Medical Plans

In-State AZ
The City of Mesa is contracted with a third party administrator (TPA) AmeriBen, to deliver the medical benefit program including coverage, verification, claims processing, pre-certification, case management, and disease management. Members may contact Ameriben customer service (Monday through Friday from 7am to 6pm MST) or visit the member portal to access Explanation of Benefits (EOB)'s, PPO provider directory, and other tools to navigate healthcare needs.

Contact Information:                  AmeriBen
Claims Address:                         PO BOX 7186
                                                     Boise, ID 83707

Phone Number:                          1-855-258-6467
Website:                                      www.myameriben.com

 

Out-of-State Plan
Members who reside out of state more than 4 months out of the year should enroll in the out-of-state plan by completing an Out-of-State Dependent Form. Blue Cross Blue Shield of Arizona (BCBSAZ) is the Out-of-State third party administrator for the medical benefit program including medical coverage questions, claims processing, pre-certification, case management, and disease management.  There is no change to premiums or plan design.

Out-of-state members must use BCBS Blue providers for in-network coverage.  For help locating out of state providers go to: Finding Providers

*Please Note: Deductibles and coinsurance accumulators do not transfer between the Out-of-State Plan and the In-State Medical Plan or vice versa.

 

City of Mesa Medical Plan Highlights
Members may choose among three different medical plans depending upon their needs.

The three medical plans offered are:

  • Choice PPO Plan (80/20) - This plan features 80% coverage after the $300 per person/$900 family deductible has been met for in-network services. PPO BCBSAZ providers are considered as in-network for this plan. $2,300 per person/$6900 family out of pocket annual maximum family.
  • Copay Choice PPO Plan - There is a $20 copay for office visits. PPO BCBSAZ providers are considered in-network. $3,300 per person/$6,600 family out of pocket annual maximum.
  • Basic Choice Plan (50/50) - This plan offers catastrophic coverage for the individual with few medical expenses. $550 deductible per person/$1,650 family, coinsurance 50/50, $4,500 per person/$9,000 family out of pocket annual maximum family. PPO BCBSAZ providers are considered as in-network.

 

2015 Medical Plan Overview

 

For a full summary of detailed coverage, please refer to the City of Mesa Plan Document:  

City of Mesa Plan Document

 

 

 

 

 

 

 

 

Employee Benefits Office 20 E

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


E-mail (password resets cannot be done via email)

Forms

Federally Mandated Notices