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157.174.227.4  Public Scan

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Submitted URL: http://floridablue.com/ndnotice
Effective URL: https://www.floridablue.com/ndnotice
Submission: On February 11 via manual from IN — Scanned from DE

Form analysis 2 forms found in the DOM

<form action="">
  <div class="row">
    <div class="medium-9 large-9 columns">
      <input type="text" class="global-search-input" placeholder="" title="Search field" required="">
    </div>
    <div class="medium-3 large-3 columns section-search-go">
      <ul class="inline-list">
        <li>
          <button type="submit" id="search-go" class="button secondary">Search</button>
        </li>
        <li>
          <a href="#" class="global-search-toggle" title="Close Search"><span data-icon="" class="icon-remove"></span></a>
        </li>
      </ul>
    </div>
  </div>
</form>

Name: memberLoginForm — POST https://gwlogin.bcbsfl.com/login/authenticate

<form method="post" id="memberLoginForm" action="https://gwlogin.bcbsfl.com/login/authenticate" name="memberLoginForm">
  <div class="row body white">
    <input value="https://gwprofile.bcbsfl.com/profile/interstitial" name="TARGET" type="hidden">
    <input value="$SM$L7WsmPil+DmXJzdHjV2t4kMlfGcoTwgUXFYnrKfShUtMe7DANIjbEA==" name="SMAGENTNAME" type="hidden">
    <input value="06-00057b23-0df1-103a-949b-80f1ad32fefe" name="REALMOID" type="hidden">
    <input value="0" name="smauthreason" type="hidden">
    <div class="columns small-12 text-left">
      <p class="h1-small oil">
        <span class="icon icon-user-1" aria-hidden="true"></span> Members
      </p>
      <label for="memberLoginUsername" class="require">User ID:</label>
      <input id="memberLoginUsername" class="input" name="USERNAME" value="" type="text">
      <label for="memberLoginPassword" class="require">Password:</label>
      <input id="memberLoginPassword" class="input" name="PASSWORD" value="" type="password">
    </div>
    <div class="columns small-12 text-left">
      <div id="recaptcha" class="g-recaptcha" data-sitekey="6LfueGYcAAAAAKm6vONC93H1b7HVvRFnjhbiS409" data-callback="onSubmit" data-size="invisible">
        <div class="grecaptcha-badge" data-style="bottomright"
          style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
          <div class="grecaptcha-logo"><iframe title="reCAPTCHA"
              src="https://www.google.com/recaptcha/enterprise/anchor?ar=1&amp;k=6LfueGYcAAAAAKm6vONC93H1b7HVvRFnjhbiS409&amp;co=aHR0cHM6Ly93d3cuZmxvcmlkYWJsdWUuY29tOjQ0Mw..&amp;hl=de&amp;v=BycHQdSIhzR_1EcOLw2mOzYQ&amp;size=invisible&amp;cb=t04k3ehihlwr"
              width="256" height="60" role="presentation" name="a-nroby9aghuz" frameborder="0" scrolling="no" sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"
              data-gtm-yt-inspected-2299813_292="true"></iframe></div>
          <div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
            style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
        </div><iframe data-gtm-yt-inspected-2299813_292="true" style="display: none;"></iframe>
      </div>
      <button class="primary small" id="loginSubmit">GO</button>
      <script>
        onload();
      </script>
      <!-- <a onclick="ga('send', 'event', 'button', 'click', 'Login topper');" href="#" id="submit-validate" class="button success expand-small">GO</a> -->
    </div>
  </div>
  <div class="row foot white">
    <div class="columns small-12 text-center top-1x fs1">
      <!-- <a href="https://registration.bcbsfl.com/ecir/public/fps.do?request_locale=en&userType=member&TARGET=https://mwe.bcbsfl.com/wps/myportal/mbs/" >Trouble Logging In?</a> -->
      <a href="https://registration.bcbsfl.com/ecir/public/MemberForgotUserid.do?userType=member&amp;TARGET=https://mwe.bcbsfl.com/wps/myportal/mbs/">Forgot your User ID</a> or
      <a href="https://registration.bcbsfl.com/ecir/public/MemberForgotPasswordPersonalInformation.do?userType=member&amp;TARGET=https://mwe.bcbsfl.com/wps/myportal/mbs/" aria-label="forgot your password">Password?</a>
      <br>
      <span class="icon blue icon-edit-write" aria-hidden="true"></span>
      <a href="https://registration.bcbsfl.com/ecir/public/Registration.do?request_locale=en&amp;userType=member&amp;TARGET=https://mwe.bcbsfl.com/wps/myportal/mbs">New Member Registration</a>
      <!-- <a href="https://registration-stga.bcbsfl.com/ecir/public/Registration.do?request_locale=en&userType=member&TARGET=https://mwe.bcbsfl.com/wps/myportal/mbs">New Member Registration</a> -->
    </div>
  </div>
</form>

