Dental Plans

The City of Mesa has contracted with a third party administrator (TPA) Delta Dental, to deliver our dental benefit program to you. Delta Dental will administer the claims and appeals process. Members may choose among three dental plans depending upon their individual needs.

On any of the three plans, you may choose any licensed dental care provider.

The three dental plans offered are:

Preventive Choice Plan - Provides 100% coverage for preventive services and pays 80% up to $700* on limited restorative care (basic restorative care only). Orthodontia and major restorative services are not covered.

 

Dental Choice Plan - Provides 100% coverage for preventive services, and pays 80% up to $1700* on basic and major restorative coverage. Orthodontia is not covered.

 

Dental Choice Plus Plan - Provides 100% coverage for preventive services, and pays 80% up to $2000* on basic and major restorative coverage. Orthodontia is covered at 80% up to $1500 per calendar year ($3000 lifetime max). Orthodontia treatment that is started before the patient's effective date with the City of Mesa Health Plan is not reimbursable under this plan.

*Subject to $50 deductible per person/$150 family maximum

 

 

Employee Benefits
20 E Main Street, Suite 600
Mesa, AZ 85201
Office hours:
Mon -Thurs 7am-6pm
(480) 644-2299 - Phone
(480) 644-4548 - Fax

Option 1: Medical Plan

Ameriben

-Verification & Coverage

-Claim Status

-Pre-certification

-Disease & Case Management

-Medical Appeals

-Request Medical/Prescription Card

Option 2: Prescription Plan

CVS Caremark

 -Prescription Coverage

-Authorizations

-Appeals

Option 3: Dental Plan

Delta Dental

-Verification & Coverage

-Claims

-Appeals

-Request Dental Card

Option 4: 2015 FSA

ConnectYourCare

-Claims

-FSA Balance

-Request FSA Card

-Appeals

Option 5: Eligibility - Active Employees 

-New Hires

-COBRA

-Qualifying Events

Option 6: Eligibility - Retired Employees

-Premium Information

-Qualifying Events

-COBRA

 Option 7: General Questions

Option 9: 2014 FSA- Benefits Office


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Forms

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