHealth Urgent Care, 1158 Broadway, Hewlett, NY 11557, P: 516-218-2929 ProHealth Urgent Care, 148 Sunrise Highway, West Islip, NY 11795, P: 631-620-3580 ProHealth Urgent Care, 1797 Coney Island Avenue, Brooklyn, NY 11230, P: 718-676-1499 ProHealth Urgent Care, 331 Kings Highway, Brooklyn, NY 11233, P: 718-974-7818 ProHealth Urgent Care, 2960 Victory Boulevard, Staten Island, NY 10314, P: 718-370-2014 ProHealth Urgent Care, 164-50 Cross Bay Boulevard, Howard Beach, NY 11414, P: 718-848-8412 ProHealth Urgent Care, 129 W Sunrise Highway, Freeport, NY 11520, P: 516-442-7090 ProHealth Urgent Care, 7001 Amboy Road, Staten Island, NY 10307, P: 347-838-6991 ProHealth Urgent Care, 4108 Avenue U, Brooklyn, NY 11233, P: 718-252-2581 ProHealth Urgent Care, 339 Main Street, Huntington, NY 11743, P: 631-470-9000

Urgent Care (continued) ProHealth Urgent Care, 26 Court Street, Brooklyn, NY 11242, P: 347-335-0062 ProHealth Urgent Care, 6906 18th Avenue, Brooklyn, NY 11204, P: 718-621-5933 ProHealth Urgent Care, 132-01 14th Avenue, College Point, NY 11356, P: 917-285-2158 ProHealth Urgent Care, 358 Arden Avenue, Staten Island, NY 10314, P: 718-227-7666 ProHealth Urgent Care, 254-61 Nassau Boulevard, Little Neck, NY 11362, P: 917-563-1660 ProHealth Urgent Care, 1167 Wantagh Avenue, Wantagh, NY 11793, P: 516-900-1201 ProHealth Urgent Care, 259-25 Union Turnpike, Glen Oaks, NY 11004, P: 516-597-5070 WESTMED, 171 Huguenot Street, New Rochelle, NY 10801, P: 914-848-8000 WESTMED, 210 Westchester Avenue, White Plains, NY 10604, P: 914-682-0700 WESTMED, 1 Theall Road, Rye, NY 10580, P: 914-848-8000 WESTMED, 3030 Westchester Avenue, Purchase, NY 10577, P: 914-831-4100 WESTMED, 73 Market Street, Yonkers, NY 10710, P: 914-682-0700 WESTMED, 720 White Plains Road, Suite 270, Scarsdale, NY 10583, P: 914-831-4170 WESTMED, 899 Park Avenue, New York, NY 10075, P: 212-995-2600

2200 Northern Blvd., Entrance A, East Hills, NY 11548 855-706-7545 CareConnect.com CareConnect Insurance Company, Inc. CCFacilitiesProspectV16-06.17

Notice of Non-Discrimination CareConnect Insurance Company, Inc. ( CareConnect ) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. CareConnect does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. CareConnect: Provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters 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: Qualified interpreters Information written in other languages If you need these services, contact CareConnect s Senior Director, Quality Improvement. If you believe that CareConnect 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: CareConnect Senior Director, Quality Improvement 2200 Northern Blvd., Suite 104, East Hills, NY 11548 Phone: 855-706-7545 TTY: 855-226-7318 Fax: 844-447-2525 Email: CareConnectAppeals@careconnect.com You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Senior Director, Quality Improvement 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. CareConnect Insurance Company, Inc.

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