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SECTION 1557 NOTIFICATION: DISCRIMINATION IS AGAINST THE LAW

We comply with applicable Federal civil rights laws and do not discriminate on
the basis of race, color, national origin, age, disability, or sex. We do not
exclude people or treat them differently because of race, color, national
origin, age, disability, or sex.

We provide:

 * 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)

 * 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:

 * Health and vision coverage: 1-800-352-2583
 * Dental, life, and disability coverage: 1-888-223-4892
 * Federal Employee Program: 1-800-333-2227

   

   If you believe that we have failed to provide these services or discriminate
   on the basis of race, color, national origin, disability, age, sex, gender
   identity or sexual orientation, you can file a grievance with:

   Health and vision coverage (including FEP members):
   Section 1557 Coordinator
   4800 Deerwood Campus Parkway, DCC1-7
   Jacksonville, FL 32246
   1-800-477-3736 x29070
   1-800-955-8770 (TTY)
   Fax: 1-904-301-1580
   section1557coordinator@floridablue.com
   
   Dental, life and disability coverage:
   Civil Rights Coordinator
   17500 Chenal Parkway
   Little Rock, AR 72223
   1-800-260-0331
   1-800-955-8770 (TTY)
   civilrightscoordinator@fclife.com
   
   
   

   You can file a grievance in person or by mail, fax, or email. If you need
   help filing a grievance, the Section 1557 Coordinator 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, by mail or phone at:

   U.S. Department of Health and Human Services
   200 Independence Avenue, SW
   Room 509F, HHH Building
   Washington, DC 20201
   1-800–368–1019
   1-800–537–7697 (TDD)
   
   
   Complaint forms are available at
   http://www.hhs.gov/ocr/office/file/index.html

   ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de
   asistencia lingüística. Llame al 1-800-352-2583 (TTY: 1-877-955-8773). FEP:
   Llame al 1-800-333-2227

   ATANSYON: Si w pale Kreyòl ayisyen, ou ka resevwa yon èd gratis nan lang pa
   w. Rele 1-800-352-2583 (pou moun ki pa tande byen: 1-800-955-8770). FEP: Rele
   1-800-333-2227

   CHÚ Ý: Nếu bạn nói Tiếng Việt, có dịch vụ trợ giúp ngôn ngữ miễn phí dành cho
   bạn. Hãy gọi số 1-800-352-2583 (TTY: 1-800-955-8770). FEP: Gọi số
   1-800-333-2227

   ATENÇÃO: Se você fala português, utilize os serviços linguísticos gratuitos
   disponíveis. Ligue para 1-800-352-2583 (TTY: 1-800-955-8770). FEP: Ligue para
   1-800-333-2227

   注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電1-800-352-2583（TTY:
   1-800-955-8770)。FEP：請致電1-800-333-2227

