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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.

ADOA ontacts enefit Services Division 100 N. 15th Ave #260 Phoenix, AZ 85007 602.542.5008 or 1.800.304.3687 Fax 602.542.4744 benefitoptions.az.gov

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SUBMITTING A CHANGE REQUEST - Benefit …

benefitoptions.az.gov

SUBMITTING A CHANGE REQUEST Requested benefit changes must be submitted in writing to ADOA Benefit Services Division within 31 calendar days of the event. EFFECTIVE DATE OF THE CHANGE

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ELIGIBLE RETIREES - Benefit Options-Home

benefitoptions.az.gov

SUBMITTING A NEW RETIREMENT APPLICATION ELIGIBLE RETIREES The following persons are eligible to participate in the Arizona Benefit Options program:

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Benefit Guide Active Employees

benefitoptions.az.gov

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ADOA Benefit Options 2018 Benefit Guide Retired Employees

benefitoptions.az.gov

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HSA Preventive Drug List - 2018 - AZ

benefitoptions.az.gov

MedImpact Healthcare Systems, Inc. pbm.medimpact.com Copyright © 2017 MedImpact Healthcare Systems, Inc. All rights reserved. HSA Preventive Drug List - 2018 …

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INSTRUCTIONS - Benefit Options-Home

benefitoptions.az.gov

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STATE OF ARIZONA LIMITED FLEXIBLE SPENDING …

benefitoptions.az.gov

benefit options-revised 06/24/15 state of arizona limited flexible spending accounts 2015 enrollment form new employee termination special enrollment qualified life

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OPEN ENROLLMENT 2018 - Benefit Options-Home

benefitoptions.az.gov

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INSTRUCTIONS FOR SUBMITTING A NEW …

benefitoptions.az.gov

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