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Benefit Guide - AZ

2017 Benefit Guide ADOA Contacts Benefit Services Division 100 N. 15th Ave #260 Phoenix, AZ 85007 or Fax Benefit Options Wellness Employee Assistance Program Medical Plans Aetna Policy Number 476687 Payflex Blue Cross Blue Shield of Arizona Policy Number 30855 Cigna Policy Number 3331993 UnitedHealthcare Policy Number 705963 Pharmacy Plan MedImpact Vision Plan Avesis, Inc. Advantage Plan Policy Number 11001-2178 Plan Number 938 Discount Plan Policy Number 10000-4 Plan Number 9900 Dental Plans Delta Dental of Arizona Policy Number 77777-0000 Total Dental Administrators Health Plan, Inc. (TDAHP) Policy Number 680100 Flexible Spending Accounts ASI Life & Short-Term Disability Plans The Hartford Policy Number 395211 Long-Term Disability Plans Broadspire Services, Inc. (ASRS participants) The Hartford (PSPRS, EORP, CORP, and ORP participants) Policy Number 395211 Retirement Systems Arizona State Retirement System (ASRS) Public Safety Personnel Retirement System (PSPRS) For University Employees Arizona State University HR benefits Design & Management Employees: Faculty: Northern Arizona University Human Resources University of Arizona benefits Office , Option 3 UNUM - Short-Term Disability Aetna Life Insurance Website and Contact Information 2017 B

Page| 2017 enefit Guide 1 This guide describes the comprehensive benefits package “enefit Options” offered by the State of

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