   ATTENTION: Si vous parlez français, des services d'aide linguistique vous
   sont proposés gratuitement. Appelez le 1-800-352-2583 (ATS : 1-800-955-8770).
   FEP : Appelez le 1-800-333-2227

   PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo
   ng tulong sa wika nang walang bayad. Tumawag sa 1-800-352-2583 (TTY:
   1-800-955-8770). FEP: Tumawag sa 1-800-333-2227

   ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные
   услуги перевода. Звоните 1-800-352-2583 (телетайп: 1-800-955-8770). FEP:
   Звоните 1-800-333-2227

   ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك
   بالمجان. اتصل برقم 1 - 3852-253-008 )رقم هاتف الصم والبكم: 1 - 0778-559-008 .
   اتصل برقم 1 - 008 - 333 - 7222 .

   ATTENZIONE: Qualora fosse l'italiano la lingua parlata, sono disponibili dei
   servizi di assistenza linguistica gratuiti. Chiamare il numero 1-800-352-2583
   (TTY: 1-800-955-8770). FEP: chiamare il numero 1-800-333-2227

   ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche
   Hilfsdienstleistungen zur Verfügung. Rufnummer: +1-800-352-2583 (TTY:
   +1-800-955-8770). FEP: Rufnummer +1-800-333-2227

   주의: 한국어 사용을 원하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-800-352-2583 (TTY:
   1-800-955-8770) 로 전화하십시오. FEP: 1-800-333-2227 로 연락하십시오.

   UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy
   językowej. Zadzwoń pod numer 1-800-352-2583 (TTY: 1-800-955-8770). FEP:
   Zadzwoń pod numer 1-800-333-2227.

   સુચના: જો તમે ગુજરાતી બોલતા હો, તો નન:શુલ્ક ભાષા સહાય સેવા તમારા માટે ઉપલબ્ધ
   છે. ફોન કરો 1-800-352-2583 (TTY: 1-800-955-8770). FEP: ફોન કરો 1-800-333-2227

   ประกาศ:ถ้าคุณพูดภาษาไทย คุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี
   โดยติดต่อหมายเลขโทรฟรี 1--800--352--2583 (TTY: 1--800--955--8770) หรือ FEP
   โทร 1--800--333--2227

   注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1-800-352-2583（TTY:
   1-800-955-8770）まで、お電話にてご連絡ください。FEP: 1-800-333-2227

   توجه: اگر به زبان فارسی صحبت می کنید، تسهیلات زبانی رایگان در دسترس شما خواهد
   بود. با شماره 1-800-352-2583 (TTY: 1-800-955-8770) تماس بگیريد. FEP : با
   شماره 1-800-333-2227 تماس بگیريد.

   Baa ákonínzin: Diné bizaad bee yáníłti’go, saad bee áká anáwo’, t’áá jíík’eh,
   ná hólǫ́. Kojį’ hodíílnih 1-800-352-2583 (TTY: 1-800-955-8770). FEP ígíí éí
   kojį’ hodíílnih 1-800-333-2227.





87768 0719R

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We comply with applicable Federal civil rights laws and do not discriminate on
the basis of race, color, national origin, age, disability or sex. You may
access the Nondiscrimination and Accessibility notice.

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Generally, the pronouns "our," "we" and "us" used throughout this website are
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and its subsidiaries and affiliates. However, where appropriate, the content may
identify a particular company; there, any pronouns refer to that specific
entity.

Health insurance is offered by Blue Cross and Blue Shield of Florida, Inc., DBA
Florida Blue. HMO coverage is offered by Health Options Inc., DBA Florida Blue
HMO, an HMO affiliate of Blue Cross and Blue Shield of Florida, Inc. Dental,
Life and Disability are offered by Florida Combined Life Insurance Company,
Inc., DBA Florida Combined Life, an affiliate of Blue Cross and Blue Shield of
Florida, Inc. These companies are Independent Licensees of the Blue Cross and
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enrollment and benefit determinations.

FB MFT 001 NF 092016

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